One such shift in management styles was studied in a public hospital in Alberta, Canada in 2009. The hospital implemented a Care Transformation Initiative that focused on eliminating wasteful activities and actions and applying an atmosphere of participatory management. This initiative was only implemented in one of the programs in the hospital. That program was studied along with another program in which the initiative was not implemented. The main findings of the study showed that, first of all, organizational change is difficult and takes time. Some workers, particularly older ones, were resistant to the change. The management and clinical staff reported little understanding of their specific contribution to organizational decisions. Despite these challenges, staff also reported feeling optimism that this organizational change may lead to better change in the future.