All ETDs from UAB

Advisory Committee Chair

Thomas Powers

Advisory Committee Members

Gerald Glandon

Robert Hernandez

Howard Houser

Bisakha Sen

Document Type

Dissertation

Date of Award

2007

Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions

Abstract

The purpose of this dissertation was to investigate the influence of selected environmental and organizational factors on the adoption of administrative innovations in order to better understand strategic adaptation by organizations. General systems theory, various organizational theories, strategic adaptation and management theories, and adoption and diffusion of innovation literature were used to develop a theoretical framework to address four primary and sixteen secondary hypotheses. The administrative innovation used for this study was the magnet hospital concept for enhancing attraction and retention of registered nurses in order to address a persistent workforce shortage in U.S. hospitals. Secondary data related to U.S. hospitals from the American Hospital Association, Bureau of Health Professions, and American Nurses Credentialing Center was used to test hypothesized relationships employing logistic regression methods. It was found that the groups of environmental and organizational influences singularly and jointly influenced adoption of administrative innovations supporting strategic management theory. It was also found that organizational influences were more salient than environmental influences theoretically supporting the resource based view of the firm in strategic adaptation. Specifically, it was found that environmental and organizational complexity, community resources, and control of domain were all positively and iv significantly associated with adoption of administrative innovations versus competition, network externalities, slack resources, and external communications network that were not significant. The control variables of size of hospital and type of hospital were both positive and significant. Scholars can use these results to extend knowledge of each of the factors investigated and a number of additional factors that were identified in different settings incorporating moderators, mediators, and additional controls employing longitudinal designs. Particularly compelling is the need for future research on the influence of these factors in different stages of the adoption process and in different phases of the diffusion process. Practitioners can use these findings to assess the potential for successful adoption of the magnet concept by their hospitals and to better plan their strategy for addressing persistent workforce shortages.

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