access, diffusion, ethics, pricing strategy,

The 1983 Tax Equity and Fiscal Responsibility Act (TEFRA) transformed acute care from a benevolent to malevolent environment. A dual-paradigm of resource dependency and institutional theories that balances isomorphic with economic variables has emerged to better explain hospital strategic response to the resultant constraint on resources than a traditional single paradigm approach. Using the population of non-rural, non-federal acute-care hospitals, strategic response from 1982 to 2001 is studied; distinct cost and service changes occur. Cost strategy is linked primarily to Medicare utilization, a resource dependence response. Service strategy favors high technology regardless of prospective payment diffusion, an institutional theory perspective. Strategic implications are discussed.

This article reflects on the intersection of traditional and information technology- (IT-) mediated education and proposes the need to develop a revised teaching pedagogy that better reflects the skills required for success in the 21st-century business environment. Building on the premise that neither a homogeneous traditional nor IT-mediated workplace is prevalent, it is argued that educational institutions should provide both traditional and IT-mediated alternatives, not simply because they make education more accessible to their students but because of workplace demands and therefore student needs for proficiency in the use of these enabling technologies. The implications of this premise are discussed in terms of communication skills, pedagogical and curricular change, tacit knowledge, and outcome measurement.

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