RT Journal Article SR Electronic T1 From pilot project to system solution: innovation, spread and scale for health system leaders JF BMJ Leader FD BMJ Publishing Group Ltd SP 87 OP 90 DO 10.1136/leader-2017-000055 VO 2 IS 3 A1 James Shaw A1 Joshua Tepper A1 Danielle Martin YR 2018 UL http://bmjleader.bmj.com/content/2/3/87.abstract AB Promoting the scale and spread of effective health innovations requires dedicated action from health system leaders. In order to maximise the effects of leadership strategies to promote the spread and scale of health innovations, conceptual clarity and well-defined strategies are essential. In this commentary, we propose definitions of the concepts of ‘innovation’, ‘spread’ and ‘scale’, and explain how these concepts can be used by health system leaders to generate interest, excitement and commitment for specific innovations from a broad community of stakeholders. We then outline two strategies from the community organising literature that leaders can use to promote spread and scale.