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.

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.

The Challenge of Change examines how military institutions attempted to meet the demands of the new strategic, political, and technological realities of the turbulent era between the First and Second World Wars. The contributors chose France, Germany, Great Britain, the Soviet Union, and the United States as focus countries because their military institutions endeavored to develop both the material capacity and the conceptual framework for the conduct of modern industrialized warfare on a continental scale. Also included are an introduction describing the intellectual and practical challenges facing the military reformer in peacetime and a concluding essay by Dennis Showalter drawing together the issues examined in the preceding studies and setting these themes in an interpretive, historiographical context. The Challenge of Change has been designed to meet the needs of historians, military professionals, and defense analysts.

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.

Men have long been considered difficult to engage in psychotherapy, often being described as resistant, unworkable, and unfeeling. The few available books that deal specifically with men's issues tend to lack a central theoretical focus, are highly psychoanalytic in content, or simply do not provide specific guidelines for working with men. This unique and timely volume fills an important gap in the literature by demonstrating why change is often so difficult for them. It provides detailed guidelines for helping men initiate and sustain change in their personal, familial, and professional lives.