This question keeps occurring to me in conversations with clients. I'm really not being judgemental - honest. I am the world's greatest procrastinator and tinkerer. I know how hard personal change is let alone taking a whole organisation with you. But the question hangs there in the background.
I don't think it is about scale. It is possible to tinker endlessly with big corporate projects and never get anywhere, and at the same time a well aimed, passionate tweet can change the world. This is why the idea of Trojan Mice is so powerful. Small things, repeated, going round obstacles rather than bouncing off them, instigating change one conversation at a time.
But you have to care enough to instigate and sustain even the small things. You have to have a sense of purpose and be in it for the long game. This takes energy and guts.
Bringing about changes in our organisations is hard. Numbingly hard. I often think that the tagline to my business should be "A shoulder to cry on" because part of what I do is provide a sympathetic ear to folks feeling the pain of being a lone voice in their wilderness.
In the face of this pain tinkering becomes the norm. Reading another case study instead of getting on with things. Trying to find just one more example of best practice. Endlessly asking for permission in different ways from different people - rather than asking for forgiveness.
Tinkering isn't what we are here to do. Tinkering rots your soul.