Abstract
This comparative study of 12 hospitals in one SMSA was designed to investigate the organizational determinants of social, in contrast to technological, innovations. Major independent variables include: centralization of influence on hospital decision-making; relative influence of administrators, trustees, and medical staff; and social change values of decision-makers. Dependent variables are 20 recent innovations in obstetrical programs and services, labeled social or technological on the basis of judges' ratings. Study results provide substantial empirical support for the conceptual distinction between social and technological innovations and for the proposition that hospital conditions favorable to social innovation differfrom those conducive to technological innovation. Social innovations in obstetrics are most likely to prosper in hospitals where individuals with influence on hospital-wide decisions are ideologically committed to social change. Additional conditions for social innovation include an obstetrical staff who have little influence on hospital-wide decisions, affiliation with a medical school, and frequent medical staff committee meetings. It is suggested that these latter conditions act to increase the flow of communication about innovations, to support the legitimacy of social change, and to increase the influence opportunities available to the hospital's dominant group.
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