Healthcare in the United States is a system that, organizationally speaking, is fragmented. Each hospital facility is independently operated and is responsible for the hiring of its own employees. However, corrupt individuals can take advantage of this fragmentation and move from hospital to hospital, gaining employment while hiding previous employment history. Traditionally, hospitals have been reluctant to share information on their previous employees, even with other hospitals, for fear of issues surrounding defamation, negligent hiring, and violation of the employee's privacy. However, growth in healthcare services is expected to rise exponentially in the near future, increasing the demand for employees. The need, therefore, to exchange pertinent information regarding employees will become necessary as hospitals seek qualified employees to fill positions throughout their organizations. One way to promote this information exchange is to develop trusted information sharing networks among hospital units. This study examined the problems surrounding organizational information sharing as well as the current level of employee information sharing being conducted by hospitals nationwide. Utilizing a survey of hospital administrators, this study drew upon the theoretical foundations of the Diffusion of Innovation Theory, the Knowledge Management Theory, the Social Exchange Theory and the earlier organizational information sharing frameworks established by Dawes (1996) and Landsbergen and Wolken (1998; 2001) in order to examine the variables that contribute to propensity of hospital administrators to engage in the sharing of employee information with other organizations.

Most research on Employee Involvement (EI) has focused on large or 'mainstream' organizations. By adopting those schemes which 'appear' to work well in larger organizations, then smaller firms assume there will be enhanced employee commitment beyond formal contractual requirements. The main question in this paper is whether EI schemes designed by management will suffice under the 2004 Information and Consultation of Employees (ICE) Regulations. It focuses on SMEs which tend to favour informal and direct EI, and it remains unclear how these methods will be played out under the new regulatory environment. Evidence from four case studies is presented here and it suggests that the ICE Regulations impose new challenges for smaller firms given their tendency to provide information rather than consult with employees. It also appears organizational factors, workplace relations history and the way processes are implemented at enterprise level may be far more important than size itself.