The Effects of Innovation Ambidexterity, Regulatory Pressure, and Resource Orchestration Capability on Organizational Agility: Evidence from Indonesian Hospitals

<ns5:p> Background Organizational agility is critical for hospitals operating under regulatory demands, service complexity, and changing environmental conditions. This study examined how innovation ambidexterity, regulatory pressure, and resource orchestration capability influence organizational agility in Indonesian hospitals. Methods A cross-sectional organizational survey was conducted among 81 hospital directors in Indonesia. The model tested the effects of innovation ambidexterity, regulatory pressure, and resource orchestration capability on organizational agility. The hypotheses were analyzed using partial least squares structural equation modeling in SmartPLS 4, with measurement-model assessment, collinearity diagnostics, bootstrapping, and effect-size evaluation. Results All hypothesized relationships were positive and significant. Innovation ambidexterity had the strongest effect on organizational agility (β = 0.438, p < 0.001; f <ns5:sup>2</ns5:sup> = 0.447), followed by resource orchestration capability (β = 0.366, p = 0.004; f <ns5:sup>2</ns5:sup> = 0.265) and regulatory pressure (β = 0.218, p = 0.005; f <ns5:sup>2</ns5:sup> = 0.151). The model explained a substantial proportion of variance in organizational agility (R <ns5:sup>2</ns5:sup> = 0.807). Conclusions The findings show that organizational agility in hospitals is shaped primarily by internal strategic and managerial capabilities, while regulatory pressure acts as a meaningful external catalyst. The study positions agility as a capability-dependent response in which hospitals convert innovation balance, resource orchestration, and institutional demands into adaptive organizational action. </ns5:p>