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This case study aims to shed light on what went wrong with the introduction of new surgical suture in a Dutch hospital operating theatre following a tender. Transition to working with new surgical suture was organized in accordance with legal and contractual provisions, and basic principles of change management were applied, but resistance from surgeons led to cancellation of supplies of the new suture.

Researchers had access to all documents relevant to the tendering procedure and crucial correspondence between stakeholders. Seventeen in-depth, 1 h interviews were conducted with key informants who were targeted through maximum variation sampling. Patients were not interviewed. The interviews were recorded, transcribed and analysed by discourse analysis. A trial session and workshop were participatively observed. A cultural psychological perspective was adopted to gain an understanding of why certain practices appear to be resistant to change.

For the cardiothoracic surgeons, suture was more than just stitching material. Suture as a tactile element in their day-to-day work environment is embedded within a social arrangement that ties elements of professional accountability, risk avoidance and direct patient care together in a way that makes sense and feels secure. This arrangement is not to be fumbled with by outsiders.

By understanding the practical and emotional stakes that medical professionals have in their work, lessons can be learned to prevent failure of future change initiatives.

The cultural psychological perspective adopted in this study has never been applied to understanding failed change in a hospital setting.

The purpose of this paper is to contribute to the theory and practice of supply chain management in terms of how an organisation should structure its supply base to be resilient to supply uncertainties and disruptions. An empirical assessment of supplier response diversity is demonstrated, and the following research question posed: Is response diversity of suppliers positively associated with supply chain resilience, more positively than mere supplier diversity is?

Resilience is operationalised as the maintenance of sales of two food products in 27 southern Finnish retail stores during two distinct disruptions. Response diversity is operationalised as 1) diversity in the personnel sizes of slaughterhouse suppliers of pork under domestic strikes and as 2) evenness in the proportions of imports and domestic supply of food oil under global price volatility. A five-step quantitative assessment is performed.

Response diversity is positively related to the maintenance of sales, more positively than diversity of individual suppliers is.

Response diversity is an advancement to the theory of supply chain resilience and supply base management, and access to big data increases practical potential.

Empirical assessments of response diversity of suppliers provide buyer companies an effective means to enhance their supply base management for resilience.

The proposed approach is useful for teaching and for authorities to enhance food security.

This first assessment of response diversity of supply chain operations presents an important advancement in the theory and practice of supply base management for resilience.