Strategic Agility and Operational Performance in Türkiye’s Public Healthcare: The Moderating Role of Future Challenges

Abstract

Rapid technological development, changing healthcare requirements, regulatory pressures, and resource constraints require public healthcare organizations to continuously adapt their resources and processes. This study examines the relationship between strategic agility and operational performance in the public healthcare sector of the Türkiye Ministry of Health and investigates whether future challenges alter this relationship. A quantitative descriptive-analytical design was adopted, with data collected cross-sectionally from middle- and upper-level employees through a structured five-point Likert-scale questionnaire. The data were analyzed using SPSS and SmartPLS 4, incorporating measurement-model assessment, partial least squares structural equation modeling, bootstrapping, and moderation analysis. The measurement results establish satisfactory indicator reliability, internal consistency, and convergent validity across the study constructs. Structural analysis demonstrates a strong and statistically significant positive relationship between strategic agility and operational performance. Strategic agility is also positively associated with each operational performance dimension, including quality, cost, flexibility, and delivery, indicating that its contribution extends across multiple aspects of organizational functioning. The moderation analysis, however, finds no statistically significant interaction between future challenges and strategic agility in explaining operational performance. Thus, the relationship between strategic agility and operational performance does not vary significantly across different levels of perceived future challenges. The study extends dynamic capabilities research to a public healthcare setting by examining strategic agility as a multidimensional organizational capability and by testing future challenges as a contextual boundary condition. The findings provide empirical evidence that adaptive organizational capabilities are closely connected with operational performance in public healthcare institutions undergoing continuous environmental and technological change.