This document discusses Real Time Strategic Change (RTSC), an approach to organizational change. It begins with definitions of RTSC and lists some of its key principles over time, distilling from 50 aphorisms to 20 principles to eventually 6 polarity pairs. These polarity pairs balance tensions like seeking new possibilities and building on the past. The document provides examples of using RTSC in different organizations and situations to reduce tuberculosis in New York City. It emphasizes flexible processes within fixed principles and mantras that guide RTSC work.