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Health care administrators’ perspectives on the role of absorptive capacity for strategic change initiatives: A qualitative study

Kash, Bita A.; Spaulding, Aaron; Gamm, Larry; Johnson, Christopher E.

doi: 10.1097/HMR.0b013e318276faf8

Background: The dimensions of absorptive capacity (ACAP) are defined, and the importance of ACAP is established in the management literature, but the concept has not been applied to health care organizations attempting to implement multiple strategic initiatives.

Purpose: The aim of this study was to test the utility of ACAP by analyzing health care administrators’ experiences with multiple strategic initiatives within two health systems.

Methodology: Results are drawn from administrators’ assessments of multiple initiatives within two health systems using in-depth personal interviews with a total of 61 health care administrators. Data analysis was performed following deductive qualitative analysis guidelines. Interview transcripts were coded based on the four dimensions of ACAP: acquiring, assimilating, internalizing/transforming, and exploiting knowledge. Furthermore, we link results related to utilization of management resources, including number of key personnel involved and time consumption, to dimensions of ACAP.

Findings: Participants’ description of multiple strategic change initiatives confirmed the importance of the four ACAP dimensions. ACAP can be a useful framework to assess organizational capacity with respect to the organization’s ability to concurrently implement multiple strategic initiatives. This capacity specifically revolves around human capital requirements from upper management based on the initiatives’ location or stage within the ACAP framework.

Practice Implications: Strategic change initiatives in health care can be usefully viewed from an ACAP perspective. There is a tendency for those strategic initiatives ranking higher in priority and time consumption to reflect more advanced dimensions of ACAP (assimilate and transform), whereas few initiatives were identified in the ACAP “exploit” dimension. This may suggest that health care leaders tend to no longer identify as strategic initiatives those innovations that have moved to the exploitation stage or that less attention is given to the exploitation elements of a strategic initiative than to the earlier stages.

Bita A. Kash, PhD, MBA, FACHE, is Assistant Professor, Department of Health Policy and Management, School of Rural Public Health, Texas A&M Health Science Center, College Station, Texas. E-mail:

Aaron Spaulding, PhD, MHA, is Assistant Professor, Department of Public Health, Brooks College of Health, University of North Florida, Jacksonville, Florida. E-mail:

Larry Gamm, PhD, is Regents Professor, Health Policy and Management Director, Center for Health Organization Transformation, College Station, Texas. E-mail:

Christopher E. Johnson, PhD, is Associate Professor of Health Services, Director, Graduate Program in Health, Services Administration, Austin Ross Chair in Health Administration, Department of Health Services, School of Public Health, University of Washington, Seattle. E-mail:

This study was funded by the National Science Foundation’s Center for Health Organization Transformation’s Grant IIP-0832439.

The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article.

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved