Introduction

In a rapidly changing and growing global business environment, almost no company is safe from competing anymore. Nowadays almost all companies operate in uncertain and dynamic competitive environments. There are many sources of changes which arise from factors such as intense global competition, reducing expected time, product life expectancy demand diversification, and new technologies.

Traditional long-term strategic planning and unchanged strategies are considered unusual sources of competitive advantage, because in most industries, there is no certainty about the evolution of the working environment and what it will look like a year from now. However, companies must be able to compete in sustainable methods. In the early 90s, the concept of lean manufacturing was designed to address these considerations (Awais, 2017).

Strategic Agility describes business flexibility and responsiveness in the market. Companies that will survive in such environment must be in persistent search for new business opportunities and expect where the next big thing comes from. Staying on the top of competition also means being able to take quick courses if that is what is needed to reach the company's great goal. A highly agile company strategically equipped to meet these challenges.

Agility

The concept of agility originated at the beginning of the 20th century from research work sponsored by the US government at the Iacocca Institute in 1991. There are many definitions of agility that have emerged on the basis of many research conducted in this field. For example (Bohn, 2017) some researchers have defined the concept of agility as being able to run profitability in a continuous and unpredictable competitive environment and also change customer opportunities. Also agility was defined as the ability to survive and thrive in a competitive environment of continuous and unpredictable change through fast and efficient interaction with changing markets driven by specially-designed products and services.

The definitions of agility show that the common features of agility are the sense and responsiveness of the business environment. For example agility determines the ability to effectively change operating situations in response to uncertain and changing requirements. Institutions must therefore be in constant search for new jobs, a sense of ability and the capability to make quick turns to survive and remain competitive.

Strategic Agility

"Strategic Agility" means the learning of quick courses and the ability to transform and renew the company without losing opportunities (Borecka-Biernat, 2016). Four scopes of strategic Agility were identified:

First, enriching the client will enable the company to be a permanent part of its customer operations. Second, cooperation to enhance competitiveness in that it synchronizes individuals and sub-nations that play a role in developing procedures to meet customer needs on a continuous basis.

Third, the organization, to master the change and uncertainty as well as to benefit of the change advantage and consider it an opportunity. Fourthly, the ultimate strategic dimension of business agility is to take advantage of the influence of people and information by encouraging creativity enabling free flow of information and exchange of ideas. Cooperation in collaborative work within the organization, individual initiative and personal responsibility.

Strategic Fitness and Company Performance

Agility Strategy is the ability to leverage the full value of chain resources to run a dime and provide the right product at the right price anywhere. This type of flexibility requires the company to "exceed manufacturing limits" to develop "liquid operations". Thus the company's strategic agility requires that. it transforms itself from a "mechanism of action" into a "knowledge plant" - an accelerated membership learning organization that produces knowledge as a key to the product. Hence, we can see the emergence of knowledge as the most important organizational asset to achieve strategic agility. This is consistent with the company's knowledge-based view, which claims that the company's most important strategic resource is its knowledge base. Knowledge is a combination of information and human context that enhances the ability of work (Hahn, 2017).

There is a three-dimensional definition of agility. This definition of strategic brilliance includes three interrelated capabilities: agility for customers, partner agility, and operating speed. Long (2000) provides a measure of strategic speed that includes the above three dimensions of strategic agility. Its measure consists of six dimensions-visibility, customer knowledge, understanding of core competencies, choice of strategic objectives, shared responsibility. knowledge of competitors and actions. We claim that the two dimensions mentioned by them. namely customer knowledge and knowledge of competitors reflect market efficiency that can be used to achieve strategic ability, not dimensions of the strategic agility (Samadi, 2016).

The other five dimensions, visibility, understanding of core capabilities, the choice of strategic objectives. Joint responsibility and actions that reflect the building of strategic agility. Vision and basic capabilities of the organization provide a necessary set of "agility and stability" required to achieve strategic agility. If the company does not have an understanding of basic capabilities, it will seek "unfit for exploitation" opportunities. Visibility provides the necessary agility to execute. as it makes all value chain partners quite distinct and stimulated for exploitation of relevant opportunities when it occurs as well as its association with high performance.

By identifying common responsibility and taking action, we can conclude that the ability of the organization to adapt its strategy and involve its key members in its strategy discussion comes through its ability to provide access to information of its customers and to keep them fully involved in project planning and implementation.

Organization's Capabilities

The Organization's resources are the assets that build the Organization's core blocks Divided into tangible assets such as its plant. Equipment, financial resources and human resources of staff and their skills intangible assets such as culture, brand name. Copyright and patents. The resources are defined as follows: "Knowledge stocks, physical assets, human capital and other tangible and intangible factors owned or controlled by the business, which enable. The Company to produce, effectively and / or effectively deliver market offers of value to certain market segments (Thite, 2012)."

Resources can be seen as the assets of a company that are hard to imitate, if not impossible to imitate, while competencies result from merging the company's specific assets, described as local capacities and knowledge that are fundamental to the day. The organization’s ability to exploit its resources; consists of business processes to convert inputs into outputs.

When the organization constantly changes and reconfigures its capabilities to make them adapt to an uncertain environment, they are called dynamic capabilities are embedded in "mutiny organizational processes that guide the evolution of corporate resource configuration and operational routine". Some researchers said that the role of management is to organize competencies to create the capabilities desired by customers. Thus, the organization’s competitiveness reflects its ability to meet customer expectations relative to the capabilities of its competitors (Oyedijo, 2012).

Competitive Capabilities

The competitive capabilities of supply chain processes are indication of strategic fitness effectiveness. These capacities should be immediate measures of performance so that corrective measure can be taken in a timely manner to improve supply chain performance. A general list of the competitive capabilities of a strategically agile company is responsiveness efficiency, flexibility and speed.

The main driving forces of strategic speed (advanced manufacturing technology, better information systems, etc.) increase customer strength and pace of innovation. Therefore, the competitiveness of a flexible, strategic company must be in line with customer satisfaction and an innovation/learning perspective. Therefore, customers' point of view of product/service, timeliness, flexibility and value combined with innovation and learning dimensions such as product/process innovation, partnership management, information flows, threats, etc., have become important competitive dimensions.

Toni (2001) detailed the performance and competitiveness of the company in costs/productivity, time (times of operation, preparation, waiting, movement time, system times, delivery speed, reliability, marketing time) flexibility (size, mix, product)) And quality (production, quality expected, quality and interior). These capabilities not only guarantee the viability of a company but also contribute to achieving leadership status by the company. Competitiveness can be divided into four categories: product quality, delivery reliability, process flexibility and cost leadership.

The competitiveness of the supply chain as size flexibility, delivery, reliability of delivery / accreditation, product conformity to specifications, quick confirmation of customer orders, quick handling with customer complaint and customer satisfaction. Using literature. the competitiveness of operations was activated up to five dimensions (Pasquali, 2017):

1- Innovation.

2- Quality.

3- Reliability.

4- Flexibility.

5- Cost / Leadership Efficiency.

Previous Studies

1. Hallgren et al., (2011) entitled "Hybrid Model of Competitiveness".

The purpose of this paper is to introduce and test a new model of competitiveness. Traditionally, the cumulative model is seen as containing one series of competitive capacity building in the company to support market needs, including quality, delivery, cost effectiveness and flexibility. Although attractive as a conceptual model, the experimental test was not able to fully support the cumulative mode. This paper recognizes the need for a hybrid approach of managing capacity progress, combines literature on trade-offs, cumulative capabilities, and winning and qualified students.

A new hybrid approach to competitively modeling competency is tested using data from the High-Performance Manufacturing Survey (HPM), Round 3, including three industries and seven countries - a total of 211 stations. The hybrid model shows better consistency with the sample data than the cumulative models suggested in the previous literature. Experimental support has been found for the traditional realization that a high level of quality is a prerequisite for a high level of delivery performance. However, cost efficiency and flexibility do not show a cumulative pattern.

2. Apicha (2012) entitled "Competitiveness of the Thai Logistics Industry: Impacts on the Company's Image and Performance".

This study was conducted to explore the competitiveness of companies engaged in logistics. The aim was to study the effects of strategic elements related to competitiveness on the image of the company, profitability and growth. The key strategic elements for building competitiveness have been proposed to be consist of quality of service, marketing capabilities and management capabilities. The results indicate that the first priority of companies in building competitiveness must depend on the provision of reliable and fast services, the provision of a variety of services, and the provision of attractive prices. The second priority level is to provide a quick response to customers, provide service facilities and attractiveness, ensure that the location of the service is suitable for access, and use modern information technology to improve service operations.

3. Oyedijo (2012) entitled "Strategic Agility and Competitive Performance in Nigerian Telecom Industry: A Pilot Inquiry".

This paper examines the relationship between strategic agility and competitive performance using the data generated by nine (9) companies in the telecommunications industry in Nigeria. A five-point Likert scale based on 21 items derived from the existing literature for measuring and evaluating the sites of test sample companies was used on different dimensions of strategic speed. Using a multi-informant questionnaire, the respondents' assessment of all elements of the strategic and average impact was summarized to obtain a strategic index for each participating company.

The strategic agility impact data was generated from the questionnaire completed by the TMT members of each company. Data on profit growth, sales revenue, financial strength, operating efficiency and performance stability were collected from corporate records. The results of the analysis showed a statistically significant relationship between strategic agility and competitive performance. Strategic agility has been found to affect the competitive performance of telecom operators in Nigeria (with a factor of 3.419). It has also been found that strategic agility has a significant impact on competitive performance and is a good indicator of competitive performance (R2 = 0.610).

4. Bhaleand Mishra (2012) entitled "Strategic Agility: Business Approach for ICT Companies in the Indian Context".

The purpose of this paper is to examine the phenomenon of ICT globalization and their strategic implications, such as IBM, CISCO and HCL in the context of India. The paper aims to explore the strategic proposals of the ICT industry and the strategic speed that these companies have been offering in recent years. This paper is conceptual in nature, using the qualitative method to prove the important issues of the international ICT business scenario, especially in the Indian Subcontinent.

An attempt was made to explore the strategic approach in order to make some vital observations ready for conclusion status. The paper considers that globalization has in fact made a quantum leap in the strategic planning of global ICT companies to classify innovation as a new direction for business performance and a so-called successful strategy in its own field. The paper considers that globalization has in fact made a quantum leap in the strategic planning of global ICT companies to classify innovation as a new direction for business performance and a so-called successful strategy in its own field. Provides an insight into the strategic integration of globalization innovation and technical aspects of the use of business practices by multinational ICT companies. The studies, together with the importance of the core literature of the global strategy institutions, are based on creating value both locally and internationally.

Study Design

Descriptive research includes data collection to test hypotheses or answer questions about the current status of the subject matter of the study.

Idealistic descriptive studies are concerned with assessing attitudes, opinions, demographic information, conditions and procedures. The research design chosen for the study is the survey research. The survey is an attempt to collect data from community members in order to determine the current status of that group with respect to one or more variables. Survey research at best can provide very valuable data. It involves careful design and implementation of each element of the search process.

The researcher designed a managed scan tool for the search sample.

The purpose of the survey tool was to collect data on attitudes towards strategic and operational competitiveness.

Hypotheses of the Study

The researcher suggests that the dimensions of strategic agility have an important impact on the competitiveness of hospital operation. Based on the study problem and literature review, the following main research hypothesis was formulated:

There is no significant difference between hospitals according to the size of hospitals in strategic agility (visibility, core competencies, selected strategic objectives, shared responsibility and action) on operational competitiveness at (α≤0.05) level.

Some of the following sub-assumptions are divided:

Community Study

The study community consists of directors and heads of department working in Iraqi private hospitals located in the city of Baghdad. In this study, Iraqi private hospitals are divided into two categories according to the size of their beds (more than 73 beds and tins than 73 beds). The questionnaire was submitted electronically to the hospitals. The researcher received the answers from the employees of the private hospitals. The number of questionnaires was 147 valid for the analysis out of 480 sent the hospitals administration with a total of 33%.

Statistical Analysis

The Statistical Package for Social Sciences (SPSS 22) was used to analyze the collected data and test the hypotheses of the research.

The statistical methods used in this research consist of a descriptive statistic that includes percentages, frequencies, methods and standard deviation to describe all research variables and questions in order to achieve the research objectives.

Results and Recommendations

Section I: Demographic variables: Demographic information was collected with closed questions, through (6) factors. (Gender, age, educational level. occupation, experience and number of beds) shown in Table 1.

Table1 Demographic Variables of the Respondents
			Number	%
1	Gender	Male	92	62.5
		Female	55	37.4
Total			147	100%
2	Age	<25	25	17
		25-40	68	46.3
		>40	54	36.7
Total			147	100%
3	Educational level	Post graduate	42	28.6
		Undergraduate	105	71.4
Total			147	100%
4	Position	General director	18	12.2
		Deputy director	8	5.4
		Unit manager	8	32.7
		Head of department	73	49.7
Total			147	100%
5	Years of experience	5-Jan	12	8.2
		10-May	24	16.3
		15-Oct	47	32
		>15	64	43.5
Total			147	100%
6	Number of beds	75	47	32
		76-100	18	12.2
		100-125	26	17.7
		>125	56	38.1
Total			147	100%

Table (1) shows the results of descriptive analysis of the demographic variables of individuals responding to the sample of the study. The table shows that 62.6% of the study sample is male and 37.4% are female. On the other hand, the percentage (83%) of the sample was over (25) years. From the experience point of view, 75.5% of respondents have more than

10 years of experience in the health care sector, this gives an indication of their role in keeping pace with rapid development in the healthcare sector. Table (7) also shows that respondents come from different jobs, which means that the sample was relatively representative.

Section II: Dimensions of Strategic Agility, Strategic Impairment was assessed through (5) dimensions (visibility, core competencies, selected strategic objectives, shared responsibility, work process) identified by reference to relevant literature (Oyedijo, 2012).

A five-measure Likert scale was used to measure the dimensions of the agility measured by 20 substances. (4) Questions were measured from (1) to (2) shown in Table 2; the basic abilities of understanding, were measured by (4) questions from (3) to (6) (4) Questions from (7) to (10) are illustrated in Table 4; shared responsibility was measured through (4) questions from (11) to (14); measures were measured through (4)) To (18) as shown in Table 5.

Table 2 Visibility: Averages and Standard Deviation
		SMA	Standard Deviation	Level
1	We find it easy to explain our general goals clearly and effectively to others.	4.2	0.68	High
2	we have clear sense of purpose and we're using it to guide our decisions in business management	4.02	0.77	High
Total		4.11	0.73	High

Table (2) shows the level of importance of visibility, with an average of 4.11. These findings show how Iraqi private hospitals are clearly communicating with staff. However, the results also show how clear the vision is, which partly directing, the process of the unit.

In general, this explains that the view of managers and heads of departments was at a high level about the visibility of Iraqi private hospitals in Baghdad. This explains also that the views of managers and heads of departments were at a high level about the visibility of private hospitals in Baghdad.

Table 3 Understanding Basic Capacities: Mean and Standard Deviation
		SMA	Standard Deviation	Level
3	We have a high level of agreement on principles that must guide our behavior in conducting our business unit operations.	3.9	0.77	High
4	We are proud of what we are trying to achieve as a business unit.	4.12	0.8	High
5	We have a good understanding of the most important skills and knowledge to provide services that are of interest to our customers.	4.16	0.78	High
6	We are well aware of the reputation of our business unit among our customers and what we are famous for in the market	4.04	0.76	High
Total		4.05	0.77	High

Table (3) shows the level of importance of understanding the basic capabilities. The methods vary between (3.90-4.16) compared to a total average of (4.05). The highest average of the item "We have a good understanding of what skills and knowledge are most important to provide services that are important to our customers" on average (4.16) and standard deviation (0.78), these results show that the private management that manages hospitals has the skills to provide good customer service.

In general, this explains that the views of managers and heads of departments were at a high level about the basic capabilities of understanding in Iraqi private hospitals in Baghdad.

In the same way, this explains that the views of the directors and heads of departments were at a high level about the basic capabilities of private hospitals in Baghdad.

Table (5) shows the level of importance of joint responsibility and action. ranging between (3.71-4.21) compared to the total average (3.90). We note that the highest average of the item "we ask people in our project teams to treat errors as opportunities for learning and improvement rather than to put blame" with the mean (4.21) and the standard deviation (0.79) which indicates that Iraqi private hospitals are spreading the culture of free blame between Their staff While the lowest average of the item. "We maintain the full involvement of our clients in the planning and implementation of projects by emphasizing the importance of their role in obtaining results," with an average of 3.71 and a standard deviation of 0.91. These findings show that Iraqi private hospitals still need to study their clients as partners rather than consumers.

Table 4 Choice of Strategic Objectives: Averages and Standard Deviation
		SMA	Standard Deviation	Level
7	We are able to identify sectors (market /customers) that place high value on the attributes of our service.	3.91	0.87	High
8	We know which of the core capabilities of our business unit are most important in creating value for existing or new segments.	3.9	0.84	High
9	We can describe the special skills, knowledge and know-how that include our greatest strengths and depend on them to maintain our competitive advantage.	4.13	0.3	High
10	We have procedures to identify and renew services that provide a good match between hospital capabilities and our market opportunities.	3.9	0.8	High
Total		3.96	0.79	High

Table 5 Shared Responsibility and Action: Averages and Standard Deviation
		SMA	Standard Deviation	Level
11	We ask people in our project teams to treat errors as opportunities to improve learning rather than to put blame.	4.21	0.79	High
12	We provide easy access to information that interests our customers and the people we work with.	3.91	0.8	High
13	We encourage people in our project teams, including the customer, to act as if each of us is responsible for the final results of the overall project, not just for the part that has been assigned to us.	3.84	0.91	High
14	We keep our clients fully engaged in the planning and execution of projects that emphasize the importance of their role in obtaining results	3.71	0.91	High
15	We make sure that the people we work with are totally or fully aware of our strategy and purpose.	3.97	0.87	High
16	We are able to adapt our strategy to changing circumstances without losing sight of the overall objective of the strategy.	3.94	0.82	High
17	We involve the key people we work with in our strategy discussions and brainstorm on how best to implement them.	3.85	0.79	High
18	We discuss frequently with the people we work with the kinds of actions needed to best implement a business unit strategy.	3.82	0.82	High
Total		3.9	0.95	High

Table (6) shows statistically significant differences between the members of the study sample from the point of view of the hospital size with regard to the effect of the strategic agility on the competitiveness of the process. The value (F) was (4.110) the importance level (0.008) (a < 0.05) To find out which type of hospital size differences were in their favor, the Scheffe test was conducted to determine which category of hospital size varied, Table 7 shows.

Table 6 Anova Test to Determine the Impact of its Strategic Agility on the Process of Competitiveness in Volume And Hospitals "of Iraqi Private Hospitals in Baghdad
	Total squares	DF	Squares averages	F	Sig*
Between groups	2.805	3	0.935	4.11	0.008
Within groups	32.529	143	227
Total	35.334	146

Table 7 Scheffe Multivariate Testing
No. of beds (I)	No. of beds (J)	Average difference	Sig*
<75	76-100	0.1252	0.826
	101-125	0.1784	0.507
	>125	0.3286	0.009
76-100	75	0.1252	0.826
	76-100	0.0531	0.988
	125	0.2034	0.482
101-125	<75	0.1784	0.507
	76-100	0.531	0.988
	>125	0.1502	0.624
>125	<75	0.3286	0.009
	76-100	0.2034	0.482
	101-125	0.1502	0.624

Table (7) shows that the differences were in favor of the category (>125 beds), which explains the greatest impact of its strategic agility on operational competitiveness in (>125 beds) class. Thus, rejecting the null hypothesis and accepting the alternative hypothesis.

There are statistically significant differences between hospitals by its size in strategic agility (visibility, core competencies, selected strategic objectives, shared responsibility, and action) impact on competitive operational capacity at (a <0.05).

Conclusion

Based on the results of the study, the researcher concludes the following points:

1. Iraqi private hospitals are aware of the dimensions of their strategic agility, especially in view of the high levels of competitive and turbulent environment, which proves that Iraqi private hospitals follow the strategic leadership and defined the concept of agility as capable of operating profitability in a continuous and unpredictable competitive environment and changing the opportunities of customers.

2. Some of the dimensions of strategic agility have an impact on the competitiveness of operations in Iraqi private hospitals, which are in line with Alexeeva (2015) suggesting that the agile organization achieves better cost, quality, speed, flexibility and innovation at the same time. Without compromising on any of these standards supported by Oyedijo (2012) results that showed a significant relationship between strategic agility and competitive performance.

3. The dimensions of strategic agility (visibility and core competencies) do not affect the competitiveness of processes (innovation, quality of service, delivery reliability, and process flexibility and cost leadership).

4. Iraqi private hospitals are able to create value and use it in choosing their customers.

5. Iraqi private hospitals are able to use their capabilities in the value chain strategy, which proves and supports what Bohn and others found in 2017 that agility is more valuable in environmental change conditions as it enables companies to achieve compatibility between supply side capabilities and market demand.

6. According to the size of the hospital there is a significant difference in the impact of strategic agility on the practical competitiveness.

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Received: 30-Dec-2021, Manuscript No. AEJ-21-8975; Editor assigned: 16-Nov-2021, PreQC No. AEJ-21-8975(PQ); Reviewed: 07-Dec-2021, QC No. AEJ-21-8975; Revised: 27-Dec-2022, Manuscript No. AEJ-21-8975(R); Published: 31-Jan-2022