The primary purposes of this study were to: (a) examine the characteristics of six types of contemporary, nonprofit general hospitals; (b) analyze the extent to which environmental conditions and contextual factors determine structural-functional characters of the selected hospitals; (c) explore the relationships between selected hospital characteristics and the quality of nurses' work climate; and (d) develop a descriptive data base for future theoretical and empirical work. The conceptual framework for the study was derived from modern and contingency theories of administration and organizational behavior. A model base on contingency theory was developed to guide the study. The model suggested that the nature and organizing of health care services in acute care hospitals were to a large extent dependent upon external environmental changes and pressures.

Although the overall design of the study was descriptive and cross-sectional in nature, there were elements of comparative design since the study compared six types of acute care, nonprofit general hospitals. In addition, an embedded multiple case study design was used based on the needs to: (a) deal with multiple sources of data; (b) minimize biases of the investigator; (c) increase objectivity; and (d) focus on more than one unit of analysis. Qualitative data from case studies included: observations, records, reports, and interviews with hospital and nursing administrators (n = 18). Quantitative data on a selected group of staff nurses (n-544) were obtained through the use of a standardized instrument to measure the nurses' perceptions of the work climate in which they were employed. The quantitative data were derived from a larger research project of which this study was a part (Bailey & Chiriboga, 1984). The data were analyzed using both descriptive and statistical procedures.

The study findings indicated that substantial changes in the structural-functional characteristics have occurred in the study hospitals as a result of changing external environmental conditions. These changes have also influenced the work climate of nurses and subsequently their work attitudes and behaviors.