How do nonprofit organizations affect substantial change?

I've been at the Direct Marketing Association Nonprofit Federation Leadership Summit in Tucson, where the theme is all about empowering nonprofits to change. What's interesting is how many high-ranking executives of nonprofits, and the vendors that serve them, are really satisfied with the status quo.

Even some of the speakers on the platform were talking about modest changes to direct mail packages, modest investment in new technology, and no real changes in the relationships within the organization or between the organization and its donors.

There seems to be some connection between mission and acceptance to change. Those organizations that respond to disasters, serve the poor and hungry, and seek major political change are generally those whose leaders have been advocates of change. Meanwhile, those who represent or serve the basic "organs and diseases" are still clinging to their premium-based direct mail packages and mainframe databases.

Guess which organizations NPA would prefer to work with?