Compliance Paradox in Complex Organizations: Evidence from Medication Errors Healthcare Management in Healthcare Systems
DOI:
https://doi.org/10.65150/EP-jmrr/V2E4/2026-08Keywords:
Medication error, compliance behavior, system complexity, compliance paradox, PLS-SEMAbstract
Medication errors remain a persistent challenge in healthcare systems despite various efforts to improve procedural compliance. This study aims to analyze the relationship between compliance behavior and medication errors by integrating socio-technical perspectives and the moderating role of system of complexity. Data were collected from 260 healthcare professionals in Manado, North Sulawesi, Indonesia and analyzed using the Partial Least Squares Structural Equation Modeling (PLS-SEM) approach to test direct, mediation, and moderation relationships among variables. The results show that socio-technical factors have a positive and significant effect on compliance behavior and a negative effect on medication errors. Furthermore, compliance behavior was found to have a negative effect on medication errors and acted as partial mediator in this relationship. However, system complexity significantly weakened the negative effect of compliance behavior on medication errors, indicating that increased compliance does not always lead to decrease in errors under complex system conditions. These findings reveal a phenomenon of compliance paradox, where procedural compliance become less effective in environments with high complexity. This study contributes to the development of socio-technical perspective and provides practical implications regarding the importance of system simplification and cognitive load reduction to enhance patient safety.
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Copyright (c) 2026 Anita Linda Yohana Pratasik, Agus Supandi Soegoto, Joubert Barens Maramis, Hendra Novie Tawas (Author)
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