STRATEGIC POSITIONING OR INSTITUTIONAL COERCION? THE STRUCTURE OF GOVERNING BOARDS

The strategic management perspective suggests that organizations structure their governing boards to complement the strategic goals of the organization. In contrast, the institutionalization perspective holds that organizations structure their governing boards to respond to institutional pressures in their task environment. Regardless of which perspective is followed, three structural dimensions of governing boards are expected to be affected: size, diversity of composition, and medical staff representation. A study was conducted to relate the institutional requirements and strategies of acute care hospitals to the structural characteristics of their boards of directors. Results indicated that, after controlling for organizational size and membership in a multihospital system, the governing board structure of 109 acute care hospitals varied significantly both as a function of their overall business strategy and as a function of institutional linkages. However, the proportion of the total variance in board structure accounted for by strategy variables was approximately twice as much as that accounted for by institutional variables.