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.
Authors
- Kevin Johnson (ORCID: https://orcid.org/0000-0001-6245-7637)
- Patrick Groulx (ORCID: https://orcid.org/0000-0002-3325-3544)
- Pierre‐Luc Fournier (ORCID: https://orcid.org/0000-0002-0395-2176)
- Desirée H. van Dun (ORCID: https://orcid.org/0000-0002-6279-5510)
- Mira Thoumy
Institutions
- HEC Montréal (CA)
- Université de Sherbrooke (CA)
- Université du Québec à Montréal (CA)
- Lebanese American University (LB)
- Politecnico di Milano (IT)
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
Funders
- Social Sciences and Humanities Research Council of Canada