What drives hospital wards' ambidexterity: Insights on the determinants of exploration and exploitation.

Ambidexterity Change management Creativity Efficiency Exploitation Exploration Hospital Improvement Innovation Leadership Organization Organizational Support Quality Strategy

Journal

Health policy (Amsterdam, Netherlands)
ISSN: 1872-6054
Titre abrégé: Health Policy
Pays: Ireland
ID NLM: 8409431

Informations de publication

Date de publication:
12 2019
Historique:
received: 08 08 2018
revised: 09 09 2019
accepted: 08 10 2019
pubmed: 13 11 2019
medline: 17 9 2020
entrez: 13 11 2019
Statut: ppublish

Résumé

Hospital wards are required to exploit current knowledge and explore for new knowledge. Ambidexterity (i.e., the capability to combine both exploitation and exploration) is a major issue in healthcare as result of the growing expectations that hospitals wards have the capability to manage the trade-off between high-quality delivery of care and cost-containment. This study sheds novel light on the determinants of ambidextrous behaviours in hospital wards. A theoretical framework has been built on the extant literature. The main determinants of ambidexterity are opening/closing leadership, organisational support, organisational creativity and environmental dynamism. The model has been tested empirically through data collected via survey administered to head physicians in charge of hospital wards. After the quality check, 80 questionnaires were available for the statistical analysis based on a hierarchical sequential linear regression model (with enter methodology). Results showed that opening (β = 0.389;p < 0.001) and closing (β = 0.288;p < 0.01) leadership, as well as organisational creativity (β = 0.499 p < 0.001) are necessary to materialize ambidextrous behaviours (Adj.R² = 0.529). Environmental dynamism does not moderate these relationships. While opening leadership (β = 0.375;p < 0.01), organisational creativity (β = 0.270;p < 0.05) and environmental dynamism (β = 0.224;p < 0.1) are determinants of exploration, closing leadership (β = 0.506;p < 0.001) and organisational creativity (β = 0.529;p < 0.001) are determinants of exploitation. Head physicians' leadership style as well as organizational creativity play a pivotal role in materializing ambidextrous behaviours in wards.

Identifiants

pubmed: 31711631
pii: S0168-8510(18)30345-2
doi: 10.1016/j.healthpol.2019.10.004
pii:
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1298-1307

Informations de copyright

Copyright © 2019 Elsevier B.V. All rights reserved.

Auteurs

Emanuela Foglia (E)

LIUC - Università Cattaneo, Italy.

Lucrezia Ferrario (L)

LIUC - Università Cattaneo, Italy.

Emanuele Lettieri (E)

Politecnico di Milano, Italy. Electronic address: emanuele.lettieri@polimi.it.

Emanuele Porazzi (E)

LIUC - Università Cattaneo, Italy.

Luca Gastaldi (L)

Politecnico di Milano, Italy.

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