What was required to achieve what he did?

Every year, the hospital provided free turkeys to employees during the Thanksgiving holiday. Eventually, the tradition became an entitlement and a significant financial obligation. Rather than perpetuate the entitlement mentality, the executive team transformed this time-honored tradition into a meaningful and purposeful event.
Instead of distributing gift coupons for staff to cash in at the local grocery store, the organization arranged for a refrigerated semi to be parked in front of the hospital during Thanksgiving week. Wearing freezer mitts and warm jackets, each member of the executive team personally participated by handing a frozen turkey to each employee. In return, to impress on staff the importance of gratitude, employees had to write down something they were thankful for before receiving a turkey. Not only was this perceived as a cherished interaction and discussion between employee and executive during the distribution, but the activity was used as a tracking process to ensure that only one turkey was distributed per employee.