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The goal and system resource approaches represent alternative conceptions of organizational effectiveness. The goal approach views effectiveness in terms of internal organizational objectives and performance. Organization-environment relations are the focus of the system resource approach, though previous applications of this perspective have been limited to profit-making organizations. This paper reconceptualizes the system resource approach for use in public agencies and examines the flow of organizational resources as an indicator of effectiveness.

Organizational change may be considered as analogous to scientific change. Kuhn's analysis of scientific activities as paradigm guided is applied to an organizational framework to suggest that organizational activities may be understood in the same fashion. This perspective is briefly applied to the current controversy in health care. Research attention is directed toward the use of knowledge in organizational activities and in health care in particular. [ABSTRACT FROM AUTHOR]