From an intraorganizational perspec

From an intraorganizational perspective, it is also possible to separate legitimating processes operating with respect to different organizational functions. One can imagine examinations of the legitimacy of public organizations that separate decision making by councils or legislatures from implementation activities by public agencies or contracting agents. The technical and managerial aspects of hospitals that we distinguish in our study have historically been structurally differentiated (Smith, 1955): physicians, organized as the medical staff, carry out and oversee technical activities; administrators oversee and attend to the managerial activities,

What Is the Salience of the Legitimacy Assessments?

All legitimacy assessments are not of equal importance In the case of hospitals, normative assessments by industry- wide professional associations have more salience than do regulative or cognitive assessments, at least during the post- World-War-II period. It is also clear that all constituencies do not have equal weight, and their assessments do not have equal influence. What may be less obvious is that the salience of one or another legitimacy assessment may also vary over time and place (see Dacin, 1997) In general, the more the assessments of particular constituencies tap into the beliefs and values currently dominant in the institutional environment, the more salience we would expect them to have for the organization. But this still begs the question of how salience should be operationalized. Typical performance criteria-whether defined in financial, quality, or other
terms-tend to presume the salience of one or another di- mension of legitimation and are thus useless in delineating institutional salience itself. Following past work in neoinstitutiona I and ecological theory (e.g" Hannan and Freeman, 1989; Baum and Oliver, 1992), we consider the relative impact of managerial and technical legitimacy on organizational survival as appropriate indicators of salience, given the generality of survival as a success criterion.

Legitimacy in Hospital Organizations

The foregoing review suggests the importance of crafting arguments and selecting legitimacy measures that take into account the distinctive features of the organizations under study, as well as their context. Our study focuses on the population of hospitals located in the San Francisco Bay area of northern California during the period between 1945 and 1990 and the extent to which various indicators of hospital legitimacy have affected organizational survival. We also examine the effects associated with changes over time in the institutional environments of the medical sector and organizational factors that relate to technical or managerial legitimacy, Diverse sources and targets. Hospitals operate in highly institutionalized environments that put substantial pressures on both their technical and managerial components. Parsons (1960) distinguished between three levels within organizations: (1) a technical level, which is responsible for transforming production inputs into outputs, (2) a managerial level, which administers and obtains essential resources for the technical production system, and (3) an institutional level, which relates an organization to its environment and attempts to secure its legitimacy (see also Thompson, 1967), Our usage departs somewhat from Parsons' lead in applying these distinctions: we argue that legitimation efforts by officials at the institutional level can be targeted at either the technical level or the managerial level, or both."
The securing of managerial legitimacy is closely tied to Weber's (1968) conception of legitimate authority. Managerial legitimacy involves normative support for organizational mechanisms such as personnel management, accounting practices, and the rules of conduct and structure of the ad- ministrative staff. With respect to hospitals, in particular, such legitimacy is typically conferred through oversight bodies (e.g., the American Hospital Association) that review the structure and functions of governance boards and administrator hierarchies. By contrast, technical legitimacy is focused on aspects of core technology, including normative support for staff qualifications, training programs, work procedures, and quality assurance mechanisms. In the healthcare sector, these assessments revolve around patient focused tasks, such as diagnosis, treatment, education, and continuum of care, as well as ethical standards concerning patient rights (JCAHO, 1996). More so than most organizations, hospitals have traditionally attempted to differentiate structurally, so as to separate and insulate the sphere of technical tasks, under the jurisdiction of the medical staff, from administrative tasks, under the control of managers (Smith, 1955; Goss. 1961).5

Hasil (Bahasa Indonesia) 1:

Dari perspektif intraorganizational, hal ini juga mungkin untuk memisahkan legitimating proses operasi sehubungan dengan fungsi-fungsi organisasi yang berbeda. Satu bisa membayangkan ujian legitimasi dari organisasi umum yang terpisah pengambilan keputusan oleh Dewan atau legislatif dari pelaksanaan kegiatan oleh badan publik atau kontrak agen. Aspek-aspek teknis dan manajerial rumah sakit yang kita membedakan dalam studi kami secara historis telah struktural dibedakan (Smith, 1955): dokter, disusun sebagai petugas medis, melaksanakan dan mengawasi kegiatan teknis; Administrator mengawasi dan hadir untuk kegiatan manajerial,Apakah arti-penting penilaian legitimasi?All legitimacy assessments are not of equal importance In the case of hospitals, normative assessments by industry- wide professional associations have more salience than do regulative or cognitive assessments, at least during the post- World-War-II period. It is also clear that all constituencies do not have equal weight, and their assessments do not have equal influence. What may be less obvious is that the salience of one or another legitimacy assessment may also vary over time and place (see Dacin, 1997) In general, the more the assessments of particular constituencies tap into the beliefs and values currently dominant in the institutional environment, the more salience we would expect them to have for the organization. But this still begs the question of how salience should be operationalized. Typical performance criteria-whether defined in financial, quality, or otherterms-tend to presume the salience of one or another di- mension of legitimation and are thus useless in delineating institutional salience itself. Following past work in neoinstitutiona I and ecological theory (e.g" Hannan and Freeman, 1989; Baum and Oliver, 1992), we consider the relative impact of managerial and technical legitimacy on organizational survival as appropriate indicators of salience, given the generality of survival as a success criterion.Legitimacy in Hospital OrganizationsThe foregoing review suggests the importance of crafting arguments and selecting legitimacy measures that take into account the distinctive features of the organizations under study, as well as their context. Our study focuses on the population of hospitals located in the San Francisco Bay area of northern California during the period between 1945 and 1990 and the extent to which various indicators of hospital legitimacy have affected organizational survival. We also examine the effects associated with changes over time in the institutional environments of the medical sector and organizational factors that relate to technical or managerial legitimacy, Diverse sources and targets. Hospitals operate in highly institutionalized environments that put substantial pressures on both their technical and managerial components. Parsons (1960) distinguished between three levels within organizations: (1) a technical level, which is responsible for transforming production inputs into outputs, (2) a managerial level, which administers and obtains essential resources for the technical production system, and (3) an institutional level, which relates an organization to its environment and attempts to secure its legitimacy (see also Thompson, 1967), Our usage departs somewhat from Parsons' lead in applying these distinctions: we argue that legitimation efforts by officials at the institutional level can be targeted at either the technical level or the managerial level, or both."The securing of managerial legitimacy is closely tied to Weber's (1968) conception of legitimate authority. Managerial legitimacy involves normative support for organizational mechanisms such as personnel management, accounting practices, and the rules of conduct and structure of the ad- ministrative staff. With respect to hospitals, in particular, such legitimacy is typically conferred through oversight bodies (e.g., the American Hospital Association) that review the structure and functions of governance boards and administrator hierarchies. By contrast, technical legitimacy is focused on aspects of core technology, including normative support for staff qualifications, training programs, work procedures, and quality assurance mechanisms. In the healthcare sector, these assessments revolve around patient focused tasks, such as diagnosis, treatment, education, and continuum of care, as well as ethical standards concerning patient rights (JCAHO, 1996). More so than most organizations, hospitals have traditionally attempted to differentiate structurally, so as to separate and insulate the sphere of technical tasks, under the jurisdiction of the medical staff, from administrative tasks, under the control of managers (Smith, 1955; Goss. 1961).5

Hasil (Bahasa Indonesia) 2:

Dari perspektif intraorganizational, juga memungkinkan untuk memisahkan proses operasi sehubungan dengan fungsi-fungsi organisasi yang berbeda legitimasi. Satu bisa membayangkan pemeriksaan dari legitimasi organisasi publik yang memisahkan pengambilan keputusan oleh dewan legislatif atau dari kegiatan pelaksanaan oleh lembaga publik atau agen kontrak. Aspek teknis dan manajerial rumah sakit yang kita membedakan dalam penelitian kami secara historis telah struktural dibedakan (Smith, 1955): dokter, diselenggarakan sebagai staf medis, melaksanakan dan mengawasi kegiatan teknis; administrator mengawasi dan mengurus kegiatan manajerial, Apa Apakah Arti-dari Penilaian Legitimasi? Semua penilaian legitimasi tidak sama pentingnya Dalam kasus rumah sakit, penilaian normatif oleh asosiasi profesional macam industri-memiliki lebih arti-penting daripada penilaian regulatif atau kognitif, setidaknya selama periode Dunia-Perang-II pasca. Hal ini juga jelas bahwa semua konstituen tidak memiliki bobot yang sama, dan penilaian mereka tidak memiliki pengaruh yang sama. Apa yang mungkin kurang jelas adalah bahwa arti-penting dari satu atau penilaian legitimasi lain juga dapat bervariasi dari waktu ke waktu dan tempat (lihat dacin, 1997) Secara umum, semakin banyak penilaian dari konstituen tertentu memasuki keyakinan dan nilai-nilai saat ini yang dominan di lingkungan kelembagaan , semakin arti-penting kita akan mengharapkan mereka untuk memiliki bagi organisasi. Tapi ini masih menimbulkan pertanyaan tentang bagaimana arti-penting harus dioperasionalkan. Kriteria-apakah kinerja khas didefinisikan dalam keuangan, kualitas, atau lainnya istilah-cenderung menganggap arti-penting satu atau mension di- lain legitimasi dan dengan demikian tidak berguna dalam menggambarkan arti-penting kelembagaan itu sendiri. Setelah kerja masa lalu di neoinstitutiona I dan teori ekologi (misalnya "Hannan dan Freeman, 1989; Baum dan Oliver, 1992), kami mempertimbangkan dampak relatif dari legitimasi manajerial dan teknis pada kelangsungan hidup organisasi sebagai indikator yang tepat dari arti-penting, mengingat umum hidup sebagai kriteria keberhasilan. Legitimasi dalam Organisasi Rumah Sakit The terdahulu Ulasan menunjukkan pentingnya kerajinan argumen dan memilih tindakan legitimasi yang memperhitungkan fitur khas dari organisasi yang diteliti, serta konteks mereka. Studi kami berfokus pada populasi rumah sakit yang terletak di area San Francisco Bay of California utara selama periode antara 1945 dan 1990 dan sejauh mana berbagai indikator rumah sakit legitimasi telah mempengaruhi kelangsungan hidup organisasi. Kami juga meneliti efek terkait dengan perubahan dari waktu ke waktu dalam lingkungan kelembagaan sektor medis dan organisasi faktor yang berhubungan dengan teknis atau manajerial legitimasi, sumber Beragam dan target. Rumah sakit beroperasi dalam lingkungan yang sangat melembaga yang menempatkan tekanan besar pada kedua komponen teknis dan manajerial mereka. Parsons (1960) membedakan antara tiga tingkatan dalam organisasi: (1) tingkat teknis, yang bertanggung jawab untuk mengubah input produksi menjadi output, (2) tingkat manajerial, yang mengurus dan memperoleh sumber daya penting untuk sistem produksi teknis, dan (3 ) tingkat kelembagaan, yang berhubungan organisasi dengan lingkungannya dan upaya untuk mengamankan legitimasi (lihat juga Thompson, 1967), penggunaan kami berangkat agak dari Parsons 'memimpin dalam menerapkan perbedaan ini: kami berpendapat bahwa upaya legitimasi oleh pejabat di tingkat kelembagaan dapat ditargetkan baik pada tingkat teknis atau tingkat manajerial, atau keduanya. "The mengamankan legitimasi manajerial terkait erat dengan (1968) konsepsi Weber otoritas yang sah. legitimasi Manajerial melibatkan dukungan normatif untuk mekanisme organisasi seperti manajemen personalia, praktik akuntansi , dan aturan perilaku dan struktur staf administratif. Sehubungan dengan rumah sakit, khususnya, legitimasi seperti biasanya diberikan melalui badan pengawas (misalnya, American Hospital Association) yang meninjau struktur dan fungsi dari papan pemerintahan dan administrator hirarki. Sebaliknya, legitimasi teknis difokuskan pada aspek teknologi inti, termasuk dukungan normatif untuk kualifikasi staf, program pelatihan, prosedur kerja, dan mekanisme jaminan kualitas. Di sektor kesehatan, penilaian ini berkisar pasien terfokus tugas, seperti diagnosis, pengobatan, pendidikan, dan kontinum perawatan, serta standar etika mengenai hak pasien (JCAHO, 1996). Lebih daripada kebanyakan organisasi, rumah sakit secara tradisional berusaha untuk membedakan struktural, sehingga untuk memisahkan dan melindungi lingkup tugas-tugas teknis, di bawah yurisdiksi staf medis, dari tugas-tugas administratif, di bawah kendali manajer (Smith, 1955; Goss. 1961) 0,5