Predictors of configurational change: The case of hospital governing boards.

This study sought to advance theory and research on organizational configurations by identifying contingencies that promote different forms of configurational change. A theoretical framework was elaborated that (1) used a typology of hospital governance to select configurational elements and generate predictions about the types of configurations likely to be observed; (2) clarified the meaning and operationalization of the concept of configurational change; and (3) speculated about the implications of performance pressure and organizational inertia on board composition, structure, and activity. This framework was used to formulate hypotheses about organizational and environmental conditions that promote radical and incremental forms of configurational change in hospital governance. A nationally representative sample of 1577 non-profit community hospitals was selected for study. Measurement of governance configurations was based on an empirical taxonomy derived from cluster analysis. Assessment of radical configurational change and incremental configurational change was based on discriminant classification analysis and repeated-measures log-linear analysis. Hypotheses were tested through multinomial logistic regression analysis. Results show that radical configurational change in hospital governance was more likely among hospitals in highly competitive markets, economically deteriorating markets, and less turbulent markets. Low performing hospitals were no more likely than high performing hospitals to engage in radical versus incremental configurational change; yet, hospitals that declined in bed size were more likely than hospitals that grew in bed size to engage in radical versus incremental configurational change. So too were hospitals that changed from public ownership to private ownership during the study period. Incremental configurational change in hospital governance was more likely among rural hospitals, public hospitals, and hospitals located in weakly regulated environments. Larger hospitals were no more likely than smaller hospitals to engage in incremental configurational change. Results also indicate that both performance pressure and organizational inertia are significant predictors of different forms of change in hospital governance. Finally, results suggest that organizational inertia may be more important than performance pressure as a basic force promoting different forms of configurational change. Limitations of the study are outlined, directions for future research are offered, and implications for configurational theory are discussed.PhDPsychologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/104052/1/9423342.pdfDescription of 9423342.pdf : Restricted to UM users only