Verkkowhen brittani marcell emerged from a medically induced coma in late 2008, having been brutally beaten with a shovel in her home in albuquerque, new. Verkkochanges in the nursing environment are an integral part of nursing practice. The findings of this integrated review confirm the complexity and. Verkkothe authors discuss gaps and barriers in the current design of health and health systems, and the needed escalation of transformation including transition. Verkko8:08am jun 17, 2018. Verkkonumerous approaches are available to making changes in healthcare systems such as lean, six sigma, the model for improvement, healthcare delivery. Verkkothe extensive analysis reported on the topic allows contextualizing the organizational change initiatives in the healthcare world, where the individual.