Modelling the Organizational Health Using Soft Systems Methodology: A Holistic Approach

Modelling the Organizational Health Using Soft Systems Methodology: A Holistic Approach | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Modelling the Organizational Health Using Soft Systems Methodology: A Holistic Approach Hosein Tayeba, Bijan Nahavandi, Mahdi Homayounfar This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8414400/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 4 You are reading this latest preprint version Abstract Due to the effect of organizational health (OH) on organizations’ productivity, innovation, and profitability, as well as improved employees’ satisfaction and retention, this research aims to use an analytical approach for analyzing the complex phenomenon of organizational health, which has a dynamic nature in today's business world. This paper highlights the need for analyzing organizational health from a systems approach perspective, specifically utilizing the unique soft systems methodology. The proposed framework is applied to a case study in Iran construction industry. It is indicated that organizational health is a complex and multi-layered concept that goes beyond organizational performance. A comprehensive understanding of organizational health can reveal critical issues that affect future performance, despite current satisfactory performance. While the approach presented in this research is holistic and systematic, it is not a universal solution for all organizations and requires specific details related to each organization's health.The research offers a new perspective on organizational health by proposing a systems approach and utilizing the soft systems methodology, indicating the concept's complexity and multi-dimensionality. Despite previous studies in the field of organizational health, the research highlights the need for a deeper and more careful analysis of this topic. Organizational Health System Approach Soft Systems Methodology (SSM) CATWOE Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 1. Introduction The workplace provides an essential setting for health promotion, as employees spend most of their day at work (Greenberg et al., 2021 ). Indeed, employees are the essential driver of organizations' excellence and the most valuable asset to their achievements (Lee et al., 2023 ). Therefore, promoting practices such as monitoring and alleviating employee health symptoms, offering health-promoting events and psychological counseling, and using flexible work arrangements and scheduling can strengthen employees’ resources such as positive emotions, self-esteem, and feelings of approval and recognition and make organizations healthy (Chen & Eyoun, 2021 ; Chiang & Hsieh, 2012 ). The topic of organizational health (OH) is not a novel concept, as far back as the mid-1990s, Chris Argyris endeavored to explore "the way in which an organization can effectively achieve health" (Argyris, 1970 ). Miles also described organizational health in 1969 as a situation that goes beyond short-term organizational effectiveness and entails a set of relatively durable characteristics (Miles, 1969 ). Organizational health is defined as the investments made in the present time to ensure future survival and growth (Keller and Price, 2011 ). It also defined as an organization’s effort to transform organization and delivery of care and services to make it easier for employees to acquire, understand, and use information to take care of their health (Farmanova et al., 2018 ; Bremer et al., 2021 ). Organizational health helps organizations to achieve their goals, create competitive advantages, and boost employees’ well-being by determining an organization’s ability to establish, communicate, and implement a proper business strategy while retaining employees highly engaged (Jaafari et al., 2023 ). A healthy organization is one that not only sustains itself in its environment but also cultivates management and developmental skills. Recent studies have shown that improving organizational health is crucial for achieving organizational performance (Inceoglu et al., 2018 ). Organizations that prioritize employee well-being, learning and development, and strong leadership are more likely to thrive in the long-term (Bremer et al., 2021 ). Organizational health is a broad field of study that encompasses a wide range of research topics related to the well-being and effectiveness of organizations. Systematic review of the literature shows that there are various field of research in organizational health such as; employee well-being (Kelloway et al., 2017 ; Min and Su, 2020 ; Singh and Jha, 2022 ), organizational culture, performance management (Nair et al. 2014 ; Inceoglu et al., 2018 ), and change management (Tuan, 2013 ) are four categories of research that fall under the light of organizational health. Accordingly, a healthy organization is one that not only survives in its environment, but also develops its employees’ well-being, culture, performance management and development. Despite its importance, organizational health remained a complex and challenging issue. Despite, McKinsey's coherent studies by Keller and Price ( 2011 ) in various industries from 2006 to 2011, which led to the development of an overall organizational health model, organizational health became an extremely complex and highly uncertain issue, particularly in today's turbulent business environment; therefore, it is regarded as a soft and unstructured organizational phenomenon. Accordingly, it is prominent to take a deeper approach for its analysis and modeling. Soft Systems Methodology (SSM) is a useful approach for analyzing and modeling organizational issues, particularly in the face of high uncertainty and diverse perspectives. SSM emphasizes the importance of involving stakeholders with different views and experiences in the analysis process, and uses purposeful conceptual models to structure discussions and identify areas for improvement. In conclusion, improving organizational health is critical for organizations to thrive in the long-term. Furthermore, by adopting a systemic perspective and applying SSM, organizations can gain a more nuanced understanding of their strengths and weaknesses, and take targeted actions to improve their overall health and sustainability. This study aims to explore the utility of a systemic perspective, particularly the SSM, in modeling organizational health. The primary contribution of this research is the application of SSM to a complex real-world problem, specifically the concept of organizational health. This study has developed an integrated and comprehensive analytical framework for analyzing, constructing, and modeling organizational health. To demonstrate the effectiveness of this approach, the framework was implemented in an Iranian construction company, using purposeful sampling and expert interviews to identify problematic situations and desired outcomes. The SSM's seven steps were used to draw a rich picture, perform CATWOE analysis, and develop a conceptual model. Based on this analysis, strategies were proposed to improve organizational health and performance in the company. This applied research contributes to the development of knowledge to promote organizational health in a non-structured environment and can be applied to different societies. The research question is twofold: firstly, how can the SSM be applied in this context? And secondly, what are the key steps and characteristics of implementing this approach? 2 Literature Review 2.1 Organizational Health Prior to the 1990s, there was limited research on organizational health. Since then, the scope of research in this field has expanded significantly, especially when concepts such as organizational capacity, organizational change, workplace health, occupational health and healthy organization came into the field of social science and management research. The term “Organizational Health” was first used by Miles in 1965 to study the organizational climate of schools (Tsui and Cheng 1999 ). In the late 1990s, the concept of organizational health first evolved as the most important source of competitive advantage (Keller and Price, 2011 ). Organizational health refers to a situation beyond the short-term effectiveness of the organization and deals with to a set of relatively durable characteristics. Accordingly, organizational health refers to the continuity and survival of the organization in its environment, adaptation to its environment, and the promotion and expansion of its ability to further adaptability. The clear point of this definition is that a healthy organization successfully deals with external opposition forces and effectively directs them towards the main goals and objectives of the organization (Hoy and Miskel, 2012 ). Healthy organizations as living and dynamic organisms in the environment can emerge and grow by providing the essential and adequate facilities, and by providing healthy and valuable goods and services can meet environmental needs and facilitate the process of growth and prosperity of society (Kelloway et al., 2017 ). In fact, organizational health is not only the survival of the organization in the environment, but doing something beyond it means the long-term development of the organization. In such a situation, satisfaction and health (physical, mental, and social) of employees are prominent, because it provides the basis for improving the organizational performance (Alman, 2010 ). As mentioned before, the importance of organizational health has led to many studies in recent years. Lee et al. ( 2023 ) described the development and implementation of a low-cost organizational health assessment through five phases: development of the assessment, data collection, analysis, metrics and data visualization, and dissemination of findings and development of interventions. Jaafari et al. ( 2023 ) developed an original two-subscale measure that evaluates organizational health behavior determinants. This scale can help create an environment at work that boosts productivity, engagement, and retention. Hur et al. ( 2023 ) examined the moderating role of perceived organizational health climate and health-oriented leadership on the mindfulness–resilience relationship. According to their findings, the positive relationship between these two variables was more pronounced when perceived organizational health climate was high. Singh and Jha ( 2022 ) studied the bi-directional relationship between employee well-being and organizational health. The results show that when organizational health is good, employees’ health will also be good but not vice versa. Farooq et al. ( 2017 ) investigated the effect of sustainable leadership and talent management on university transformation by the mediating role of organizational health. Nair et al. ( 2014 ) studied the factors affecting organizational health in the framework of systems theory in order to create a measurement model that can be applied to measure business performance with organizational change. Most organizational health studies are in the field of education and training organizations and less in the field of business and industry (Tuan, 2013 ; Xenidis and Theocharous, 2014 ; Singh and Jha, 2017 ). This highlights the need for studies related to the concept of organizational health in the field of business. One of the most complete and inspiring organizational health studies in business was conducted by the McKinzy Institute (Keller & Price, 2011 ; Keller & Schaninger, 2019 ). This study showed 9 elements of organizational health in the form of three axes of alignment, execution, and renewal and presented the Organizational Health Index (OHI) to measure organizational health status. Recently, Tounsi et al. ( 2021 ) developed a model for measuring organizational health in an aviation organization by using a mixed method and conceptualizing 8 dimensions of organizational health. On the other hand, Dive ( 2004 ) equates a healthy organization with complex structures, management processes, knowledge systems, and activities that must be consistent with the organization's strategy. Therefore, organizational health is very complex with different layers and all organizational stakeholders are involved in its formation or decline. This aspect of organizational health has not received much attention in current studies, which is recognized as the theoretical gap in the present paper. This new perspective on organizational health requires the use of more effective tools in such a way that makes it possible to understand the uncertainty and ambiguity associated with organizational health. The present study tries to consider and deepen organizational health as one of the most fundamental business issues in today's world, and one of the soft phenomena in the field of business. This is considered as the difference between the present study and the model presented by the McKinzey Group. In other words, the present study considers organizational health as a very complex and unstructured problem that cannot be easily analyzed and modeled using common approaches and, therefore, requires the use of soft methodologies. 2.2 Soft system methodology (SSM) Prior to the 1970s, quantitative and computational methodologies were oriented very much towards solving human and managerial problems. These methodologies, called hard methodologies, are based on engineering and scientific principles, have a tool-oriented and systematic approach, and are suitable for simple systems in which people have the same perceptions of the problem situation. On the other hand, diverse methodologies are required to solve human and managerial problems that are related to turbulent and very complex situations. These types of methodologies, called soft methodologies, have a holistic, interpretive, systematic and problem-oriented perspective, and their purpose is to deal with problem-solving situations that are based on contradictory worldviews and purposeful actions (Higham, 2014 ). One of the approaches that has been developed to introduce human and social systems is the SSM. This approach was introduced by Peter Checkland through a work program at Lancaster University in the 1960s as a reaction to the traditional management view of natural and value-free objective truth. The SSM is an action-oriented method that creates learning by researching problem situations. In soft systems problems, there can be a wide range of acceptable and correct answers. Usually, the SSM is applied in a situation with a large number of stakeholders with various benefits, in which conflicts are inevitable. In this case, hard methodologies are not efficient because structuring the problem is impossible. (Checkland,1972). Soft systems methodology (SSM) is an organized and flexible process for dealing with problematic situations, that need to be improved to become more acceptable and less ambiguous. In practice, this methodology is illustrated as a seven-step analysis process in both real-world and abstract worlds, which uses the concept of human activity system as an important tool for data collection and action to improve the situation (Wilson, 2001 ; Checkland and Poulter, 2006 ). Figure 1 shows the steps of the SSM. These steps are presented concisely as follows: Figure 1 The steps of the Soft Systems Methodology (Checkland and Poulter, 2006 ) 1. Unstructured problem situation (Identify the situation that is thought to be problematic) : This is a general research stage about the problem environment. Besides, in this stage, a meeting is held including managers and employees involved with the problem as well as analysts, to review the activities and methods of doing work. 2. Structured problem situation (Express the problem situation by a rich picture) : Through a rich picture, the problem situation, including its involved people, their concerns, and the problem structure are pictured. 3. Selecting relevant systems and providing their root definitions : In this stage, based on the conceptual and systemic world, the root definitions of relevant systems are defined. Root definitions not only describe the desired systems, but also describe the details of the systems, including customers, actors, owners, etc. a) PQR formula (Do P by a Q in order to achieve R) for root definitions : This formula provides a basis for root definitions. b) CATWOE (Customer, Actor, Transformation, Worldview, Owner, Environmental Constraints) analysis to enrich root definitions : CATWOE is used for the purpose of examining root definitions and the correctness of the selected words. Adequacy criterion : This criterion refers to the proper functioning of the transformation event and its purpose is to achieve the desired goals of the transformation process (do the tools work?). Efficiency criterion : This criterion indicates the minimum and correct use of resources in the transformation process. Effectiveness criterion : This criterion indicates whether the transformation process can help achieve higher or longer-term goals. 4. Conceptual modelling . This requires gathering concepts in a mental structure and presenting a conceptual model. 5. Comparison of the conceptual model and rich picture : This stage is performed for the improvement of the current status. 6. Identifying feasible and desired changes : In this stage, desired and feasible changes are identified. 7. Implementing organizational change : This stage involves an operational plan including all required tasks to make determined changes. Conceiving the SSM as a systems approach, capable in dealing with issues with complexities affected by human role in systems and social environments, in this research the SSM is applied to study and analyze the most important intellectual orientations of stakeholders regarding current issues, and each of the unknown dimensions of organizational health, and based on consensus provide an integrated and holistic framework for organizational health. 3 Research Methodology The integrated framework of the research in the field of organizational health based on the systems perspective of the SSM, is presented in Fig. 2 . According to the presented framework in the real world, it is essential to look at organizational health and its dimensions as a complex and problematic situation, and these conditions are carefully and deeply explained and analyzed. Having a rich picture of these conditions is possible only by considering the views and attitudes of internal and external role players or the same organizational stakeholders. Obviously, identifying and communicating effectively with all stakeholders, conducting careful analysis, and satisfying their demands and expectations will greatly contribute to the quality of the model. In addition to regarding the various and diverse thoughts in the organization, such an image provides a basis for creating root definitions of organizational health. This is the way in which weaknesses of previous approaches to organizational health have reasonably improved. The steps of the present approach can be described as follows: Collecting and reviewing organizational health concepts and tools for measuring organizational health Identifying the most important characteristics of organizational health Preparing main questions for the interview Purposeful sampling from different groups of stakeholders Identifying the mission, strategies, and main processes of the organization under study and its main stakeholders, demands, expectations, and problematic situations Adapting the current status of the organization to the characteristics of a healthy Expressing the problem conditions in the form of a rich picture Analyzing the intervention, social and political systems Receiving stakeholder feedback on the rich picture and Analyzing data to discover concerns Verifying the rich picture of the problem situation in the real world Defining root definitions of organizational health using PQR Enriching root definitions using CATWOE Presenting the root definitions and receiving the opinions of the stakeholders Providing an initial conceptual model of organizational health tailored to each group of stakeholders Receiving stakeholder feedback on the conceptual model and applying possible changes Presenting the final conceptual model of organizational health Preparing a list of operational measures of organizational health Holding a meeting on political analysis and the feasibility of actions 4 Empirical Study The case study of this research is a holding in the construction industry. The most important mission of this holding in the past years has been to create value through construction projects with the priority of attracting private sector investors in the form of partnership contracts, so that up to 95% of its projects have been completed through partnership contracts. As stated in the SSM, in order to discover the thoughts and worldviews of the stakeholders involved in the issue, it is essential to answer the main question of which stakeholders and concerns are involved in organizational health issues and decisions. Figure 3 shows the internal and external stakeholders of the case. Here, a summary of the steps taken to implement the research model of the study is described. 1) Identifying the problem situation (s). The most important organizational issues can be significantly extracted by interviewing and holding focus groups. Various concerns of different stakeholders are explained below: Employees : Mergers and downsizing, workplace conditions, increasing work stress, job dissatisfaction, experts leaving the organization, restriction of replacement forces, authoritarian style of leaders and managers, etc. Managers and deputies : Restrictions on decision-making powers, bureaucratic processes, excessive interference and influence of the main shareholder, frequent change of leaders and senior managers, long-term stagnation of the housing market, obstacles and restrictions of the main shareholder in creating some construction uses, etc. Main shareholder : Poor performance of previous managers, incidence of collusion and rent, legal cases in companies, budget failure, negative attitude on the part of the main shareholder, etc. Partners and suppliers : The difficult and ambiguous process of selecting a partner or investor, imposing technical specifications contrary to local customs, etc. Customers : Not paying attention to the demands and requirements of customers regarding the product, a lack of variety of sales methods, and non-compliance of the final product with the sales contract. 2) Expressing the situation by presenting a rich picture. At this stage, organizational and situation-related challenges, shortcomings and problems are considered from the perspective of each of the stakeholders identified in the previous stage, with the aim of providing a clear, rich picture of the problematic situation. Figure 4 shows a rich picture of the problem situation of the case study. 3) Selecting relevant systems and providing their root definitions. The PQR formula refers to P, by Q, to achieve R. An example of the results of the PQR formulation of two key stakeholders, namely shareholders and holding managers, to derive the basic definitions of organizational health is presented in Table 1 . It should be noted that this formula should be applied to all stakeholders Table 1 PQR structure for two groups of key stakeholders Questions Stakeholders P - What? Q - How? R - Why? Shareholders (major and minor) Optimal fulfillment of commitments and operational plans By investing in economically viable construction projects and avoiding the sale of raw materials (without any economic value added), timely payment of financial obligations along with the implementation of plans and budgets, etc. To improve financial indicators and organizational credibility Managers and deputies Improving the authority level of decision-making, planning and execution The right to choose regarding the purchase and operation of real estate inside and outside the organization, entering other geographical areas inside and outside the country and streamlining processes along with the development of technology, technical, managerial and executive capabilities of companies, etc. To improve efficiency, dynamism, adaptability and survival The stakeholders play great roles in shaping the issue of organizational health. With regard to the initial root definitions, words extracted from interviews, it can be inferred that the first group of stakeholders includes major and minor stakeholders, customers and consumers play the role of policymakers, and the second group includes construction holding managers, managers of subsidiaries, employees, construction partners, applicants, and investors play the role of implementers. Hereupon, the two mentioned root definitions provide two dominant attitudes, perspectives or worldviews for organizational health. To achieve an enriched root definition of these two attitudes (policymakers and implementers), the process of determining the CATWOE elements in the form of six core components of the company is performed according to Table 2 . Table 2 CATWOE elements Elements of CATWOE Element description Policy-makers Implementers Shareholders, customers, and consumers Managers of holding and companies, employees, construction partners and investors C (Customer) There are people who directly benefit or suffer from system outputs Holding and subsidiaries, partners and investors, and people and society Shareholders, customers and consumers, and applicants A (Actor) Actors are the people who perform the activities of the system and cause transformation to take place in the system Leaders of major shareholders, government, legislative organizations, and municipalities Managers of holding and companies, employees, building partners and investors T (Transformation) The transformation that takes place in the system is the main process, action and activity in order to create value A dynamic, committed and capable group in achieving goals and missions with a transparent performance in fulfilling economic and social commitments and value creation, etc. An independent team in the development of construction businesses with the benefit of the participation and effective interaction of key stakeholders in the optimal management of resources, development of partnerships, etc. W (Worldview) Worldview refers to what makes system activity meaningful Improving organizational performance and health in the construction and housing sector will bring the possibility of value, credibility and economic and social trust Stakeholder alignment through delegating authority and trust to implementers, the possibility of the development and use of the capabilities and abilities of stakeholders O (Owner) Is a person or system that has the ability to create or stop the transformation process The main shareholder Leaders of the construction the holding company, investor partners and builders, and legal entities E (Environment) It is the environment around the system, especially the assumptions and constraints that are imposed on it Policies communicated by the shareholder, shareholder nominal credit, rules and regulations, restrictions on the portfolio available, lengthy processes, time-consuming decisions, etc. Restrictive construction laws, principal restrictions imposed by the major shareholder, reduced access to productive real estate, liquidity deficit, parallel market fluctuations, etc. Final root definitions . Final root definitions are derived from the results of the PQR and CATWOE techniques. - The policy-makers: “The construction holding (the company under study) must act in such a way that the economic value creation of the estates under ownership, along with the accreditation to the main shareholder, is taken into consideration… This will lead to the provision of appropriate and cost-effective services, gaining trust and social role for the system.” - The implementers: “ An organization with a unified entity that defines organizational health in such a way that includes the decision-making authority in the development of construction businesses, along with determining performance measurement criteria and reciprocal accountability, relying on the support of its key stakeholders ...” At the end of this stage, questions such as what each of the stakeholders expects? What are stakeholders’ common beliefs and their differences? are answered. 4) Developing conceptual models. The modeling process is about putting together the parts required for the explanation of the system’s activities. At this stage, an image of the desired sub-systems, and the relationships between them is presented. It should be noted that according to the SSM, with respect of the problem, each of the stakeholders has its own root definition. Regarding each of the root definitions, there is a conceptual model. Considering a cyclical relationship between them, the agreed model is obtained. 5) Developing final conceptual models. Accordingly, in the holding company, the final conceptual model was prepared with the aim of stimulating the thinking of everyone involved, and influenced by the conceptual models of each perspective, by integrating some activities and several modifications. Figure 5 illustrates the final model of organizational health resulting from the research approach in the case study. According to the figure, the results of the models in accordance with the worldview of each group of stakeholders, after summarizing and reaching consensus are presented in the form of the final conceptual model of organizational health. 6) Comparing the final conceptual model with the real world. Once the model is created, each activity can be examined to define how to evaluate its performance. Therefore, if it is said that the "current mode" of performing the activity is poor, the criterion (performance measurement) is the basis of value judgment, and any improvement can be evaluated according to the same criterion. Asking the following questions from the experts and personnel at different organizational levels can greatly help to identify good changes and validate the model (Checkland and Poulter, 2006 ): Do activities occur in the real world? How? By what criteria should it be judged and valued? Are these activities important in the current situation? For example, in the case study, it was found that the majority of activities are not taking place, and the remains are not efficient; therefore, for the improvement of situation, suggestions can be offered. 7) Suggestions for change. Based on the results of the previous step, the analyst should take steps to change the situation. The analyst must propose measures and solutions that are to some extent desirable to all stakeholders and at the same time take into account the social and cultural conditions of the situation. Such actions must be taken through the improvement cycle. In the case study, in order to analyze the proposed measures by holding meetings with organizational stakeholders, the final activities were presented to them and in order to categorize them, each suggestion or improvement action based on criteria of rationality, necessity, and feasibility is evaluated and the maximum opinion of the members is agreed upon and the result of the evaluation of each action. The results of steps 5 and 6 are briefly described below. The organizational health model of the study (Fig. 5 ) is an image of the final conceptual model, which includes two levels of actions by policy-makers and implementers. The most essential conditions for achieving a better evaluation and promotion of organizational health are: holding needs the necessary flexibility and agility in decision-making and speeding up processes and operations by being in the middle layer of operations. It is important to review and update strategies and long-term planning and to develop the missions and businesses of the holding company and its subsidiaries. Strengthening real estate should be a priority. It can be stated as another significant point that the results of the implementation of the integrated approach in this study show compliance and overlap with the general headings of organizational health models, especially the McKinsey Institute model. Therefore, many targeted activities resulting from the implementation of the proposed approach in the case study, can be categorized as Fig. 6 in the form of multiple characteristics. 5 Conclusion The goal of soft systems methodology (SSM) is to model and identify current issues in social systems such as organizations and businesses. Such problems are often unstructured problems and wicked messes that SSM is able to identify the invisible aspects of such problems from various angles with a holistic view and pave the way for providing solutions in order to solve problems. As explained in this study, organizational health is an appropriate example of such issues, which is a very deep, penetrating, and far-reaching concept. As has been repeatedly mentioned in the literature, organizational health is more than organizational performance because there are many organizations that show good performance but their future performance is at risk due to organizational health problems and ignoring it. However, according to the results of studies, the good news is that performance and health are complementary and not contradictory. It can be declared that addressing the issue of organizational health as much as possible with the use of methodologies such as the SSM sounds like a shining a powerful beam of light, as a result of which the path of organizations will be brighter to get rid of existing problems and shape the future more effectively than competitors. It is worth noting that although in this study it is attempted to provide an integrated and applicable framework, but one of the output features of the SSM is the uniqueness of requirements, conditions and the model. This means that not only the model related to each organization is unique, but also the results can be used only for the case study, and its generalization even to a similar organization requires re-examination according to the framework and make the necessary adjustments on the basis of the conditions of that organization; however, the use of the procedure and instructions are the same. Some another similar studies can be referred in the case of comparing the results of the present study with previous studies in the field of organizational health. For example, Lowe and Yearworth ( 2017 ) have developed a system engineering approach for monitoring organizational health as an enabler for continued resilience, which presents organizational health characteristics in the form of 21 dimensions in 4 dimensions of identity, resources, management and adaptation to the environment. The framework presented by Keller and Price ( 2011 ) at the McKinsey Institute has also been reviewed. For the future studies further exploration in the use of the SSM, its repetition in various organizations, as well as the use of other systemic approaches to examine organizational health as soft and unstructured issues in organizations are recommended. Additionally, their results can be compared with the findings of this study to expand the literature in this area. Declarations Funding The authors declare that no specific funding was received for this research from any funding agency in the public, commercial, or not-for-profit sectors. Clinical trial registration This study is not a clinical trial and does not involve any clinical interventions or human subjects in a medical context. No registration details are required. Clinical trial number: not applicable. Declaration of competing interests There are no competing interests associated with this work. References Alman, D. (2010). Improving Organizational Performance to Employee well-being. Organizational Health Journal, 2 (2), 28-33. Argyris, C. (1970). The organization: What makes it healthy? Harvard Business Review, 48 (3), 195-208. Bremer, D., Klockmann, I., Jaß, Härter, M., von dem Knesebeck, O. & Lüdecke, D. (2021). Which criteria characterize a health literate health care organization? – a scoping review on organizational health literacy. BMC Health Services Research, 21, 664. Checkland, P. (1972). Towards a systems-based methodology for real-world problem solving. Journal of Systems Engineering, 3 (2), 87-116. Checkland, P., & Poulter, J. (2006). Learning for action: A short definitive account of SSM for practitioners, teachers and students. John Wiley. Chen, H., & Eyoun, K. (2021). Do mindfulness and perceived organizational support work? Fear of COVID-19 on restaurant frontline employees’ job insecurity and emotional exhaustion. International Journal of Hospitality Management, 94, 102850. https://doi.org/10.1016/j.ijhm.2020.102850 Chiang, C. & Hsieh, T. (2012). The impacts of perceived organizational support and psychological empowerment on job performance: The mediating effects of organizational citizenship behavior. International Journal of Hospitality Management, 31 (1), 180–190. https://doi.org/10.1016/j.ijhm.2011.04.011 Dive, B. (2004). The healthy organization: A revolutionary approach to people & management (2nd ed.). Kogan Page. Farmanova, E., Bonneville, L., & Bouchard, L. (2018). Organizational Health Literacy: Review of Theories, Frameworks, Guides, and Implementation Issues. Inquiry, 55, 46958018757848. Farooq, M., Othman, A., Sahari Nordin, M., & Burhan Ibrahim, M. (2017). Analyzing the relationship between sustainable leadership, talent management and organization health as predictors of university transformation. Journal of Positive Management, 8 (1), 32-50. Greenberg, K. L., Donchin, M., Leiter, E. & Zwas, D. R. (2021). Health ambassadors in the workplace: a health promotion intervention mobilizing middle managers and RE-AIM evaluation of outcomes. BMC Public Health, 21, 1585. https://doi.org/10.1186/s12889-021-11609-8. Higham, A. P. (2014). Conceptual framework for the sustainable benefit evaluation of UK social housing projects (Doctoral dissertation, Sheffield Hallam University). Hoy, W., & Miskel, C. (2012). Educational Administration: Theory, Research, and Practice (9th ed.). New York, NY: McGraw-Hill Higher Education. Hur, W. M., Shin, Y. & Kim, J.Y. (2023). Service Employees’ Mindfulness and Job Crafting amid COVID-19: The Roles of Resilience, Organizational Health Climate, and Health-Oriented Leadership. Current Psychology, https://doi.org/10.1007/s12144-023-04714-x Inceoglu, I., Thomas, G., Chu, C., Plans, D., Gerbasi, A. (2018). Leadership behavior and employee well-being: An integrated review and a future research agenda. The Leadership Quarterly, 29 (1), 179-202. Jaafari, M., Alzuman, A., Ali, Z., Tantry, A., & Ali, R. (2023). Organizational Health Behavior Index (OHBI): A Tool for Measuring Organizational Health. Sustainability, 15 (18), 13650. Keller, S., & Price, P. (2011). Beyond performance: How great organizations build ultimate competitive advantage. John Wiley & Sons. Keller, S., & Schaninger, B. (2019). Beyond performance 2.0: A proven approach to leading large-scale change. John Wiley & Sons. Kelloway, E. K., Nielsen, K., & Dimoff, J. K. (2017). Leading to occupational health and safety: How leadership behaviors impact organizational safety and well-being. Wiley-Blackwell. Lee, S., Pasquarella, F.J., de La Peza, D., Lizano, E.L. & Santoro, K. (2023). Planning and Implementing an Organizational Health Assessment in a Community Mental Health Setting. Community Mental Health Journal, 59, 693–702. Lowe, D., & Yearworth, M. (2017). Ensuring continued enterprise resilience: Developing a method for monitoring health. In 2016 Conference on Systems Engineering Research, University of Bristol. Miles, R. E. (1969). Organizational health: An integrative approach. Academy of Management Review, 52-63. Min, H., & Su, S. (2020). Examining relationships between personality profiles and organizational health outcomes. Personality and Individual Differences, 164, 110118. Nair, H., Kumar, D. & Ramalu, S. (2014). Organizational health: Delineation, constructs and development of a measurement model. Asian Social Science, 10 (14), 203-213. Singh, A. & Jha, S. (2017). Unearthing Organizational Health Determinants for Effective Globalization of an Indian Organization. In K. N. K. Rana, P. Rastogi, & P. Budhwar (Eds.), Riding the New Tides: Navigating the Future Through Effective People Management (pp. 27-36). Emerald Publications. Singh, A. & Jha, S. (2022). Relationship between employee well-being and organizational health: symbiotic or independent? Industrial and Commercial Training, 54 (2), 231-249. https://doi.org/10.1108/ICT-03-2021-0018 Son, J., & Jung, J. (2021). Applying soft systems methodology to analyze organizational health: A case study of a nonprofit organization. Nonprofit and Voluntary Sector Quarterly, 50 (1), 133-154. Tounsi, M., Amin, F., & Ansari, M. (2021). Design of Organizational Health Model for the Tunisian Aviation Organization. Economic and Management Research Journal, 15 (2), 15-34. Tsui, A. S., & Cheng, Y. Y. (1999). The relationship between organizational culture, leadership behavior, and job satisfaction: An empirical study of Taiwan's non-profit organizations. The International Journal of Human Resource Management, 10 (3), 520-535. Tuan, L. (2013). Underneath organizational health and knowledge sharing. Journal of Organizational Change Management, 26 (1), 139-168. Wilson, B. (2001). Soft Systems Methodology: Conceptual Model Building and Its Contribution. John Wiley. Xenidis, Y. & Theocharous, K. (2014). Organizational health: definition and assessment. Procedia Engineering, 85, 562-570. Zhang, J., Li, Y., Li, X., & Li, Y. (2022). The relationship between organizational health and employee well-being: The moderating effects of work–family conflict and psychological safety. International Journal of Environmental Research and Public Health, 19 (1), 155. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers invited by journal 02 Mar, 2026 Editor assigned by journal 09 Jan, 2026 Submission checks completed at journal 25 Dec, 2025 First submitted to journal 20 Dec, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8414400","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":599217863,"identity":"90347960-6dad-4fd7-a8f3-0a2ec85a50b3","order_by":0,"name":"Hosein Tayeba","email":"","orcid":"","institution":"Islamic Azad University","correspondingAuthor":false,"prefix":"","firstName":"Hosein","middleName":"","lastName":"Tayeba","suffix":""},{"id":599217864,"identity":"95f1dc6a-78fb-407f-9338-2d8cc21d8f06","order_by":1,"name":"Bijan Nahavandi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA20lEQVRIiWNgGAWjYBACAwYGNgjrMPOBAxAWYwOxWtgSSNVygMeAOIeZSzc/e/CzzS6P7zjPxwM/2xjk+RuY2z7g02I555i5YW9bcrHkYd4NB3vbGAxnHGBsnoHXYTcSzCR4zjAnbgBqOcDbxsC4gYGxGb9fbqR/k/xzph6ohefBwb9tDPZEaMkxk+apOAzSwnAYaEsiQS2WM3LKpGUqjifOPMxmcFjmnETyjMMEtJhLpG+TfGNQndh3/vDjj2/KbGz729sf49WCDiQYGJhJ0jAKRsEoGAWjABsAAARmS5MjFjZ+AAAAAElFTkSuQmCC","orcid":"","institution":"Islamic Azad University, Science and Research Branch","correspondingAuthor":true,"prefix":"","firstName":"Bijan","middleName":"","lastName":"Nahavandi","suffix":""},{"id":599217865,"identity":"21b0b1bd-c15a-4790-b5f4-353db5b05557","order_by":2,"name":"Mahdi Homayounfar","email":"","orcid":"","institution":"Islamic Azad University Rasht Branch","correspondingAuthor":false,"prefix":"","firstName":"Mahdi","middleName":"","lastName":"Homayounfar","suffix":""}],"badges":[],"createdAt":"2025-12-20 22:08:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8414400/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8414400/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104404678,"identity":"86c61b04-a7b0-49e9-94c2-bf988506ee38","added_by":"auto","created_at":"2026-03-11 12:20:49","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":148446,"visible":true,"origin":"","legend":"\u003cp\u003eThe steps of the Soft Systems Methodology (Checkland and Poulter, 2006)\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8414400/v1/6ea61e8996727f52e0c1afec.png"},{"id":104181560,"identity":"e7e58a70-9259-4ff5-adbd-493e4136c33b","added_by":"auto","created_at":"2026-03-08 17:28:31","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":505307,"visible":true,"origin":"","legend":"\u003cp\u003eAn integrated and holistic approach to organizational health\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-8414400/v1/d6116e4362c76f282e96afe1.png"},{"id":104181558,"identity":"11ff92b4-32a8-415b-8666-13afde3475a5","added_by":"auto","created_at":"2026-03-08 17:28:31","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":57847,"visible":true,"origin":"","legend":"\u003cp\u003eOrganizational Stakeholders\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-8414400/v1/3f0e162fa47c817c94ded0aa.png"},{"id":104181559,"identity":"a1a1d2bd-2a5b-4fdf-b421-d6eb82a2507b","added_by":"auto","created_at":"2026-03-08 17:28:31","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":1028701,"visible":true,"origin":"","legend":"\u003cp\u003eRich picture; the problem situations of organizational health from the perspectives of stakeholders\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-8414400/v1/ef97590a555027c8791a6a60.png"},{"id":104403540,"identity":"8ea02e59-5384-47ff-a473-afc43096c05d","added_by":"auto","created_at":"2026-03-11 12:18:31","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":670593,"visible":true,"origin":"","legend":"\u003cp\u003eFinal conceptual model of the organizational health\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-8414400/v1/b6045751359ec680c0b61565.png"},{"id":104404154,"identity":"323073e9-b95b-497f-8b75-e0804b0e9d85","added_by":"auto","created_at":"2026-03-11 12:19:46","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":622703,"visible":true,"origin":"","legend":"\u003cp\u003eAdaptation of research results to McKinsey approach\u003c/p\u003e","description":"","filename":"6.png","url":"https://assets-eu.researchsquare.com/files/rs-8414400/v1/2067b0b066ffc7dc68d9121c.png"},{"id":106092829,"identity":"7beeb161-ccb8-4d85-b8d6-2ef2f3ab0e56","added_by":"auto","created_at":"2026-04-03 11:26:59","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":3497319,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8414400/v1/60a72aed-1ccd-4b69-8c85-b63333a885f0.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Modelling the Organizational Health Using Soft Systems Methodology: A Holistic Approach","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eThe workplace provides an essential setting for health promotion, as employees spend most of their day at work (Greenberg et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Indeed, employees are the essential driver of organizations' excellence and the most valuable asset to their achievements (Lee et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Therefore, promoting practices such as monitoring and alleviating employee health symptoms, offering health-promoting events and psychological counseling, and using flexible work arrangements and scheduling can strengthen employees\u0026rsquo; resources such as positive emotions, self-esteem, and feelings of approval and recognition and make organizations healthy (Chen \u0026amp; Eyoun, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Chiang \u0026amp; Hsieh, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2012\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe topic of organizational health (OH) is not a novel concept, as far back as the mid-1990s, Chris Argyris endeavored to explore \"the way in which an organization can effectively achieve health\" (Argyris, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e1970\u003c/span\u003e). Miles also described organizational health in 1969 as a situation that goes beyond short-term organizational effectiveness and entails a set of relatively durable characteristics (Miles, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e1969\u003c/span\u003e). Organizational health is defined as the investments made in the present time to ensure future survival and growth (Keller and Price, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). It also defined as an organization\u0026rsquo;s effort to transform organization and delivery of care and services to make it easier for employees to acquire, understand, and use information to take care of their health (Farmanova et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Bremer et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Organizational health helps organizations to achieve their goals, create competitive advantages, and boost employees\u0026rsquo; well-being by determining an organization\u0026rsquo;s ability to establish, communicate, and implement a proper business strategy while retaining employees highly engaged (Jaafari et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). A healthy organization is one that not only sustains itself in its environment but also cultivates management and developmental skills. Recent studies have shown that improving organizational health is crucial for achieving organizational performance (Inceoglu et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Organizations that prioritize employee well-being, learning and development, and strong leadership are more likely to thrive in the long-term (Bremer et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOrganizational health is a broad field of study that encompasses a wide range of research topics related to the well-being and effectiveness of organizations. Systematic review of the literature shows that there are various field of research in organizational health such as; employee well-being (Kelloway et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Min and Su, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Singh and Jha, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2022\u003c/span\u003e), organizational culture, performance management (Nair et al. \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Inceoglu et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), and change management (Tuan, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2013\u003c/span\u003e) are four categories of research that fall under the light of organizational health. Accordingly, a healthy organization is one that not only survives in its environment, but also develops its employees\u0026rsquo; well-being, culture, performance management and development. Despite its importance, organizational health remained a complex and challenging issue.\u003c/p\u003e \u003cp\u003eDespite, McKinsey's coherent studies by Keller and Price (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2011\u003c/span\u003e) in various industries from 2006 to 2011, which led to the development of an overall organizational health model, organizational health became an extremely complex and highly uncertain issue, particularly in today's turbulent business environment; therefore, it is regarded as a soft and unstructured organizational phenomenon. Accordingly, it is prominent to take a deeper approach for its analysis and modeling. Soft Systems Methodology (SSM) is a useful approach for analyzing and modeling organizational issues, particularly in the face of high uncertainty and diverse perspectives. SSM emphasizes the importance of involving stakeholders with different views and experiences in the analysis process, and uses purposeful conceptual models to structure discussions and identify areas for improvement. In conclusion, improving organizational health is critical for organizations to thrive in the long-term. Furthermore, by adopting a systemic perspective and applying SSM, organizations can gain a more nuanced understanding of their strengths and weaknesses, and take targeted actions to improve their overall health and sustainability. This study aims to explore the utility of a systemic perspective, particularly the SSM, in modeling organizational health.\u003c/p\u003e \u003cp\u003eThe primary contribution of this research is the application of SSM to a complex real-world problem, specifically the concept of organizational health. This study has developed an integrated and comprehensive analytical framework for analyzing, constructing, and modeling organizational health. To demonstrate the effectiveness of this approach, the framework was implemented in an Iranian construction company, using purposeful sampling and expert interviews to identify problematic situations and desired outcomes. The SSM's seven steps were used to draw a rich picture, perform CATWOE analysis, and develop a conceptual model. Based on this analysis, strategies were proposed to improve organizational health and performance in the company. This applied research contributes to the development of knowledge to promote organizational health in a non-structured environment and can be applied to different societies.\u003c/p\u003e \u003cp\u003eThe research question is twofold: firstly, how can the SSM be applied in this context? And secondly, what are the key steps and characteristics of implementing this approach?\u003c/p\u003e"},{"header":"2 Literature Review","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003e2.1 Organizational Health\u003c/h2\u003e\n \u003cp\u003ePrior to the 1990s, there was limited research on organizational health. Since then, the scope of research in this field has expanded significantly, especially when concepts such as organizational capacity, organizational change, workplace health, occupational health and healthy organization came into the field of social science and management research. The term \u0026ldquo;Organizational Health\u0026rdquo; was first used by Miles in 1965 to study the organizational climate of schools (Tsui and Cheng \u003cspan class=\"CitationRef\"\u003e1999\u003c/span\u003e). In the late 1990s, the concept of organizational health first evolved as the most important source of competitive advantage (Keller and Price, \u003cspan class=\"CitationRef\"\u003e2011\u003c/span\u003e). Organizational health refers to a situation beyond the short-term effectiveness of the organization and deals with to a set of relatively durable characteristics. Accordingly, organizational health refers to the continuity and survival of the organization in its environment, adaptation to its environment, and the promotion and expansion of its ability to further adaptability. The clear point of this definition is that a healthy organization successfully deals with external opposition forces and effectively directs them towards the main goals and objectives of the organization (Hoy and Miskel, \u003cspan class=\"CitationRef\"\u003e2012\u003c/span\u003e). Healthy organizations as living and dynamic organisms in the environment can emerge and grow by providing the essential and adequate facilities, and by providing healthy and valuable goods and services can meet environmental needs and facilitate the process of growth and prosperity of society (Kelloway et al., \u003cspan class=\"CitationRef\"\u003e2017\u003c/span\u003e). In fact, organizational health is not only the survival of the organization in the environment, but doing something beyond it means the long-term development of the organization. In such a situation, satisfaction and health (physical, mental, and social) of employees are prominent, because it provides the basis for improving the organizational performance (Alman, \u003cspan class=\"CitationRef\"\u003e2010\u003c/span\u003e).\u003c/p\u003e\n \u003cp\u003eAs mentioned before, the importance of organizational health has led to many studies in recent years. Lee et al. (\u003cspan class=\"CitationRef\"\u003e2023\u003c/span\u003e) described the development and implementation of a low-cost organizational health assessment through five phases: development of the assessment, data collection, analysis, metrics and data visualization, and dissemination of findings and development of interventions. Jaafari et al. (\u003cspan class=\"CitationRef\"\u003e2023\u003c/span\u003e) developed an original two-subscale measure that evaluates organizational health behavior determinants. This scale can help create an environment at work that boosts productivity, engagement, and retention. Hur et al. (\u003cspan class=\"CitationRef\"\u003e2023\u003c/span\u003e) examined the moderating role of perceived organizational health climate and health-oriented leadership on the mindfulness\u0026ndash;resilience relationship. According to their findings, the positive relationship between these two variables was more pronounced when perceived organizational health climate was high. Singh and Jha (\u003cspan class=\"CitationRef\"\u003e2022\u003c/span\u003e) studied the bi-directional relationship between employee well-being and organizational health. The results show that when organizational health is good, employees\u0026rsquo; health will also be good but not vice versa. Farooq et al. (\u003cspan class=\"CitationRef\"\u003e2017\u003c/span\u003e) investigated the effect of sustainable leadership and talent management on university transformation by the mediating role of organizational health. Nair et al. (\u003cspan class=\"CitationRef\"\u003e2014\u003c/span\u003e) studied the factors affecting organizational health in the framework of systems theory in order to create a measurement model that can be applied to measure business performance with organizational change.\u003c/p\u003e\n \u003cp\u003eMost organizational health studies are in the field of education and training organizations and less in the field of business and industry (Tuan, \u003cspan class=\"CitationRef\"\u003e2013\u003c/span\u003e; Xenidis and Theocharous, \u003cspan class=\"CitationRef\"\u003e2014\u003c/span\u003e; Singh and Jha, \u003cspan class=\"CitationRef\"\u003e2017\u003c/span\u003e). This highlights the need for studies related to the concept of organizational health in the field of business. One of the most complete and inspiring organizational health studies in business was conducted by the McKinzy Institute (Keller \u0026amp; Price, \u003cspan class=\"CitationRef\"\u003e2011\u003c/span\u003e; Keller \u0026amp; Schaninger, \u003cspan class=\"CitationRef\"\u003e2019\u003c/span\u003e). This study showed 9 elements of organizational health in the form of three axes of alignment, execution, and renewal and presented the Organizational Health Index (OHI) to measure organizational health status. Recently, Tounsi et al. (\u003cspan class=\"CitationRef\"\u003e2021\u003c/span\u003e) developed a model for measuring organizational health in an aviation organization by using a mixed method and conceptualizing 8 dimensions of organizational health. On the other hand, Dive (\u003cspan class=\"CitationRef\"\u003e2004\u003c/span\u003e) equates a healthy organization with complex structures, management processes, knowledge systems, and activities that must be consistent with the organization\u0026apos;s strategy. Therefore, organizational health is very complex with different layers and all organizational stakeholders are involved in its formation or decline. This aspect of organizational health has not received much attention in current studies, which is recognized as the theoretical gap in the present paper.\u003c/p\u003e\n \u003cp\u003eThis new perspective on organizational health requires the use of more effective tools in such a way that makes it possible to understand the uncertainty and ambiguity associated with organizational health. The present study tries to consider and deepen organizational health as one of the most fundamental business issues in today\u0026apos;s world, and one of the soft phenomena in the field of business. This is considered as the difference between the present study and the model presented by the McKinzey Group. In other words, the present study considers organizational health as a very complex and unstructured problem that cannot be easily analyzed and modeled using common approaches and, therefore, requires the use of soft methodologies.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\n \u003ch2\u003e2.2 Soft system methodology (SSM)\u003c/h2\u003e\n \u003cp\u003ePrior to the 1970s, quantitative and computational methodologies were oriented very much towards solving human and managerial problems. These methodologies, called hard methodologies, are based on engineering and scientific principles, have a tool-oriented and systematic approach, and are suitable for simple systems in which people have the same perceptions of the problem situation. On the other hand, diverse methodologies are required to solve human and managerial problems that are related to turbulent and very complex situations. These types of methodologies, called soft methodologies, have a holistic, interpretive, systematic and problem-oriented perspective, and their purpose is to deal with problem-solving situations that are based on contradictory worldviews and purposeful actions (Higham, \u003cspan class=\"CitationRef\"\u003e2014\u003c/span\u003e).\u003c/p\u003e\n \u003cp\u003eOne of the approaches that has been developed to introduce human and social systems is the SSM. This approach was introduced by Peter Checkland through a work program at Lancaster University in the 1960s as a reaction to the traditional management view of natural and value-free objective truth. The SSM is an action-oriented method that creates learning by researching problem situations. In soft systems problems, there can be a wide range of acceptable and correct answers. Usually, the SSM is applied in a situation with a large number of stakeholders with various benefits, in which conflicts are inevitable. In this case, hard methodologies are not efficient because structuring the problem is impossible. (Checkland,1972).\u003c/p\u003e\n \u003cp\u003eSoft systems methodology (SSM) is an organized and flexible process for dealing with problematic situations, that need to be improved to become more acceptable and less ambiguous. In practice, this methodology is illustrated as a seven-step analysis process in both real-world and abstract worlds, which uses the concept of human activity system as an important tool for data collection and action to improve the situation (Wilson, \u003cspan class=\"CitationRef\"\u003e2001\u003c/span\u003e; Checkland and Poulter, \u003cspan class=\"CitationRef\"\u003e2006\u003c/span\u003e). Figure \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e shows the steps of the SSM. These steps are presented concisely as follows:\u003c/p\u003e\n \u003cp\u003eFigure \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e The steps of the Soft Systems Methodology (Checkland and Poulter, \u003cspan class=\"CitationRef\"\u003e2006\u003c/span\u003e)\u003c/p\u003e\u003cspan\u003e\n \u003cp\u003e\u003cstrong\u003e1. Unstructured problem situation (Identify the situation that is thought to be problematic)\u003c/strong\u003e: This is a general research stage about the problem environment. Besides, in this stage, a meeting is held including managers and employees involved with the problem as well as analysts, to review the activities and methods of doing work.\u003c/p\u003e\n \u003c/span\u003e \u003cspan\u003e\n \u003cp\u003e\u003cstrong\u003e2. Structured problem situation (Express the problem situation by a rich picture)\u003c/strong\u003e: Through a rich picture, the problem situation, including its involved people, their concerns, and the problem structure are pictured.\u003c/p\u003e\n \u003c/span\u003e \u003cspan\u003e\n \u003cp\u003e\u003cstrong\u003e3. Selecting relevant systems and providing their root definitions\u003c/strong\u003e: In this stage, based on the conceptual and systemic world, the root definitions of relevant systems are defined. Root definitions not only describe the desired systems, but also describe the details of the systems, including customers, actors, owners, etc.\u003c/p\u003e\n \u003c/span\u003e\u003cspan\u003e\n \u003cp\u003e\u003cem\u003ea) PQR formula (Do P by a Q in order to achieve R) for root definitions\u003c/em\u003e: This formula provides a basis for root definitions.\u003c/p\u003e\n \u003c/span\u003e \u003cspan\u003e\n \u003cp\u003e\u003cem\u003eb) CATWOE (Customer, Actor, Transformation, Worldview, Owner, Environmental Constraints) analysis to enrich root definitions\u003c/em\u003e: CATWOE is used for the purpose of examining root definitions and the correctness of the selected words.\u003c/p\u003e\n \u003c/span\u003e\n \u003cul\u003e\n \u003cli\u003e\n \u003cp\u003e\u003cem\u003eAdequacy criterion\u003c/em\u003e: This criterion refers to the proper functioning of the transformation event and its purpose is to achieve the desired goals of the transformation process (do the tools work?).\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003e\u003cem\u003eEfficiency criterion\u003c/em\u003e: This criterion indicates the minimum and correct use of resources in the transformation process.\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003e\u003cem\u003eEffectiveness criterion\u003c/em\u003e: This criterion indicates whether the transformation process can help achieve higher or longer-term goals.\u003c/p\u003e\n \u003c/li\u003e\n \u003c/ul\u003e\n\u003c/div\u003e\n\u003cdiv class=\"Heading\"\u003e4. \u003cstrong\u003eConceptual modelling\u003c/strong\u003e. This requires gathering concepts in a mental structure and presenting a conceptual model.\u003c/div\u003e\n\u003cp\u003e\u003cspan\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e5. Comparison of the conceptual model and rich picture\u003c/strong\u003e: This stage is performed for the improvement of the current status.\u003c/p\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003cdiv class=\"Heading\"\u003e6. \u003cstrong\u003eIdentifying feasible and desired changes\u003c/strong\u003e: In this stage, desired and feasible changes are identified.\u003c/div\u003e\n\u003cp\u003e\u003cspan\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e7. Implementing organizational change\u003c/strong\u003e: This stage involves an operational plan including all required tasks to make determined changes.\u003c/p\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003cp\u003eConceiving the SSM as a systems approach, capable in dealing with issues with complexities affected by human role in systems and social environments, in this research the SSM is applied to study and analyze the most important intellectual orientations of stakeholders regarding current issues, and each of the unknown dimensions of organizational health, and based on consensus provide an integrated and holistic framework for organizational health.\u003c/p\u003e"},{"header":"3 Research Methodology","content":"\u003cp\u003eThe integrated framework of the research in the field of organizational health based on the systems perspective of the SSM, is presented in Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e2\u003c/span\u003e. According to the presented framework in the real world, it is essential to look at organizational health and its dimensions as a complex and problematic situation, and these conditions are carefully and deeply explained and analyzed. Having a rich picture of these conditions is possible only by considering the views and attitudes of internal and external role players or the same organizational stakeholders. Obviously, identifying and communicating effectively with all stakeholders, conducting careful analysis, and satisfying their demands and expectations will greatly contribute to the quality of the model. In addition to regarding the various and diverse thoughts in the organization, such an image provides a basis for creating root definitions of organizational health.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThis is the way in which weaknesses of previous approaches to organizational health have reasonably improved. The steps of the present approach can be described as follows:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eCollecting and reviewing organizational health concepts and tools for measuring organizational health\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eIdentifying the most important characteristics of organizational health\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ePreparing main questions for the interview\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ePurposeful sampling from different groups of stakeholders\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eIdentifying the mission, strategies, and main processes of the organization under study and its main stakeholders, demands, expectations, and problematic situations\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eAdapting the current status of the organization to the characteristics of a healthy\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eExpressing the problem conditions in the form of a rich picture\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eAnalyzing the intervention, social and political systems\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eReceiving stakeholder feedback on the rich picture and\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eAnalyzing data to discover concerns\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eVerifying the rich picture of the problem situation in the real world\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eDefining root definitions of organizational health using PQR\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eEnriching root definitions using CATWOE\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ePresenting the root definitions and receiving the opinions of the stakeholders\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eProviding an initial conceptual model of organizational health tailored to each group of stakeholders\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eReceiving stakeholder feedback on the conceptual model and applying possible changes\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ePresenting the final conceptual model of organizational health\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ePreparing a list of operational measures of organizational health\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eHolding a meeting on political analysis and the feasibility of actions\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e"},{"header":"4 Empirical Study","content":"\u003cp\u003eThe case study of this research is a holding in the construction industry. The most important mission of this holding in the past years has been to create value through construction projects with the priority of attracting private sector investors in the form of partnership contracts, so that up to 95% of its projects have been completed through partnership contracts. As stated in the SSM, in order to discover the thoughts and worldviews of the stakeholders involved in the issue, it is essential to answer the main question of which stakeholders and concerns are involved in organizational health issues and decisions. Figure \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e shows the internal and external stakeholders of the case.\u003c/p\u003e\n\u003cp\u003eHere, a \u003cstrong\u003esummary\u003c/strong\u003e of the steps taken to implement the research model of the study is described.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1) Identifying the problem situation (s).\u003c/strong\u003e The most important organizational issues can be significantly extracted by interviewing and holding focus groups. Various concerns of different stakeholders are explained below:\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\n \u003cp\u003e\u003cem\u003eEmployees\u003c/em\u003e: Mergers and downsizing, workplace conditions, increasing work stress, job dissatisfaction, experts leaving the organization, restriction of replacement forces, authoritarian style of leaders and managers, etc.\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003e\u003cem\u003eManagers and deputies\u003c/em\u003e: Restrictions on decision-making powers, bureaucratic processes, excessive interference and influence of the main shareholder, frequent change of leaders and senior managers, long-term stagnation of the housing market, obstacles and restrictions of the main shareholder in creating some construction uses, etc.\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003e\u003cem\u003eMain shareholder\u003c/em\u003e: Poor performance of previous managers, incidence of collusion and rent, legal cases in companies, budget failure, negative attitude on the part of the main shareholder, etc.\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003e\u003cem\u003ePartners and suppliers\u003c/em\u003e: The difficult and ambiguous process of selecting a partner or investor, imposing technical specifications contrary to local customs, etc.\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003e\u003cem\u003eCustomers\u003c/em\u003e: Not paying attention to the demands and requirements of customers regarding the product, a lack of variety of sales methods, and non-compliance of the final product with the sales contract.\u003c/p\u003e\n \u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003e2) Expressing the situation by presenting a rich picture.\u003c/strong\u003e At this stage, organizational and situation-related challenges, shortcomings and problems are considered from the perspective of each of the stakeholders identified in the previous stage, with the aim of providing a clear, rich picture of the problematic situation. Figure \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e shows a rich picture of the problem situation of the case study.\u003c/p\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3) Selecting relevant systems and providing their root definitions.\u003c/strong\u003e The PQR formula refers to P, by Q, to achieve R. An example of the results of the PQR formulation of two key stakeholders, namely shareholders and holding managers, to derive the basic definitions of organizational health is presented in Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e. It should be noted that this formula should be applied to all stakeholders\u003c/p\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u0026nbsp;\u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003ePQR structure for two groups of key stakeholders\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003eQuestions\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStakeholders\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP - What?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eQ - How?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eR - Why?\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eShareholders (major and minor)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOptimal fulfillment of commitments and operational plans\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eBy investing in economically viable construction projects and avoiding the sale of raw materials (without any economic value added), timely payment of financial obligations along with the implementation of plans and budgets, etc.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTo improve financial indicators and organizational credibility\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eManagers and deputies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eImproving the authority level of decision-making, planning and execution\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eThe right to choose regarding the purchase and operation of real estate inside and outside the organization, entering other geographical areas inside and outside the country and streamlining processes along with the development of technology, technical, managerial and executive capabilities of companies, etc.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eTo improve efficiency, dynamism, adaptability and survival\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eThe stakeholders play great roles in shaping the issue of organizational health. With regard to the initial root definitions, words extracted from interviews, it can be inferred that the first group of stakeholders includes major and minor stakeholders, customers and consumers play the role of policymakers, and the second group includes construction holding managers, managers of subsidiaries, employees, construction partners, applicants, and investors play the role of implementers. Hereupon, the two mentioned root definitions provide two dominant attitudes, perspectives or worldviews for organizational health. To achieve an enriched root definition of these two attitudes (policymakers and implementers), the process of determining the CATWOE elements in the form of six core components of the company is performed according to Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e.\u0026nbsp;\u003c/p\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eCATWOE elements\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eElements of CATWOE\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eElement description\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePolicy-makers\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eImplementers\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eShareholders, customers, and consumers\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eManagers of holding and companies, employees, construction partners and investors\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eC\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e(Customer)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eThere are people who directly benefit or suffer from system outputs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eHolding and subsidiaries, partners and investors, and people and society\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eShareholders, customers and consumers, and applicants\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eA\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e(Actor)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eActors are the people who perform the activities of the system and cause transformation to take place in the system\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLeaders of major shareholders, government, legislative organizations, and municipalities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eManagers of holding and companies, employees, building partners and investors\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eT\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e(Transformation)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eThe transformation that takes place in the system is the main process, action and activity in order to create value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eA dynamic, committed and capable group in achieving goals and missions with a transparent performance in fulfilling economic and social commitments and value creation, etc.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAn independent team in the development of construction businesses with the benefit of the participation and effective interaction of key stakeholders in the optimal management of resources, development of partnerships, etc.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eW\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e(Worldview)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eWorldview refers to what makes system activity meaningful\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eImproving organizational performance and health in the construction and housing sector will bring the possibility of value, credibility and economic and social trust\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStakeholder alignment through delegating authority and trust to implementers, the possibility of the development and use of the capabilities and abilities of stakeholders\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eO\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e(Owner)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIs a person or system that has the ability to create or stop the transformation process\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eThe main shareholder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eLeaders of the construction the holding company, investor partners and builders, and legal entities\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eE\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e(Environment)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIt is the environment around the system, especially the assumptions and constraints that are imposed on it\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePolicies communicated by the shareholder, shareholder nominal credit, rules and regulations, restrictions on the portfolio available, lengthy processes, time-consuming decisions, etc.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRestrictive construction laws, principal restrictions imposed by the major shareholder, reduced access to productive real estate, liquidity deficit, parallel market fluctuations, etc.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cem\u003eFinal root definitions\u003c/em\u003e. Final root definitions are derived from the results of the PQR and CATWOE techniques.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e- The policy-makers: \u003cem\u003e\u0026ldquo;The construction holding (the company under study) must act in such a way that the economic value creation of the estates under ownership, along with the accreditation to the main shareholder, is taken into consideration\u0026hellip; This will lead to the provision of appropriate and cost-effective services, gaining trust and social role for the system.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e- The implementers: \u0026ldquo;\u003cem\u003eAn organization with a unified entity that defines organizational health in such a way that includes the decision-making authority in the development of construction businesses, along with determining performance measurement criteria and reciprocal accountability, relying on the support of its key stakeholders\u003c/em\u003e...\u0026rdquo;\u003c/p\u003e\n\u003cdiv class=\"BlockQuote\"\u003e\n \u003cp\u003eAt the end of this stage, questions such as what each of the stakeholders expects? What are stakeholders\u0026rsquo; common beliefs and their differences? are answered.\u003c/p\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cspan\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e4) Developing conceptual models.\u003c/strong\u003e The modeling process is about putting together the parts required for the explanation of the system\u0026rsquo;s activities. At this stage, an image of the desired sub-systems, and the relationships between them is presented. It should be noted that according to the SSM, with respect of the problem, each of the stakeholders has its own root definition. Regarding each of the root definitions, there is a conceptual model. Considering a cyclical relationship between them, the agreed model is obtained.\u003c/p\u003e\u003cspan\u003e\n \u003cp\u003e\u003cstrong\u003e5) Developing final conceptual models.\u003c/strong\u003e Accordingly, in the holding company, the final conceptual model was prepared with the aim of stimulating the thinking of everyone involved, and influenced by the conceptual models of each perspective, by integrating some activities and several modifications. Figure \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e illustrates the final model of organizational health resulting from the research approach in the case study. According to the figure, the results of the models in accordance with the worldview of each group of stakeholders, after summarizing and reaching consensus are presented in the form of the final conceptual model of organizational health.\u003c/p\u003e\n\u003c/span\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003cp\u003e\u003cspan\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e6) Comparing the final conceptual model with the real world.\u003c/strong\u003e Once the model is created, each activity can be examined to define how to evaluate its performance. Therefore, if it is said that the \u0026quot;current mode\u0026quot; of performing the activity is poor, the criterion (performance measurement) is the basis of value judgment, and any improvement can be evaluated according to the same criterion.\u003c/p\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\n \u003cp\u003eAsking the following questions from the experts and personnel at different organizational levels can greatly help to identify good changes and validate the model (Checkland and Poulter, \u003cspan class=\"CitationRef\"\u003e2006\u003c/span\u003e):\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003e\u003cem\u003eDo activities occur in the real world? How?\u003c/em\u003e\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003e\u003cem\u003eBy what criteria should it be judged and valued?\u003c/em\u003e\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003e\u003cem\u003eAre these activities important in the current situation?\u003c/em\u003e\u003c/p\u003e\n \u003c/li\u003e\n\u003c/ul\u003e\n\u003cdiv class=\"BlockQuote\"\u003e\n \u003cp\u003eFor example, in the case study, it was found that the majority of activities are not taking place, and the remains are not efficient; therefore, for the improvement of situation, suggestions can be offered.\u003c/p\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cspan\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e7) Suggestions for change.\u003c/strong\u003e Based on the results of the previous step, the analyst should take steps to change the situation. The analyst must propose measures and solutions that are to some extent desirable to all stakeholders and at the same time take into account the social and cultural conditions of the situation. Such actions must be taken through the improvement cycle.\u003c/p\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\n \u003cp\u003eIn the case study, in order to analyze the proposed measures by holding meetings with organizational stakeholders, the final activities were presented to them and in order to categorize them, each suggestion or improvement action based on criteria of rationality, necessity, and feasibility is evaluated and the maximum opinion of the members is agreed upon and the result of the evaluation of each action. The results of steps 5 and 6 are briefly described below.\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003eThe organizational health model of the study (Fig. \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e) is an image of the final conceptual model, which includes two levels of actions by policy-makers and implementers. The most essential conditions for achieving a better evaluation and promotion of organizational health are:\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003e\u003cem\u003eholding needs the necessary flexibility and agility in decision-making and speeding up processes and operations by being in the middle layer of operations.\u003c/em\u003e\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003e\u003cem\u003eIt is important to review and update strategies and long-term planning and to develop the missions and businesses of the holding company and its subsidiaries.\u003c/em\u003e\u003c/p\u003e\n \u003c/li\u003e\n \u003cli\u003e\n \u003cp\u003e\u003cem\u003eStrengthening real estate should be a priority.\u003c/em\u003e\u003c/p\u003e\n \u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eIt can be stated as another significant point that the results of the implementation of the integrated approach in this study show compliance and overlap with the general headings of organizational health models, especially the McKinsey Institute model. Therefore, many targeted activities resulting from the implementation of the proposed approach in the case study, can be categorized as Fig. \u003cspan class=\"InternalRef\"\u003e6\u003c/span\u003e in the form of multiple characteristics.\u003c/p\u003e"},{"header":"5 Conclusion","content":"\u003cp\u003eThe goal of soft systems methodology (SSM) is to model and identify current issues in social systems such as organizations and businesses. Such problems are often unstructured problems and wicked messes that SSM is able to identify the invisible aspects of such problems from various angles with a holistic view and pave the way for providing solutions in order to solve problems. As explained in this study, organizational health is an appropriate example of such issues, which is a very deep, penetrating, and far-reaching concept. As has been repeatedly mentioned in the literature, organizational health is more than organizational performance because there are many organizations that show good performance but their future performance is at risk due to organizational health problems and ignoring it. However, according to the results of studies, the good news is that performance and health are complementary and not contradictory. It can be declared that addressing the issue of organizational health as much as possible with the use of methodologies such as the SSM sounds like a shining a powerful beam of light, as a result of which the path of organizations will be brighter to get rid of existing problems and shape the future more effectively than competitors.\u003c/p\u003e \u003cp\u003eIt is worth noting that although in this study it is attempted to provide an integrated and applicable framework, but one of the output features of the SSM is the uniqueness of requirements, conditions and the model. This means that not only the model related to each organization is unique, but also the results can be used only for the case study, and its generalization even to a similar organization requires re-examination according to the framework and make the necessary adjustments on the basis of the conditions of that organization; however, the use of the procedure and instructions are the same. Some another similar studies can be referred in the case of comparing the results of the present study with previous studies in the field of organizational health. For example, Lowe and Yearworth (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) have developed a system engineering approach for monitoring organizational health as an enabler for continued resilience, which presents organizational health characteristics in the form of 21 dimensions in 4 dimensions of identity, resources, management and adaptation to the environment. The framework presented by Keller and Price (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2011\u003c/span\u003e) at the McKinsey Institute has also been reviewed. For the future studies further exploration in the use of the SSM, its repetition in various organizations, as well as the use of other systemic approaches to examine organizational health as soft and unstructured issues in organizations are recommended. Additionally, their results can be compared with the findings of this study to expand the literature in this area.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that no specific funding was received for this research from any funding agency in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial registration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study is not a clinical trial and does not involve any clinical interventions or human subjects in a medical context. No registration details are required. Clinical trial number: not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration of competing interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere are no competing interests associated with this work.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAlman, D. (2010). Improving Organizational Performance to Employee well-being. Organizational Health Journal, 2 (2), 28-33.\u003c/li\u003e\n\u003cli\u003eArgyris, C. (1970). The organization: What makes it healthy? Harvard Business Review, 48 (3), 195-208.\u003c/li\u003e\n\u003cli\u003eBremer, D., Klockmann, I., Ja\u0026szlig;, H\u0026auml;rter, M., von dem Knesebeck, O. \u0026amp; L\u0026uuml;decke, D. (2021). Which criteria characterize a health literate health care organization? \u0026ndash; a scoping review on organizational health literacy. BMC Health Services Research, 21, 664.\u003c/li\u003e\n\u003cli\u003eCheckland, P. (1972). Towards a systems-based methodology for real-world problem solving. Journal of Systems Engineering, 3 (2), 87-116.\u003c/li\u003e\n\u003cli\u003eCheckland, P., \u0026amp; Poulter, J. (2006). Learning for action: A short definitive account of SSM for practitioners, teachers and students. John Wiley.\u003c/li\u003e\n\u003cli\u003eChen, H., \u0026amp; Eyoun, K. (2021). Do mindfulness and perceived organizational support work? Fear of COVID-19 on restaurant frontline employees\u0026rsquo; job insecurity and emotional exhaustion. International Journal of Hospitality Management, 94, 102850. https://doi.org/10.1016/j.ijhm.2020.102850\u003c/li\u003e\n\u003cli\u003eChiang, C. \u0026amp; Hsieh, T. (2012). The impacts of perceived organizational support and psychological empowerment on job performance: The mediating effects of organizational citizenship behavior. International Journal of Hospitality Management, 31 (1), 180\u0026ndash;190. https://doi.org/10.1016/j.ijhm.2011.04.011\u003c/li\u003e\n\u003cli\u003eDive, B. (2004). The healthy organization: A revolutionary approach to people \u0026amp; management (2nd ed.). Kogan Page.\u003c/li\u003e\n\u003cli\u003eFarmanova, E., Bonneville, L., \u0026amp; Bouchard, L. (2018). Organizational Health Literacy: Review of Theories, Frameworks, Guides, and Implementation Issues. Inquiry, 55, 46958018757848. \u003c/li\u003e\n\u003cli\u003eFarooq, M., Othman, A., Sahari Nordin, M., \u0026amp; Burhan Ibrahim, M. (2017). Analyzing the relationship between sustainable leadership, talent management and organization health as predictors of university transformation. Journal of Positive Management, 8 (1), 32-50.\u003c/li\u003e\n\u003cli\u003eGreenberg, K. L., Donchin, M., Leiter, E. \u0026amp; Zwas, D. R. (2021). Health ambassadors in the workplace: a health promotion intervention mobilizing middle managers and RE-AIM evaluation of outcomes. BMC Public Health, 21, 1585. https://doi.org/10.1186/s12889-021-11609-8.\u003c/li\u003e\n\u003cli\u003eHigham, A. P. (2014). Conceptual framework for the sustainable benefit evaluation of UK social housing projects (Doctoral dissertation, Sheffield Hallam University).\u003c/li\u003e\n\u003cli\u003eHoy, W., \u0026amp; Miskel, C. (2012). Educational Administration: Theory, Research, and Practice (9th ed.). New York, NY: McGraw-Hill Higher Education.\u003c/li\u003e\n\u003cli\u003eHur, W. M., Shin, Y. \u0026amp; Kim, J.Y. (2023). Service Employees\u0026rsquo; Mindfulness and Job Crafting amid COVID-19: The Roles of Resilience, Organizational Health Climate, and Health-Oriented Leadership. Current Psychology, https://doi.org/10.1007/s12144-023-04714-x\u003c/li\u003e\n\u003cli\u003eInceoglu, I., Thomas, G., Chu, C., Plans, D., Gerbasi, A. (2018). Leadership behavior and employee well-being: An integrated review and a future research agenda. The Leadership Quarterly, 29 (1), 179-202.\u003c/li\u003e\n\u003cli\u003eJaafari, M., Alzuman, A., Ali, Z., Tantry, A., \u0026amp; Ali, R. (2023). Organizational Health Behavior Index (OHBI): A Tool for Measuring Organizational Health. Sustainability, 15 (18), 13650.\u003c/li\u003e\n\u003cli\u003eKeller, S., \u0026amp; Price, P. (2011). Beyond performance: How great organizations build ultimate competitive advantage. John Wiley \u0026amp; Sons.\u003c/li\u003e\n\u003cli\u003eKeller, S., \u0026amp; Schaninger, B. (2019). Beyond performance 2.0: A proven approach to leading large-scale change. John Wiley \u0026amp; Sons.\u003c/li\u003e\n\u003cli\u003eKelloway, E. K., Nielsen, K., \u0026amp; Dimoff, J. K. (2017). Leading to occupational health and safety: How leadership behaviors impact organizational safety and well-being. Wiley-Blackwell.\u003c/li\u003e\n\u003cli\u003eLee, S., Pasquarella, F.J., de La Peza, D., Lizano, E.L. \u0026amp; Santoro, K. (2023). Planning and Implementing an Organizational Health Assessment in a Community Mental Health Setting. Community Mental Health Journal, 59, 693\u0026ndash;702.\u003c/li\u003e\n\u003cli\u003eLowe, D., \u0026amp; Yearworth, M. (2017). Ensuring continued enterprise resilience: Developing a method for monitoring health. In 2016 Conference on Systems Engineering Research, University of Bristol.\u003c/li\u003e\n\u003cli\u003eMiles, R. E. (1969). Organizational health: An integrative approach. Academy of Management Review, 52-63.\u003c/li\u003e\n\u003cli\u003eMin, H., \u0026amp; Su, S. (2020). Examining relationships between personality profiles and organizational health outcomes. Personality and Individual Differences, 164, 110118.\u003c/li\u003e\n\u003cli\u003eNair, H., Kumar, D. \u0026amp; Ramalu, S. (2014). Organizational health: Delineation, constructs and development of a measurement model. Asian Social Science, 10 (14), 203-213.\u003c/li\u003e\n\u003cli\u003eSingh, A. \u0026amp; Jha, S. (2017). Unearthing Organizational Health Determinants for Effective Globalization of an Indian Organization. In K. N. K. Rana, P. Rastogi, \u0026amp; P. Budhwar (Eds.), Riding the New Tides: Navigating the Future Through Effective People Management (pp. 27-36). Emerald Publications.\u003c/li\u003e\n\u003cli\u003eSingh, A. \u0026amp; Jha, S. (2022). Relationship between employee well-being and organizational health: symbiotic or independent? Industrial and Commercial Training, 54 (2), 231-249. https://doi.org/10.1108/ICT-03-2021-0018\u003c/li\u003e\n\u003cli\u003eSon, J., \u0026amp; Jung, J. (2021). Applying soft systems methodology to analyze organizational health: A case study of a nonprofit organization. Nonprofit and Voluntary Sector Quarterly, 50 (1), 133-154.\u003c/li\u003e\n\u003cli\u003eTounsi, M., Amin, F., \u0026amp; Ansari, M. (2021). Design of Organizational Health Model for the Tunisian Aviation Organization. Economic and Management Research Journal, 15 (2), 15-34.\u003c/li\u003e\n\u003cli\u003eTsui, A. S., \u0026amp; Cheng, Y. Y. (1999). The relationship between organizational culture, leadership behavior, and job satisfaction: An empirical study of Taiwan\u0026apos;s non-profit organizations. The International Journal of Human Resource Management, 10 (3), 520-535.\u003c/li\u003e\n\u003cli\u003eTuan, L. (2013). Underneath organizational health and knowledge sharing. Journal of Organizational Change Management, 26 (1), 139-168.\u003c/li\u003e\n\u003cli\u003eWilson, B. (2001). Soft Systems Methodology: Conceptual Model Building and Its Contribution. John Wiley.\u003c/li\u003e\n\u003cli\u003eXenidis, Y. \u0026amp; Theocharous, K. (2014). Organizational health: definition and assessment. Procedia Engineering, 85, 562-570.\u003c/li\u003e\n\u003cli\u003eZhang, J., Li, Y., Li, X., \u0026amp; Li, Y. (2022). The relationship between organizational health and employee well-being: The moderating effects of work\u0026ndash;family conflict and psychological safety. International Journal of Environmental Research and Public Health, 19 (1), 155.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"systemic-practice-and-action-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"spaa","sideBox":"Learn more about [Systemic Practice and Action Research](http://link.springer.com/journal/11213)","snPcode":"11213","submissionUrl":"https://submission.nature.com/new-submission/11213/3","title":"Systemic Practice and Action Research","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Organizational Health, System Approach, Soft Systems Methodology (SSM), CATWOE","lastPublishedDoi":"10.21203/rs.3.rs-8414400/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8414400/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eDue to the effect of organizational health (OH) on organizations’ productivity, innovation, and profitability, as well as improved employees’ satisfaction and retention, this research aims to use an analytical approach for analyzing the complex phenomenon of organizational health, which has a dynamic nature in today's business world. This paper highlights the need for analyzing organizational health from a systems approach perspective, specifically utilizing the unique soft systems methodology. The proposed framework is applied to a case study in Iran construction industry. It is indicated that organizational health is a complex and multi-layered concept that goes beyond organizational performance. A comprehensive understanding of organizational health can reveal critical issues that affect future performance, despite current satisfactory performance. While the approach presented in this research is holistic and systematic, it is not a universal solution for all organizations and requires specific details related to each organization's health.The research offers a new perspective on organizational health by proposing a systems approach and utilizing the soft systems methodology, indicating the concept's complexity and multi-dimensionality. Despite previous studies in the field of organizational health, the research highlights the need for a deeper and more careful analysis of this topic.\u003c/p\u003e","manuscriptTitle":"Modelling the Organizational Health Using Soft Systems Methodology: A Holistic Approach","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-08 17:28:16","doi":"10.21203/rs.3.rs-8414400/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewersInvited","content":"","date":"2026-03-02T10:30:51+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-09T11:09:57+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-12-26T03:24:45+00:00","index":"","fulltext":""},{"type":"submitted","content":"Systemic Practice and Action Research","date":"2025-12-20T21:51:52+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"systemic-practice-and-action-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"spaa","sideBox":"Learn more about [Systemic Practice and Action Research](http://link.springer.com/journal/11213)","snPcode":"11213","submissionUrl":"https://submission.nature.com/new-submission/11213/3","title":"Systemic Practice and Action Research","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"383b2326-cae3-42b4-beec-b13998042cfc","owner":[],"postedDate":"March 8th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-03-08T17:28:16+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-08 17:28:16","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8414400","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8414400","identity":"rs-8414400","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}