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The University Journal Volume 5 Issue 1 2022 ISSN: 2519 – 0997 (Print)
Organizational Agility Capabilities and Sustainable Competitive
Advantage in Private Multi-Practice Hospitals in Kenya
John Ngeche* and Veronicah Kaluyu
United States International University-Africa, Nairobi, Kenya
*Corresponding Author’s Email: jhngeche@gmail.com
Abstract
This study’s purpose was to explore the relationship between organizational agility and sustained
competitive advantage among Kenyan Private Multi-Practice Hospitals (PMPHs). The study was
driven by positivism philosophy and used a descriptive correlational research design. The target
population included 690 managers from 46 private level 5 hospitals in Kenya from which a sample of
253 managers was obtained using stratified simple random sampling technique. To gather data, a
standardized questionnaire was administered. The collected data were analysed using descriptive
statistics (means, percentages, frequencies and standard deviations) and structural equation modelling.
The findings from the study established that organizational agility of the PMPHs in Kenya had a
significant positive effect on their sustained competitive advantage (β= 0.556, CR = 5.158, p <0.05).
There are implications from the study findings for Kenya's private hospital administration to enhance
the organizational agility capabilities of their hospitals such as sensing capabilities, leveraging
capabilities and reconfiguration capabilities, as an avenue to effectively, and efficiently respond to the
complex and dynamic external environment.
Keywords: Kenya, Organizational Agility Capabilities, PMPHs, Sustainable Competitive Advantage
Introduction
In today's complex and dynamic operating environment, coupled with cut-throat competition,
the key to organizational success is attaining and sustaining a competitive advantage (Zuñiga-
Collazos et al., 2019). Sustainable competitive advantage consists of a company's capabilities
and resources that are difficult for competitors to replicate, hence providing a greater long-term
advantage (Prabowo et al., 2021). This long-term advantage may be impacted by generic
strategies, according to Porter (1985). In addition, Hoffman (2000) and Barney (2002) claimed
that the value, imitability, scarcity and organization of a firm's resources are the primary factors
of realizing and retaining competitive advantage (Cardeal & Antonio, 2012). Whether internal
or external forces are seen as the source of competitive advantage, many schools of thought
have emerged (Barney, 2002; Singh et al., 2018). Some researchers like Barney, 1997) and
Torres et al. (2018) have conceptualized sustainable competitive advantage from a market-
based approach, which sees it as being driven by external variables, whilst others, such as
Bharadwaj et al. (1993) and Li et al. (2021), view it from a resource-based model, hence
attributing its effect to internal organizational elements. Mahdi and Nassar (2021) note that this
divergence in schools of thinking exacerbates the conundrum of precisely what defines a
strategy that enables a business to attain and maintain a competitive advantage.
Cite: Ngeche, J., & Kaluyu, V. (2022). Organizational Agility Capabilities and Sustainable
Competitive Advantage in Private Multi-Practice Hospitals in Kenyya. The University
Journal, 5(1), 179-194.
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Ngeche & Kaluyu Organizational Agility Capabilities and Sustainable …
According to various authors, sustained competitive advantage is a prerequisite to survive in
this tumultuous environment (Longo et al., 2019; Singh et al., 2020). However, the
contemporary dynamic environment imposes limits on the deep-rooted strategic planning and
strategy formulation procedures, which are characterized by lengthy study and precise
preparation (Sousa, 2010). The hypercompetitive climate has compelled businesses to seek
new sources of competitive advantage in a decreasing amount of time (Baskarada & Koronios,
2018). Identified opportunities are unexpected and fleeting (Eisenhardt & Bingham, 2017),
which necessitates agility and speed (Appelbaum et al., 2017) since the best plans are
ineffective if they take too long to implement (Glassman et al., 2015). Thus, Mazzoni et al.
(2021) note that organizational adaptability, is crucial for achieving and maintaining a
competitive edge in an environment of complexity, dynamism and cutthroat competition.
Organizational agility is an organization’s capability to efficiently and effectively respond to
the environmental changes (Hossain et al., 2021). Agility is achieved by reconfiguring ones
underlying bases to value create, protect and capture higher yield activities (Teece, Peteratd, &
Leih, 2016). Organizational agility is increasingly being realized as paramount to achieving
and sustaining competitive advantage (Baskarada & Koronios, 2018; Zitkiene & Deksnys,
2018). This realization is fuelled by an acknowledgement that organizations are generally
aligned for internal efficiency rather than agility. In such cases, the organizational processes
and structures that traditionally navigated them are no longer fit in the current highly dynamic
environment (Kotter, 2014). Organizational agility commits to bridge the inertia gap between
organizational addictiveness speed and the environmental volatility speed (Wischnevsky,
2004) and enhances the pursuit of gaining and sustaining competitive advantage (Baskarada &
Koronios, 2018; Zitkiene & Deksnys, 2018).
How organizations develop and successfully integrate organizational agility capabilities into
their activities remains paramount to sustaining their competitive advantage (Schuiling, 2014;
Sune & Gibb, 2015; Yang & Liu, 2012). There is dearth of literature on how organizations
integrate agility capabilities into their activities. Moreover, there has not been sufficient or
consistent literature in management on the integration of organizational agility capabilities
(Singh, Sharma, Hill, & Schnackenberg, 2013). Equally, Appelbaum et al. (2017) noted that
most studies seeking to address the concept organizational agility have focused on its
characteristics rather than the underpinning organizational capabilities. Further, there lacks a
scholarly general consensus in the extant literature on the principal dynamic capabilities
underpinning the organizational agility as well as on its exact constructs (Baskarada &
Koronios, 2018).
To attain the required levels of agility, an organization must develop its pool of dynamic
capabilities so as to cope with the deep uncertainty by enhancing its ability to respond promptly
(Eisenhardt & Martin, 2000; Pereira et al., 2018; Sune & Gibb, 2015). In a plausible extension
to this view, Worley et al. (2014) added that, agility is the ability to establish, as a repeatable
organizational resource, the capability to undertake prompt, effective and sustained
organizational change. These effects of agility are supported by dynamic capabilities rationale
as an organization ability to expeditiously integrate and reconfigure resources to align to the
changing environment to attain and sustain competitive advantage (Teece, 2007). Besides,
Baskarada and Koronios (2018) observe that the dynamic capabilities view seeks to describe
agility by concentrating on the second order capabilities that enable an organization to adapt
its resources.
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Statement of the Problem
The volatility, disruptions and complexity in the economic environment has adversely affected
the healthcare industry in Kenya, as hospitals face stiff competition within their business
ecosystem (Siciliani & Straume, 2019). Approximately 10,000 Kenyans travel abroad
annually, predominantly to India and Thailand, for medical treatment despite the country
offering 90 percent of the procedures because of patient apprehension of the local healthcare
quality and high costs (Mutisya, 2020; Netherlands Enterprise Agency, 2016). This indicates
that Kenyan healthcare system is not competitive in comparison with the healthcare systems of
other emerging nations. The Kenyan healthcare system comprise of the private and public
sectors, with the public sector majorly incorporating mostly government-controlled or owned
organizations. The private healthcare sector is made up of commercial or for-profit, non-
governmental organization (NGO) and the faith-based organization (FBO) (Muga et al., 1999;
NEA, 2016). All the healthcare facilities in the country are subdivided into six tiers based on
the amenities and services that they provide. According to Kenya Medical Practitioners and
Dentists Council (KMPDC, 2021), level one is the lowest and incorporates healthcare
organizations that provides the fewest services, whereas level six has the most. Besides, Mariita
(2019) notes that government referral hospitals make up Level 6. KMPDC (2021) observe that
Level five is the most competitive and sophisticated for the private sector, with 42 private and
four public health care facilities. However, in 2022 level 6 was split into 6A and 6B, where
eight of level 5 hospitals that had specialised facilities became 6B and the 2 Level 6B
government hospitals plus an addition of 2 others became level 6A (KMPDC, 2022). Hence
level 5 in this paper also includes level 6B.
Singh et al. (2020) opine that the disruption and competition in the healthcare sector has
affected the private multi-practice hospitals (PMPHs) in Kenya. These hospitals are
experiencing fierce competition from a variety of sources, and just having a multispecialty
offering is not enough (Cooper et al., 2011). This failure to respond to and manage the changes
has resulted in a loss of trust among stakeholders and patients due to poor performance, leading
to patient loss to rivals, and the threat of bankruptcy (Agwunobi & Osborne, 2016; Singh et
al., 2020). As a result of their failure to meet rising health-care needs, hospitals are fighting to
overcome increased competition (Gudwani et al., 2012). In Kenya, a study by the Kenya
Healthcare Federation (KHF, 2018) established that, despite having highly specialized
equipment, the healthcare system faces challenges such as healthcare financing challenges,
insufficient personnel for task completion, as well as ineffective processes all of which directly
impede their ability to achieve long-term competitive advantage.
This study thus sought to address the contextual gap of failure or reduced ability of local private
multi-practices hospitals in Kenya to attract patients seeking health care outside the country as
well as to the local competitors eating into their market share. The findings of the study can be
used not only to enhance the perception of PMPHs as the preferred health care service providers
in their areas of excellence, but to increase their visibility and to position them for superior
performance in an increasingly competitive and globalized market, and in essence enhance
their ability to sustain their competitive advantage. Earlier studies have resoundingly affirmed
that the principal approach in addressing this advancing competition is to develop SCA (Longo
et al., 2019; Porter & Lee, 2013; Shaygan, 2018). It hence becomes vital for PMPHs to be
vigilant so as to bolster their capabilities to overcome threats or seize opportunities brought
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about by the changes in the healthcare environment (Shaygan, 2018) and to sustain their
competitive advantage.
However, there remains a deficit of empirical studies on the future direction of sustainability
in the healthcare sector (Rodríguez et al., 2019). Additionally, with the heightened volatility
extant literature is void on the current sources of sustained competitive advantage (Singh et al.,
2020; Van de Ven et al., 2013). Thus, the study built on the previous work of Singh et al.,
(2020) that sort to identify sources of sustained competitive advantage in a dynamic
environment of hospitals with several medical specialities. In its findings there was emphasis
on technology advancement, dynamism and environmental adaptability. However, the study
offered insight in the context of India and hence it would be a rich source in understanding the
Kenyan context, which faces similar challenges. The following hypothesis is thus developed:
H0: Organizational agility capabilities have no significant influence on sustainable
competitive advantage among PMPHs in Kenya.
Literature Review
Theoretical Review
This study was based on the dynamic capabilities (DC) theory by Teece et al., (1997), which
states that the environment is dynamic and competitive, and that companies who are unable to
alter their capabilities in response to this are doomed to fail. The theory arose in reaction to the
shortcomings of the RBV theory, which failed to conceptualize resources as not only existing,
but also having the capacity to be developed and reconfigured (Galvin et al., 2014).The theory
outlines how organizations mix, develop, and reconfigure both internal and external
organization specific abilities into new competences that are aligned with their dynamic
environment (Teece et al., 1997). An organization's existing physical and intangible positions
and resource bases, which create organizational processes, are established by the organization's
experience and former pathways. It uses its ability to discover and capitalize on opportunities,
ultimately enhancing them (Winter, 2013). These capabilities include organizational agility
capabilities such as sensing capabilities, leveraging capabilities, and reconfiguration
capabilitiesthat enable the organization to attain a strategic fit with the dynamic environment
(Karman & Savanevičienė, 2020). It is these new capabilities that can enable an organization
create new paths, positions and resource pools which may lead to sustained competitive
advantage (Miles, 2012).
Empirical Review
Increased environmental volatility has rendered traditional bureaucratic processes, structures
and planned episodic change programs to be unfit in the pursuit of competitive advantage
(Appelbaum et al., 2017). The new norm calls for a more agile organization with sensing
capabilities that align with speed to the changing forces of the environment. Chen (2019)
empirically tested how sensing capabilities are achieved and how in turn they can enhance an
organization’s competitive advantage. The results established that sensing capabilities in the
supply chain had a positive impact on competitive advantage. These findings were in line with
Arif et al. (2008), Panayides and Lun (2009) and Swafford et al. (2008) that supply chain
sensing capabilities will enhance an organization’s competitive advantage. A similar study by
Battour et al., (2021) investigated the impact of sensing capabilities on sustained competitive
advantage in the context of large and medium sized organizations. The findings showed that
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there was a significant direct effect of strategic agility capability of sensing on sustained
competitive advantage.
Several scholars have articulated the importance of strategic agility aspect of sensing in
enabling organizations to respond soundly to the turbulent environmental conditions (Nejatian
et al., 2019; Vecchiato, 2015; Yildiz & Aykanat, 2021). Sensing as a strategic agility is an
organization constant ability to detect changes in its environment and effectively adapt the flow
of action so as to sustain its competitive advantage (Weber & Tarba, 2014). In line with these
views, Battour et al. (2021) investigated the impact of sensing as a strategic agility on sustained
competitive advantage in the context of large and medium sized organizations. The findings
showed that there was a significant direct effect of sensing strategic agility on sustained
competitive advantage. These findings were in line with several previous studies (Ahmad,
2015a; Al-Sa’adi et al., 2017; Baskarada & Koronios, 2018) that supported this outcome.
Hyper-competitive markets brought about by turbulent environments and market complexities
have continued to pose a major threat to organizations’ survival. Thus strategic agility
capabilities of seizing has been posited by scholars as an aegis under strategic management to
overcome this threat due to its deemed capability to sustain competitive advantage (Al-daibat,
2017; Al-Sa’adi et al., 2017; Teece et al., 2016). Nurcholis (2019) investigated the effect of
organizational agility in terms of seizing capabilities on SCA. The findings showed that seizing
capabilities significantly affect sustained competitive advantage. This meant that an
organization capability to promptly sense the environmental changes, leverage on the
opportunities or address the threats and to adequately reconfigure its resource bases in line with
the environment dictates, can directly enhance their competitive advantage sustainability. This
findings supported previous research by Weber & Tarba (2014) that posited seizing capabilities
as the primary determinant of an organization to sustain its competitive advantage. The findings
also concur with Karman and Savaneviciene’s (2021) study that similarly found strategic
agility capabilities of sensing and seizing to be significantly associated with sustainability
practices.
Increased technological changes in the market has necessitated organization to continuously
improve their business model efficiency and subsequently develop new solutions to cope with
the potential of new threats (Bican & Brem, 2020; Li, 2020). Thus continuous improvement of
existing products and services through targeted agility is an exploitation aspect that is pursued
by organization in order to respond to market demands (Kohtamäki et al., 2010). Previous
research has indicated that seizing as a strategic agility capability enables an organization to
meet demands and remain competitive thus enhancing productivity and minimising failure
(O’Cass et al., 2014). Additionally, a study by Clauss et al. (2021) established that
organizations that seize opportunities by designing business models to satisfy consumers and
capture value are able to attain and sustain a competitive advantage. Seizing thus enables
organizations to acquire and develop knowledge and information to enable it to take advantage
of environmental opportunities while managing threats.
With market uncertainities, understanding agility would be a valuable organisational attribute.
Teece et al. (2016) posited that it required an overall model for better comprehension and for
that he offered the dynamic capabilities framework. This has contributed to the continued
dynamic capabilities consideration when reflecting on the organizational agility. In light of
this, Prabowo et al. (2021)explored the effect of reconfiguration capabilities on SCA. The
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study’s target scope was small and medium organizations in the service and apparel sector. The
findings revealed that reconfiguration capabilities have a positive and significant effect on
sustained competitive advantage. Another study by Barahmah et al. (2021) examined the effect
of strategic agility aspect of reconfiguration on SCA. The study findings revealed that strategic
agility has a direct and significant impact on SCA. The findings were consistent with previous
studies (Baskarada & Koronios, 2018; Hemmati et al., 2016) that illustrated the compelling
impact of reconfiguration capabilities in enhancing the organizations’ responsiveness to
changes and disruptions in the environment.
Organization’s development of unique agile capabilities, such as reconfiguration capabilities
act as the basis for sustained competitive advantage. Reconfiguration capabilities are a
responsive and dynamic capability that enhances an organization’s ability to deal with the
turbulent and volatile business environment (Oosthuizen & Scheepers, 2018). Knowledge
management is one such organization capability that in configuration with other resources and
capabilities leads to sustainability of sustained competitive advantage (Karasneh, 2020). In
tandem are other soft capabilities in the organization that are reconfigured to enable an
organization to discover and respond to threats and opportunities in the market with ease, speed
and dexterity (Tallon et al., 2018). In line with these thoughts, Rafi et al. (2021) investigated
the effects of reconfirmation capabilities on organizational performance. In the findings
reconfiguration capabilities were found to be positively related to organization performance
and sustained competitive advantage. The study also established that the presence of
reconfirmation capabilities in an organization positively influences responsiveness of the
organization to both internal and external environmental changes.
Conceptual Framework
Figure 1 presents the conceptual framework which illustrates the hypothesized relationships.
Organizational agility is a concept that is complex, multidimensional, and context specific,
whose capabilities embody the ability to sense environmental changes, and respond quickly to
unpredictable change through flexibly reconfiguring resources, knowledge, processes, and
capabilities (Yang & Liu, 2012, In Appelbaum et al., 2017). For the purpose of this study, the
constructs of organizational agility were sensing, seizing and transformation, as adapted from
the dynamic capabilities framework (Teece et al., 2016). Organizational sensing entails the
ability of the organization to identify and assess opportunities in the organization’s external
environment (Teece et al., 2016). Seizing entails mobilizing resources to enable the
organization to take advantage of opportunities in the environment (Baskarada & Koronios,
2018). Transforming or reconfiguration capabilities entails the ability of the organization to
sustain competitive edge by enhancing, assimilating, protecting, and renewing its resources in
line with the state of the environment (Breznik & Lahovnik, 2016).The study’s dependent
variable was long-term competitive advantage, which was assessed in terms of better
product/service quality, accreditation(s), corporate image, and market share (Agwunobi &
Osborne, 2016).
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Figure 1: Conceptual Framework
Methodology
The purpose of this study was to describe, explain, and confirm the results of the effect of
agility capabilities of PMPHs on their sustained competitive advantage. The study was
conducted using a descriptive correlational research design and guided by the positivist
research philosophy. The descriptive correlation design as posited by Creswell and Creswell
(2018), and Saunders et al. (2016), aided in the testing and explanation of the associations
between the agility capabilities and sustained competitive advantage. Besides, Zikmund et al.
(2013) argued that correlational design is appropriate when the study seeks to establish a
relationship between variables.
The study's target population consisted of 690 personnel recruited from Kenya's 46 level 5
PMPHs that were in Kenya as of March 2021 (KMPDC, 2021). The personnel comprised of
ten heads of specialised departments/units, four administrative heads, and the
CEO/Administrator of each of the 46 hospitals as the units of analysis. Yamane (1967) sample
size formula was used to compute a sample size of 253. The core data for this research was
collected using a standardized questionnaire. The findings were summarized using descriptive
statistics such as frequencies, means, and standard deviations, while structural equation
modelling (SEM) was utilized to examine the impact of organizational agility capabilities on
sustained competitive advantage. The Analysis of Moment Structures (AMOS) software
version 26 was used for SEM.
Results
Analysis for Organizational Agility Capabilities
The respondents in this study were administered with a total of 253 questionnaires, out of which
215 were correctly completed and returned. This equated to an 85% response rate. Males
accounted for 61.9% of those who responded, while females accounted for 38.1%. Besides,
30.7% of respondents were between the ages of 36 and 40, with just 0.5% older than 63. Only
3.3% of survey participants had college diplomas or certificates, whereas the majority (50.7%)
held postgraduate degrees. Furthermore, 39.1% of respondents had worked in PMPHs for
between 6 and 10 years, while just 2.8 percent had worked in PMPHs for more than 20 years.
Moreover, the majority of responders (65.6%) were department directors, and 6.5 percent were
administrators or CEOs. Furthermore, the majority of respondents (71.2%) had worked in their
roles at PMPHs for less than five years, while those who had worked in PMPHs for more than
16 to 20 years were just 0.9%.
Independent Variable
Dependent Variable
Organization Agility Capabilities
•Sensing Capabilities
•Seizing Capabilities
•Reconfiguration capabilities
Sustainable Competitive Advantage
• VRIO
• Increase in market share
• Sustainability of Accreditation(s)
• Corporate image
• Superior quality products/services
H0
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On a five-point Likert scale, the prevalence of organizational agility capabilities in the PMPHs
was analyzed (strongly disagree to strongly agree). The responses were analyzed using means
(M) and standard deviations (SD). According to the descriptive data in Table 1, the majority
of respondents believed that their PMPHs displayed organizational agility capabilities in all
three aspects evaluated. Leveraging competencies (M = 4.11, SD = 0.514) were the most
prevalent followed by sensing capabilities (M=4.05, SD = 0.449), and then reconfiguration
competencies (M = 3.98, SD = 0.522). The standard deviations were all below 1, suggesting
that there were little differences between the averages.
Table 1: Descriptive Statistics for Organizational Agility Capabilities
Constructs
Minimum
Maximum
Mean
Std. Deviation
Sensing Capabilities
2.80
5.00
4.0474
.44949
Leveraging Capabilities
2.50
5.00
4.1147
.51359
Reconfiguration capabilities
2.71
5.00
3.9841
.52237
Confirmatory Factor Analysis and SEM for Organizational Agility Capabilities
The purpose of the CFA in the analysis was to determine how well the observed data matched
the pre-specified empirical model. The model was found to be well-fitting (χ2/df = 2.904,
RMSEA=0.049, GFI=0.917, CFI=0.931). The fitness of the model I plied that the data was
appropriate to be fitted for SEM. However, before SEM, diagnostic tests that included linearity
tests, test of outliers, heteroscedasticity test and test of the normality of residuals were
undertaken and all the tests indicated that the model assumptions were met. Thus, SEM was
used to evaluate the effect of organizational agility capabilities (OAC) on sustained competitive
advantage (SCA). Sensing capabilities (SC), leveraging capabilities (LC), and reconfiguration
capabilities (RC) were the latent variables in the path diagram. Figure 2 shows that, according
to the fitted structural equation model, a unit change in organizational agility capabilities
(OAC) leads to a corresponding 0.56 change in sustainable competitive advantage (SCA). The
R-squared (R2 = 0.31) implied that organizational agility capabilities explained 31% of the
variation in sustainable competitive advantage of PMPHs in Kenya.
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χ2 = 383.277; DF=132; CFI=0.931; GFI=0.917; RMSEA=0.049
Figure 2: SEM for Influence of Organizational Agility Capabilities on Sustainable
Competitive Advantage
The study also generated the SEM model's standardized regression weights and estimates
which are provided in Table 2.
Table 2: Regression Coefficients for Organizational Agility Capabilities on Sustainable
Competitive Advantage
Relationship
Estimate
Beta
S.E
CR
P
Intercept
.309
.181
1.702
0.090
SC <--- OAC
.596
.982
.167
3.573
0.000
RC <--- OAC
1.000
.813
LC <--- OAC
.826
.862
.155
5.319
0.000
SCA <--- OAC
.652
.556
.126
5.158
0.000
Table 2 shows that organizational agility capabilities (OAC) and sustainable competitive
advantage (SCA) have a positive and statistically significant relationship (Beta = 0.556,
CR=5.158, p 0.05). As a consequence, the study’s null hypothesis was rejected. The findings
also show that a one-unit change in organizational agility capabilities leads to a corresponding
change of 0.556 in PMPHs' sustainable competitive advantage. The regression equation that
resulted from the SEM was;
!"#$%&'()*+,-.($&$&/(*0)/%'$%1(* 2 *34536* 7 *34889*:;1%'&<%$&,'%=*01&=$>*+%.%?&=&$&(#* 7 *@
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Ngeche & Kaluyu Organizational Agility Capabilities and Sustainable …
The implication from this regression equation is that when a private hospital has no
organizational agility capabilities, its sustainable competitive advantage will be 0.309.
Furthermore, an improvement in organizational agility capabilities would lead to an
improvement in the hospitals sustained competitive advantage.
Discussion
This study determined that organizational agility capabilities had a significant positive
influence on sustainable competitive advantage among PMPHs in Kenya. These findings
support the dynamic capabilities theory which, according to Teece et al. (1997), hypothesizes
that an organization is able to adapt to the changing environment by developing its resource
and agility capabilities portfolio, based on the sequences of path dependent processes. Besides,
the findings concur with the observation by Winter (2013) that through reconfiguration
capabilities, organizations are able to form new capabilities that enable it to achieve congruence
with the dynamic environment and hence attain sustainable competitive advantage. Another
previous study with similar findings to the findings from this study is by Appelbaum et al.
(2017) which determined that increased environmental volatility calls for a more agile
organization that align with speed to the changing forces of the environment, thereby providing
it with sustainable competitive advantage. Besides, the study by Appelbaum et al. (2017)
determined that organizational agility and transformation are integral factors that enabled firms
to attain sustainable competitive advantage, organizational performance and organizational
survival.
Dagnino et al. (2020) also had similar findings to those in this study that fast response and
constant innovation are primary underpinnings and sources of sustainable competitive
advantage. Moreover, the results also agreed with the results by Srivastava et al. (2013) that
firms could attain sustained competitive advantage through their capability to develop a set of
unique competences such as sensing, seizing and reconfiguration. Another study by Chen
(2019) established that agility in this case in the context of supply chain had a positive impact
on competitive advantage. The findings from this study are in line with Arif et al. (2008),
Panayides and Lun (2009) and Swafford et al. (2008) which all determined that supply chain
agility will enhance an organization’s competitive advantage. The findings from this study are
also supported by various scholars such as Nejatian et al. (2019), Vecchiato (2015) and Yildiz
and Aykanat (2021) who have articulated the importance of strategic agility capabilities in
enabling organizations to respond soundly to the turbulent environmental conditions. The
results from this study also concur with Battour et al. (2021) that there is a significant direct
effect of strategic agility on sustained competitive advantage. The findings from this study are
also in support with several previous studies such as Ahmad (2015a;), Al-Sa’adi et al. (2017)
and Baskarada and Koronios (2018) which all determined that organizational agility was vital
for sustainable competitive advantage of the modern organization.
Conclusion and Recommendations
The findings from this study lead to the conclusion that capabilities of PMPHs in organizational
agility are essential to attain and sustain a competitive edge. Furthermore, the findings imply
that in the healthcare industry, sensing, leveraging, and reconfiguring capabilities are critical
for hospitals seeking a long-term competitive edge over the competition. As a consequence,
the findings of this research have significance for executives of PMPHs who want to improve
their hospitals' organizational agility skills, such as sensing, leveraging, and reconfiguration.
Specifically, top management should lead their hospitals in systematically searching for new
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business concepts by continually scanning the environment, bringing together creative and
knowledgeable employees in the organization to identify new business opportunities, and
linking with external creative and knowledgeable persons to help in identifying new business
opportunities. Besides, top management should set a tone at the top that motivates employees
to adopt new ways of working, provide room for employees to exploit new opportunities, and
continually encourage employees and other managers to promote new visions, goals and ideas.
Additionally, top management should enhance the capacity of their hospitals to quickly
implement their planned activities with regard to their customers, and respond to changes in
products, customers or service needs.
The emphasis of this paper was on the effect of organizational capabilities on PMPHs' long-
term competitive advantage in Kenya. While the study yielded valuable results, there are
numerous additional areas in which further research is recommended. First, owing to varying
resource capacity, these results may not be generalizable to other lower-level PMPHs (Level 1
– level 4). As a result, further study on how the capabilities in organizational agility and their
influence on long-term competitive advantage among hospitals in the Level one to level four
is recommended. The results emanating from such research would take into consideration the
specific character and setting of these lower-level PMPHs, which may have fewer resources
than those that were incorporated in this study.
Acknowledgments
The authors would like to express their gratitude to United States International University -
Africa for the technical assistance in carrying out this study. The Graduate School of the United
States International University in Africa was quite helpful in guiding the authors through this
research. Besides, the authors appreciate all the private level 5 hospitals that participated in the
study for their priceless input.
References
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