Exploring agile leadership, ambidextrous leadership, organizational agility, and innovation behaviors among nurse managers: an explanatory mixed-methods study.

AIM: To describe agile leadership, ambidextrous leadership, organizational agility, and innovation behaviors among nurse managers and explore how these practices are experienced in clinical management.

BACKGROUND

Agile leadership, organizational responsiveness, and innovation are increasingly relevant to nursing management. However, these concepts may overlap substantially when measured through same-source self-report, making qualitative contextualization important for understanding how they are experienced in practice.

METHODS

An exploratory sequential explanatory mixed-methods study was conducted in a tertiary Saudi hospital. Forty-four nurse managers completed measures of agile leadership, ambidextrous leadership, organizational agility, and innovation behaviors. Thirty-two nurse managers then participated in semi-structured interviews analyzed thematically. Quantitative data were analyzed descriptively and exploratorily, and qualitative data were analyzed thematically. Greater interpretive weight was given to the qualitative phase.

RESULTS

Nurse managers reported moderate agile and ambidextrous leadership and high organizational agility and innovation behaviors. The four measures showed near-unity correlations, limiting construct-specific interpretation. Qualitative analysis generated five themes: agile leadership as flexibility and human-centered responsiveness; ambidextrous leadership as balancing opening and closing behaviors; organizational agility as adaptive unit functioning; innovation as problem-driven practice; and contextual challenges influencing leadership effectiveness.

CONCLUSION

The findings indicate a highly interrelated agile leadership-organizational functioning profile. The primary contribution lies in the qualitative findings, which show how nurse managers described flexibility, delegation, balancing operational and improvement work, problem-driven innovation, and contextual constraints within Saudi clinical management. Larger multisite and multi-source studies are needed to determine whether the measured constructs are empirically distinct.