Innovation Ambidexterity, Regulatory Pressure, and Resource Orchestration Capability as Explanatory Factors of Organizational Agility: Evidence from Indonesian Hospitals

Background Organizational agility is important for hospitals facing service complexity, regulatory demands, and environmental change. This study examined the associations of innovation ambidexterity, resource orchestration capability, and regulatory pressure with organizational agility in a purposively sampled Indonesian hospital context. Methods A cross-sectional organizational survey was analyzed using partial least squares structural equation modeling (PLS-SEM) in SmartPLS 4. The original interim extract included 81 records, of which one (R001, 5 January 2026) was a pre-survey test submission. The corrected primary analysis includes 80 eligible key-informant responses and retains the final 29-indicator reflective global measurement model. Bootstrap inference used 5,000 subsamples; the 44-indicator model and an N = 78 subset served as sensitivity checks. Results Innovation ambidexterity showed the largest positive standardized association with organizational agility (β = 0.440, t = 4.511, p < 0.001), followed by resource orchestration capability (β = 0.363, t = 2.869, p = 0.004) and regulatory pressure (β = 0.227, t = 2.958, p = 0.003). The three explanatory factors jointly accounted for 81.0% of the in-sample variance in agility (R 2 = 0.810). Measurement diagnostics require caution, particularly for RPR internal consistency and some Fornell–Larcker comparisons. Conclusions These findings describe positive explanatory associations within the analyzed hospital sample, not causal effects or verified out-of-sample prediction. The global innovation ambidexterity construct represents joint exploratory and exploitative indicator levels and does not directly test a balance between the two orientations.