Examining the relationship between transformational leadership, organizational culture and organizational change perception in a hospital setting: a structural equation modeling approach

OpenAlex · English

PURPOSE: This study aims to examine how transformational leadership influences organizational change perception in accredited and digital hospitals, and whether organizational culture subdimensions mediate this relationship. DESIGN/METHODOLOGY/APPROACH: This cross-sectional and explanatory study was conducted in two public hospitals in Izmir, Türkiye, both accredited and holding digital hospital certificates. Using stratified sampling to ensure professional representation, data were collected from 527 employees. Structural equation modeling was used to analyze the relationships among variables. FINDINGS: Transformational leadership was found to have a significant effect on organizational change perception (β = 0.614). When organizational culture subdimensions were included as mediators, the effect size decreased to β = 0.179, indicating a partial mediating effect. Among the mediators, adhocracy culture, clan culture, hierarchy culture and market culture showed differing indirect effects in this relationship. The findings highlight the importance of organizational culture in shaping change perceptions in hospital settings. PRACTICAL IMPLICATIONS: The study highlights that strengthening transformational leadership practices and fostering an adhocracy-oriented culture can improve hospitals' readiness for organizational change, such as accreditation and digital transformation, while also supporting employee engagement and successful change initiatives. ORIGINALITY/VALUE: By focusing on hospitals undergoing both accreditation and digitalization, this study contributes to understanding how leadership and culture interact in complex healthcare environments. The results offer practical insights for health managers aiming to foster successful change through cultural development and transformational leadership.