Untangling standardization and administrative burden as microfoundations of agility in healthcare

The capability of healthcare organizations to provide high-quality care is in part determined by their workers’ ability to adapt to a complex and uncertain environment. Since healthcare operations are often highly standardized and bureaucratized, adapting and responding to internal and external changes is no small feat. This study investigates these tensions as determinants of individual agility. Using survey data collected from 2,173 Canadian nurses along with structural equation modelling, the study assesses a hypothetical model to understand how process standardization and administrative burden influence individual agility and, in turn, the quality of care provided to patients. The results show that the quality of care provided by nurses to their patients is increased by their internal and external individual agility . These, in turn, are positively influenced by process standardization but inhibited by administrative burden . This study extends current literature on the microfoundations of agility in healthcare by providing theoretical and practical contributions on the impact of enabling and coercive bureaucracy.

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Publication Details

Journal
BMC Health Services Research
Published
2026-07-23
DOI
https://doi.org/10.1186/s12913-026-15179-6
Primary Topic
Interprofessional Education and Collaboration
Type
article
Field-Weighted Citation Impact
0.00

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article

Untangling standardization and administrative burden as microfoundations of agility in healthcare

Kevin Johnson, Patrick Groulx, Pierre‐Luc Fournier, Desirée H. van Dun et al.
BMC Health Services Research
Interprofessional Education and Collaboration
article

Untangling standardization and administrative burden as microfoundations of agility in healthcare

Kevin Johnson, Patrick Groulx, Pierre‐Luc Fournier, Desirée H. van Dun, Mira Thoumy
article en

Abstract

The capability of healthcare organizations to provide high-quality care is in part determined by their workers’ ability to adapt to a complex and uncertain environment. Since healthcare operations are often highly standardized and bureaucratized, adapting and responding to internal and external changes is no small feat. This study investigates these tensions as determinants of individual agility. Using survey data collected from 2,173 Canadian nurses along with structural equation modelling, the study assesses a hypothetical model to understand how process standardization and administrative burden influence individual agility and, in turn, the quality of care provided to patients. The results show that the quality of care provided by nurses to their patients is increased by their internal and external individual agility . These, in turn, are positively influenced by process standardization but inhibited by administrative burden . This study extends current literature on the microfoundations of agility in healthcare by providing theoretical and practical contributions on the impact of enabling and coercive bureaucracy.

BMC Health Services Research
HEC Montréal (CA), Université de Sherbrooke (CA), Université du Québec à Montréal (CA), Lebanese American University (LB), Politecnico di Milano (IT)
Social Sciences and Humanities Research Council of Canada
Openalex Percentile: Top 6%
Interprofessional Education and Collaboration
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Untangling standardization and administrative burden as microfoundations of agility in healthcare — Kevin Johnson, Patrick Groulx, et al. · BMC Health Services Research (2026) | TGRS Research Map | TGRS