The traditional distinction between strategy process and strategy content has perhaps limited the ability of strategic management research to explain the determinants of organizational performance. In addition, empirical attention needs to be paid to the role of the context within which strategy is formed. This study examined the extent to which synergies between process, content, and context explained the peformance of a geographic segment of the hospital industry. Results showed that (a) both process and content were significantly related to performance; (b) including process/content interactions significantly enhanced explanation of performance; and (c) context is an important moderator of these relationships. Implications are drawn for both research and practice.
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References
1.
Albert, Y S. & Whetten. D.A. (1985). Organizational identity. Pp. 263-295 in L.L. Cummings & B.M. Staw (Eds.), Research in organizational Behavior, Vol. 7. Greenwich, CT: JAI Press.
2.
Aldrich, H. (1979). Organizations and environments. Englewood Cliffs, NJ: Prentice-Hall.
3.
Alexander, J.A. & Amburgey, T.L. (1987). The dynamics of change in the American hospital industry: Transformation or selection?Medical Cure Review, 44: 279-321.
4.
Ashmos, D.P. & McDaniel, R.R. (1991). Physician participation in hospital strategic decision making: The effect of hospital strategy and decision content. Health Services Research, 26: 375-401.
5.
Bettis, R.A. (1981). Performance differences in related and unrelated firms. Strategic Management Journal, 2: 379-394.
6.
Bettis, R.A. & Hall, W.K. (1982). Diversification strategy, accounting determined risk, and accounting determined return. Academy of Management Journal, 25: 254-264.
7.
Blair, J.D. & Boal, K.B. (1991). Strategy formation processes in health care organizations: A context-specific examination of context-free strategy issues. Journal of Management, 17: 305-344.
8.
Blau, P.M. & Schoenherr, R.A. (1971). The structure of organizations. New York: Basic Books.
9.
Bourgeois, L.J. & Eisenhardt, K.M. (1988). Strategic decision processes in high velocity environments: Four cases in the microcomputer industry. Management Science, 34: 816-835.
10.
Brittain, J. & Freeman, J. (1980). Organizational proliferation and density dependent selection, Pp. 291-338 in J. Kimberly & R. Miles (Eds.), The organizational life cycle. San Francisco: Jossey-Bass.
11.
Buzzell, R.D., Gale. B.T., & Sultan, R.G.M. (1975). Market share-A key to profitability. Harvard Business Review, 53,(1): 97-106.
12.
Carmines, E.G. & Zeller. R.A. (1979). Reliability and validity assessment. Newbury Park, CA: Sage.
13.
Carroll, G. & Delacroix. J. (1982). Organizational mortality in the newspaper industries of Argentina and Ireland: An ecological approach. Administrative Science Quarterly, 27: 169-198.
14.
Caves, R. & Porter, M. (1977). From entry barriers to mobility barriers: Conjectural decisions and contrived deterrence to new competition. Quarterly Journal of Economics, 91: 241-261.
15.
Caves, R. & Pugel, T. (1980). Intraindustry differences in conduct and performance: Viable strategies in U.S. manufacturing industries. New YorkUniversity Monograph.
16.
Child, J. (1972). Organizational structure, environment, and performance: The role of strategic choice. Sociology, 6: 1-22.
17.
Cool. K. & Schendel, D. (1987). Strategic group formation and performance: The case of the U.S. pharmaceutical industry, 1963.1982. Management Science, 33: 1102-1124.
18.
Cosier, R.A. & Aplin, J.C. (1980). A critical view of dialectical inquiry as a tool in strategic planning. Strategic Management Journal, 1: 343-356.
19.
Daft. R.L. & Lengel, R.H. (1986). Organizational information requirements, media richness, and structural design. Management Science, 32: 554-571.
20.
Daft, R.L. & Macintosh. N.B. (1981). A tentative exploration into the amount and equivocality of information processing in organizational work units. Administrative Science Quarterly: 26: 207-224.
21.
Daft. R.L., Sormunen. J. & Parks, D. (1988). Chief executive scanning, environmental characteristics, and company performance: An empirical study. Strategic Management Journal, 9: 123-139.
22.
Daft, R.L. & Weick, K.E. (1984). Toward a model of organizations as interpretive systems. Academy of Management Review, 9: 284-295.
23.
Dess, G.G. (1987). Consensus on strategy formulation and organizational performance: Competitors in a fragmented industry. Strategic Management Journal, 8: 259-271.
24.
Duhaime, I.M. & Schwenk. CR. (1985). Conjectures on cognitive simplification in acquisition and divestment decision making. Academy of Management Review, 10: 287-295.
25.
Dutton, J.E. & Dukerich, J. (1991). Keeping an eye on the mirror: The role of image and identity in organizational adaptation. Academy of Management Journal, 34: 511-554.
Eisenhardt, K.M. & Bourgeois, L.J. (1988). Politics of strategic decision making in high velocity environments: Toward a mid-range theory. Academy of Management Journal, 31: 737-770.
28.
Fahey, L. & Christensen, H.K. (1986). Evaluating the research on strategy content. Journal of Management, 12: 167-183.
29.
Finkelstein, S. & Hambrick, D.C. (1990). Top-management-team tenure and organizational outcomes: The moderating role of managerial discretion. Administrative Science Quarterly, 35: 484-503.
30.
Fottler, M.D. (1987). Health care organizational performance: Present and future research. Journal of Management, 13: 361-391.
31.
Fottler, M.D. & Lanning. J.A. (1986). A comprehensive incentive approach to employee health care cost containment. California Management Review, 29: 75-94.
32.
Fredrickson, J.W. (1984). The comprehensiveness of strategic decision processes: Extension, observations, future directions. Academy of Management Journal, 27: 445-466.
33.
Fredrickson, J.W. (1986). An exploratory approach to measuring perceptions of strategic decision process constructs. Strategic Management Journal, 7: 473-483.
34.
Fredrickson, J.W. & Mitchell, T.R. (1984). Strategic decision processes: Comprehensiveness and performance in an industry with an unstable environment. Academy ofManagement Journal, 27: 399-423.
35.
Gale, B.T. (1972). Market share and rate of return. Review ofEconomics and Statistics, 54: 412-423.
36.
Ginn, G.O. (1990). Strategic change in hospitals: An examination of the response of the acute care hospital to the turbulent environment of the 1980s. Health Services Research, 25: 565-591.
37.
Gioia, D.A. & Chittipeddi, K. (1991). Sensemaking and sensegiving in strategic change initiation. Strategic Management Journal, 12: 433-448.
38.
Hall, R.H., Haas, J.E. & Johnson, N.J. (1967). Organizational size, complexity, and formalization. American Sociological Review, 32: 903-912.
39.
Hall, R.I. (1984). The natural logic of management policy making: Its implications for the survival of an organizationManagement Science, 30: 905-927.
40.
Hambrick, D.C. (1979). Environmental scanning, organizational strategy, and executive roles: A study in three industries. Unpublished doctoral dissertation, Pennsylvania State University.
41.
Hambrick, D.C. & Finkelstein, S. (1987). Managerial discretion: A bridge between polar views on organizations. Pp. 369-406 in L.L. Cummings & B.M. Staw (Eds.), Research in organizational behavior, Vol. 9. Greenwich, CT: JAI Press.
42.
Hambrick, D.C., Geletkanycz, M.A. & Fredrickson, J.W. (1993). Top executive commitment to the status quo: Some tests of its determinants. Strategic Management Journal, 14: 401-418.
43.
Hambrick, D.C. & Lei, D. (1985). Toward an empirical prioritization of contingency variables for business strategy. Academy of Management Journal, 28: 763-788.
44.
Hamermesh, R.G., Anderson, M.J. & Harris, J.E. (1978). Strategies for low market share businesses. Harvard Business Review, 56(3): 95-102.
45.
Hayes, S.L. III, Spence, A.M., & Marks, D.V.P. (1983). Competition in the investment banking industry. Cambridge, MA: Harvard University Press.
46.
Hedberg, B.L., Nystrom, P.C. & Starbuck, W.H. (1976). Camping on seesaws: Prescriptions for a self-designing organization. Administrative Science Quarterly, 21: 41-65.
47.
Hergert, M. (1987). Causes and consequences of strategic grouping in U.S. manufacturing industries, International Studies of Management and Organization, 18: 26-49.
48.
Hofer, C. & Schendel, D. (1978). Strategy formulation: Analytical concepts. St. Paul, MN: West Publishing.
49.
Hogarth, R.M. & Makridakis, S. (1981). Forecasting and planning: An evaluation. Management Science, 27(2): 115-138.
Hrebiniak, L.G., Joyce, W.F. & Snow, C.C. (1989). Strategy, structure, and performance: Past and future research. Pp. 3-54 in C.C. Snow (Ed.), Strategy, organization design, and human resource management. Greenwich, CT: JAI Press.
52.
Huber, G.P., O’Connell, M.J. & Cummings, L.L. (1975). Perceived environmental uncertainty: Effects of information and structure. Academy ofManagement Journal, 18: 725-740.
53.
Huff, A.S. & Reger. R.K. (1987). A review of strategic process research. Journal of Management, 13: 211-236.
54.
Ireland, R.D., Hitt, M.A., Bettis, R.A. & de Porras, D.A. (1987). Strategy formulation processes: Differences in perceptions of strength and weakness indicators and environmental uncertainty by managerial level. Strategic Management Journal, 8: 469-486.
55.
Janis, I.L. (1989). Crucial decisions: Leadership in policymaking and crisis management. New York: Free Press.
56.
Jemison, D.B. & Sitkin, S.B. (1986). Corporate acquisitions: A process perspective. Academy of Management Review, 11: 145-163.
57.
Kerlinger, F. (1986). Foundations of behavioral research. New York: Holt, Rinehart & Winston.
58.
Ketchen, D.J., Thomas, J.B. & Snow, CC. (1993). Organizational configurations and performance: A comparison of theoretical approaches. Academy ofManagement Journal, 36: 1278-1313.
59.
Kimberly, J.R. (1976). Organizational size and the structuralist perspective: A review, critique, and proposal, Administrative Science Quarterly, 21: 571-597.
60.
Kimberly, J.R. & Zajac, E.J. (1985). Strategic adaptation in health care organizations: Implications for theory and research. Medical Care Review, 42: 267-301.
61.
Longest, B.B. (1990). Interorganizational linkages in the health sector. Health Care Management Review, 15(1): 17-28.
62.
Meyer, A.D. (1982). Adapting to environmental jolts. Administrative Science Quarterly, 27: 515-536.
63.
Meyer, A.D. (1991). What is strategy’s distinctive competence?Journal of Management, 17: 821-833.
64.
Michel, A. & Shaked, I. (1984). Does business diversification affect performance?Financial Management, 13(4): 18-25.
65.
Miles, R.E. & Snow, C.C. (1978). Organizational strategy, structure, and process. New York: McGraw-Hill.
66.
Miles, R.E. & Snow, C.C. (1986). Network organizations: New concepts for new forms. California Management Review, 28: 62-73.
67.
Miles, R.H. (1982). Coffin nails and corporate strategies. Englewood Cliffs, NJ: Prentice-Hall.
68.
Miller, D. (1989). Matching strategies and strategy making: Process, content, and performance. Human Relations, 42: 241-260.
69.
Miller, D. & Friesen, P.H. (1983). Strategy-making and the environment: The third link. Strategic Management Journal, 4: 221-235.
70.
Miller. D., Kets de Vries. M.F.R. & Toulouse, J. (1982). Top executive locus of control and its relationship to strategy-making. structure, and environment. Academy of Management Journal, 25: 237-253.
71.
Miller, D. & Mintzberg, H. (1983). The case for configuration. Pp. 57-73 in G. Morgan (Ed.), Beyond method: Strategies for social research. Newbury Park. CA: Sage.
72.
Milliken, F.J. & Lam, T.K.1991. The effects of an Organizations recent performance history on strategic persistence and change: The role of managerial interpretations. Pp. 129-156 in P. Shrivastava. A.S. Huff & J.E. Dutton (Eds.), Advances in strategic management,, Vol. 7. Greenwich. CT: JAI Press.
73.
Mintzberg, H. (1973). Strategy making in three modes. California Management Review, 16: 44-53.
74.
Mintzberg, H. (1987a). Crafting strategy. Havard Business Review, 65(4): 66-75
75.
Mintzberg, H. (1987b). The strategy concept I: Five P’s for strategy. California Management Review, 30: 11-24.
76.
Mintzberg, H. (1990a). Mintzberg on management: inside our strange world of organizations. New York: Free Press.
77.
Mintzberg, H. (199Ob). Strategy formation: Ten schools of thought. Pp. 105-235 in J. Fredrickson (Ed.). Perspective and strategic management. Cambridge. MA: Ballinger.
78.
Mintzberg, H., Raisinghani, D. & Theoret. A. (1976). The structure of “unstructured decisions. Administrative Science Quarterly, 21: 246-275.
79.
Mintzberg, H. & Waters, J.A. (1985). Of strategies, deliberate and emergent. Strategic Management Journal, 6: 257-272.
80.
Narayanan, V.K. & Fahey, L. (1982). The micro-politics of strategy formulation. Academy of Management Review, 7: 25-34.
81.
Newman, H.H. (1978). Strategic groups and the structure-performance relationship. Review of Economics and Statistics, 60: 417-427.
82.
Oster, S. (1982). Intraindustry structure and the ease of strategic change. Review of Economics and Statistics, 64: 376-384.
83.
Palepu, K. (1985). Diversification strategy, profit, performance, and the entropy measure. Strategic Management Journal, 6: 239-255.
84.
Pearce, J.A. II, Freeman, E. B. & Robinson, R.B. (1987). The tenuous link between formal strategic planning and financial performance. Academy of Management Review, 12: 658-675.
85.
Peters. T. (1990). Prometheus barely unbound. Academy of Management Executive, 4(4): 70-84.
86.
Pettigrew, A. & Whipp, R. (1991). Managing change for competitive Success: Oxford: Basil Blackwell.
87.
Pettigrew, A. & Whipp, R. (1993). Managing the twin processes of competition and change: The role of intangible assets. Pp. 3-42 in P.L. Lorange, B. Chakravarthy, J. Roos & A. Van de Ven (Eds.), Implementing strategic processes: Change, Learning, and Co-operation. Cambridge. MA: Blackwell Business.
88.
Pfeffer. J. (1981). Power in organizations. Marshfield, MA: Pitman.
89.
Pfeffer. .I. & Salancik, G.R. (1978). The external control of organizations: A resource dependent views. New York: Harper & Row.
90.
Porter, M.E. (1979). The structure within industries and companies’ performance. Review of Economics and Statistics, 61: 214-227.
91.
Porter, M.E. (1980). Competitive strategy: Techniques for analyzing industries and competitors. New York: Free Press.
92.
Provan, K.G. (1991). Receipt of information and influence over decisions in hospitals by the board. chief executive officer, and medical staff. Journal of Management Studies, 28: 281-298.
93.
Pugh, D.S., Hickson, D.J., Hinings, C.R. & Turner. C. (1968). Dimensions of organization structure. Administrative Science Quarterly, 13: 65-91.
Rhyne, L.C. (1986). The relationship of strategic planning to financial performance. Strategic Management Journal, 7: 423-436.
97.
Ritvo, R.A., Salipente, R. & Notz, W.W. (1979). Environmental scanning and problem recognition by governing boards: The response of hospitals to declining birth rates. Human Relation, 3: 227-235.
98.
Rumelt, R.P. (1974). Strategy, structure, and economic performance. Boston: Harvard Business School.
99.
Schwalbach, J. (1991). Profitability and market share: A reflection on the functional relationship. Strategic Management Journal, 12: 299-306.
100.
Scott Morton, M. (1991). The corporation of the 90’s: Information technology and organizational transformation. New York: Oxford University Press.
101.
Segev, E. (1987). Strategy, strategy making, and performance. Management Science, 33: 258-269.
102.
Shortell, S.M. & Zajac, E.J. (1990). Health care organizations and the development of the strategic management perspective. Pp. 144-180 in S. Mick (Ed.), Innovations in health care delivery. San Francisco: Jossey-Bass.
103.
Shottell, S.M., Morrison, E.M. & Friedman, B. (1990). Strategic choices for America’s hospitals: Managing change in turbulent times. San Francisco: Jossey-Bass.
104.
Smircich, L. & Stubbart, C. (1985). Strategic management in an enacted world. Academy of Management Review, 10: 124-136.
105.
Snow, C.C. & Thomas, J.B. (1994). Field research methods in strategic management: Contributions to theory building and theory testing. Journal of Management Studies, 31: 457-480.
106.
Summer, C.E., Bettis, R.A., Duhaime, I.H., Grant, J.H., Hambrick, D.C., Snow, C.C. & Zeithaml, C.P. (1990). Doctoral education in the field of business policy and strategy. Journal of Management, 16: 361-398.
107.
Thomas, J.B., Clark, S.M. & Gioia, D.G. (1993). Strategic sensemaking and organizational performance: Linkages among scanning, interpretation, action, and outcomes. Academy of Management Journal, 36: 239-270.
108.
Thomas, J.B. & McDaniel, R.R. (1990). Interpreting strategic issues: Effects of strategy and the information-processing structure of top management teams. Academy of Management Journal, 33: 286-306.
109.
Thomas, J.B.. Shankster, L.J. & Mathieu, J.E. (1994). Antecedents to organizational issue interpretation: The roles of single-level, cross-level, and content cues. Academy of Management Journal, 37: 1252-1284.
110.
Thorelli, H.B. (1977.) Strategy + structure = performance: The strategic planning imperative. Bloomington, IN: Indiana University Press.
111.
Tushman, M.L. & Anderson, P. (1986). Technological discontinuities and organizational environments. Administrative Science Quarterly, 31: 439-465.
112.
Tushman, M.L. & Romanelli, E. (1985). Organizational evolution: A metamorphosis model of convergence and reorientation. Pp. 171-222 in B.M. Staw & L.L. Cummings (Eds.), Research in organizational Behavior, Vol. 7. Greenwich, CT: JAI Press.
113.
Venkatraman, N. (1989). The concept of fit in strategy research: Toward verbal and statistical correspondence. Academy of Management Review, 14: 423-444.
114.
Walsh, J.P. & Ungson, G.R. (1991). Organizational memory. Academy of Management Review, 16: 57-91.
Weick, K.E. (1979). The social psychology of organizing. Reading, MA: Addison-Wesley.
117.
Weick. K.E. (1987). Substitutes for strategy. Pp. 221-233 in D. Teece (Ed.), The competitive challenge: Strategies for industrial innovation. Cambridge, MA: Ballinger.
118.
Wernerfelt, B. (1984). A resource-based view of the firm. Strategic Management Journal, 5: 171-180.
119.
Woo, C.Y. (1983). Evaluation of strategies and performance of low ROI market share leaders. Strategic Management Journal, 4: 123-135.
120.
Zajac, E.J. & Shortell, SM. (1989). Changing generic strategies: Likelihood, direction, and performance implications. Strategic Management Journal, 10: 413-430.
121.
Zammuto, R.F. (1988). Organizational adaptation: Some implications of organizational ecology for strategic choice. Journal of Management Studies, 25(2): 105-120.
