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007), a score above the national average on appropriate use of imaging-a measure of low-value care (odds ratio = 1.04, p 0.042), and higher HCAHPS patient experience scores (b = 0.12, p 0.012). The degree of Lean implementation was not associated with any of the other 6 performance measures. Lean is an organizationwide sociotechnical performance improvement system. As such, the actual degree of implementation throughout the organization as opposed to mere adoption is, based on the present findings, more likely to be associated w
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