Table 1

Potential compatibility gaps

TransformationThe adopting hospital modifies its functioning to fit the assumptions behind Productive Ward and the actual use of Productive Ward does not significantly differ from its intended use.
CustomisationInvolves both adapting Productive Ward and adjusting ward processes.
Loose couplingProductive Ward is adopted only superficially, in a ritualistic way with the functioning of the hospital remaining largely unaffected.
Co-optationProductive Ward becomes captured and distorted to serve the interests of the most powerful stakeholders.