Riding the waves of uncertainty: Towards strategic agility in medicine supply systems

Abstract

We investigate how organizations embedded in a supply system collectively respond to risks and seize opportunities arising from crisis events under shifting forms of uncertainty. Using the United Kingdom (UK) medicine supply system as the research context, we explore how decision-makers navigated the effects of an event with knowable implications (UK's European Union exit, 2016–2020) followed by an event with unknowable implications (COVID-19 global pandemic, 2020–2021). We adopt a longitudinal case research design that incorporates causal loop diagramming, to understand the system's responses. We find that learning evolves as crisis events unfold, changing from surface (know-what) to deep (know-why and -how) and at the highest level, it is transcendent. Transcendent learning entails understanding system effects into the future (i.e., beyond the past and present) and in relation to other supply systems (i.e., beyond the UK system). Capabilities to absorb, avoid, and accelerate away from shocks are developed sequentially as learning changes. We contribute to prior research by developing a theory of system-level strategic agility and the adaptation processes that underpin it. The latter hinge on dynamic resource (re)allocation and the continuous (re)configuration of processes, protocols, regulations, and structures.