There is constant pressure on hospitals to improve health care delivery and increase cost effectiveness. New initiatives are the order of the day in the dramatically different health care systems of the United States and Great Britain. Often, as we know all too well, these efforts are not successful. In The Challenge to Change, Rebecca Kolins Givan analyzes the successes and failures of efforts to improve hospitals and explains what factors make it likely that the implementation of reforms will rewarded by positive transformation in a particular institution’s day-to-day operation. Givan’s in-depth qualitative case studies of both top-down initiatives and changes first suggested by staff on the front lines of care point clearly to the importance of all hospital workers in effecting change and even influencing national policy. Givan illuminates the critical role of workers, managers, and unions in enabling or constraining changes in policies and procedures and ensuring their implementation. Givan spotlights an Anglo-American model of hospital care and work organization, even while these countries retain their differences in access and payment. Entrenched professional roles, hierarchical workplace organization, and the sometimes-detached view of policymakers all shape the prospects for change in hospitals. Givan provides important examples of how the dedication and imagination of the people who work in hospitals can make all the difference when it comes to providing quality health care even in a challenging economic environment.

Michael Fullan and other notable experts present a cohesive model of tri-level reform—school, district, and state educators collaborating to build and strengthen capacity for change.

This edited volume addresses how the state system, the organizing political institution in world politics, copes with challenges of rapid change, unanticipated crises, and general turmoil in the twenty-first century. These disruptions are occurring against the background of declining US influence and the rising power of countries in Asia, Africa, and Latin America. Traditional inter-state security concerns coexist with new security preoccupations, such as rivalries likely to erupt over the resources of the global commons, the threat of cyber warfare, the ever-present threat of terrorism, and the economic and social repercussions of globalization. The contributors explore these key themes and the challenges posed by rapid change.

Teaching Physical Activity: Change, Challenge, and Choice guides you in designing activities and games through which you can meet your objectives while engaging all the participants in your class or group. Including foundational material on teaching activities and games ; 45 ready-to-use games and activities to get you started right away numerous tips, ideas, and strategies to help you fully understand and implement this approach.

In an era of increased global competition, of business takeovers, downsizing, restructuring, and even outright failure, intelligent organizational change is the most difficult challenge facing American business. The authors present a comprehensive overview which will be essential for managers.

Created by Brook Noel as she sought to "make over" her own life in an achievable step-by-step fashion, "The Change Your Life Challenge" program revolves around the theory that most people fail because they attempt to make huge life changes when mental energy and esteem are low. With the theory of "a journey of a thousand miles begins with a single step," Noel shows how simple daily actions can result in an entire lifelong makeover.