Calculate Age Adjusted Mortality Rate

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Conduct research to address the following:

Requirements:

  1. Calculate the 2006 all cause age-adjusted mortality rates for males and females for the United States using the direct and indirect method of age adjustment.
  2. Calculate the 2006 all cause age-adjusted mortality rates for males and females for the state in which you live using the direct and indirect method of age adjustment.
  3. Compare the calculated 2006 age-adjusted mortality rates in males and females between the United States and the state in which you live. Write a one line interpretation of the rate.

Your paper should:

  • be 1-2 pages in length.
  • properly cite research sources.
  • show how you calculated your answers.
  • be free of spelling and grammar errors.

Direct versus Indirect Method of Adjustment

Direct method – Assume that the observed population had the same distribution of characteristics as the reference population. Apply the experience of the observed population to the reference population. Direct age adjustment methods apply age specific rates or the experience from study populations to an age distribution from a reference population.             

           However, when age-specific rates are unavailable in the study populations, we use the indirect method of adjustment.            

Indirect method – Assume that the observed population had the experienceof the reference population.  Apply the experience of the reference population to the observed population. The indirect method uses the age specific rates from a reference population to derive the expected number of cases or deaths in the study populations.          

 

Experience = morbidity rate or mortality rate

Characteristics = age, gender, …

For A-PLUS WRITER ONLY

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Health education and health promotion programs focus on changing health behavior. Public health interventions are increasingly using theoretical frameworks to guide the design, implementation, and evaluation components to achieve behavior change and increase the health of the community.

From the assigned readings this week, review the following Web resource:

Based on your research, select a behavior change theory and provide an example of how that theory applies to a health promotion program. Then, respond to the following:

  • Describe the effectiveness of behavioral theories in bringing about behavior change in a health promotion program.
  • In the example you cite, examine the factors that led to the decision to apply your chosen theory to the specific health promotion program.
  • Describe how the health promotion program was designed to incorporate the elements of this theory.

Support your statements with appropriate examples and scholarly references.

Part 2: Social Determinants Impacting Public Health

Social determinants of health have a significant impact on public health issues. They are the social, economic, and environmental conditions that are not distributed equally among populations. Those living in poverty and unsanitary living conditions are usually more susceptible to disease. Inaccessible healthcare systems and an unstable government without policies to address these disparities also contribute to the burden of disease.

From the assigned readings this week, review the following Web resource:

Respond to the following:

  • Evaluate the social determinants that may impact current public health issues within the U.S.
  • Select a current public health issue in the U.S. and describe the social determinant that impacts the issue.
  • Describe existing practices that are in place to improve economic or social determinants. What additional measures can you recommend?
  • In your opinion, analyze whether more can be done to address the issue. Include an analysis of whether policy creates interference.

Support your statements with appropriate examples and scholarly references.

2 Nursing Assignments: Cardiovascular Alterations & Discussion 2: Anaphylactic Shock

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Discussion 1: Cardiovascular Alterations

At least once a year, the media report on a seemingly healthy teenage athlete collapsing during a sports game and dying of heart complications. These incidents continue to outline the importance of physical exams and health screenings for teenagers, especially those who play sports. During these health screenings, examiners check for cardiovascular alterations such as heart murmurs because they can be a sign of an underlying heart disorder. Since many heart alterations rarely have symptoms, they are easy to miss if health professionals are not specifically looking for them. Once cardiovascular alterations are identified in patients, it is important to refer them to specialists who can further investigate the cause.

Consider the following scenario:
A 16-year-old male presents for a sports participation examination. He has no significant medical history and no family history suggestive of risk for premature cardiac death. The patient is examined while sitting slightly recumbent on the exam table and the advanced practice nurse appreciates a grade II/VI systolic murmur heard loudest at the apex of the heart. Other physical findings are within normal limits, the patient denies any cardiovascular symptoms, and a neuromuscular examination is within normal limits. He is cleared with no activity restriction. Later in the season he collapses on the field and dies.

To prepare:

·         Review the scenario provided, as well as Chapter 24 in the Huether and McCance text. Consider how you would diagnose and prescribe treatment for the patient.

·         Select one of the following patient factors: genetics, ethnicity, or behavior. Reflect on how the factor you selected might impact diagnosis and prescription of treatment for the patient in the scenario.

QUESTIONS to be addressed in my assignment:

1.     A description of how you would diagnose and prescribe treatment for the patient in the scenario.

2.     Then explain how the factor you selected might impact the diagnosis and prescription of treatment for that patient.

3.     Summary with Conclusion

 

REMINDERS:

1)        2-3 pages (addressing the 3 questions above excluding the title page and reference page).

2)      Kindly follow APA format for the citation and references! References should be between the period of 2011 and 2016. Please utilize the references at least three below as much as possible and the rest from yours.

3)     Make headings for each question.

 

 

Discussion 2: Anaphylactic Shock

The treatment of anaphylactic shock varies depending on a patient’s physiological response to the alteration. Immediate medical intervention and emergency room visits are vital for some patients, while others can be treated through basic outpatient care.

Consider the January 2012 report of a 6-year-old girl who went to her school nurse complaining of hives and shortness of breath. Since the school did not have any medication under her name to use for treatment and was not equipped to handle her condition, she was sent to an emergency room where she was pronounced dead. This situation has raised numerous questions about the progression of allergic reactions, how to treat students with severe allergies, how to treat students who develop allergic reactions for the first time, and the availability of epinephrine in schools. If you were the nurse at the girl’s school, how would you have handled the situation? How do you know when it is appropriate to treat patients yourself and when to refer them to emergency care?

To prepare:

·         Review “Anaphylactic Shock” in Chapter 23 of the Huether and McCance text, “Distributive Shock” in Chapter 10 of the McPhee and Hammer text, and the Jacobsen and Gratton article in the Learning Resources.

·         Identify the multisystem physiologic progression that occurs in anaphylactic shock. Think about how these multisystem events can occur in a very short period of time.

·         Consider when you should refer patients to emergency care versus treating as an outpatient.

·         Select two patient factors different from the one you selected in this week’s first Discussion: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the process of anaphylactic shock.

 

QUESTIONS to be addressed in my assignment:

1.     An explanation of the physiological progression that occurs in anaphylactic shock.

2.     Describe the circumstances under which you would refer patients for emergency care versus treating as an outpatient.

3.      Explain how the patient factors you selected might impact the process of anaphylactic shock.

4.     Summary with Conclusion

 

REMINDERS:

1)        2-3 pages (addressing the 4 questions above excluding the title page and reference page).

2)      Kindly follow APA format for the citation and references! References should be between the period of 2011 and 2016. Please utilize the references at least three below as much as possible and the rest from yours.

3)     Make headings for each question.

 

RESOURCES:

 

Readings

·         Huether, S. E., & McCance, K. L. (2012). Understanding pathophysiology (Laureate custom ed.). St. Louis, MO: Mosby.

o    Chapter 22, “Structure and Function of the Cardiovascular and Lymphatic Systems”

This chapter examines the circulatory system, heart, systemic circulation, and lymphatic system to establish a foundation for normal cardiovascular function. It focuses on the structure and function of various parts of the circulatory system to illustrate normal blood flow. 

o    Chapter 23, “Alterations of Cardiovascular Function”

This chapter presents the pathophysiology, clinical manifestations, evaluation, and treatment of various cardiovascular disorders. It focuses on diseases of the veins and arteries, disorders of the heart wall, heart disease, and shock.

o    Chapter 24, “Alterations of Cardiovascular Function in Children”

This chapter examines cardiovascular disorders that affect children. It distinguishes congenital heart diseases from acquired cardiovascular disorders.

·         McPhee, S. J., & Hammer, G. D. (2010). Pathophysiology of disease: An introduction to clinical medicine (Laureate Education, Inc., custom ed.). New York, NY: McGraw-Hill Medical.

o    Chapter 10, “Cardiovascular Disorders: Heart Disease”

This chapter begins by exploring the normal structure and function of the heart. It then examines the etiology, pathophysiology, and clinical manifestations of five heart disorders: arrhythmias, congestive heart failure, valvular heart disease, coronary artery disease, and pericardial disease.

·         Jacobsen, R. C., & Gratton, M. C. (2011). A case of unrecognized prehospital anaphylactic shock.Prehospital Emergency Care, 15(1), 61–66. 
Retrieved from the Walden Library databases. 

This article provides information relating to the diagnosis and management of anaphylactic shock. It also explores difficulties encountered when diagnosing uncommon clinical presentations of anaphylactic shock.

Optional Resources

·         American Heart Association. (2012). Retrieved from http://www.heart.org/HEARTORG/

·         Million Hearts. (2012). Retrieved from http://millionhearts.hhs.gov/index.html

·         National Heart, Lung, and Blood Institute. (2012). Retrieved from http://www.nhlbi.nih.gov/

 

 

 

MN 505 Unit 4

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Read: Story, L., Mayfield-Johnson, S., Downey, L. H., Anderson-Lewis, C., & Day, R. (2010). Getting on Target with Community Health Advisors (GOTCHA): An innovative stroke prevention project. Story et al. GOTCHA. Nursing Inquiry, 17(4), 373-384.

 

  1. Discuss the goals, implementation, and evaluation of the program.
  2. What would you change to increase effectiveness of the program and why?
  3. What do you view as strengths of the program and why?

These MUST be ansrered 1.2.3. etc…… MUST BE APA…….. At least 3 citations not more than 5 years old. If you are unable to access this story let me know! This is part 1 of a 3 part discussion and it is very important. 

 

 

 

Class 
Please use the following guidelines:
Getting on Target with Community Health Advisors (GOTCHA): An innovative stroke prevention project attached for your review

Goals
Be specific

Implementation
Do not forget to include those involved in the proposal as often they can be pivotal in the success of our planned change.  

Evaluation 
How are we going to measure what we plan to do so we know it worked and was worth doing or to see if we need to make changes? 

Change to the program and Rationale
Be specific

Strengths and Rationale
Be specific

 

 

 

 

Essay

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current   health behavior  research on obesity .

 

 For  this  Assignment,  you  will  build  upon  your previous  work  by  proposing  goals  and  objectives  of  a  fesible  health  intervention,  project,  or program to address the health behavior  components of this health issue which is OBESITY .

 

You  will  begin  this  Assignment  by  providing  a  summary  of  the  selected  health  issue  OBESITY and corresponding  health  behavior  theories.  In  outline  format,  you  will  provide  three  goals  for  the proposed  health  intervention,  project,  or  program.  Each  goal  should  have  at  least  2–3 objectives.  Goals  and  objectives  must  reflect  health  behavior  at  the  intrapersonal, interpersonal,  or  community-based  level.  Goals  and  objectives  must  also  be  specific, measurable,  achievable,  relevant,  and  time-bound  (i.e.,  SMART  goals).  Conclude  this Assignment  with  a  short  discussion  on  possible  barriers  or  challenges  to  implementing  these goals and objectives. Requirements

 

•  Utilize  the  Unit  4  Assignment  Template  that I attached

 

 Provide  proper  APA  style  citation  and  referencing  for  all  sources  used  to  develop goals  and  objectives. 

Nursing Assignment: Create a Screencast Script for Pulmonary Edema

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Assignment: Creating a Screencast

Many people today have become intrinsic consumers of knowledge and search the Internet daily for both personal and professional reasons. Nurse educators can build on these natural, information-seeking tendencies by using Screencasts (also known as webcasts). Screencasts, a popular tool in both education and industry, allow presenters to record the output of their computer screen. Similar to asking a colleague to sit at your side while you describe the features of new software to him or her, a Screencast allows you to record and share your screen. This asynchronous capability is especially beneficial to nurse educators who teach students in online and hybrid environments.

For this Assignment, you create a Screencast. Over the next 3 weeks, you will engage in the following phases:

·         Design: During this phase you create a script for your Screencast.

·         Record: During this phase, you will use your script to create a 3- to 5-minute Screencast. Your Screencast must include both audio and video.

·         Share: You will be submitting your script and your Screencast to your instructor for graded feedback.

To prepare (Design Phase)

·         Review this week’s media presentation, Screencast Demonstration. Reflect on the content presented by Dr. Tim Bristol. In addition, consider how the computer output and audio narration might have increased student understanding and engagement.

·         Reflect on the learning needs of an audience that you might teach in the future. Of these needs, which concept, skill, or process might you effectively teach by recording your computer screen? Furthermore, which websites or computer programs might you utilize during your instruction?

·         Review the Screencast Script: An Example document. View Dr. Bristol’s Screencast a second time, comparing the script to his onscreen navigation and dialogue.

·         Select your audience of learners and learning need. The learning need that you select for your Screencast must be different than one chosen for a previous Discussion or Assignment. You may, however, select the same audience of learners.

·         Refer to the Assignment Planner document for specific details and requirements for completing this Assignment.

·         Begin to design your script for the Screencast using the Screencast Template document.

Components to complete for this Assignment*

·         Final version of Screencast Script

 

·         3- to 5-minute Screencast

 

Reminders: This is not an essay….

My topic for the screencast script is Pulmonary Edema… I want the Signs and Symptoms, treatment and nursing intervention of patient with Pulmonary edema.

ReFollow the uploaded Screencast Script example and template below.

HIM 210 PROJECT

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Step 1: Business Understanding

1. There are wide discrepancies of charges and payments between institutions

a. Larger hospitals charge more and receive higher payments

b. Urban hospitals charge more, but do not receive higher payments

2. Are the variations due to excessive charging or lower payments?

a. Excess Charge = Charge/Payment

b. Cost-to-charge ratio = Payment/Charge

 

　

 

 

Step 2: Data Understanding

 

1. IPPS Data

a. Medicare Provider Utilization and Payment Data: Inpatient

i. Total Discharges

ii. Average Covered Charges

iii. Average Total Payments

2. Census Data- because of the size of this file this has been limited to NY ONLY – this file is text -CSV so it will have to be opened in EXCEL first.　　

a. 2010 ZCTA to Metropolitan and Micropolitan Statistical Areas Relationship File

i. Zipcode

ii. CBSA

 

　

 

 

Step 3: Data Preparation

 

 

 

    1. 　Filter the IPPS file to only include NY

 

  • Add the CBSA from the Census Data file to the IPPS Data fileCopy the CBSA column and Paste Special as values only

 

  • Use VLOOKUP

 

  • Remove #N/A values- Use Find/Replace

 

  • Insert a new column

 

  • In the new column, use the IF function to recategorize the hospital geography

 

  • If the hospital has an identified CBSA, recategorize that hospital as urban

 

  • If the hospital does not have a CBSA, recategorize that hospital as rural

 

  • Copy the Geography column and Paste Special as values only

 

  • Calculate Excessive charges= Charge-Payment

 

  • Calculate Cost-to-charge Ratio (CRR) = Payment/Charge

 

  • Copy the Excess Charge and CCR columns and Paste Special as values only

 

  • Save the file as a .csv

 

  • Also, save a version of the file as a .xlsx

 

  • In the .xlsx version, click in any of the cells, format as a table (HOME – “Format as Table”)

 

  • In the .xlsx version, name the table (DESIGN – “Table Name” – enter “DRG”)

 

  • Save

 

 

 

 

 

　Step 4: Modeling

 

 

 

1. Create a PIVOT TABLE of the count of hospitals for each geographic region (INSERT- PivotTable). REMEMBER: click the checkbox “Add this data to the Data Model”

2. Create a PIVOT TABLE to calculate the following for each geographic region:

a. Average Total discharges

b. Average Covered charges

c. Average Total Payments

d. Average Medicare Payments

e. Average Excess charges

f. Average Cost-to-charge ratio (CCR)

3. Use COUNTIF to count the number of rural and urban hospitals (compare these results to what is provided in a PIVOT TABLE

 

 

 

 

　

=COUNTIF(DRG[Geo],”Urban”)

=COUNTIF(DRG[Geo],”Rural”)

4. Use SUMPRODUCT to count the number of rural and urban hospitals that have a cost-to-charge ratio greater than or equal to 0.5 and those less than 0.5 (How should we normalize these results? Calculate the proportion!).

 

　

=SUMPRODUCT((DRG[Geo]=”Urban”)*(DRG[CCR]<0.5))

=SUMPRODUCT((DRG[Geo]=”Urban”)*(DRG[CCR]>=0.5))

=SUMPRODUCT((DRG[Geo]=”Rural”)*(DRG[CCR]<0.5))

=SUMPRODUCT((DRG[Geo]=”Rural”)*(DRG[CCR]>=0.5))

5. Create a PIVOT TABLE of the count of each MS-DRG

6. Create graphs to depict the above information (INSERT – CHARTS)

7. Open R

8. Open R commander

a. Type the following into R:

library(Rcmdr)

9. Import the data into R Commander using the following script:

dataset<- read.csv(file.choose())

Locate the IPPS csv data file and click “OK”

10. Activate the dataset in R commander

a. Click <No active dataset> and find “dataset”

b. Confirm the number of rows and columns as compared to the original dataset

11. Obtain a summary of the following numeric data (Statistics – Summaries – Numeric Summaries – Hold down Ctrl and click the variable names shown below – Click OK):

 

　　　　　　　　　　　　　　　　　　　　　　　 a. Average Covered charges

b. Average Total Payments

c. Average Medicare Payments

d. Excess charges

e. Cost-to-charge ratio (CCR)

　12. Create two graphs of the “Plot of means” to compare Total Average Charges, Total Average Payment, Excess Charge, and CRR by geographic location

13. Use a two-sample T-test to determine if there are significant differences in the following data between rural and urban hospitals:

a. Count of hospitals

b. Total discharges

c. Covered charges

d. Total Payments

e. Medicare Payments

f. Excess charges

g. Cost-to-charge ratio (CCR)

 

　

 

 

Step 5: Evaluation

 

1. Summarize the findings

a. Are there confounding variables that we should have considered in our analysis?

i. Hint: Frequency of MS-DRG codes for each geographic location

 

　

 

 

Step 6: Deployment

 

1. How would these findings be relevant to your organization and what might your organization do with this sort of information?

 

 

 

 

Nursing Discussion: Common Barriers to Team Collaboration

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Nursing Discussion: Common Barriers to 
Team Collaboration

 

What were your initial reactions when you learned that this course consisted of an overarching team project? Did you have any concerns about working in a team?

 

In general, teamwork and collaboration is viewed as a stressful endeavor. In fact, many students and professionals feel that they can complete work better, faster, and quicker on their own. Many might even shy away from the opportunity to collaborate with others for fear of time constraints, miscommunication, conflicting views, and incivility among group members. However, the value of collaboration truly outshines any perceived negative barriers. In particular, collaboration gives educators the opportunity to enrich curriculum with the expertise and experiences of a group of professionals. It also pushes each educator to think “outside of the box” to incorporate innovative strategies, views, and learning opportunities. In fact, the days of one instructor developing a course are being quickly phased out by collaborative approaches. Many of today’s institutions require a panel of experts to creatively and critically collaborate on course development. As such, it is imperative that you begin to understand not only how to work effectively in a team but also how to overcome common barriers that can occur during the team collaboration process.

 

To prepare:

·         Reflect on your team’s collaborative process. What barriers has your team experienced? How have you and others in your team worked to overcome these barriers? If you believe that your team has not experienced any barriers or difficulties, reflect on common barriers presented in this week’s Learning Resources.

·         How could these strategies be used to help nurse educators? In addition,

 

Questions to be addressed in my paper:

 

  1. Review the article “Overcoming Challenges to Collaboration: Nurse Educators’ Experiences in Curriculum Change” uploaded below. Consider the benefits of and barriers to team collaboration. 

2.     Select one barrier that has a significant influence on a team approach to curriculum development.

3.     An explanation of a barrier that can significantly influence a team approach to curriculum development and why.

4.     Search the Walden Library or in the internet to identify an article that presents strategies for overcoming your selected barrier. Describe two strategies you could implement to overcome this barrier, as well as how these strategies could help increase postive team collaboration.  

5.     How could these two strategies be used to help nurse educators?

6.     Justify your response by citing references to this week’s Learning Resources and your selected article as appropriate.

7.     Then, upload or provide a hyperlink to that article.

8.     Summary/Conclusion of the discussion: Common Barriers to 
Team Collaboration

 

Reminders:

1.      Put APA citations and references 2011 – 2016….

2.      Put headings on each addressed question.

 

 

 

Required Readings

Billings, D. M., & Halstead, J. A. (2016). Teaching in nursing: A guide for faculty (5th ed.). St. Louis, MO: Elsevier.

  • Chapter 10, “Designing Courses and Learning Experiences” (pp.159–185)

 

Chapter 10 explains how to design curricula in response to society’s needs. The importance of creating curricula that influences students both inside and outside of the classroom is emphasized.

Chiang, C-K., Chapman, H., & Elder, R. (2011). Overcoming challenges to collaboration: Nurse educators’ experiences in curriculum change. Journal of Nursing Education, 50(1), 27–33. 

Retrieved from the Walden Library databases.

 

Though this article is set in Taiwan, it provides nursing students who plan to practice in the United States with an exemplary approach to the collaboration process and how to overcome problems related to teamwork.

Heinrich, K. T. (2010). An optimist’s guide for cultivating civility among academic nurses. Journal of Professional Nursing, 26(6), 325–331. 

Retrieved from the Walden Library databases.

 

Cohesiveness across an academic institution can sometimes be hard to achieve. This article explores the benefits of connected relationships as well as strategies for creating cohesiveness in academic environments.

Heinrich, K. T. (2011). Take the civility challenge: How partnership practices can turn toxic workplaces terrific. Nurse Educator, 36(5), 224–227.

 

 

Heinrich’s article explains how beneficial partnerships can change toxic workplaces.

For A-plus writer only

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Between 2004 and 2007, the National Institutes of Health conducted a STEP vaccine clinical trial—Phase IIB “test-of-concept” study.

The STEP study is the name of a clinical trial to test an experimental human immunodeficiency virus (HIV) vaccine. The STEP study enrolled 3,000 participants at sites in Australia, Brazil, Canada, the Dominican Republic, Haiti, Jamaica, Peru, Puerto Rico, and the United States. The study was designed to test an HIV vaccine, which aimed to stimulate production of immune system T-cells that can kill HIV-infected cells.

Based on its first evaluation of vaccine efficacy, the findings showed there were 24 cases of HIV infection among the 741 volunteers who received at least one dose of the investigational vaccine compared with 21 cases of HIV infection among the 762 volunteers who were vaccinated with the placebo. In volunteers who received at least two vaccinations, there were 19 cases of HIV infection among the 672 volunteers who received the investigational vaccine and 11 instances of HIV infection among the 691 volunteers who received placebo. The study investigators of the vaccine trials have decided to cease immunizations and are contacting study volunteers to inform them of the developments.

Reference:

National Institutes of Health (2007). National Institute of Allergy and Infectious
           Diseases: Immunizations are discontinued in two HIV vaccine trials.
           Retrieved from http://www.niaid.nih.gov/news/newsreleases/2007/
           Pages/step_statement.aspx

research further on the STEP study, the STEP vaccine clinical trials, and their parameters.

Based on your research, understanding, and above information, answer the following questions:

 

  • Prior to beginning this study, how would you have described the risks and benefits of the study to participants?
  • What are the ethical issues surrounding this study at the beginning and when the decision was made to terminate the study?

Due in 2 hours

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Macy’s and IBM are companies that sell two different products, both dealt with similar difficulties of organizational problems and change. IBM focused on coordinating activities to create the most value for each customer which would produce a supply chain of global operations, independent operations that each member focused and grow business based on local response. The mindset of the IBM managers, were that the IBM store each operated, were not IBM but of each country the stores were operating in, this produced little connection with the country and corporate operations.

 

Macy’s business was divided into geographic districts and focused on regional market, this gave the managers autonomy but they wouldn’t develop the market place response. Whereas IBM focused open decentralization (Spector, 2013).

 

Regional differentiation called for Macy’s new strategy, while its formal structure made such differentiation difficult, if not impossible. So, in order to achieve that strategy, Macy’s changed its structure. After running six pilots, the company moved to a focus on regional markets (Spector, 2013). In all organizations, the activities of employees need to be focused on two separate issues (Spector, 2013):

 

 

 

1. The functional or technical activities required to achieve the desired out- comes of the organization. 2. Responsiveness to the external marketplace (customers, suppliers, competitors, regulators, and so on) in which the organization has elected to compete.

 

 

 

It is therefore important that leaders understand the impact that various structural choices will have on the focus of employees and, consequently, on their behavior. Organization structure is a mechanism for helping to achieve the desired focus. Therefore, when a new strategy calls for a new focus, it is likely that the structure of the organization will need to change. By letting the managers make the decisions within their store was a great idea in order to make this change effective.

 

 

 

IBM’s decentralized structure worked wonders for the company. Country managers could focus on their own regions and grow the business based on local responsiveness. But if local responsiveness was the benefit of decentralized structures, the cost was low collaboration. In IBM’s case, they didn’t have the manager’s support when trying to implement change.

 

 

 

Gerstner announced a new structure. Twelve customer groups (such as banking, government, and insurance) and one small and medium‐sized company group would take over all IBM accounts, including responsibility for budgets and personnel. The restructuring reassigned most employees in non‐U.S. operations to a specific group; they would now report to the global leaders of their industry group rather than to their country general managers. “The response from country general managers was overwhelmingly negative. It will never work and you will destroy the company were statements that expressed their resistance. Some country general managers responded by simply ignoring the new structure (Spector, 2013).” One regional executive unilaterally decided to block all communications between Gerstner and the field.

 

 

 

Reference

 

 

 

Spector, Bert. (2013). Implementing Organizational Change, 3rd Edition. Vital Source Bookshelf Online.  Retrieved July 19, 2016, fromhttps://bookshelf.vitalsource.com/#/books/9781256713