This paper reports on a multimethod study of 16 hospitals implementing an innovative technology for cardiac surgery. This inductive study led to propositions about new technology adaptation and how group and organizational characteristics influence this process and its outcomes. The findings reveal substantial differences in how an identical technology was integrated into ongoing practice in a set of structurally homogeneous organizations. A set of factors at the group level of analysis differentiated successful and unsuccessful adopters: characteristics of operating room teams charged with implementing the new technology—team leader behavior, team psychological safety, team learning behavior, and boundary spanning— were associated with successful adoption. Team membership stability was associated with the rate of efficiency improvement using the new technology. Organizational factors, such as size, type (academic versus community hospital) and organizational support for and experience with innovation, were not associated with either outcome. We develop new theoretical propositions, and suggest that team learning may moderate the strong relationship between structure and technology adaptation. DISRUPTED ROUTINES 2

The purpose of this study was to determine hospital executive management’s perceptions of how turbulence in the politico-legal sector of the macroenvironment impacted the strategic management systems of Tennessee hospitals. In particular, how did Federal and State funding restrictions (Medicare and TennCare) impact the strategic planning and implementation process of their hospitals? The study was also designed to gain insight regarding specific changes to strategic management systems that may have resulted from these funding restrictions. The research was conducted during April and May of 2003. Data were gathered by surveying the Chief Executive Officers (CEOs) of acute care hospitals in Tennessee using a survey instrument covering the areas of strategy formulation, implementation, and evaluation. Fifty-five percent of CEOs of Tennessee’s acute care hospitals responded to the study Using the number of hospital beds as an indicator of hospital size, the results of a Chi Square test demonstrated that the sample of CEOs responding approximated the population (Chi Square=.986, df=6, p=.986). Proportions of CEOs representing for-profit hospitals and rural hospitals also approximated population proportions. The results of the data analysis gave insight into how reductions in TennCare and Medicare

Towards the best corporate governance practices model for public universities in developing countries: the case of Kenya