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Risk-taking as a strategic capability in public hospitals: multidimensional performance effects in a
Hellen Njeri Ndung'u1, Duncan Mugambi Njeru1, Stephen Makau Muathe2
1Department of Business Studies, University of Embu, Embu, Kenya.
Journal of Health Organization and Management
|July 20, 2026
Summary
Risk-taking as a strategic capability significantly enhances organizational effectiveness in public hospitals. Understanding organizational characteristics like personnel numbers is key to improving performance in resource-constrained healthcare systems.
Area of Science:
- Healthcare Management
- Organizational Behavior
- Strategic Management
Background:
- Public hospitals in resource-constrained systems face unique performance challenges.
- Strategic capabilities are crucial for navigating complex healthcare environments.
- Risk-taking behavior is increasingly recognized as a potential strategic capability.
Purpose of the Study:
- To investigate if risk-taking acts as a strategic capability to enhance firm performance in public hospitals.
- To analyze the impact of risk-taking on organizational effectiveness and relevance within resource-constrained healthcare settings.
Main Methods:
- Survey data collected from 151 public hospitals.
- Multivariate general linear model employed for analysis.
- Hospital level, bed capacity, and personnel numbers used as control variables.
Main Results:
- Risk-taking demonstrated a significant positive effect on organizational effectiveness.
- Risk-taking did not significantly influence organizational relevance after controlling for other factors.
- Organizational characteristics, such as personnel numbers, are important for performance enhancement.
Conclusions:
- Risk-taking can be a valuable strategic capability for improving public hospital performance, particularly internal service provision.
- Entrepreneurial commitment, when integrated with governance, can boost performance without compromising mission or vision.
- Future research should utilize longitudinal designs and objective performance metrics for stronger causal inference.
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