Combining an incremental approach with the implementation of an Enterprise System (ES) is seen as a kind of catch 22. Vendors and implementers nevertheless lately tend to adhere to cyclical approaches with shortened implementation times. This way of working approaches the incremental philosophy, but also influences the requirements on how the implementation process is managed in perspective of its ambitions. In this paper we derive a framework to explore ambition level and relate it to the used implementation approaches in five hospitals. From the results we first observe a rise in the use of cyclical approaches. Secondly we see a dynamic relationship between implementation approach and ambition level in four of the investigated hospitals. This means that the hospitals start drifting in their ambition level, implementation approach or even both. We conclude that such a drift in most cases leads to implementation problems if not aligned within one implementation cycle.