Research Article: 2024 Vol: 28 Issue: 6
Iyad Mahmoud Odeh, The World Islamic Sciences & Education University
Shaker Jaralla Alkshali, The World Islamic Sciences & Education University
Citation Information: Odeh, I.M., Alkshali, S. J., (2024). The Impact Of Strategic Agility On The Quality Of Healthcare At Jordanian Private Hospitals. International Journal of Entrepreneurship, 28(S6),1-11
This study aimed to verify the impact of strategic agility on healthcare quality in accredited Jordanian private hospitals. The study population consisted of managers in top and middle management working in 16 hospitals. The study was conducted on a sample of 164 managers. To achieve the study objectives, simple and multiple regression coefficients were used through the SPSS program. The study concluded that there is a moderate level of practicing strategic agility, and there is a high level of healthcare quality in these hospitals. The study results showed that there is a significant impact of strategic agility on healthcare quality and that strategic agility has a significant impact on each dimension of healthcare quality. The study presented a set of recommendations, including increasing the attention of the administrations of accredited hospitals to the fluidity of resource to provide what employees need to perform their tasks, as well as disseminating the hospital's vision among employees to ensure its understanding and contribute to achieving it and enhancing the management's interest in facilitating healthcare provision procedures
Strategic agility, healthcare quality, strategic sensitivity, healthcare continuity, private hospitals, Jordan.
In today's developments and changes in the business environment flexible modern management methods such as strategic agility, this concept has occupied an important position in contemporary organizations, especially the health sector, and has become a necessity, not an option or an intellectual luxury. In addition to its role in improving the quality of healthcare, achieving close alignment between strategic agility and quality of healthcare improves the health system and medical practices according to scientific methodology, responsiveness, and interaction with developments and responses to beneficiaries' needs and desires.
The significant development of contemporary organizations requires them to adopt strategies such as strategic agility by employing the organizations' ability to exploit opportunities for their survival. To this end, executives must play an active role and promote teamwork, as well as the use of resources in a meaningful, quick, and intelligent manner (Doz & Kosonen, 2007). Organizations must have the flexibility and ability to adapt and capture opportunities faster than competitors (Doz & Kosonen, 2010).
Quality is an essential feature of customer satisfaction by meeting their needs and expectations. Juran considers that three management processes for quality achievement are called Juran's triangle, and include: quality planning, quality control, and quality improvement (Juran et al., 1999, 26.30). The quality of healthcare is an indispensable basis in technological development and automation, which has made directing energies through integrated systems and adopting modern strategies that keep pace with challenges and developments. The world will see a revolution in the quality of healthcare (Juran et al., 1999, 960-961). Based on the above, this study aims to identify the impact of strategic agility on the quality of health care at Jordanian private hospitals.
Study problem and questions
The problem with the study is to highlight the quality of healthcare in terms of healthcare safety, healthcare continuity, healthcare timeliness, healthcare appropriateness, and healthcare accessibility in Jordanian accredited private hospitals, the extent to which strategic agility in terms of strategic sensitivity, vision clarity, unity of leadership and resource fluidity can be played in achieving the quality of healthcare at Jordanian private hospitals.
Private hospitals face intense competition, challenges, volatility, and changes that require quality healthcare, and adopting a strategic agility strategy will enable these hospitals to acquire competitive capabilities that will enable them to survive and continue under market variables and meet patients' needs and satisfaction. The quality of healthcare is one of these hospitals' biggest concerns. In a dynamic and highly competitive environment, hospitals strive to achieve the best standards of excellence to preserve their entity. The problem of studying is based on the following questions:
1. What is the impact of strategic agility on the quality of healthcare at Jordanian private hospitals?
2. What is the relative importance of strategic agility and its dimensions (strategic sensitivity, vision clarity, unity of leadership, and resource fluidity) at Jordanian private hospitals?
3. What is the importance level of healthcare quality and its dimensions (healthcare safety, healthcare continuity, healthcare timeliness, healthcare appropriateness, and healthcare accessibility) at Jordanian private hospitals?
Study Importance
The importance of the study is to highlight the impact of strategic agility on the quality of healthcare in private Jordanian hospitals. Through this, the importance of the study can be divided into two parts:
- Scientific importance: The scientific importance of this study is highlighted by knowing the nature of the relationship between the study variables, which are strategic agility and the quality of healthcare. Its importance also stems from clarifying the dimensions of strategic agility (strategic sensitivity, vision clarity, unity of leadership, and resource fluidity) as well as the dimensions of healthcare quality (healthcare safety, healthcare continuity, healthcare timeliness, healthcare appropriateness, and healthcare accessibility) at Jordanian private hospitals.
The researchers noticed, through reviewing previous studies related to the subject, the scarcity of studies that linked the study variables (strategic agility and healthcare quality ), especially in the Arab environment. Therefore, the researchers hope that this study will be a qualitative addition that works to enrich knowledge in the field of its variables and contribute to filling some of the gaps in the Arab library in this field, in addition to providing a theoretical framework for the most important aspects related to these concepts.
- Practical importance: The importance of the study emerges from the importance of the society to which it will be applied, which is Jordanian private hospitals, and the study will seek to investigate the level of interest in strategic agility and its impact on the quality of healthcare in Jordanian private hospitals, to reach results and provide some recommendations for improvement and addressing deficiencies. Jordanian private hospitals are considered among the leading organizations in Jordan and neighboring countries in providing an integrated series of high-quality health services and contributing to achieving patient satisfaction. The researchers hope that this study and the results that were reached will be a reference for decision-makers from administrations to evaluate the level of quality of health care and the impact of strategic agility and its reflection in achieving the goals of these hospitals, through the recommendations that will be presented to decision-makers in them.
Study Objectives
1. Identify the impact of strategic agility with its dimensions (strategic sensitivity, vision clarity, unity of leadership, and resource fluidity) on the quality of healthcare with its dimensions (healthcare safety, healthcare continuity, healthcare timeliness, healthcare appropriateness, and healthcare accessibility) at Jordanian private hospitals.
2. Identify the importance level of strategic agility and its dimensions (strategic sensitivity, vision clarity, unity of leadership, and resource fluidity) at Jordanian private hospitals.
3. Identify the importance level of healthcare quality and its dimensions (healthcare safety, healthcare continuity, healthcare timeliness, healthcare appropriateness, and healthcare accessibility) at Jordanian private hospitals.
Strategic Agility
Contemporary organizations live with a range of challenges, volatility, and changes, such as political, economic, and technological challenges, the ceiling of expectations, and customer orientations. This has made organizations take proactive and swift action by adopting strategic agility approaches to adapt to the changing environment and to achieve survival and objectives (Hameed et al., 2022).
There are multiple definitions of agility in the literature review, but all of them pose to the organizations' ability to deal with unpredictable environmental changes, such as changing customer, market, and competition requirements. The organization must have speed, responsiveness, and flexibility to gain useful capabilities (Sahid et al., 2021, 71.73, 90). Strategic agility can be seen as a thoughtful and meaningful interaction, with three dimensions: strategic sensitivity, unity of leadership, and resource fluidity (Doz & Kokosen, 2010). Strategic agility requires insight and flexibility in entrepreneurship, operational excellence, and strategic toughness, as well as the organization's ability to create value, survival, and strategic needs through its flexibility to cope with changes, developments, and competition and to adjust strategic direction to developments (Doz & Kokosen, 2008).
Strategic agility refers to the organization's ability to take proactive and preventive steps before events occur to enable it to outperform its competitors (Al-Shanti & Jayar, 2021). Rossan and Al-Momani (2022) also know the strategic agility of the organization's follow-up to changes in the business environment and its ability to adapt its strategy to these changes, capture opportunities and avoid threats.
Aldabet (2022) considers strategic agility to be the organization's ability to be flexible and agile by adjusting its strategic path in response to developments and changes in the volatile business environment, working to capture opportunities and avoid threats. Zahrani (2022) defines it as one of the concepts of modern management that brings success, survival, and excellence to the organization in a volatile business environment and supports sudden change by taking advantage of opportunities.
Strategic agility represents the organization's ability to have a clear vision, make timeliness and effective decisions because of its vigilance, flexibility, sensing, and speed, work to allocate the necessary resources, adapt and respond quickly to the changes surrounding its environment, capture opportunities to meet its customers' renewed needs, achieve its objectives, and develop these strategic directions to ensure their survival and excellence (Abdulwahab et al. 2024).
Strategic agility dimensions
Tenggono et al. (2024); Doz (2020); Alshawabkeh (2024); Zahrani (2022); Al-Marri and Al-Bashabsha (2020) agree on strategic agility dimensions: unity of leadership, strategic sensitivity, resource fluidity, adds both; Amini and Rahmani (2023), Rusan and Al- Momani (2022); the following dimensions of strategic agility are: vision clarity, identification of strategic objectives, while in this study the following dimensions will be addressed: strategic sensitivity, vision clarity, unity of leadership, and resource fluidity.
1. Strategic sensitivity: Openness, foresight, intelligence, innovation, and sensing means a great deal of information. The main capabilities that shape strategic sensitivity are internal dialogue between the parties, consisting of two components: enrichment, conceptual diversity, and cognitive diversity, open strategic processes that include strategic cooperation and practical experience, high strategic vigilance and flexibility of vision, contradictory objectives and openness to the future vision (Doz, 2020). It is also known for being able to open up a great deal of information and data to capture opportunities and avoid threats in the light of the organization's resources, capabilities, and capabilities (Al-Marri and Al-Shabshah, 2020).
2. Vision clarity: Vision defines the mental image, ambitions, and perceptions that organizations seek in the future (Dora and Jaradat, 2014, 91). It is a desirable and attractive vision of the future and constitutes the goal and destination to be reached, and requires a concerted effort and work together to achieve it (Al Kaabi, 2018, 259). The vision has several characteristics for its formulation: defines the direction of the organization, is abbreviated, does not care about numbers, is easy to understand, has some kind of challenge and enthusiasm, but is applicable, concrete, ambitious, and comprehensive, defines the organization's direction and creates unity of purpose (Goetch & Davis, 2016, 35).
Vision clarity represents the ambition and future direction based on the analysis of the internal and external environment (Al-Shanti and Aljaiar, 2021). As Al-rossan and Almomni (2022) know, the future forecasting process is realistic based on opportunities.
3. Unity of leadership: Leadership is the ability to formulate a worthwhile vision and the commitment of individuals to it with enthusiasm and motivation to achieve the desired goals. Successful leadership has several characteristics, including unanimous, convincing, and positive influence, positive and persistent example, acceptance of criticism, ability to overcome resistance, and effective communication (Goetch & Davis, 2016, 118-119). Leadership is also aware of the ability to guide the light of a clear strategic vision, keep pace with changes, guide efforts, motivate workers, and overcome challenges to achieve a specific goal (HCAC, 2020, 394).
Unity of leadership refers to the speed and audacity of decision-making and commitment away from the policy of winning and losing (Doz, 2020). These quick decisions are made in the light of understanding the strategic situation and options available and setting aside any personal dimensions or special differences (Doz & Kosonen 2008).
4. Resource fluidity: Resources are defined by the organization's human resources assets from the experience, skills, and talents of workers and non-human resources as material, financial, information, and technological resources (Dora & Jaradat, 2014, 557).
Resource fluidity is the ability to have flexibility and the possibility of transferring resources from one location to another when needed (Al Marri & Al Bashabsha, 2020). Also known as the rapid distribution of resources and the ability to reshape competencies and capabilities (Doz, 2020).
Quality of Healthcare
Quality of healthcare is a prerequisite and must be applied because it is linked to patients' safety, especially with developments in the health sector. Quality is defined as doing the right thing, in the right way, at the right time, and for the right person to obtain the best outcomes (Jardali et al., 2008, 13, 20). Quality is characterized by a dynamic situation that contributes to meeting and exceeding expectations and achieving added value, not only in products and services but also in processes, individuals, and the environment (Goetsh & Davis, 2016, 3). Quality is a proactive and continuous effort to know the customer's expectations conforming to standards and specifications, and taking corrective action in case of non-conformity (Alassaf & Akgun, 2009, 1).
Healthcare represents the degree of customer satisfaction achieved through the conformity of the service with the standards. It is the superior care and care received by the recipient of the service by the appropriate provider, in the appropriate place and the appropriate manner (Ross, 2014.6,9). It is also known to provide healthcare to high-level patients through the application of health standards, to meet the patient's requirements and provide comfort and access to the desired results, and is characterized by continuity care (Hussein & Aboudi, 2021). There are also various services provided by hospitals and health centers to deal with all patients and their health problems and work to treat them and provide them with the right advice and guidance (Al-Qarni, 2023).
Quality of health care is the degree of care provided to people which contributes to the achievement of the desired results according to current professional knowledge and has several dimensions: issues of patient perspective, safety of care environment, adequacy and accessibility of health care, continuity, effectiveness, efficiency and timely delivery (JCI, 2025, 2-4). It is also known as those standards and means adopted by the health sector to develop the level of health care and raise the satisfaction of service recipients (Al-Qarni, 2023).
To achieve healthcare quality, ISQua adopts healthcare standards and quality and works to rehabilitate accredited residents. In turn, ISQ grants accreditation to international organizations, which in turn grants accreditation to hospitals and health centers if they apply healthcare standards (HCAC, 2020).
Dimensions of Healthcare Quality
1. Healthcare safety: Providing care with technical performance by employing scientific medical knowledge and technology, correct diagnosis, correct and appropriate treatment of the patient situation, and high skill, without mistakes (Nash et al., 2019, 10). Healthcare safety is defined as ensuring that no harm, illness, or injury is caused by a particular operation, taking a particular medication or service, whether intentional or unexpected and working to avoid potential risks (HCAC, 2020, 400).
2. Healthcare continuity: Healthcare continuity is defined by the extent of coordination between services and healthcare for service recipients and service providers (HCAC, 2020, 389). It is also known for the continuous provision of services and healthcare through the design and implementation of hospital operations to ensure their continuity and in coordination with health service providers, representing the degree of care provided to patients through the health staff over time (JCI, 2025, 29, 388).
3. Healthcare timeliness: Implementation of performance required within the specified time frame to achieve effectiveness and satisfaction of the customer (Ross, 2014.7). It is defined as the time required for recipients to receive the necessary care and enjoy the speed, i.e. the balance between the quality of care and the speed of care (Nash et al., 2019, 10).
4. Healthcare appropriateness: The appropriateness of healthcare is defined by the compatibility and relevance of the service to the patient's needs provided by modern best practices (HCAC, 2020, 387). Also known as doing the right thing to achieve the best results (AC, 2019, 4).
5. Healthcare accessibility: accessibility to healthcare is defined as providing timely and fair services (AC, 2019, 4). It is known that patients have access to the required service when they need it and on time (HCAC, 2019, 387).
Relationship between strategic agility and quality of healthcare
In the Al-Otaibi study (2022), the results showed a positive, strong, and dismissive correlation between organizational agility in its dimensions (sensing agility, decision-making agility, and application agility) and improved career quality in its dimensions (improving employee performance, improving job functions and improving the functional climate) in government hospitals. Another study by Ozkan and Salepcioglu (2022) showed a positive impact of organizational agility in sustainable quality management and the mediating role of innovation in interpreting that impact. The Nafei study (2016) showed a high correlation between organizational agility in its dimensions (agility of decision-making, agility, sensing agility) and quality of working life in Egyptian commercial banks. In the same vein, the Lowry and Wilson study (2016) noted a positive impact between the agility of information technology in its dimensions (information agility, strategy agility, system agility) and the quality of information technology service in its dimensions (concrete, reliability, response, assurance, empathy).
Study Hypotheses
H1: There is a statistically significant impact of strategic agility on the quality of healthcare at Jordanian private hospitals.
H2: There is a statistically significant impact of strategic agility on the safety of healthcare at Jordanian private hospitals.
H3: There is a statistically significant impact of strategic agility on the continuity of healthcare at Jordanian private hospitals.
H4: There is a statistically significant impact of strategic agility on the timeliness of healthcare at Jordanian private hospitals.
H5: There is a statistically significant impact of strategic agility on the appropriateness of healthcare at Jordanian private hospitals.
H6: There is a statistically significant impact of strategic agility on the accessibility of healthcare at Jordanian private hospitals.
Sampling
The current study population of leadership is at 16 accredited private Jordanian hospitals. The researcher adopted the prorated random stratified sample method to determine the sample from the study population, where the size of each hospital sample is commensurate with the size of the population sample as a whole, and therefore the size of the population-representative sample of 164 from the managers and middle management.
Study Tool
The study relied on the identification in this study as appropriate and included the identification in three parts, as follows:
Part I: This part includes the personal and functional characteristics of the study sample individuals and includes (sex, age, education, experience, and job title).
Part II: This section contains items that measured the independent study variable's strategic agility in its dimensions (strategic sensitivity, vision clarity, unity of leadership, and resource fluidity), the number of which is 20.
Part III: This part includes items measuring the quality of healthcare in its dimensions (healthcare safety, healthcare continuity, healthcare timeliness, healthcare appropriateness, and healthcare accessibility), the number of which is 25.
It is noted from Table 1 that all Cronbach alpha values for the items of the dimensions of strategic agility and the quality of healthcare enjoy internal consistency, as they all exceeded 0.70, which indicates the quality of the study data. The mean for all items of the dimensions of strategic agility was at average levels, the highest for unity of leadership with a mean of 0.61 and a standard deviation of 0.89, and the lowest for resource fluidity with a mean of 0.47 and a standard deviation of 0.84.
| Table 1 Descriptive Statistics | ||||
| Std. deviation | Mean | Alpha | Items | Dimension |
| 0.86 | 3.48 | 0.91 | 5 | Strategic sensitivity |
| 0.92 | 3.53 | 0.91 | 5 | Vision clarity |
| 0.89 | 3.61 | 0.9 | 5 | Unity of leadership |
| 0.84 | 3.47 | 0.91 | 5 | Resource fluidity |
| 0.76 | 4.03 | 0.92 | 5 | Healthcare safety |
| 0.85 | 3.79 | 0.92 | 5 | Healthcare continuity |
| 0.85 | 3.72 | 0.92 | 5 | Healthcare timeliness |
| 0.79 | 3.94 | 0.92 | 5 | Healthcare appropriateness |
| 0.83 | 3.71 | 0.92 | 5 | Healthcare accessibility |
The multiple linear regression coefficient was used to test H1, which is related to the impact of strategic agility on the quality of health care. Table 2 shows the results of the hypothesis test. The results showed that there is a significant impact of strategic agility on the quality of healthcare, as R2=0.76. This means that the variance in the quality of healthcare in Jordanian private hospitals is due to strategic agility by 76%, and F=126.32 with a significance level of Sig.=0.000. As for the dimensions of strategic agility in the same table, the results indicated that all of them were significant with a significance level less than 0.05.
| Table 2 Impact of Strategic Agility on Healthcare Quality | |||
| Variable | B | T | Sig. |
| Strategic sensitivity | -0.15 | -1.98 | 0.049 |
| Vision clarity | 0.32 | 3.95 | 0 |
| Unity of leadership | 0.31 | 4.02 | 0 |
| Resource fluidity | 0.31 | 4.54 | 0 |
| R2 =0.76 | F=126.32 | Sig.=0.000 | |
Table 3 presents the results of testing H2, H3, H4, H5, and H6 regarding the impact of strategic agility on each dimension of healthcare quality: healthcare safety, healthcare continuity, healthcare timeliness, healthcare appropriateness, and healthcare accessibility. These hypotheses were tested using a simple linear regression coefficient, and the results indicated that there is a significant impact of strategic agility on each dimension of healthcare quality with an interpretation percentage of 0.64, 0.69, 0.63, 0.62, and 0.61, respectively, at a significance level of 0.000.
| Table 3 Impact of Strategic Agility on Healthcare Safety, Healthcare Continuity, Healthcare Timeliness, Healthcare Appropriateness, and Healthcare Accessibility | ||||
| Hypothesis | r2 | b | f | Sig. |
| H2 | 0.64 | 0.74 | 287.52 | 0 |
| H3 | 0. 69 | 0.86 | 363.89 | 0 |
| H4 | 0.63 | 0.82 | 272.6 | 0 |
| H5 | 0.62 | 0.76 | 259.12 | 0 |
| H6 | 0.61 | 0.79 | 257.87 | 0 |
This study focused on investigating the impact of strategic agility on the quality of healthcare in accredited Jordanian private hospitals. The results of the study showed that there are moderate levels of practicing strategic agility by the administrations of these hospitals. Hospitals can predict future needs, have a vision that guides them when making decisions, and have the ability to implement strategic plans approved by senior management. They also have sufficient flexibility to allocate resources according to their needs.
The results showed that there are high levels of healthcare quality in the hospitals under study. Hospitals rely on modern technologies to examine patients and follow up on their health status until they reach a state of recovery, and patients receive healthcare according to easy procedures, from a qualified medical team with the provision of sufficient facilities to obtain healthcare.
Study results indicated that there is a significant impact of strategic agility on healthcare quality in accredited Jordanian private hospitals. Having sufficient flexibility in hospitals to respond to changes in the environment, having appropriate coordination between different departments, and management encouraging employee initiatives help provide a safe work environment for service recipients, provide timely healthcare, and obtain appropriate treatment. This result is consistent with the findings of Ozkan and Salepcioglu (2022) which showed the impact of organizational agility on sustainable quality management.
Study results showed that there is a significant impact of strategic agility in all dimensions of healthcare. The fact that hospitals have sensor systems that enable them to provide the necessary information, employees understand the vision of these institutions, and the ability of their departments to deal with challenges, all of this reflected in a significant way in providing healthcare in the required manner and ensuring communication between healthcare providers in the hospital, ensuring speed in providing healthcare and patients receiving appropriate treatment for their conditions, in light of the existence of smooth procedures to benefit from the healthcare provided by the hospital.
The researchers recommend the following for accredited Jordanian private hospitals:
• Increase hospital administrations' interest in resource fluidity by identifying the resources needed by each department in the hospital, promoting a culture of optimal use of resources by employees, facilitating the procedures for transferring resource from one department to another, and facilitating employees' access to the resources they need easily.
• Increase hospitals' interest in strategic sensitivity by having a special administrative unit that acts as a sensor to collect information and provide predictions of what will happen in the future in the sector to develop work.
• Increase interest in disseminating the hospital's vision to all employees to make it clearer and more understandable to them, which enables them to contribute to achieving it.
• Encourage managers to make bold decisions after clarifying the goals to be achieved, in addition to implementing the strategic plans that have been approved by senior management, as well as encouraging employees to submit initiatives to improve healthcare quality.
• Enhance management's interest in facilitating healthcare provision procedures by reviewing these procedures and making amendments to them, which helps in providing healthcare at the appropriate time and speed.
• Enhancing healthcare continuity provision by providing a sufficient number of service providers and paying attention to solving their problems.
• Encouraging private hospitals in Jordan to adopt a strategic culture of agility through training programs covering all levels of management and staff, to enhance the Organization's ability to adapt to changes quickly and effectively.
• Encourage innovation at the administrative and medical levels by providing incentives to staff and developing in-house programs to support new ideas that can contribute to improving the quality of healthcare.
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