Table 1

Organisational responses to a quality improvement intervention8

TransformationThe organisation modifies its processes with the result that the intervention has the intended effect.
CustomisationThe organisation adapts the intervention in the process of changing organisational processes.
Loose couplingThe intervention is implemented in a superficial way with organisational processes remaining largely unaffected.
CorruptionThe intervention becomes captured and distorted to reinforce existing organisational roles and power structures.