How Organizational Identity Affects Hospital Performance: Comparing Predictive Power of Mission Statements and Sector Affiliation

Abstract

Organizational identity is an important concept in organizational theory, as it can contextualize the behavior of organizations and members. The literature presents divergent perspectives on organizational identity: some studies have characterized organizational identity as constrained by institutional forces, whereas others have contended it is socially constructed by organizational members. Studies have largely focused on the former perspective, measuring organizational identity by sector affiliation; the latter approach has rarely been empirically tested. Therefore, in addition to sector affiliation, this article proposes a different approach to operationalizing organizational identity by examining hospitals’ mission statements. The study also examines which of these dual forces have more predictive power regarding organizational performance. Together with hospitals’ sector affiliation, we test how the presence and frequency of mission statement language regarding access, cost, quality, or unique organizational values affect hospitals’ various performance metrics. Regression analyses with 172 acute hospitals in Florida reveal significant relationships between types of mission statement content, sectors, and performance indicators.

Keywords:

• healthcare administration
• hospital performance
• mission statement
• organizational identity
• performance measurement

Notes

Notes

1 Mortality rate is a frequently used measure of hospital performance, especially in the healthcare literature examining health care treatment outcomes (e.g., Krumholz et al., 2009; Werner & Bradlow, 2006). However, due to data accessibility, we did not use mortality rate but instead referred to patient satisfaction and readmission rate. These two variables better fit the purpose of this study given our focus on general performance management rather than the results of specific healthcare treatments.

2 HCAHPS is a national, standardized survey of hospital patients about their experiences during inpatient hospital stays. These data are accessible at https://data.medicare.gov/Hospital-Compare/Patient-survey-HCAHPS-Hospital/dgck-syfz.

3 The 30-day readmission score is based on excess readmission score, not readmission rate, which is calculated by dividing a hospital’s number of “predicted” 30-day readmissions by the number “expected” based on an average hospital with similar patients. A higher score indicates a greater likelihood of readmission.

4 When public hospitals were used as a subgroup, “premium” and “religious” were omitted because of collinearity.

Additional information

Notes on contributors

Naon Min

Naon Min is a doctoral candidate in the Askew School of Public Administration and Policy at Florida State University. Her research interests include public management, public values, public service delivery mechanism, and organizational theory. E-mail: [email protected].

Ruowen Shen

Ruowen Shen is an assistant professor at the Hugo Wall School of Public Affairs of Wichita State University. Her research interests include local governance, collaborative network, and urban sustainability. E-mail: [email protected].

David Berlan

David Berlan is an assistant professor at the Reubin O’D. Askew School of Public Administration & Policy of Florida State University. His research examines the role of ideas in organizational change. E-mail: [email protected].

Keon-Hyung Lee

Keon-Hyung Lee is professor of public administration and public health and the director of the Reubin O’D. Askew School of Public Administration & Policy at Florida State University. His research interests include health service administration, health care finance, and performance management. Email: [email protected].