To make a significant impact or measurable difference.
To do something that actually matters, implying that most of what we do doesn't.
"Will this move the needle?" (Translation: Is this worth doing, or are we just creating work to look busy? Note: asking this question in a meeting is itself not moving the needle.)
From analog meters and gauges. The needle hasn't moved. The needle never moves. We are staring at a stationary needle and calling it strategy.