In this study, the key technology and nurse management decisions made by US hospitals in response to market needs were identified. It has been shown that technology implementation places a strong demand on nurse staff competency. While new strategic information systems are emerging, hospitals must provide on-the-job technological training for their nursing staffs. Of course, technology is not a cure-all; rather, it is a tool that can be used by skilled nurse professionals in transforming sick patients into well patients with reasonable efficiency. The causal relationships between technology, nurse management decisions and performance established in this study are an important addition to the healthcare services literature. The results of our study also show that given the size constraint, large hospitals tend to invest more in equipment and technology for providing technology related services as compared to smaller hospitals. On the other hand, small rural hospitals tend to place more emphasis on staff development than their counterparts in urban areas. #