Deliberate versus emergent organisational agility in paediatric health-care delivery: evidence from an Italian case study

Purpose This paper examines how organisational agility, defined as an institution's ability to thrive in an unpredictable and ever-changing business environment, presents itself within a pediatric day hospital, a little-explored public sector context, and how it influences the patient experience. Design/methodology/approach We integrated (1) a real-time survey of 443 patient journeys, (2) a 109-respondent agility questionnaire for healthcare professionals and (3) 16 semi-structured interviews, following the McKinsey 5S framework and the dynamic-capabilities view. Descriptive statistics and ordinal-logistic models were triangulated with thematic coding. Findings Agility scores were highest for structure (83%) and people (73%) but lowest for strategy (46%) and technology (40%). Flexible scheduling keeps median appointment deviations to 32minutes while sustaining high satisfaction (4.5/5). Staff tenure > 15 years predicts lower perceived agility (β = –0.27, p < 0.01). Transparent information and courteous interactions raised the odds of top-quartile patient experience more than eightfold (p < 0.001). Practical implications A four-step roadmap (strategic alignment, user-centred IT, experiential learning loops, senior-staff engagement) can institutionalise “deliberate agility” in similar units. Originality/value This is the first study to operationalise the 5S framework in an Italian tertiary paediatric context, offering a granular, data-driven link between agility and patient experience.