Figure 7

Diverse strategies taken by the QTOM representatives in successful implementation of the Open Master. (1) If leadership see the “big picture” to their participation, staff are able to overcome resistance with moderate effort. (2) Assembling a community of practice within the department can serve as a multiplicative effect to overcome resistance to change. (3) Without leadership support, there can be alternative routes to implementation – but they may require substantial effort on the part of the championing staff