Yet despite these advances, large scale improvements to its clinical care are yet to materialise, and delirium remains almost invisible to the general public.
That vote prompted the government to commit enough resources to PFI and almos to allow these methods to become serious options for large-scale improvement too.
The second is the large-scale improvement of transmission and distribution infrastructure of the electric grid.
Professional development for educators is a fundamental key to large-scale improvement of learning for children.
Most of us are aware of the seriousness of the problem, and most of us would like to see large-scale improvement.
The truth is, we have reached a tipping point and, here in this audience, were hundreds of passionate advocates -- parents, teachers, unions, business leaders, philanthropists, community activists -- taking different approaches to reaching the same goal: Large-scale improvement to our education system.
A greater understanding of these infrastructure changes often plays a key role in the success of large-scale improvement efforts.
This is particularly the case in general practice, which, in comparison with the hospital sector, is relatively new to large-scale improvement efforts.
Other large-scale improvement programmes have already been implemented and evaluated in other domains, e.g. regarding safety in health care and social care [ 11- 15].
Robust evidence of the effectiveness of an intervention can be extremely valuable in providing weight to arguments for its uptake and spread, and positive findings from independent evaluation of large-scale improvement programmes help legitimise claims to success.
In line with the aims of the study, the 10 'challenges' from the published guidance for large-scale improvement initiatives (Box 1) were used deductively as a framework and as a programme-level theory to structure the analytical process.
