First, data were gathered from a program implementation, and not from a research study.
However, conversations can at most be a necessary condition for the implementation of strategies, and not a sufficient one.
One explanation is that our efficacy study was actually a pragmatic randomized clinical trial and a partial implementation under relatively normal circumstances, and not a "laboratory setup".
However the agent was found to be with moderate influence in the implementation process, hence a supporter and not a driver.
A crystal clear structural roadmap is necessary for sustainable Lean implementation since Lean implementation is a journey and not an adoption of isolated practices.
This result was expected, since respondents were instructed to talk about their individual role in the implementation process, and not the implementation process as a whole.
The latter then controls the QMS operation, prepares all the necessary documentation, etc. However the Ministry of Health did not provide health care organizations the needed support in QMS implementation and did not ensure a systemic coordination of the quality improvement process.
Its effect was also viewed as longer lasting because implementation is not a discrete event and instructions and tools would always be available once developed.
The full rollout of Obamacare, and its successful implementation, is not a foregone conclusion, especially as time frames extend past the next mid-term election.
Unfortunately, implementation is not a secondary issue and implementing mergers in the media business is harder than it is in most other industries.The government is partly to blame.
