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

Objectives: 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.

Methods: 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: 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.

Conclusions: Head physicians' leadership style as well as organizational creativity play a pivotal role in materializing ambidextrous behaviours in wards.