Leadership in Health Services最新文献

{"title":"Archetypes of bad physician leaders - a qualitative study from a large Finnish central hospital.","authors":"Sari Huikko-Tarvainen, Tommi Auvinen","doi":"10.1108/LHS-12-2024-0154","DOIUrl":"https://doi.org/10.1108/LHS-12-2024-0154","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to explore the archetypes of bad leaders as perceived by Finnish physicians across various hierarchical levels. Understanding these archetypes is essential for addressing leadership deficiencies and mitigating the detrimental effects of bad leadership and the positivity bias in leadership research.</p><p><strong>Design/methodology/approach: </strong>Data were collected through in-person, semi-structured interviews with Finnish physicians (<i>n</i> = 50), including residents, specialists, heads of departments and chief physicians. Inductive content analysis, followed by thematization, was used to identify recurring themes and patterns of bad leadership behaviors. Initial codes were generated and subsequently categorized into archetypes of bad leadership, which were further organized into broader thematic categories of bad leadership.</p><p><strong>Findings: </strong>Based on our findings, the authors identified four main themes of bad leadership encompassing seven archetypes of bad leaders, addressing incompetence, lack of transparency, exploitation, bad workload management, bullying, psychological harassment and inequity: lack of support and accessibility (absent and dismissive), authoritarianism and abuse of power (autocratic, bully and manipulative), incompetence and ineffectiveness (incompetent) and unfairness and discrimination (unfair). These issues occurred occasionally in different situations.</p><p><strong>Practical implications: </strong>The findings indicate that a leader's behavior and leadership style directly affect physicians' well-being and work satisfaction, potentially contributing to higher physician turnover and reduced quality of patient care. These results underscore the importance of fostering leadership education that emphasizes communication skills, emotional intelligence and conflict resolution to enhance constructive leadership behaviors.</p><p><strong>Originality/value: </strong>To the best of the authors' knowledge, no prior empirical research has specifically examined the archetypes of bad physician leaders.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"38 5","pages":"48-64"},"PeriodicalIF":1.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relevance of leader-member exchange during a crisis: assessing the mediating role of social exchange relationships to predict intention to leave.","authors":"Facundo Garcia-Pereyra, Julia Miralles-de-Imperial, Ryan Armstrong","doi":"10.1108/LHS-08-2024-0087","DOIUrl":"https://doi.org/10.1108/LHS-08-2024-0087","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to explore how the strength of relations between organization, leader and nursing staff influences the intention to leave one's job during crisis conditions. Drawing on social exchange theory, this study analyzes how perceived organizational support and leader-member exchange (LMX) mediate the effect of informational justice and personal protective equipment (PPE) on intention to leave among nurses.</p><p><strong>Design/methodology/approach: </strong>The research uses partial least squares structural equation modeling with a sample of 159 surveys from nurses gathered in Argentina during April-November 2020.</p><p><strong>Findings: </strong>The study finds that the LMX has a mediating effect between informational justice, the provision of PPE and the intention to leave. Perceived organizational support was not significantly related to the intention to leave due to COVID-19.</p><p><strong>Practical implications: </strong>Even during crises like COVID-19, high-quality relationships between supervisors and supervisees can reduce the likelihood of leaving an organization, while organizational support may be less important during such times. The findings suggest that organizations and health-care managers should pay attention to having effective planning and provision of PPE and provide clear and accurate information during crisis periods.</p><p><strong>Originality/value: </strong>The study contributes to social exchange theory literature during crises. The findings suggest that in times of crises in nursing, the LMX takes on greater significance and becomes central in explaining the connection between resources, information and the decision to leave one's organization.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The deleterious effects of abusive supervision in health-care organizations.","authors":"Homayoun Pasha Safavi, Mona Bouzari","doi":"10.1108/LHS-12-2024-0155","DOIUrl":"https://doi.org/10.1108/LHS-12-2024-0155","url":null,"abstract":"<p><strong>Purpose: </strong>Grounded on the affective event theory, this study aims to investigate the mediating effect of psychological distress in the relationship between abusive supervision and three negative outcomes, namely, solitary-oriented behavior, boreout and sabotage behavior. The study also examined the moderating of anger in the link between abusive supervision and psychological distress.</p><p><strong>Design/methodology/approach: </strong>Data was collected from nurses working in private and public hospitals in Iran. Structural equation modeling and bootstrapping techniques have been applied.</p><p><strong>Findings: </strong>This study confirmed that abusive supervision eventually leads to unfavorable employee outcomes via the mediation effect of psychological distress. Moreover, anger moderates the association between abusive supervision and psychological distress.</p><p><strong>Originality/value: </strong>This research contributes to the existing service literature by investigating the consequences of abusive supervision among nurses.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leadership's role in conflict management during health information technology adoption decisions: qualitative study.","authors":"Uzay Damali, William Ross, Tanner Holst, Derek Daly","doi":"10.1108/LHS-11-2024-0138","DOIUrl":"https://doi.org/10.1108/LHS-11-2024-0138","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to explore how hospital leadership manages conflicts arising from the risks and complexities of adopting Health Information Technology (HIT).</p><p><strong>Design/methodology/approach: </strong>This qualitative study uses Yin's (2014) case study methodology, drawing on in-depth interviews with leaders from a research hospital system and a critical access hospital to develop a conceptual model of leadership's role in managing HIT-related conflicts.</p><p><strong>Findings: </strong>This study identifies 30 factors related to HIT-related conflicts. Critical access hospitals face higher risks due to resource constraints, though their impact on stakeholders is lower. Increased complexity, shaped by close-knit cultures and reliance on external networks, is offset by reduced bureaucracy, enabling quicker decision-making. Leadership in both settings uses servant leadership and similar conflict management strategies, including process, content and motivational controls. Furthermore, heightened HIT-related conflicts correlate with adoption and implementation delays, prompting proactive leadership interventions.</p><p><strong>Originality/value: </strong>This research fills a gap by examining how hospital leadership mediates conflicts during HIT adoption in a research hospital system and a critical access hospital.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transformational leadership and teamwork as catalysts for motivation and job satisfaction among doctors: the case of Republic of North Macedonia.","authors":"Darko Iliev, Leslie Thomas Szamosi, Giovanni Oscar Serafini, Natasha Ilieva","doi":"10.1108/LHS-09-2024-0106","DOIUrl":"https://doi.org/10.1108/LHS-09-2024-0106","url":null,"abstract":"<p><strong>Purpose: </strong>The COVID-19 pandemic has amplified the importance of motivation, job satisfaction, leadership and teamwork in health care. This study aims to explore their dynamics among medical doctors in the South-East European country of Republic of North Macedonia. Although prior research highlights the impact of leadership and teamwork on job satisfaction and motivation, comprehensive analyses within this regional medical context remain scarce.</p><p><strong>Design/methodology/approach: </strong>This research uses a quantitative approach, gathering primary data through an online survey of 166 medical doctors, including both practicing physicians and department heads, representing 10% of officially registered practitioners. Descriptive analysis summarised the data and identified patterns, whereas inferential analysis examined variable relationships and predictions through correlation, regression and analysis of variance to assess group differences.</p><p><strong>Findings: </strong>No significant differences in motivation were found across primary, secondary or tertiary health-care systems, but team orientation varied (<i>p</i> = 0.00). A positive correlation emerged between transformational leadership and job satisfaction (<i>r</i> = 0.73). Applying multiple linear regression, it was concluded that 68.3% of the variability in job satisfaction could be explained through components of leadership and motivation levels (<i>r²</i> = 0.68). A statistically significant preference for transformational leadership is evident, fostering increased job satisfaction and team collaboration.</p><p><strong>Originality/value: </strong>The study offers crucial insights, particularly in light of the country's severe brain-drain, one of the most acute in Europe. Policies that emphasise effective leadership development and teamwork training for medical doctors could counter this trend by fostering greater overall motivation and job satisfaction.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical leadership in a complex adaptive system (CAS) reducing out-of-pocket healthcare expenses in an emergency department in Nepal.","authors":"Suchit Amatya, Dayaram Lamsal, Buddhike Sri Harsha Indrasena, Jill Aylott, Lisa Fox, Remig Wrazen","doi":"10.1108/LHS-02-2024-0019","DOIUrl":"https://doi.org/10.1108/LHS-02-2024-0019","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;This research used ethical leadership to engage doctors to implement an international National Institute for Clinical Excellence (NICE) guideline (NICE, 2014) in an emergency department (ED) in Nepal. The purpose of this study was to reduce unwarranted clinical variation in decision-making and thereby reduce unnecessary costs for patients by paying for computed tomography (CT) scans after a head injury where they are not clinically indicated. The World Health Organization (WHO) in its 17 Sustainable Development Goals (SDGs) (United Nations, 2017), identified SDG 3.8 as a goal to reduce \"out-of-pocket\" (OOP) health spending in low medium income countries (LMIC) to reduce poverty.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design/methodology/approach: &lt;/strong&gt;A quantitative study was designed, using a multiple-choice questionnaire based on the NICE head injury guideline 2014, with &lt;i&gt;n&lt;/i&gt; = 27 doctors at pre- and post-training. Retrospective baseline patient data was collected from 149 patients (&lt;i&gt;n&lt;/i&gt; = 149). These data were individually matched with the patient online record system and a detailed history, and the indication of CT head referral was reviewed on the clinical history part of the patient's notes. A teaching session for doctors explained a flowchart for the NICE CT Head Guideline and different figures and case scenarios regarding patients presenting with a head injury were discussed. All data were collected and entered into a Microsoft Excel spreadsheet 2013. An analysis of the data was done by Statistical Package for Social Sciences version 18. A sample of 302 patients (&lt;i&gt;n&lt;/i&gt; = 302) were followed up after implementation of the guideline in the department.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;In this study, most common causes of head injury are RTA followed by physical assault and fall injury. There was no statistical difference in the type of injury &lt;i&gt;p&lt;/i&gt; &lt; 0.05. &lt;i&gt;X&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; (2, &lt;i&gt;n&lt;/i&gt; = 454) = 2.4467, &lt;i&gt;p&lt;/i&gt; = 0.2942, meaning that at both stages of the research the injury pattern was the same. Compliance has not improved statistically, and this may be due to a low power as it is only 44%. However, there is an appreciable improvement of compliance from 46.3% (before) to 56% (after), which is nearly 10% improvement. Translated to CT scans, this can be taken as reducing unnecessary CTs by 10%. Since 302 CTs were performed in the second phase, this study has demonstrated that nearly 30 unnecessary CT scans have been prevented from being carried out. If one CT cost 20 pounds, then the total saving was 600 pounds. If this study was undertaken over one month, then the total saving for a year would be 600 × 12 = 7200 pounds.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research limitations/implications: &lt;/strong&gt;This study set out to improve the quality of care provided to patients with a head injury who presented to an ED in Nepal. In Nepal as in other LMIC healthcare delivery is improving but there are still low levels of health insurance resulting in","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical leadership in nursing in an ever-changing world: a bibliometric analysis.","authors":"Havva Yesildere Saglam, Fatmanur Sena Karakisla","doi":"10.1108/LHS-12-2024-0149","DOIUrl":"https://doi.org/10.1108/LHS-12-2024-0149","url":null,"abstract":"<p><strong>Purpose: </strong>Leadership plays a critical role in improving the quality of care, minimizing risks to patients and staff and improving patient care outcomes. The purpose of this study is to analyze the structure of publications in the field of clinical leadership in nursing and to provide an overview of its development, trends and focus.</p><p><strong>Design/methodology/approach: </strong>This study is descriptive bibliometric study. Data were collected from Web of Science on August 24, 2023. The population of the study consisted of 1,979 articles between 1994 and 2023 in the field of clinical leadership in nursing obtained from R Studio and WoS database.</p><p><strong>Findings: </strong>The country where clinical leadership was most frequently studied was USA (<i>n</i> = 706). The most frequently used keywords by authors were leadership (843 times), nursing (329 times) and nurses (143 times). In the early years, the most frequently used trending topics were \"quality,\" \"culture,\" \"change\" and \"leadership style,\" while in recent years the trending topics were \"burnout\" and \"COVID-19.\"</p><p><strong>Practical implications: </strong>Due to the limited knowledge on this subject, this study will make an important contribution to the literature and will shed light on new studies to be planned on clinical leadership.</p><p><strong>Originality/value: </strong>It has been observed that the issue of clinical leadership in nursing has become even more important in recent years following radical changes in the world such as pandemics and disasters. It has been observed that studies on this subject have increased rapidly in recent years. While the topics of job satisfaction, burnout and Covid-19 were frequently studied, it was observed that mentoring, collaboration, organization of new graduate nurses, moral difficulties and clinical leadership in nursing education were studied more limitedly.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engaging leadership and work recovery among key personnel of a major health-care and social services reform.","authors":"Kirsikka Selander, Nina Nevanperä, Risto Nikunlaakso, Eveliina Korkiakangas, Jaana Laitinen","doi":"10.1108/LHS-09-2024-0109","DOIUrl":"https://doi.org/10.1108/LHS-09-2024-0109","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this paper is to investigate the experiences of engaging leadership and work recovery among preparers of a major health-care and social services reform in Finland in 2022; to investigate whether engaging leadership was associated with work recovery; and to investigate whether engaging leadership alleviated the harmful effect of job demands on work recovery.</p><p><strong>Design/methodology/approach: </strong>Altogether 258 reform preparers participated in four job well-being surveys. Means and paired <i>t</i>-test were used to measure engaging leadership and work recovery during the study period. Hierarchical multiple linear regression analysis was used to analyze associations between engaging leadership, job demands and recovery from work.</p><p><strong>Findings: </strong>Experiences of engaging leadership and recovery from work decreased during the study period. A change in engaging leadership had a small positive association with work recovery at endpoint. A change in job demands had a stronger association with work recovery at endpoint. Engaging leadership did not alleviate the association between job demands and recovery from work.</p><p><strong>Originality/value: </strong>This study expands previous work recovery literature by demonstrating that engaging leadership style can improve work recovery during health and social care reforms. However, engaging leadership style alone is insufficient to alleviate job demands, and therefore more effective management of job demands is needed. Practically, the findings can be used to plan and lead future reforms.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":"38 5","pages":"35-47"},"PeriodicalIF":1.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leadership styles and EMR adoption: insights from Bali's primary care clinics.","authors":"Made Indra Wijaya","doi":"10.1108/LHS-01-2025-0003","DOIUrl":"https://doi.org/10.1108/LHS-01-2025-0003","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to explore the influence of leadership styles, using full-range leadership theory (FRLT), and technology acceptance, guided by the technology acceptance model (TAM), on the implementation of electronic medical records (EMRs) in primary care settings in Bali.</p><p><strong>Design/methodology/approach: </strong>Using a mixed-methods approach, this research analyzes data from 120 primary care clinics in Bali with a total of 1,204 respondents. Quantitative data were collected through structured surveys assessing leadership styles and EMR acceptance, supplemented by qualitative insights from 30 interviews and 6 focus group discussions. Statistical methods, including the Chi-Square Test of Independence and pairwise comparisons using adjusted residuals, were used to examine the relationships between leadership styles, EMR adoption, perceived usefulness and ease of use.</p><p><strong>Findings: </strong>The Chi-Square Test of Independence revealed a significant association between leadership style and EMR adoption level (χ² = 30.33, <i>p</i> < 0.001). Transformational leadership was strongly associated with higher full EMR adoption rates, while Laissez-Faire leadership showed a significant association with no EMR adoption. Qualitative data supported these findings, emphasizing the critical role of proactive, supportive leadership in enhancing technology acceptance.</p><p><strong>Originality/value: </strong>This study uniquely integrates FRLT and TAM within the context of EMR adoption in Bali's health-care system, providing new insights into how leadership and technology perceptions interact to influence implementation outcomes in a diverse health-care environment.</p>","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening Lebanese health care: exploring the impact of organizational culture on employee loyalty through trust and job satisfaction.","authors":"Johnny Chaanine","doi":"10.1108/LHS-09-2024-0114","DOIUrl":"10.1108/LHS-09-2024-0114","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;This study aims to examine the relationships between organizational culture, employee loyalty, trust and job satisfaction within the Lebanese health-care sector. It addresses the critical need to improve employee retention and organizational performance in a context marked by economic instability and political uncertainty. By analyzing data from 270 health-care professionals, the study aims to explore how different aspects of organizational culture - such as transparency, supportiveness and ethical leadership - affect employee trust and satisfaction. These factors, in turn, play a significant role in enhancing employee loyalty, which is crucial for reducing turnover and ensuring the stability of health-care services.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design/methodology/approach: &lt;/strong&gt;The research used a quantitative methodology, gathering data from 270 health-care professionals across various private health-care institutions in Lebanon. A structured survey was used, and responses were analyzed using structural equation modeling (SEM) to test the proposed hypotheses. The SEM approach was chosen for its ability to evaluate both measurement and structural models, ensuring robust validation of the theoretical framework. Partial least squares (PLS-SEM) was specifically applied, given its suitability for smaller sample sizes and complex models. After screening and cleaning the data, the final sample size was 270, ensuring a representative and accurate analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;The research findings reveal that a strong organizational culture significantly enhances employee loyalty, mediated by higher levels of trust and job satisfaction. Cultures characterized by transparency, supportiveness and ethical leadership are shown to build trust among employees, which directly contributes to greater job satisfaction. This satisfaction, in turn, plays a crucial role in strengthening employee loyalty, helping to reduce turnover rates and maintain organizational stability. The study underscores the importance of fostering a positive corporate culture as a strategic tool in health-care settings, particularly in challenging environments like Lebanon, to improve both employee engagement and overall performance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Originality/value: &lt;/strong&gt;This study offers originality by focusing on the underexplored Lebanese health-care sector, particularly in the context of organizational culture's impact on employee loyalty, trust and job satisfaction. While much research has been conducted in more stable economies, this study addresses the unique socio-economic challenges faced by health-care institutions in Lebanon, including political instability and economic volatility. By using SEM, the research provides new insights into the critical role of transparent, supportive and ethically driven organizational cultures in enhancing employee engagement and retention. These findings offer both theoretical contributions and practical applicat","PeriodicalId":46165,"journal":{"name":"Leadership in Health Services","volume":" ","pages":"263-279"},"PeriodicalIF":1.7,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}