Perception, selection & performance: Hospitals\u27 adaptation strategies

This project examines the question of whether and how board composition by occupational category influences hospital performance particularly during periods of environmental change and distress. I propose a theoretical framework drawn from the economic and management literature that ties board composition to organizational performance when there is a good fit between the board\u27s composition and the organization\u27s environment. To examine the question and test the theoretical framework, the study uses a mixed-methods approach by first conducting one-on-one interviews with hospital executives to collect qualitative data followed by analyzing 10 years of quantitative hospital data from all general and specialty hospitals in California. Using this dataset, I examine how the interaction of board composition with changes in local competition as well as new governmental policies influence hospitals\u27 financial, access to care and quality of care performance measures. This study finds that both business and medical board members have a positive influence on hospitals\u27 financial performance while business and community board members have a positive influence on hospitals\u27 access to care measures. Understanding that more research needs to be conducted, particularly with respect to how board composition influences hospitals\u27 quality of care provided, this study finds solid empirical support for the theoretical framework linking hospital board composition to organizational performance