Paraphrase: This paper examined the skills and knowledge required to plan and implement the system wide organizational changes affecting Roxboro Medical Center. It described the decision making process involved in a RIF, possible challenges and conflicts that would be encountered, ethical responsibilities when making RIF decisions, a general overview of the reorganization plan, implementation of Kotter's 8 Step Change Model, along with potential conflicts and benefits of it, as well as the anticipated organizational impact of a RIF and strategies to overcome them. The task of organizational restructuring can have significant social impacts. When faced with the responsibility to develop a reduction in workforce plan, management should approach the task by first incorporating strategies that reinforce the mission and values of the organization. They should also maintain transparent communication and a sense of heightened perception. This will allow them to comprehend and understand the emotions their staff are experiencing during this difficult time. It is also important to involve key stakeholders early on in the process to ensure organizational policy and processes are followed. Along with the organizational strategies identified, implementation of a well-chosen change model is instrumental in the execution of any system wide change process