Journals / Eskişehir Osmangazi Üniversitesi İktisadi ve İdari Bilimler Dergisi / 2026 / Cilt: 20 Sayı: 1

Interaction of Environmental Uncertainty, Organisational Ambidexterity and Performance in Public and Private Healthcare Organisations

Kamu ve Özel Sağlık Kuruluşlarında Çevresel Belirsizlik, Örgütsel Ustalık ve Performans Etkileşimi

Mesut Ardıç(TOKAT GAZİOSMANPAŞA ÜNİVERSİTESİ, ERBAA SAĞLIK BİLİMLERİ FAKÜLTESİ)0000-0002-6630-0669
Mahmut Akbolat(SAKARYA ÜNİVERSİTESİ)0000-0002-2899-6722
Musa Said Döven(TOKAT GAZİOSMANPAŞA ÜNİVERSİTESİ)0000-0001-7499-8430
Pages
255–280
Publication Date
2025-04-01
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The results showed the mediating effect of organizational mastery on the effect of environmental uncertainty perceived by health institution managers on hospital performance.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:This study examines the interaction of environmental uncertainty, organizational performance, and organizational ambidexterity in healthcare organizations.
📊
Key Findings & Data:A questionnaire was applied to 266 managers working in public and private hospitals in the Central Black Sea Region.
💡
Conclusion & Impact:The results showed the mediating effect of organizational mastery on the effect of environmental uncertainty perceived by health institution managers on hospital performance.
🔬Design:Survey & Empirical Study
📍Scope:Comprehensive Sample
⚙️Variables:Algılanan Çevresel Belirsizlik · Örgütsel Performans · Örgütsel Ustalık

Abstract

This study examines the interaction of environmental uncertainty, organizational performance, and organizational ambidexterity in healthcare organizations. A questionnaire was applied to 266 managers working in public and private hospitals in the Central Black Sea Region. A quantitative research method was used in the study. Data were collected through face-to-face and online (via Google Forms) questionnaire techniques. The data were analyzed using SPSS and AMOS programs. The results showed the mediating effect of organizational mastery on the effect of environmental uncertainty perceived by health institution managers on hospital performance. Therefore, it is recommended that hospitals adopt organizational mastery strategies to be effective in dealing with environmental uncertainty and intense competition.

Özet

Bu çalışmanın amacı, sağlık kuruluşlarında çevresel belirsizlik, örgütsel performans ve örgütsel ustalık etkileşimini incelemektir. Orta Karadeniz Bölgesi'ndeki kamu ve özel hastanelerde çalışan 266 yöneticiye anket uygulanmıştır. Çalışmada nicel araştırma yöntemi kullanılmıştır. Araştırmada veriler yüz yüze ve çevrim içi (Google Form aracılığıyla) anket tekniği ile toplanmıştır. Verilerin analizinde SPSS ve AMOS programları ile analiz edilmiştir. Sonuçlar, sağlık kuruluşları yöneticilerinin algıladıkları çevresel belirisizliğin hastane performansı üzerindeki etkisinde örgütsel ustalığın aracılık etkisini göstermiştir. Bu nedenle, hastanelerin çevresel belirsizlik ve yoğun rekabet ortamında etkin olabilmeleri için örgütsel ustalık stratejilerini benimsemeleri önerilmektedir.

🔖

Cite This Article

Ardıç, M., Akbolat, M., Döven, M. S. (2025). Interaction of Environmental Uncertainty, Organisational Ambidexterity and Performance in Public and Private Healthcare Organisations. Eskişehir Osmangazi Üniversitesi İktisadi ve İdari Bilimler Dergisi, Cilt: 20 Sayı: 1, 255–280. https://doi.org/10.17153/oguiibf.1527238

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (128)

  1. Abu-Jarad, I. Y., Yusof, N. A., & Nikbin, D. (2010). A review paper on organizational culture and organizational performance. International Journal of Business and Social Science, 1(3),26-46.
  2. Acar, Z. & Acar, P. (2014). Organizational culture types and their effects on organizational performance in Turkish hospitals. Emerging Markets Journal, 3(3), 17-31. https://doi.org/10.5195/emaj.2014.47
  3. Adhikara, M. A., Sumarli, J. N., & Sutisna, D. (2020). Management control system and hospital performance among public sector: Is environment uncertainty and information technology the issue?. Management, 12(1), 2381-2394.
  4. Akinleye, D. D., McNutt, L. A., Lazariu, V., & McLaughlin, C. (2019). Correlation between hospital finances and quality and safety of patient care. PLoS One, 14 (8): e0219124. https://doi.org/10.1371/journal.pone.0219124
  5. Alhawamdeh, M. M. M. (2021). Relevance of strategic planning process, organizational ambidexterity organizational capabilities and decision-making style hotels performance. Journal of Contemporary Issues in Business and Government, 27 (3), 1503-1514.
  6. Alıcı, İ. (2020). Algılanan örgütsel destek ile örgütsel sinizmin örgütsel performansa olan etkisinde pozitif psikolojik sermayenin aracılık etkisi[Yayınlanmamış doktora tezi] Tokat Gaziosmanpaşa Üniversitesi.
  7. Altunoğlu, A. E., & Doğan, B. (2014). Bilgi yönetimi, çevre, teknoloji ve örgütsel performans ilişkileri. Journal of Internet Applications and Management, 5 (1), 21-37. https://doi.org/10.5505/iuyd.2014.91300
  8. Altuntaş, G., & Dönmez, D. (2010). Girişimcilik yönelimi ve örgütsel performans ilişkisi: Çanakkale bölgesinde faaliyet gösteren otel işletmelerinde bir araştırma. İstanbul Üniversitesi İşletme Fakültesi Dergisi, 39 (1), 50-74.
  9. Ark, A. R.(2008). Strategıc orıentatıon and busıness performance relatıonshıp wıth focus on busıness and functıonal level strategy fıt: an empırıcal study on turkısh enterprıses [Yayınlanmamış doktora tezi] Marmara Üniversitesi.
  10. Arslan, V. (2016). Yönetici desteğinin iş memnuniyeti, duygu düzenleme becerisi ve örgütsel performans algısı üzerine aracı etkisi: Sağlık sektöründe bir araştırma [Yayınlanmamış doktora tezi] Dicle Üniversitesi.
  11. Artun, C. (2020). Otel işletmelerinde dinamik yetenekler, hizmet inovasyonu ve performans ilişkisi: çevresel belirsizlik ve örgütsel yapının rolü[Yayınlanmamış doktora tezi] Muğla Sıtkı Koçman Üniversitesi.
  12. Atuahene-Gima, K. (2005). Resolving the capability-rigidity paradox in new product innovation. Journal of Marketing, 69 (4), 61–83. https://doi.org/10.1509/jmkg.2005.69.4.61
  13. Azar, A., Rahmani, N., & Khadivar, A. (2016), The impact of budgetary slack on performance-based budgeting. Actual Problems of Economics, 184 (10):397-412.
  14. Badri, M. A., Davis, D., & Davis, D. (2000). Operations strategy, environmental uncertainty and performance: a path analytic model of industries in developing countries. Omega, 28 (2), 155-173.
  15. Bamel, U. K., & Bamel, N. (2018). Organizational resources, KM process capability and strategic flexibility: A dynamic resource-capability perspective. Journal of Knowledge Management, 22 (7), 1555–1572. https://doi.org/10.1108/jkm-10-2017-0460
  16. Barr, P. S. (1998). Adapting to unfamiliar environmental events: a look at the evolution of interpretation and its role in strategic change. Organization Science, 9 (6), 644-669. https://doi.org/10.1287/orsc.9.6.644
  17. Bastian, E., & Muchlish, M. (2012). Perceived environment uncertainty, business strategy, performance measurement systems and organizational performance. Procedia-Social and Behavioral Sciences, 65 (3), 787-792. https://doi.org/10.1016/j.sbspro.2012.11.200
  18. Bayer, Ü. E., & Cengiz, M. (2020). Sağlık sektöründeki yönetim kaosuna büyük veri çözüm sunabilir mi? Turan: Stratejik Arastirmalar Merkezi, 12(46), 275-285.
  19. Begun, J. W., & Kaissi, A. A. (2004). Uncertainty in health care environments: myth or reality?. Health Care Management Review, 29 (1), 31-39. https://doi.org/10.1097/00004010-200401000-00005
  20. Benson, J. K. (1975). The ınterorganizational network as a political economy. Administrative Science Quarterly, 20, 229-249.
  21. Bernal, P., Maicas, J. P., & Vargas, P. (2019). Exploration, exploitation and innovation performance: Disentangling the evolution of industry. Industry and Innovation, 26, 295– 320. https://doi.org/10.1080/13662716.2018.1465813
  22. Bettis-Outland, H. (2012). Decision-makings impact on organizational learning and information overload. Journal of Business Research, 65 (6), 814-820. https://doi.org/10.1016/j.jbusres.2010.12.021
  23. Bierly III, P. E., & Daly, P. S. (2007). Alternative knowledge strategies, competitive environment, and organizational performance in small manufacturing firms. Entrepreneurship Theory And Practice, 31 (4), 493-516. https://doi.org/10.1111/j.1540-6520.2007.00185.x
  24. Bildik, R. (2024). The relationship between environmental uncertainty perception, creative thinking and strategic thinking: A study on private hospital managers. [Unpublished doctoral thesis]. Sakarya University.
  25. Birkinshaw, J., Zimmermann, A., & Raisch, S. (2016). How do firms adapt to discontinuous change? Bridging the dynamic capabilities and ambidexterity perspectives. California Management Review, 58 (4), 36-58. https://doi.org/10.1525/cmr.2016.58.4.36
  26. Bodwell, W. (2011). A theoretical model of organizational ambidexterity in hospitals [Unpublished doctoral thesis]. Colorado State University School of Education.
  27. Bodwell, W., & Chermack, T. J. (2010). Organizational ambidexterity: Integrating deliberate and emergent strategy with scenario planning. Technological Forecasting and Social Change, 77 (2), 193-202. https://doi.org/10.1016/j.techfore.2009.07.004
  28. Burak, M. F., & Deniz, R. B. (2021). Kurum kültürü, sürdürülebilir rekabet avantajı, çevresel belirsizlik ve kurumsal performans ilişkisi: Türk ihracatçı firmaları. International Journal of Arts and Social Studies, 4 (6), 49-83.
  29. Burgess, N., Strauss, K., Currie, G., 6 Wood, G. (2015). Organizational ambidexterity and the hybrid middle manager: The case of patient safety in UK hospitals. Human Resource Management, 54 (S1), 87-109. https://doi.org/10.1002/hrm.21725
  30. Cao, Q., Gedajlovic, E., & Zhang, H. (2009). Unpacking organizational ambidexterity: Dimensions, contingencies, and synergistic effects. Organization Science, 20(4), 781- 796. https://doi.org/10.1287/orsc.1090.0426
  31. Capkun, V., Messner, M., & Rissbacher, C. (2012). Service specialization and operational performance in hospitals. International Journal of Operations & Production Management, 32 (4), 468-495. https://doi.org/10.1108/01443571211223103.
  32. Chaharmahali, M. S., & Amir Siadat, S. (2010). Achieving organizational ambidexterity: understanding and explaining ambidextrous organizations [Unpublished master's thesis]. Linköping University.
  33. Chi, T., & Sun, Y. (2013). Development of firm export market oriented behavior: Evidence from an emerging economy. International Business Review, 22(1), 339-350. doi:10.1016/j.ibusrev.2012.05.003.
  34. Chong, K. (1995). Strategy, perceived environmental uncertainty, management accounting systems and performance: An empirical investigation [Unpublished master's thesis]. Cowan University.
  35. Christmann, P. (2000). Effects of “best practices” of environmental management on cost advantage: The role of complementary assets. Academy of Management Journal, 43(4), 663–680. https://doi.org/10.5465/1556360
  36. Cingöz, A., & Akdoğan, A. A. (2015). Örgütsel ustalık (organizational ambidexterity): örgütsel ustalık düzeyini belirlemede araştırıcı ve yararlanıcı stratejilerin etkileşimsel rolü. Aksaray Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 7 (2), 59-68.
  37. Çetenak, E. H. (2012). İşletme grubu ılişkisinin firma performansına etkisi: İMKB’de bir uygulama. [Yayımlanmamış doktora tezi]. Çukurova Universitesi.
  38. Çınaroğlu, S. (2017). Sağlıkta performans ölçümünden stratejik performans yönetimine: Path projesi örneği. Verimlilik Dergisi, 1, 75-92.
  39. Daft, R. L., & Weick, K. E. (1984). Toward a model of organizations as ınterpretation systems. Academy of Management Review, 9 (2), 284-295. https://doi.org/10.2307/258441
  40. DeSarbo, W. S., Anthony Di Benedetto, C., Song, M., & Sinha, I. (2005). Revisiting the Miles and Snow strategic framework: uncovering interrelationships between strategic types, capabilities, environmental uncertainty, and firm performance. Strategic Management Journal, 26 (1), 47-74.
  41. Dess, G. G., & Beard, D. W. (1984). Dimensions of organizational task environments. Administrative Science Quarterly, 29 (1), 52-73. https://doi.org/10.2307/2393080
  42. Dew, N., Read, S., Sarasvathy, S.D., & Wiltbank, R., (2009). Effectual versus predictive logics in entrepreneurial decision-making: differences between experts and novices. J. Bus. Ventur, 24 (4), 287–309.
  43. Du, J., & Chen, Z. (2018). Applying Organizational Ambidexterity in strategic management under a “VUCA” environment: Evidence from high tech companies in China. International Journal of Innovation Studies, 2 (1), 42 52. https://doi.org/10.1016/j.ijis.2018.03.003
  44. Duncan, R. B. (1976). Characteristics of Organizational environments and perceived environmental uncertainty. Administrative Science Quarterly, 17, 313–327. https://doi.org/10.2307/2392145
  45. Dwirandra, A. A. N. B., & Astika, I. B. P. (2020). Impact of environmental uncertainty, trust and information technology on user behavior of accounting information systems. The Journal of Asian Finance, Economics, and Business, 7 (12), 1215–1224. https://doi.org/10.1016/j.digbus.2022.100026
  46. Elbanna, S., & Alhwarai, M. (2012). The influence of environmental uncertainty and hostility on organization performance. UAEU-FBE-Working Paper Series, 1, 1-23.
  47. Engel, Y., Dimitrova, N.G., Khapova, S.N., & Elfring, T., (2014). Uncertain but able: entrepreneurial self-efficacy and novices' use of expert decision-logic under uncertainty. J. Bus. Ventur. Insights, 1 (1-2), 12–17. https://doi.org/10.1016/j.jbvi.2014.09.002
  48. Eren, M. Ş., Tokgöz, E., Hasan, G., & Saylan, O. (2013). Pazar odaklılığın nitel performans üzerindeki etkisinde öğrenme odaklılık ve yenilikçiliğin düzenleyici etkisi. Dokuz Eylül Üniversitesi İktisadi İdari Bilimler Fakültesi Dergisi, 28 (2), 1-39.
  49. Foglia, E., Ferrario, L., Lettieri, E., Porazzi, E., & Gastaldi, L. (2019). What drives hospital wards’ ambidexterity: insights on the determinants of exploration and exploitation. Health policy, 123 (12), 1298-1307. https://doi.org/10.1016/j.healthpol.2019.10.004
  50. Gifford, R., Fleuren, B., van de Baan, F., Ruwaard, D., Poesen, L., Zijlstra, F., & Westra, D. (2022). To uncertainty and beyond: identifying the capabilities needed by hospitals to function in dynamic environments. Medical Care Research and Review, 79(4), 549-561. https://doi.org/10.1177/10775587211057416
  51. Gong, L., Liu, Z., Rong, Y., & Fu, L. (2021). Inclusive leadership, ambidextrous innovation and organizational performance: the moderating role of environment uncertainty. Leadership & Organization Development Journal, 42 (5), 738-801. https://doi.org/10.1108/lodj-06-2020-0253
  52. Gubbi, S.R., Aulakh, P.S., Ray, S., Sarkar, M.B., & Chittoor, R. (2010). Do international acquisitions by emerging-economy firms create shareholder value? The case of Indian firms. J. Int. Bus. Stud., 41 (3), 397–418. https://doi.org/10.1057/jibs.2009.47
  53. Guillemette, M. G., Raymond, L., & Paré, G. (2022). Assessing the maturity and performance of the IT function in acute-care hospitals: a configurational view. Health Systems, 1-13, https://doi.org/10.1080/20476965.2022.2075797
  54. Gülenç, S. (2019). Medikal turizm hizmeti veren hastanelerde sağlık otelciliği hizmetleri ile örgütsel ustalık ilişkisi [Yayımlanmamış doktora tezi]. Anadolu Üniversitesi.
  55. Hair, J. F., Anderson, R. E., Tatham, R. L. and Black, W. C. (1998). Multivariate data analysis. (5th ed. ) Prentice Hall.
  56. Hamann, P. M., Schiemann, F., Bellora, L., & Guenther, T. W. (2013). Exploring the dimensions of organizational performance: A construct validity study. Organizational Research Methods, 16 (1), 67-87. https://doi.org/10.1177/1094428112470007
  57. Hammad, S. A., Jusoh, R., & Ghozali, I. (2013). Decentralization, perceived environmental uncertainty, managerial performance and management accounting system information in Egyptian hospitals. International Journal of Accounting and Information, 21 (4), 314-330. https://doi.org/10.1108/ijaim-02-2012-0005
  58. Han, M., & Celly, N. (2008). Strategic ambidexterity and performance in international new ventures. Canadian Journal of Administrative Sciences, 25 (4), 335-349. https://doi.org/10.1002/cjas.84
  59. Haque, M., & Ali, I. (2016). Uncertain environment and organizational performance: The mediating role of organizational innovation. Asian Social Science, 12(9), 124-138. https://doi.org/10.5539/ass.v12n9p124.
  60. Herzallah, A., Gutierrez-Gutierrez, L. J., & Rosas, J. F. M. (2017). Quality ambidexterity, competitive strategies, and financial performance: An empirical study in industrial firms. International Journal of Operations & Production Management, 37, 1496 1519.
  61. Hicks, J. B. (2019). Examining the relationship between leadership styles, environmental uncertainty, and financial performance in health care. [Unpublished doctoral thesis] Northcentral University.
  62. Ho, L. A. (2008). What affects organizational performance? The linking of learning and knowledge management. Industrial Management & Data Systems, 108 (9), 1234-1254. https://doi.org/10.1108/02635570810914919
  63. Hoque, Z. (2004). A contingency model of the association between strategy, environmental uncertainty and performance measurement: impact on organizational performance. International Business Review, 13(4),485–502. https://doi.org/10.1016/j.ibusrev.2004.04.003
  64. Hughes, P., Hughes, M., Stokes, P., Lee, H., Rodgers, P., & Degbey, W. Y. (2020). Micro-foundations of organizational ambidexterity in the context of cross-border mergers and acquisitions. Technological Forecasting and Social Change, 153, 119932. https://doi.org/10.1016/j.techfore.2020.119932
  65. Hwang, E. J. (2005). Strategic management and financial performance in South Korean apparel retail stores [Unpublished doctoral thesis] State University.
  66. Irk, E., & Döven, M. S. (2018). Uyum döngüsü: örgüt-çevre uyum sürecine ilişkin bir model. Stratejik Yönetim Araştırmaları Dergisi, 1(2), 85-112.
  67. Jahanshahi, A.A., & Brem, A. (2020). Entrepreneurs in post-sanctions Iran: innovation or imitation under conditions of perceived environmental uncertainty? Asia Pacific Journal of Management, 37, 531–551. https://doi.org/10.1007/s10490-018-9618-4
  68. Jansen, J. J. P., Vera, D., & Crossan, M. (2009). Strategic leadership for exploration and exploitation: The moderating role of environmental dynamism. Leadership Quart, 20 (1) 5–18. https://doi.org/10.1016/j.leaqua.2008.11.008
  69. Jurksiene, L., & Pundziene, A. (2016). The relationship between dynamic capabilities and firm competitive advantage: The mediating role of organizational ambidexterity. European Business Review, 28 (4), 431-448. https://doi.org/10.1108/ebr-09-2015-0088
  70. Kafetzopoulos, D. (2020). Organizational ambidexterity: antecedents, performance and environmental uncertainty. Business Process Management Journal, 27(3), 922-940. https://doi.org/10.1108/bpmj-06-2020-0300
  71. Kalaycı Ş. (2014). Spss uygulamalı çok değişkenli istatistik teknikleri (6. Baskı, s. 128-151) içinde. Asil Yayın Dağıtım.
  72. Karagöz, Y. (2017). Spss ve amos uygulamalı bilimsel araştırma yöntemleri ve yayın etiği (1. Baskı s,468-513). Nobel Yayın Dağıtım.
  73. Karaman, D. (2019). Çevresel belirsizliğin kaynak bağımlılığına etkisi: konaklama işletmelerinde bir araştırma. International Journal of Academic Value Studies, 5(1), 25-45. https://doi.org/10.23929/javs.855
  74. Kırılmaz, H., Kırılmaz Kılıç, S., & Kahraman, M. (2018). Sağlık personelinin bilgi sistemi işlevlerini kullanımları ve örgütsel performansa etkisi. Strategic Public Management Journal, 4(8), 62-80. https://doi.org/10.25069/spmj.474458
  75. Kim, H. S., Kim, Y. H., Woo, J. S., & Hyun, S. J. (2015). An analysis of organizational performance based on hospital specialization level and strategy type. PloS one, 10(7), e0132257. https://doi.org/10.1371/journal.pone.0132257
  76. Köseoglu, M. A., Topaloglu, C., Parnell, J. A., & Lester, D. L. (2013). Linkages among business strategy, uncertainty and performance in the hospitality industry: Evidence from an emerging economy. International Journal of Hospitality Management, 34, 81-91. https://doi.org/10.1016/j.ijhm.2013.03.001
  77. Lavie, D., Kang, J., & Rosenkopf, L. (2011). Balance within and across domains: the performance implications of exploration and exploitation in alliances. Organization Science, 22, 1517–1538. https://doi.org/10.1287/orsc.1100.0596
  78. Lin, Z., Yang, H., & Demirkan, I. (2007). The performance consequences of ambidexterity in strategic alliance formations: Empirical investigation and computational theorizing. Management Science, 53 (10), https://doi.org/10.1287/mnsc.1070.0712
  79. Lingelbach, D., Sriram, V., Mersha, T., &Saffu, K. (2015). The innovation process in emerging economies an effectuation perspective. Int. J. Entrep. Innov., 16 (1), 5–17. https://doi.org/10.5367/ijei.2015.0172
  80. Lipshitz, R., & Strauss, O. (1997). Coping with uncertainty: A naturalistic decision-making analysis. Organizational Behavior and Human Decision Processes, 69(2), 149–163. https://doi.org/10.1006/obhd.1997.2679
  81. Lo, F. Y. (2013). The dynamic adjustment of environment, strategy, structure, and resources on firm performance. International Entrepreneurship and Management Journal, 9(2), 217- 227. https://doi.org/10.1007/s11365-012-0222-7
  82. Lonial, S. C., & Raju, P. S. (2001). The impact of environmental uncertainty on the market orientation--performance relationship: A study of the hospital industry?. Journal of Economic & Social Research, 3 (1), 5-27.
  83. Magerakis, E., & Habib, A. (2021). Environmental uncertainty and corporate cash holdings: The moderating role of CEO ability. International Review of Finance, 22 (3), 402-432. https://doi.org/10.1111/irfi.12355
  84. March, J. G. (1991). Exploration and exploitation in organizational learning. Organization Science 2 (1), 71–87. https://doi.org/10.1287/orsc.2.1.71
  85. Matanda, M. J., & Freeman, S. (2009). Effect of perceived environmental uncertainty on exporter–importer inter-organisational relationships and export performance improvement. International Business Review, 18(1), 89-107. https://doi.org/10.1016/j.ibusrev.2008.12.004
  86. McMullen, J. S., & Shepherd, D. A. (2006). Entrepreneurial action and the role of uncertainty in the theory of the entrepreneur. Academic Management Review, 31(1), 132–152. https://doi.org/10.5465/amr.2006.19379628
  87. Mellinger, C. D., & Hanson, T. A. (2020). Methodological considerations for survey research: Validity, reliability, and quantitative analysis. Linguistica Antverpiensia, New Series: Themes in Translation Studies, 19, 172–190. https://doi.org/10.52034/lanstts.v19i0.549
  88. Murphy, G. B., Trailer, J. W., & Hill, R. C. (1996). Measuring performance in entrepreneurship research. Journal of Business Research, 36, 15-23. https://doi.org/10.1016/0148-2963(95)00159-x
  89. Najmi, K., Kadir, A. R., & Kadir, M. I. A. (2018). Mediation effect of dynamic capability in the relationship between knowledge management and strategic leadership on organizational performance accountability. International Journal of Law and Management, 60 (2), 517-529. https://doi.org/10.1108/ijlma-01-2017-0004
  90. Nguyen, O T. K., Liu, L. Y. J., Haslam, J., & McLaren, J. (2021). The moderating effect of perceived environmental uncertainty and task uncertainty on the relationship between performance management system practices and organizational performance: evidence from Vietnam. Production Planning & Control, 1-19, https://doi.org/10.1080/09537287.2021.1934586
  91. Nikpour, A. (2017). The impact of organizational culture on organizational performance: The mediating role of employee’s organizational commitment. International Journal of Organizational Leadership,6, 65-72. https://doi.org/10.33844/ijol.2017.60432
  92. Nosella, A., Cantarello, S.,& Filippini, R. (2012). The intellectual structure of organizational ambidexterity: A bibliographic investigation into the state of the art. Strategic Organization, 10(4), 450–465. https://doi.org/10.1177/1476127012457979
  93. Ogunyomi, P.& Bruning, N. S. (2015). Human resource management and organizational performance of small and medium enterprises (SMEs) in Nigeria. The International Journal of Human Resource Management, 27 (6), 612-634. https://doi.org/10.1080/09585192.2015.1033640
  94. Porter, M. (1985). Competitive advantage: Creating and sustaining competitive performance. Free Press. Raisch, S., & Birkinshaw, J. (2008). Organizational ambidexterity: Antecedents, outcomes, and moderators. Journal of Management, 34 (3), 375-409. https://doi.org/10.1177/0149206308316058
  95. Raisch, S., Birkinshaw, J., Probst, G., & Tushman, M. L. (2009). Organizational ambidexterity: Balancing exploitation and exploration for sustained performance. Organization Science, 20(4), 685-695. https://doi.org/10.1287/orsc.1090.0428
  96. Reis, J., & Spencer, P. S. (2019). Decision-making under uncertainty in environmental health policy: new approaches. Environmental Health and Preventive Medicine, 24(57). https://doi.org/10.1186/s12199-019-0813-9
  97. Richard, O. C., Wu, P., & Chadwick, K. (2009). The impact of entrepreneurial orientation on firm performance: the role of CEO position tenure and industry tenure. The International Journal of Human Resource Management, 20 (5), 1078-1095. https://doi.org/10.1080/09585190902850281
  98. Rowe, W. G.,& Morrow Jr, J. L. (1999). A note on the dimensionality of the firm financial performance construct using accounting, market, and subjective measures. Canadian Journal of Administrative Sciences/Revue Canadienne des Sciences de l'Administration, 16 (1), 58-71.
  99. Sabherwal, R., Sabherwal, S., Havakhor, T.,& Steelman, Z. (2019). How does strategic alignment affect firm performance? the roles of information technology investment and environmental uncertainty. MIS Quarterly, 43 (2), 453-474. https://doi.org/10.25300/misq/2019/13626
  100. Sahi, G. K., Gupta, M. C., & Cheng, T. C. E. (2020). The effects of strategic orientation on operational ambidexterity: A study of indian SMEs in the industry 4.0 era. International Journal of Production Economics, 220, 1-12, 107395.
  101. Sezer, B. (2016). Örgütsel ustalığın performans üzerindeki etkisi: Bir alan araştırması. [Yayımlanmamış yüksek lisans tezi] Kahramanmaraş Sütçü İmam Üniversitesi.
  102. Shannassy, T. O. (2007). Perceived environmental uncertainty and organization performance. Perceived Environmental Uncertainty and Organization Performance, 1-19.
  103. Sicotte C, Champagne F., Contandriopoulos A. P., Barnsley J., Béland, F., Leggat, S. G., Denis, J. L., Bilodeau, H., Langley, A., Brémond, M., & Baker G. R. (1998). A conceptual framework for analysis of health care organizations performance. Health Services Management Research, 11 (1), 24-41. https://doi.org/10.1177/09514848
  104. Sürücü, L., & Maslakçı, A. (2020). Validity and reliability ın quantitative research. Busıness &Management Studıes:An Internatıonal Journal, 8(3): 2694-2726. https://doi.org/10.15295/bmij.v8i3.1540
  105. Şimşek, M. Ş., Özgener, Ş., Kaplan, M., & Ulu, S. (2010, 8-10Temmuz). Strategic intent, organizational ambidexterity and performance: A test of the moderating role of perceived environmental uncertainty. [Panel] 6th International Strategic Management Conference, St.Petersburg. Russia.
  106. Şimşek, Z. (2009). Organizational ambidexterity: Towards a multilevel understanding. Journal of Management Studies, 46 (4), 597-624. https://doi.org/10.1111/j.1467-6486.2009.00828.x
  107. Taştan, S. B., & Torun, A. (2015). Examining the relationship between cultural values, degree of embeddedness, trust perception and environmental uncertainty with social capital structure in organizations: a study on small and medium-sized firms. Journal of Academic Overview, 49, 412-439.
  108. Tan, M. & Liu, Z. (2014). Paths to success: An ambidexterity perspective on how responsive and proactive market orientations affect SMEs’ business performance. Journal of Strategic Marketing, 22 (5), 420-441. https://doi.org/10.1080/0965254x.2013.876084
  109. Tan, R., & Hu, X. (2020). A review of Chinese literature on ambidexterity innovation and its future prospects. International Journal of Scientific Engineering and Science, 4(8), 70-76. https://doi.org/10.1561/0300000097
  110. Teeratansirikol, L., Siengthai, S., Badir, Y., & Charoenngam, C. (2013). Competitive strategies and firm performance: The mediating role of performance measurement. International Journal of Productivity and Performance Management, 62 (2), 168-184. https://doi.org/10.1108/17410401311295722
  111. Turan, A. (2014). Temel yetenek ve dış kaynaklardan yararlanma tekniklerine felsefik bir bakış: dinamik beceriler ve iş modeli yaklaşımlarıyla ilişkilendirme. Kafkas Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 5 (7), 147-170.
  112. Turner, N., Maylor, H., & Swart, J. (2015). Ambidexterity in projects: An intellectual capital perspective. International Journal of Project Management, 33(1), 177–188. https://doi.org/10.1016/j.ijproman.2014.05.002
  113. Tüfekçi, N., & Tüfekçi Ö. K. (2006). Bankacılık sektöründe farklı olma üstünlüğünün ve müsteri sadakatinin yarattığı değer: ısparta ilinde bir uygulama. Süleyman Demirel Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 2(4), 170-183.
  114. Uotila, J., Maula, M., Keil, T., & Zahra, S. A. (2009). Exploration, exploitation, and financial performance: analysis of S&P 500 corporations. Strategic Management Journal 30(2), 221-231. https://doi.org/10.1002/smj.738.
  115. Uzkurt, C. (2002). Çevresel belirsizliklere karşı rekabet avantajı yakalamada stratejik esnekliğin rolü ve firma performansına etkileri. Eskişehir Osmangazi Üniversitesi Sosyal Bilimler Dergisi, 3(1), 1-20.
  116. Van de Wetering, R.,& Versendaal, J. (2021). Information technology ambidexterity, digital dynamic capability, and knowledge processes as enablers of patient agility: Empirical study. JMIRx Med 2 (4),1-19. https://doi.org/10.2196/32336
  117. van de Wetering, R., Bosua, R., Boersma, C., & Dohmen, D. (2022). Information technology ambidexterity-driven patient agility, patient service-and market performance: a variance and fsqca approach. Sustainability, 14(7), 4371, 1. https://doi.org/10.3390/su14074371
  118. Veider, V., & Matzler, K. (2016). The ability and willingness of family-controlled firms to arrive at organizational ambidexterity. Journal of Family Business Strategy, 7(2), 105- 116. https://doi.org/10.1016/j.jfbs.2015.10.001
  119. Vélez-González, H., Pradhan, R., & Weech-Maldonado, R. (2011). The role of non-financial performance measures in predicting hospital financial performance: the case of for-profit system hospitals. Journal of health care finance, 38(2), 12-23. https://doi.org/10.1186/s12913-021-07402-3
  120. Venkatraman, N., Lee, C.H., & Iyer, B. (2009). Strategic ambidexterity and sales growth: a longitudinal test in the software sector. Organization Science, 20(4), 685-695.
  121. Wang, H., & Li, J. (2008). Untangling the effects of overexploration and overexploitation on organizational performance: The moderating role of environmental dynamism. Journal of Management 34(5), 925-951. https://doi.org/10.1177/0149206308321547
  122. Yıldız, D., & Genç, K. Y. (2020). Sürdürülebilir rekabet üstünlüğünde entelektüel sermayenin önemi: Kaynak tabanlı bir yaklaşım. Asya Studies, 4(14), 119-134. https://doi.org/10.31455/asya.756687
  123. Yıldız, H., & Karataş, G. (2018). Kuzeydoğu anadolu bölgesi’ndeki kobi’lerde örgütsel ustalık (çift yönlülük): Çatışan stratejilerin birleşimi. Manisa Celal Bayar Üniversitesi Sosyal Bilimler Dergisi, 16(4), 99-122. https://doi.org/10.18026/cbayarsos.505921
  124. Yu, X., Tao, Y., Tao, X., Xia, F., & Li, Y. (2018). Managing uncertainty in emerging economies: The interaction effects between causation and effectuation on firm performance. Technological Forecasting and Social Change, 135, 121-131. https://doi.org/10.1016/j.techfore.2017.11.017
  125. Yuchtman, E., & Seashore, S. E.(1967). A system resource approach to organizational effectiveness. American Sociological Review, 32(6), 891-903. https://doi.org/10.2307/2092843
  126. Yuen, K. F., Wang, X., Wong, Y. D., & Ma, F. (2019). A contingency view of the effects of sustainable shipping exploitation and exploration on business performance. Transport Policy, 77, 90–103. https://doi.org/10.1016/j.tranpol.2019.03.004
  127. Zhaxylyk, S. (2020). Organizational ambidexterity and resilience: empirical evidence from uncertain transition economic context. PressAcademia Procedia, 11, 47-51.
  128. Nikpour, A. (2017). The impact of organizational culture on organizational performance: The mediating role of employee’s organizational commitment. International Journal of Organizational Leadership,6, 65-72. https://doi.org/10.33844/ijol.2017.60432