Implementing Organizational Change in a Multidimensional Community College District: A Case Study

Implementing organizational change within complex organizations involves responding to external forces that impact business operations. Leaders guide their organizations through planned change processes by implementing strategic initiatives that affect the entire organization, impact business operations, and influence organizational values (Nadler & Tushman, 1989; Tushman & Nadler, 2012). Community colleges implement change initiatives on behalf of historically, non-dominant students to address systemic issues through developing more inclusive higher education practices (Harris & Wood, 2016; Tate IV, 2008). The following study investigated a matrix-structured community college district located in the Pacific Northwest that implemented change across multiple dimensions to improve student success outcomes for systemically minoritized populations. The purpose of the study was to investigate perceptions held by leaders and staff associated with change management implementation within a multidimensional higher education organization with a focus on Black male student outcomes. Through a qualitative, case study approach, the study analyzed data collected within six focus group interviews with 12 participants. Analysis of RQ1 established four major themes including high turnover/attrition, effectiveness of change, effectiveness of communication, and cross-functional teams; and RQ2 established three major themes including heightened awareness of opportunity gaps, shared vision, and cross-functional teams. Findings produced primary recommendations (integrate Achieving the Dream (ATD) into the formal structure of the district, clarifying decision-making and processes, improve transparency and communication, and thoughtful collaboration) and recommendations for future research (1) contributes to emerging literature on multidimensional higher education institutions; (2) improving educational experiences for Black male community college students; and (3) understanding organizational change processes on community college campuses

Clinical and radiographic outcomes of the simpliciti canal-sparing shoulder arthroplasty system: a prospective two-year multicenter study

BACKGROUND: Stemmed humeral components have been used since the 1950s; canal-sparing (also known as stemless) humeral components became commercially available in Europe in 2004. The Simpliciti total shoulder system (Wright Medical, formerly Tornier) is a press-fit, porous-coated, canal-sparing humeral implant that relies on metaphyseal fixation only. This prospective, single-arm, multicenter study was performed to evaluate the two-year clinical and radiographic results of the Simpliciti prosthesis in the U.S. METHODS: One hundred and fifty-seven patients with glenohumeral arthritis were enrolled at fourteen U.S. sites between July 2011 and November 2012 in a U.S. Food and Drug Administration (FDA) Investigational Device Exemption (IDE)-approved protocol. Their range of motion, strength, pain level, Constant score, Simple Shoulder Test (SST) score, and American Shoulder and Elbow Surgeons (ASES) score were compared between the preoperative and two-year postoperative evaluations. Statistical analyses were performed with the Student t test with 95% confidence intervals. Radiographic evaluation was performed at two weeks and one and two years postoperatively. RESULTS: One hundred and forty-nine of the 157 patients were followed for a minimum of two years. The mean age and sex-adjusted Constant, SST, and ASES scores improved from 56% preoperatively to 104% at two years (p \u3c 0.0001), from 4 points preoperatively to 11 points at two years (p \u3c 0.0001), and from 38 points preoperatively to 92 points at two years (p \u3c 0.0001), respectively. The mean forward elevation improved from 103° ± 27° to 147° ± 24° (p \u3c 0.0001) and the mean external rotation, from 31° ± 20° to 56° ± 15° (p \u3c 0.0001). The mean strength in elevation, as recorded with a dynamometer, improved from 12.5 to 15.7 lb (5.7 to 7.1 kg) (p \u3c 0.0001), and the mean pain level, as measured with a visual analog scale, decreased from 5.9 to 0.5 (p \u3c 0.0001). There were three postoperative complications that resulted in revision surgery: infection, glenoid component loosening, and failure of a subscapularis repair. There was no evidence of migration, subsidence, osteolysis, or loosening of the humeral components or surviving glenoid components. CONCLUSIONS: The study demonstrated good results at a minimum of two years following use of the Simpliciti canal-sparing humeral component. Clinical results including the range of motion and the Constant, SST, and ASES scores improved significantly, and radiographic analysis showed no signs of loosening, osteolysis, or subsidence of the humeral components or surviving glenoid components. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence