People create innovations. Consequently, organisations must create environments to support them in their innovative endeavours. The ambidextrous organisation is essential to support human centred innovation and therefore it is imperative to ascertain what the key determinants are in terms of structure and architecture, context and culture and leadership. Using mixed-method research approaches comprising case study and structured Kano model techniques, this paper presents an in-depth analysis of the ambidexterity initiatives of an US medical device manufacturer's new product development (NPD) department. The findings of our study illuminate the following key insights. First, we confirm that structure and architecture, context and culture and leadership are pivotal to ensuring effective ambidexterity during exploration and exploitation activities. Second, this study identifies, categorises and prioritises those salient factors that contribute to ambidexterity that organisations should adequately address to avoid undermining their pursuit of effective ambidexterity. Finally, we outline several people management considerations that are highly relevant to enhancing ambidexterity across many determinants. Ultimately, we argue that this study's findings facilitate the creation of a business ecosystem that is more conducive to operationalising effective organisational ambidexterity.