34. FIGURE 12.1 The Two Culture-Building Roles of a Company’s
Core Values and Ethical Standards, Text Alternate
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A company’s stated core values and ethical principles:
Foster a work climate where company personnel share common
and strongly held convictions about how the company’s
business is to be conducted.
Signal employees that they are expected to:
Display the company’s core values in their actions (do things
the right way)
Uphold the company’s ethical standards (do the right thing)
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FIGURE 12.2 Changing a Problem Culture, Text Alternate
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Step 1: Identify facets of the present culture that are
dysfunctional and impede good strategy execution, operating
excellence, and the achievement of performance targets.
Step 2: Specify what new actions, behaviors, and work practices
should characterize the “new” culture.
Step 3: Talk openly about problems of the present culture and
make a persuasive case for how the proposed new actions and
behaviors will improve company performance.
Step 4: Follow with visible, forceful actions—both substantive
and symbolic—to ingrain a new set of behaviors, operating
practices, and cultural norms.
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A 35-year-old woman sought care for a fever and sore throat
that she’d had for 4 days. She
denied symptoms of cough, rhinorrhea, or sputum production.
The patient’s medical history included severe recurrent
streptococcal pharyngitis as a
child and teenager. At the age of 17, she developed a fever of
105° F with associated delirium,
dysphagia, nausea, and vomiting, and missed several days of
school. She also lost 82 pounds,
developed oral thrush, and continued to feel fatigued for
approximately a year. After her
primary care physician noted a heart murmur on physical exam,
she was sent for echocardiography
and diagnosed with rheumatic fever secondary to streptococcal
pharyngitis.
Eighteen years (and numerous streptococcal infections) later,
the patient was at our facility
and we were ordering a rapid antigen detection test (RADT) for
her current illness.
The throat specimen was positive for group A ß-hemolytic
36. streptococcus (GAS). The patient’s
8-year-old daughter also had a sore throat, fever, and positive
RADT; her symptoms resolved
with oral amoxicillin for 10 days. The patient’s husband was
also treated successfully with oral
amoxicillin/clavulanate for 10 days for similar symptoms. The
patient herself, however, was
unsuccessfully treated with oral amoxicillin 500 mg twice daily
for 7 days.
She was then given oral amoxicillin/clavulanate 875 mg twice
daily for 14 days, but received
no relief. Even after receiving clindamycin 600 mg twice daily
for 10 days, she had
minimal relief and remained positive for GAS on repeat RADT.
It was at this point that tonsillectomy
was considered as a possible treatment modality for her
refractory GAS pharyngitis.
The patient consented to the procedure and underwent a
tonsillectomy. She has remained
asymptomatic for 2 years and there have been no reported
outbreaks of GAS infection
in her household.
From above Case report You must post Your Discussion
Activity which must include:
Group A Streptococcus Pharyngitis review related to above
scenario with concept, Clinical symptoms, diagnosis, specific
treatment modalities and explanations, criteria for
Tonsillectomy as surgical choice of treatment. And finally
complications of this condition.