Supply chain management has proven effective in other industries, but healthcare has found its adoption to be challenging and the reason behind it can largely be attributed to the level of complexity involved in the network. ‘Complexity’ has become a dominant feature of the lexicon of today’s supply chain management field, thereby making complexity management a key area of managerial consideration. This paper, in the context of hospital supply chain network, conceptualizes complexity dimensions as quality of relationship, volume and frequency of interactions in the network, number of elements, degree of differentiation among the actors in the network, and extent of interrelationships among network elements. The study investigates the influence of hospital supply-base complexity and customer-base complexity on key Supply Chain Practices (SCPs) using Prahalad and Ramaswamy’s (2004) Dialogue-Access-Risk Benefits-Transparency (DART) framework, linking it to dynamic capabilities literature from the value co-creation perspective, using the Service-Dominant Logic (SDL) lens.

Complexity’ has become a dominant feature in the lexicon of today’s supply chain management field. Complexity no longer remains a novel stumbling block, as the supply chain managers, irrespective of their sectors, are facing it increasingly. So understanding the nature and source of the complexity has become very important for the managers, so as to aptly find the means to manage and contain complexity. With the enhancement in technology and sector competitiveness, complexity seems to be ever spiraling up across sectors, and healthcare happens to be one of the foremost (Schneller and Smeltzer, 2006). Christopher and Lee (2004) indicated the intensifying scenario and highlighted that demand patterns across nearly every industrial and services sector is on the rise associated with increasing volatility and vulnerability of supply chains due to various aspects, including disturbances or disruptions, changing pattern of business models, adoption of stringent practices, move towards prevalence of more outsourcing, trend towards reduced supplier base, and last but most importantly, lacking in visibility and supply chain confidence. Multiple interrelated firms and supply chain actors exhibiting inherent complex interconnections are the characteristics of most buyer-supply networks across industries (Choi and Hong, 2002). Hospital supply networks happen to be one of the most crowded and complex network types, with hundreds or even thousands of actors forming the upstream and downstream network. Such networks often exhibit shift in strategies and objectives within a dynamic environment which further complicates the scenario (Pathak et al., 2007). Thus, in a Business to Business (B2B) scenario, with multiple upstream suppliers and downstream customers, the role of the focal firm in managing the complications and adapting to the network conditions becomes immensely important. It can be rationally linked to buyer-supplier network decisions and optimization aspects (Pathak et al., 2007).

Supply Chain Management Journal, Supply Chain Practices, Complexity in Healthcare, Service-Dominant Logic View, ‘Complexity’, Service-Dominant Logic (SDL), Supply Chain Practices (SCPs).