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The Challenge to change : reforming health care on the front line in the United States and the United Kingdom / Rebecca Kolins Givan.

  • Givan, Rebecca Kolins, 1975-
  • Books

About this work


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. --Publisher description.


Ithaca, NY : ILR Press, an imprint of Cornell University Press, 2016.

Physical description

xiv, 200 pages ; 24 cm.

Bibliographic information

Includes bibliographical references and index.


Health care systems in the United States and the United Kingdom: a lifetime of change -- Turbulence in the two systems -- Measuring and rewarding performance: imposing change from above in the United Kingdom -- Regulating the frontline from above: the joint commission and hospital regulation in the United States -- Pushing back from the frontline: staff responses to privatization in the National Health Service -- Building a safety culture from the frontline in the United States -- From the health care workplace to the health care system: learning from the United States and United Kingdom.


  • English

Where to find it

  • LocationStatus
    History of Medicine
    JOF /GIV
    Open shelves

Permanent link



  • 9780801450051
  • 0801450055