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Table 1 Relationship of change and practice.

From: A critical review of the research literature on Six Sigma, Lean and StuderGroup's Hardwiring Excellence in the United States: the need to demonstrate and communicate the effectiveness of transformation strategies in healthcare

  No Change in Practices Transformation in Practices
No Change in Culture Stasis Reluctant participants
Failed implementation
Transformation in Culture Turnover, loss of best people Sustainable organizational transformation