• Category 6. Change in a sociotechnical system—how to create environments that facilitate large-scale change.

  • Column 2—Consequences (why the observations matter). For each observation, the committee infers one or more consequences. That is, why do we care about the observation in question? How might it affect health care delivery?

  • Column 3—Opportunities for Action (what we can do about the consequences). Every observation-consequence pair should provide one or more opportunities for action. Solutions known today but not yet implemented are indicated by an “S” (for short-term) in Column 3; challenges for research, where solutions are not known today, are indicated by an “R” (for research) in Column 3.

In Table C.1, the notation CxOy is used. Cx refers to Category x of the committee’s observations as grouped in the table (which lists six categories of observations), and Oy refers to a particular observation as numbered in the table (which includes a total of 25 observations).

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