ORGANISATIONAL LEARNING ORIENTATION, PROACTIVE MARKET ORIENTATION, OUTCOMES: BUSINESS MODEL NOVELTY MEDIATION A QUANTITATIVE STUDY AMONG DUTCH PHYSIOTHERAPY PRIMARY HEALTHCARE ORGANISATIONS

R. Ijntema^1,2, D.-J. Barten³, B. Tjemkes⁴, H. Duits⁵, P. Westers⁶, C. Veenhof³

¹HU University of Applied Sciences, Financial-Economic Innovation, Utrecht, Netherlands, ²HU University of Applied Sciences, Innovative Human Movement Care (Physiotherapy) Research Groups, Utrecht, Netherlands, ³University Medical Centre Utrecht, Department of Rehabilitation, Physical Therapy Science and Sports, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, Netherlands, ⁴VU University Amsterdam, Department of Management and Organisation Studies, Amsterdam, Netherlands, ⁵HU University of Applied Sciences, Research Group Financial-Economic Innovation, Utrecht, Netherlands, ⁶University Medical Centre Utrecht, Department of Data Science and Biostatistics, Utrecht, Netherlands

Background: Physiotherapy primary healthcare organisations (PTPHO) need to adhere to managed competition regulations imposed by governments. Managed competition applies rules to establish efficiency in healthcare systems, with a focus on higher quality, lower costs, value for money, and standardised services. With managed competition, business principles have been introduced. PTPHOs are also challenged to compete with healthcare providers to address local community and patient needs, and to attain organisation-centred outcomes like treatment service quality and financial. Dynamic capabilities include modifying organisational routines to allow an organisation to cope with a changing environment, such as managed competition and to improve its effectiveness. Interestingly, organisational learning orientation and proactive market orientation are mentioned in dynamic capabilities literature as examples, and are each expected to have a positive influence on organisation-centred outcomes. Also, organisational learning orientation respectively proactive market orientation are expected to have a positive influence on business model novelty. Business model novelty refers to the adoption of new and different ways of transactions between an organisation and its customers, partners, and vendors compared to other competitors. Last, business model novelty may mediate between organisational learning orientation respectively proactive market orientation, and organisation-centred outcomes. The relations have not yet been validated for the PTPHO context. Their managers may not know how to attain such outcomes.

Purpose: To delineate the relations between the dynamic capabilities organisational learning orientation respectively proactive market orientation, and treatment service quality and financial organisation-centred outcomes, including the mediating role of business model novelty, within the Dutch PTPHO context.

Methods: Based on a quantitative cross-sectional design, the concepts were examined among PTPHO managers by a questionnaire. Theory-based expected relations were built and multiple regression (mediation) analyses were conducted.

Results: The relation between organisational learning orientation and treatment service quality organisation-centred outcomes relation is shown. Other relations between organisational learning orientation respectively proactive market orientation, and organisation-centred outcomes are not indicated. Positive relations are found between organisational learning orientation respectively proactive market orientation, and business model novelty. No relations exist between business model novelty and treatment service quality and financial organisation-centred outcomes. Business model novelty mediation between organisational learning orientation respectively proactive market orientation, and treatment service quality and financial organisation-centred outcomes is indicated by low estimates.

Conclusions: In the PTPHO context, the organisational learning orientation – treatment service quality organisation-centred outcomes relation upholds. All remaining relations between organisational learning orientation and proactive market orientation, and treatment service quality and financial organisation-centred outcomes have no support. The relations between organisational learning orientation and proactive market orientation, and business model novelty are supported. The mediating role of business model novelty between organisational learning orientation respectively proactive market orientation, and treatment service quality and financial organisation-centred outcomes is confirmed. However, the mediating role is indicated by low estimates.

Implications: PTPHO managers may cautiously invest in organisational learning orientation respectively proactive market orientation, and business model novelty activities. Policymakers could consider putting extra effort into gaining accurate insights into how PTPHO-centred outcomes are achieved. Business model research could mature via PTPHO-context-specific measurement.

Funding acknowledgements: Not applicable

Keywords:
Organisational learning orientation
Proactive market orientation
Business model design

Topics:
Professional issues: business skills, leadership, advocacy & change management
Primary health care
Globalisation: health systems, policies & strategies

Did this work require ethics approval? Yes

Institution: HU University of Applied Sciences Utrecht

Committee: Institutional Review Board Ethical Committee Research Healthcare Domain

Ethics number: Reference number: 159-000-2021_Rutger IJntema