Transformational leadership impact on innovative behaviour as perceived by healthcare workers in private hospitals in Jordan

Raoush, Atef Article Transformational leadership impact on innovative behaviour as perceived by healthcare workers in private hospitals in Jordan Cogent Business & Management Provided in Cooperation with: Taylor & Francis Group Suggested Citation: Raoush, Atef (2023) : Transformational leadership impact on innovative behaviour as perceived by healthcare workers in private hospitals in Jordan, Cogent Business & Management, ISSN 2331-1975, Taylor & Francis, Abingdon, Vol. 10, Iss. 3, pp. 1-16, https://doi.org/10.1080/23311975.2023.2265606 This Version is available at: https://hdl.handle.net/10419/294675 Standard-Nutzungsbedingungen: Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden. Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen. Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Terms of use: Documents in EconStor may be saved and copied for your personal and scholarly purposes. You are not to copy documents for public or commercial purposes, to exhibit the documents publicly, to make them publicly available on the internet, or to distribute or otherwise use the documents in public. If the documents have been made available under an Open Content Licence (especially Creative Commons Licences), you may exercise further usage rights as specified in the indicated licence. https://creativecommons.org/licenses/by/4.0/ Full Terms & Conditions of access and use can be found at https://www.tandfonline.com/action/journalInformation?journalCode=oabm20 Cogent Business & Management ISSN: (Print) (Online) Journal homepage: www.tandfonline.com/journals/oabm20 Transformational leadership impact on innovative behaviour as perceived by healthcare workers in private hospitals in Jordan Atef Raoush To cite this article: Atef Raoush (2023) Transformational leadership impact on innovative behaviour as perceived by healthcare workers in private hospitals in Jordan, Cogent Business & Management, 10:3, 2265606, DOI: 10.1080/23311975.2023.2265606 To link to this article: https://doi.org/10.1080/23311975.2023.2265606 © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Published online: 05 Oct 2023. Submit your article to this journal Article views: 1961 View related articles View Crossmark data MANAGEMENT | RESEARCH ARTICLE Transformational leadership impact on innovative behaviour as perceived by healthcare workers in private hospitals in Jordan Atef Raoush 1 * Abstract: Because of globalization and the ever-changing nature of businesses, particularly healthcare organizations, leaders need to determine the most effective method for bringing change that will help the organization achieve its objectives. Understanding how to encourage followers to reach organizational goals through leadership techniques adequately has become a concern for the healthcare business. Consequently, the significance of transformational leadership can be observed in bringing about that type of change in any business and understanding how to motivate followers to reach corporate goals effectively. As a result, the main objective of this study is to determine the influence of transformational leadership on healthcare workers’ innovative behavior in Jordan’s private hospitals as perceived by healthcare workers. This research employs a cross-sectional study design involving a quantitative method of data collection. In total, 412 healthcare workers from Jordanian private hospitals were included in the sample. Using simple linear regression analysis, the research findings revealed a significant transformational leadership impact on healthcare workers’ innovative behavior; the findings highlight Atef Raoush ABOUT THE AUTHOR Atef Raoush is an Associate Professor, Hospital Management Department at the Faculty of Business, Philadelphia University in Jordan. With a Ph.D. in Hospital Management and a subspecialty in TQM in Healthcare, he possesses a wealth of knowledge and expertise in the field. With nine years of experience in teaching and research, and 15 years in healthcare quality and hospital management. His key research interests include Total Quality Management, Financial Management, Performance Improvement, Leadership and governance, Human Resources Management, and Accreditation in the Healthcare Sector. Through his research activities, he aims to contribute to the advancement of these critical areas and improve healthcare services in Jordan and beyond. His work on leadership and governance aligns well with his ongoing commitment to enhancing organizational performance and fostering a culture of quality and innovation in the healthcare industry. PUBLIC INTEREST STATEMENT In this paper, the author focus on the crucial role of leadership in the success of organizations, with a particular emphasis on healthcare workers in Jordan. The study investigates the influence of transformational leadership on the innovative behaviour of these healthcare workers, an aspect that deserves more attention from healthcare decision-makers. By choosing private hospitals as the study’s context, which are integral to Jordan’s healthcare system, the author shed light on the impact of transformational leadership on innovation. The findings highlight that transformational leadership significantly affects innovation among healthcare workers. The potential implications of this research are valuable, as it contributes to a deeper understanding of how hospital leaders can positively influence their subordinates’ innovative behaviour from the perspective of the healthcare workers themselves. Raoush, Cogent Business & Management (2023), 10: 2265606 https://doi.org/10.1080/23311975.2023.2265606 Page 1 of 16 Received: 13 November 2021 Accepted: 13 September 2023 *Corresponding author: Atef Raoush, Hospital Management Department, Faculty of Business, Philadelphia University, Amman, Jordan E-mail: [email protected] Reviewing editor: Mazhar Abbas, Department of Business Administration, Cholistan University of Veterinary and Animal Sciences Bahawalpur, Pakistan Additional information is available at the end of the article © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent. the importance of hospital leaders adopting a transformational leadership style, which is crucial for motivating healthcare employees to engage in innovative behavior, In addition, Hospital leaders should focus on fostering a workplace that encourages innovation, motivates staff to gain new knowledge and skills and gives them chances to transfer their knowledge and skills into practice. Subjects: Thinking, Reasoning & Problem Solving; Leadership; Work Motivation; Personnel Selection, Assessment, and Human Resource Management; Organizational Change; Innovation Management; Leadership; Healthcare Administration and Management Keywords: transformational leadership; leadership style; innovative behavior; private hospitals; healthcare; Jordan 1. Introduction Leadership communication is vital for any institution, particularly when the external environment is continuously changing. As a result of these changes, managers must recognize how to encourage subordinates to achieve institutional goals through different leadership styles while also forming an atmosphere where subordinates work proficiently and pursue innovative thoughts (Iskandarani, 2017). When one individual persuades others to meet the basic standards for their employment gladly, this is referred to as leadership (Best et al., 2020). Leadership can also be defined as persuading people and creating an environment that allows them to achieve team or corporate objectives and goals. Because good leaders can inspire, encourage, and identify with their people in order to urge them to complete their jobs and meet the required goals (Harlianto & Afandy, 2018). Hence, possessing competent and skillful leaders gives a company a competitive advantage (Raoush, 2022). One aspect of leadership is working together with people, teams, and other resources to achieve a company’s goals. It may also be defined as the actions performed by a leader to guide and persuade staff members to embrace novel work practices (Alkahtani, 2015). Consequently, individual innovation in the workplace is highly influenced by transformational leadership. By definition, transformational leaders strive to improve follower performance to effect positive organizational change. They can achieve this goal by focusing on the needs of their followers and encouraging individual intellectual and creative stimulation. Al Dhanhani and Hazana Abdullah (2020) found that employee work performance is strongly linked to organizational culture and transformational leadership. Jiang (2017) also claims that the use of a transformational style significantly impacts worker behavior. Companies continuously strive for unique products and services to stand out from the competition and gain a competitive edge in today’s fast-paced global business climate. Organizations need to foster employee innovation in order for this to happen. Additionally, organizational leaders must collaborate with employees to guide and assist them as they develop new products and services. Therefore, Innovation, defined as the creation of new procedures and practices, is critical for a company’s long-term competitive advantage (Jia et al., 2018). Correspondingly, a corporate climate that encourages (or discourages) individual innovation can significantly impact its personnel (Iskandarani, 2017). Son et al. (2020); Al Dhanhani and Hazana Abdullah (2020); Le and Lei (2019); Dappa et al. (2019); Zhang et al. (2018) studied the effect of transformational leadership on innovation culture they reached the conclusion that transformational leadership significantly affects organizational performance and the culture of innovation. Other research has discovered a strong link between transformational leadership and team effectiveness (Abudaqa et al., 2020; Tang et al., 2020). Leadership plays an essential role in the healthcare industry since it leads to achieving many hospitals’ and health organizations’ goals. Most healthcare leaders’ actions worldwide are centered on improving health quality and developing innovative methods to address the complicated Raoush, Cogent Business & Management (2023), 10: 2265606 https://doi.org/10.1080/23311975.2023.2265606 Page 2 of 16 factors in the business setup (Gopee & Galloway, 2017). It is becoming increasingly challenging for a single healthcare leader to address all problems to create the best outcome for healthcare procedures (Barr & Dowding, 2019). Nonetheless, utilizing transformational leadership, soliciting input from all stakeholders without overlooking anyone, has proven beneficial in the healthcare business (Besieux et al., 2015; Hansen & Pihl-Thingvad, 2018). 2. Literature review and hypotheses development 2.1. Transformational leadership Most academics are fascinated by the topic of leadership, which is important to the success of organizations irrespective of their industry. There is evidence in the literature that organizational leadership is a crucial element in stimulating, supporting, facilitating, supporting, and enhancing workers’ performance (Lee et al., 2021). According to Gill and Benatar (2016), tackling global health concerns requires strong leadership. In any corporation, leadership plays a prominent role in achieving various corporate objectives (Grint et al., 2016). A leader’s leadership style, defined as how he or she provides direction, implements plans, and motivates employees, is an important aspect of corporate management (Bonau, 2017). According to Chaimongkonrojna and Steane (2015), numerous leadership theories exist. One of these is the full-range leadership theory, which divides leadership practices into three kinds: transformational, transactional, and passive-avoidant; it is a typical theory used to detect distinctions in leadership styles. In 1978, Burns coined the phrase “transformational leadership (Burns, 1978). Gill et al. (2010) defined transformational leadership as exerting inspiration over subordinates with the intention of producing dramatic shifts in their views and establishing commitment to the organization’s mission, vision, and objectives. In addition, Northouse (2016) defines it as the process by which one individual affects a group of persons to reach an expected result. He explains transformational leadership as a method that combines charismatic and visionary leadership to influence, transform, and change people by identifying their needs, motivating them to meet those needs, and taking into account their feelings, emotions, values, and ethics to help them achieve long-term goals. It is a process in which the leader and followers cooperate to help each other develop moral character and drive (Northouse, 2016). Organizations throughout the world have employed transformational leadership over the last few years. This is because previous research has shown that it improves employee performance (Ullah et al., 2018), Enhancing employee commitment (Allen et al., 2017), organizational success, work satisfaction (Muterera et al., 2016), employee creativity (Jyoti & Dev, 2015), and overall job outcomes (Asgari et al., 2020; Kim & Yoon, 2015). There is also clear evidence of a link between transformational leadership and innovation (Al Dhanhani & Hazana Abdullah, 2020; Dappa et al., 2019; Le & Lei, 2019; Son et al., 2020; Zhang et al., 2018). Myricks (2021) analyzes the link between transformative leadership and employee results as seen by employees. The information was gathered from 107 local government employees in the southern United States. The findings supported the existence of a significant correlation between transformational leadership and organizational outcomes. According to the findings, employers should apply transformational leadership behavior to improve employees’ perceptions of their leaders’ transformational leadership behavior, core self-evaluations, and job results. Le and Lei (2019) investigate the role of perceived organizational support as a moderating mechanism and knowledge sharing as a mediating function of the effect of transformational leadership in innovation. A total of 394 people from 88 Chinese businesses were polled. The findings revealed that transformational leadership influences innovation via a knowledge-sharing mediator. Through perceived organizational support, the results also demonstrated that transformational leadership and knowledge exchange impacted innovation capabilities. In order to improve innovation culture capabilities, the report emphasizes how important it is for Chinese managers to use knowledge-sharing and transformational leadership techniques. Raoush, Cogent Business & Management (2023), 10: 2265606 https://doi.org/10.1080/23311975.2023.2265606 Page 3 of 16 At two public universities in Texas (PUS) and Qatar, Al-Mansoori and Koç (2019) examine the effects of transformational leadership on the growth of engineering colleges’ innovation capabilities (PQA). The research examines transformational leadership’s impact on faculty innovation through technical publications, patents, and courses on sustainable development. The survey form was completed by 39 faculty members from both colleges, and the results were analyzed. The findings were also compared to Hofstede’s Cultural Dimensions Framework, which is constructed on data collected from huge multinational corporations in 40 countries and has five work-related values. The results showed that both universities’ leaders had some transformative leadership influences. Respondents stressed the importance of government contribution in fostering innovation. Academic staff also emphasized the importance of acknowledgment and a measurable incentive structure that facilitate faculty efforts on assignments rather than technical articles. Naguib and Naem (2018) look at the correlation between transformational leadership and innovation. The support of upper management arbitrates the association between using a transformational leadership style and subordinates’ innovation, while materials supply arbitrates the correlation between transformational leadership and subordinates’ innovation results, according to the findings. Khalili (2016) looks at how transformative leadership affects employee creativity and innovation. A transformational leadership instrument was used to survey the opinions of 1,172 workforces from various businesses in Khalili (2016). The findings show that transformative leadership, employee creativity, and innovation are linked in a favorable and meaningful way. According to the survey, Iranian business leaders should learn to be transformational leaders and practice them. Additionally, they should support and foster employee innovation and creativity in order to enhance corporate success. Bass and Avolio (1995) divided transformational leadership into four categories. It has gotten a lot of attention in the management literature, and it is still being researched: 2.1.1. Idealized influence This is the amount to which an organizational leader may win the admiration, trust, confidence, and respect of his or her followers, thereby making them role models (Bass, 1985). This is a personality trait that the followers give to the leader. The transformational leader’s behavior creates a sense of authority and pride among the team and goes above and above for the benefit of the followers, which is referred to as a charismatic influence (Avolio & Bass, 2004; Mittal, 2015). Influential leaders are approachable, self-assured, and intent on achieving great objectives (Elche et al., 2020). 2.1.2. Intellectual stimulation The degree to which an organizational leader can inspire his or her followers’ intelligent and critical thinking by raising their knowledge of the organization’s concerns and pushing them to come up with new solutions to any challenges they confront. (Walumbwa et al., 2005). While focusing on the desired vision and taking into account the ethical consequences of their activities (Avolio & Bass, 2004). 2.1.3. Inspirational motivation This refers to a leader’s capacity to communicate a vision to his or her people that is both engaging and motivating (Bass, 1985). Organizational leaders that inspire enthusiasm have high expectations for their subordinates, are optimistic about the future, and give purpose to the assigned tasks (Bass, 1985). By bringing meaning to their work, the leader inspires and motivates followers as well as other people. (Avolio & Bass, 2004; Bass, 1985; Jauhar et al., 2017; Northouse, 2016). 2.1.4. Individualized consideration This is how an organizational leader focuses on the essentials of his or her subordinates, listens to their concerns, and acts as a mentor, coach, and friend to them (Bass, 1985). This attribute is Raoush, Cogent Business & Management (2023), 10: 2265606 https://doi.org/10.1080/23311975.2023.2265606 Page 4 of 16 exhibited by a leader who cares about an individual’s strengths, ambitions, and goals to boost followers’ self-confidence in addressing any difficulties the organization can face (Avolio et al., 2004), along with preserving a justification for the undertaking and the goals that must be encountered (Mokhber et al., 2015). Transformational leaders strive to improve organizational culture affecting positive change in individuals and social systems, which benefits both the team and the organization (Ashfaque, 2020). Moreover, Transformational leaders inspire followers to take on more tasks to help them reach their greatest potential (Paulienė, 2012). This leadership style increases followers’ psychological empowerment and promotes inventiveness (Sinha et al., 2016). According to Kim and Yoon (2015), Transformational leaders inspire their staff to do their best work, which results in organizations that are innovation-focused. In the healthcare sector, a major role is played by leadership. In the current healthcare environment, it is no longer acceptable for healthcare professionals to underestimate the necessity for effective leadership (Raoush, 2022); leaders have been making noticeable moves over the recent years toward a more customer-focused approach when delivering their services (Edmunds, 2019). Such efforts may need to be more adequate to meet the needs of an evergrowing population dealing with a range of health-related challenges, given today’s healthcare service standards. Healthcare leaders have personalities that create a vision, are anticipatory and proactive, and promote sound communication across the organization (Gopee & Galloway, 2017). Future healthcare leadership entails creating consumer-focused healthcare organizations as well as rational reasoning that focuses on major areas that contribute to the continuous change of organizations. Transparency regarding service pricing and data quality, a technology employed in patient monitoring and involvement, and individualized care delivery are only a few (O’Brien & Mattison, 2016). 2.2. Innovative behaviour Due to changing environmental and economic dynamics, customer wants, and rising organizational competitiveness, innovative behavior is becoming increasingly vital (Škerlavaj et al., 2017). The innovative behavior of employees is considered to be a key factor in achieving sustainable growth and competitive advantage (Lee et al., 2021). Innovative work practices by employees are essential to the competitiveness and survival of organizations (Ashfaque, 2020). The first step in innovative behavior is recognizing a problem and coming up with a solution for it (Dhar, 2016). Bonacci et al. (2020) defined innovative behavior as addressing an issue, offering an answer through knowledge or fresh thoughts from practice, and achieving the idea to promote the institution’s benefits. Many characteristics, such as creativity, independence, risk-taking, decisionmaking, subordinates involvement, and flexibility, have been identified as cultural values fostering innovation (Naranjo-Valencia et al., 2016). Beswick et al. (2016) explain innovation as the successful employment of a novel or unconventional idea that is cost-effective, reachable, and adds worth to the consumer by resolving an existent problem and initiatives progression for the inventor; he stated that any leader should be asked the following three questions when forming a leadership group for innovation: 1) Are you ready to make innovation a priority for the upper group? If the innovation plan is to succeed, upper management support is necessary to guarantee that leadership team member embraces it. 2) Are you willing to develop a plan that aligns with the company’s desire for innovation? The plan for innovation should be pragmatic, realistic, reasonable, and feasible. 3) Are you willing to shift from a hierarchical leadership style to another that promotes empowerment and leadership over control and management? Building a leadership team with cohesion, cooperation, and ownership may demand specific leadership development in order to develop the capability to lead and control innovation. Many organizational leaders need help managing innovation since scholars generally describe it as random, non-linear, and complicated (Kahn et al., 2012). The majority of study on creativity has focused on how leaders influence their teams’ creativity rather than innovative work practices, Raoush, Cogent Business & Management (2023), 10: 2265606 https://doi.org/10.1080/23311975.2023.2265606 Page 5 of 16 leaving the role of employees in the formulation and implementation of ideas largely untapped and unexplored (Hughes et al., 2018). Management innovation has been demonstrated to support policy diffusion in association with leadership (Yi et al., 2018) and promote innovative behavior at work (Karatepe et al., 2020). In the healthcare setting, innovation can be defined as an intellectual process represented in specific behaviors by an individual or a group. Healthcare employees need to be able to accomplish activities that go beyond the established protocols of a team, group, or organization. They could look for new technology or recommend new approaches to achieve objectives. According to Afsar and Masood (2017), innovative work behaviors are described as an individual’s deliberate introduction and implementation of new ideas, methods, and procedures inside a work function in order to boost performance. Hence, Future healthcare leadership entails the construction of consumer-centered healthcare organizations that emphasize the zones that contribute to an organization’s transformation now and in the future. This will be accomplished through active employee involvement and an environment of innovation (O’Brien & Mattison, 2016). Consequently, rather than seeing innovation as a deviant and troubling habit, people will see it as a desirable and socially appreciated method (Odoardi et al., 2019). In addition to concentrating on long-term objectives and motivating others to go beyond their immediate interests in order to pursue higher-order goals, transformational leaders must articulate the need for change, generate innovative thinking, and seek support for those ideas (Chang et al., 2020). 2.3. Hypotheses development Leadership plays an essential role in the healthcare industry since it leads to achieving hospitals’ and health organizations’ goals. Most healthcare leaders’ actions worldwide are centered on improving health quality and developing innovative methods to address the complicated factors in the business setup (Gopee & Galloway, 2017). According to the previous literature review, more study of the underlying mechanism connecting transformational leadership with innovative behavior in the workplace has been suggested to be essential. For this reason, this study aims to examine the transformational leadership impact on healthcare workers’ innovative behavior; the researcher has developed the hypotheses as follows: H1: There is a significant impact of transformational leadership on workers’ innovative behavior as perceived by healthcare professionals at private hospitals in Jordan at (p ≤ 0.05). H2: There is a significant impact of Idealized Influence on innovative behavior, as perceived by healthcare professionals at private hospitals in Jordan at (p ≤ 0.05). H3: There is a significant impact of Intellectual Stimulation on innovative behavior, as perceived by healthcare professionals at private hospitals in Jordan at (p ≤ 0.05). H4: There is a significant impact on Inspirational Motivation on innovative behavior, as perceived by healthcare professionals at private hospitals in Jordan at (p ≤ 0.05). H5: There is a significant impact of Individualized Consideration on innovative behavior, as perceived by healthcare professionals at private hospitals in Jordan at (p ≤ 0.05). H6: There is a statistically significant relationship between participants’ general characteristics and innovative behavior at p ≤ 0.05. Raoush, Cogent Business & Management (2023), 10: 2265606 https://doi.org/10.1080/23311975.2023.2265606 Page 6 of 16 3. Methodology 3.1. Study design and sample This research used a quantitative data-gathering method and a cross-sectional study design. The researcher chose a quantitative method since it is used to make inferences from the data (Rahi, 2017), and the cross-sectional design highlighted the characteristics of a certain population regarding what was happening in that population (Wang & Cheng, 2020). All healthcare workers in Jordan’s private hospitals were included in the study; healthcare workers are defined as professionals who provide preventive, curative, rehabilitative and promoting health services (WHO, 2007). According to Jordan’s Ministry of Health’s annual report for 2019, the private sector operates 69 hospitals, accounting for approximately one-third of the country’s hospital beds (5334) (about 36.3 percent of total beds). Healthcare workers included in the report consist of Physicians, Dentists, Pharmacists, Registered Nurses, and Midwives, with a total of 52,329 working in private hospitals and clinics (MOH Annual Report, 2019), our population in this research was the health workers in the private hospital only. However, no official report specified the total number of health professionals working in this sector exclusively at the time this study was conducted. The participants in the research were chosen from healthcare workers who met the study’s inclusion criteria. To be eligible for the study, participants had to be healthcare personnel working in private hospitals in Jordan Hair et al. (2013) highlighted that the sample has to be representative of the population and have a sufficient number of participants. Sekaran and Bougie (2016) state that researchers can choose the sample size based on the population as follow: If the population size is 50,000, the sample should be 381, and if the population size is 100,000, the sample should be 383, based on that, A random sample of 500 surveys was sent to private hospitals in Jordan; however, only 412 of those surveys were returned, yielding an 82.4% response rate. The sample size considers enough to represent the study population (Sekaran & Bougie, 2016). Potential participants were given the study questionnaire and information regarding consent and how to participate at nine private hospitals. They were informed about the study’s purpose and nature. Participants were instructed not to include any identifying information and to send the completed questionnaire to the researcher because participation was anonymous. Furthermore, the researcher avoided any action construed as advocating or encouraging unethical behavior, such as violating the confidentiality of survey respondents, falsifying study results, misleading respondents, and avoiding legal culpability. 3.2. Survey instrument The research questionnaire was divided into two parts: the first part collected information about the participants’ baseline characteristics, such as sex, age, job title, and experience, while the second part gathered information about transformational leadership’s impact on innovative behavior. There were 28 items in the questionnaire to test hypotheses. The following Likert fivepoint scale was used to score all questionnaire items: Strongly Agree equal 5, Agree equal 4, Neutral equal 3, Disagree equal 2, and Strongly Disagree equal 1. The initial 16 questions dealt with transformational leadership, chosen and adapted from The Multifactor Leadership Questionnaire (MLQ), which was developed and amended based on research by Bass and Avolio (2000), Bass and Riggio (2006), Khalili (2016), Alahmad (2016), Albandari (2020), and Iskandarani (2017). Additionally, items 17 to 28 were chosen to assess innovation behaviors. They were created and adapted from the study of Scott and Bruce (1994), Beswick et al. (2016), DeGraff and Quinn (2007), Goffin and Mitchell (2010), Schneider (2017), Albandari (2020), and Robinson (2020). Independent expert translators translated the questionnaire from English to Arabic and backward from Arabic to English to confirm that the Arabic version was appropriately interpreted. To ensure the validity and suitability of the survey, six pre-tests conducted by interviewing three Raoush, Cogent Business & Management (2023), 10: 2265606 https://doi.org/10.1080/23311975.2023.2265606 Page 7 of 16 Barr, J., & Dowding, L. (2019). Leadership in health care. Sage Publications. https://doi.org/10.4324/ 9781315838649 Bass, B. M. (1985). Leadership and performance beyond expectations. Free Press. Bass, B. M., & Avolio, B. J. (1995). MLQ Multifactor leadership questionnaire. Mind Garden. Bass, B. M., & Avolio, B. J. (2000). Improving organizational effectiveness: Through transformational leadership. Sage. Bass, B. M., & Riggio, R. E. (2006).Transformational leadership. (2nd ed.). https://doi.org/10.4324/ 9781410617095 Besieux, T., Baillien, E., Verbeke, A. L., & Euwema, M. C. (2015). What goes around comes around: The mediation of corporate social responsibility in the relationship between transformational leadership and employee engagement. Economic and Industrial Democracy, 39(2), 249–271. https://doi.org/10.1177/ 0143831x15614914 Best, S., Stark, Z., Brown, H., Long, J. C., Hewage, K., Gaff, C., Braithwaite, J., & Taylor, N. (2020). The leadership behaviors needed to implement clinical genomics at scale: A qualitative study. Genetics in Medicine, 22(8), 1384–1390. https://doi.org/10.1038/ s41436-020-0818-1 Beswick, C., Bishop, D., & Geraghty, J. (2016). Building a culture of innovation a practical framework for placing innovation at the core of your business. KoganPage. Bonacci, I., Mazzitelli, A., & Morea, D. (2020). Evaluating climate between working excellence and organizational innovation: What comes first? Sustainability, 12 (8), 3340. https://doi.org/10.3390/su12083340 Bonau, S. (2017). How to become an inspirational leader, and what to avoid. Journal of Management Development, 36(5), 614–625. https://doi.org/10. 1108/jmd-03-2015-0047 Bradd, P., Travaglia, J., & Hayen, A. (2017). Leadership in allied health: A review of the literature. Asia Pacific Journal of Health Management, 12(1), 17–24. https:// doi.org/10.24083/apjhm.v12i1.103 Burns, J. M. (1978). Leadership. Harper and Row. Chaimongkonrojna, T., & Steane, P. (2015). Effectiveness of full range leadership development among middle managers. Journal of Management Development, 34(9), 1161–1180. https://doi.org/10.1108/jmd-01-2014-0002 Chang, W., Busser, J., & Liu, A. (2020). Authentic leadership and career satisfaction: The meditating role of thriving and conditional effect of psychological contract fulfillment. International Journal of Contemporary Hospitality Management, 32(6), 2117–2136. https://doi. org/10.1108/IJCHM-06-2019-0551 Cheung, M. F. Y., & Wong, C. S. (2011). Transformational leadership, leader support, and employee creativity. Leadership & Organization Development Journal, 32 (7), 656–672. https://doi.org/10.1108/ 01437731111169988 Dappa, K., Bhatti, F., & Aljarah, A. (2019). A study on the effect of transformational leadership on job satisfaction: The role of gender, perceived organizational politics and perceived organizational commitment. Management Science Letters, 823–834. https://doi. org/10.5267/j.msl.2019.3.006 DeGraff, J., & Quinn, S. (2007). Leading innovation: How to jump start your organization’s growth engine (1st ed.). McGraw-Hill. Dhar, R. L. (2016). Ethical leadership and its impact on service innovative behavior: The role of LMX and job autonomy. Tourism Management, 57, 139–148. https://doi.org/10.1016/j.tourman.2016.05.011 Dugan, J. P. (2017). Leadership theory: Cultivating critical perspectives. Jossey-Bass. Edmunds, M. (2019). Promoting consumer engagement in health and health care. Consumer Informatics and Digital Health, 3–24. https://doi.org/10.1007/978- 3-319-96906-0_1 Elche, D., Ruiz-Palomino, P., & Linuesa-Langreo, J. (2020). Servant leadership and organizational citizenship behavior. International Journal of Contemporary Hospitality Management, 32(6), 2035–2053. https:// doi.org/10.1108/ijchm-05-2019-0501 Elrehail, H., Emeagwali, O. L., Alsaad, A., & Alzghoul, A. (2018). The impact of transformational and authentic leadership on innovation in higher education: The contingent role of knowledge sharing. Telematics and Informatics, 35(1), 55–67. https://doi.org/10.1016/j. tele.2017.09.018 George, D., & Mallery, P. (2003). SPSS for windows step by step: A simple guide and reference (4th ed.). Allyn & Bacon. Gill, S., & Benatar, S. (2016). Global health governance and global power. International Journal of Health Services, 46(2), 346–365. https://doi.org/10.1177/ 0020731416631734 Gill, A., Fitzgerald, S., Bhutani, S., Mand, H., & Sharma, S. (2010). The relationship between transformational leadership and employee desire for empowerment. International Journal of Contemporary Hospitality Management, 22(2), 263–273. https://doi.org/10. 1108/09596111011018223 Goffin, K., & Mitchell, R. (2010). Innovation management (1st ed.). Palgrave Macmillan: https://doi.org/10. 1007/978-1-137-04752-6_1 Golden, J. H., III, & Shriner, M. (2017). Examining relationships between transformational leadership and employee creative performance: The moderator effects of organizational culture. The Journal of Creative Behavior, 53(3), 363–376. available at. https://doi.org/10.1002/jocb.216 Gopee, N., & Galloway, J. (2017). Leadership and management in healthcare (3rd ed.). SAGE. Grint, K., Jones, O. S., Holt, C., & Storey, J. (2016). What is leadership? The Routledge companion to leadership (3rd ed., pp. 3–10). Routledge. Hair, J. F., RINGLE, C. M., & Sarstedt, M. (2013). Partial least squares structural equation modeling: Rigorous applications, better results and higher acceptance. Long Range Planning, 46(1–2), 1–12. https://doi.org/ 10.1016/j.lrp.2013.01.001 Hansen, J. A., & Pihl-Thingvad, S. (2018). Managing employee innovative behaviour through transformational and transactional leadership styles. Public Management Review, 21(6), 918–944. https://doi.org/ 10.1080/14719037.2018.1544272 Harlianto, J. R., & Afandy, D. (2018). The role of leaders in stimulating innovative work behavior and its impacts towards job performance (case study: Pt. XYZ). International Journal of Engineering and Technology, 7 (3.30), 571. https://doi.org/10.14419/ijet.v7i3.30.18433 Hughes, D. J., Lee, A., Tian, A. W., Newman, A., & Legood, A. (2018). Leadership, creativity, and innovation: A critical review and practical recommendations. The Leadership Quarterly, 29(5), 549–569. https://doi.org/10.1016/j.lea qua.2018.03.001 Hyrkäs, K., Appelqvist-Schmidlechner, K., & Oksa, L. (2003). Validating an instrument for clinical supervision using an expert panel. International Journal of Nursing Studies, 40(6), 619–625. https://doi.org/10. 1016/s0020-7489(03)00036-1 İşcan, Ö. F., Ersarı, G., & Naktiyok, A. (2014). Effect of leadership style on perceived organizational performance and innovation: The role of transformational leadership Raoush, Cogent Business & Management (2023), 10: 2265606 https://doi.org/10.1080/23311975.2023.2265606 Page 14 of 16 beyond the impact of transactional leadership – an application among Turkish SME’s. Procedia - Social & Behavioral Sciences, 150, 881–889. https://doi.org/10. 1016/j.sbspro.2014.09.097 Iskandarani, K. M. (2017). Assessing the impact of transformational leadership, organizational climate, and personality on individual innovativeness at work. [Dissertation]. ProQuest LLC. Jauhar, J., Chan, S. T., & Abdul Rahim, N. (2017). The impact of reward and transformational leadership on the intention to quit of Generation Y employees in oil and gas industry: Moderating role of job satisfaction. Global Business and Management Research: An International Journal, 9(4), 426–442. Jia, X., Chen, J., Mei, L., & Wu, Q. (2018). How leadership matters in organizational innovation: A perspective of openness. Management Decision, 56(1), 6–25. https://doi.org/10.1108/MD-04-2017-0415 Jiang, Z. (2017). Proactive personality and career adaptability: The role of thriving at work. Journal of Vocational Behavior, 98, 85–97. https://doi.org/10. 1016/j.jvb.2016.10.003 Jyoti, J., & Dev, M. (2015). The impact of transformational leadership on employee creativity: The role of learning orientation. Journal of Asia Business Studies, 9(1), 78–98. https://doi.org/10.1108/jabs-03-2014-0022 Kahn, K. B., Barczak, G., Nicholas, J., Led, A., & Perks, H. (2012). An examination of new product development best practice. Journal of Product Innovation Management, 29(2), 180–192. https://doi.org/10. 1111/j.1540-5885.2011.00888.x Karatepe, O. M., Aboramadan, M., & Dahleez, K. A. (2020). Does climate for creativity mediate the impact of servant leadership on management innovation and innovative behavior in the hotel industry? International Journal of Contemporary Hospitality Management, 32(8), 2497–2517. https://doi.org/10. 1108/IJCHM-03-2020-0219 Khalili, A. (2016). Linking transformational leadership, creativity, innovation, and innovation-supportive climate. Management Decision, 54(9), 2277–2293. https://doi.org/10.1108/md-03-2016-0196 Kim, S., & Yoon, G. (2015). An innovation-driven culture in local government. Public Personnel Management, 44 (2), 147–168. https://doi.org/10.1177/ 0091026014568896 Lawshe, C. H. (1975). A quantitative approach to content validity. Personnel Psychology, 28(4), 563–575. https://doi.org/10.1111/j.1744-6570.1975.tb01393.x Lee, W. R., Choi, S. B., & Kang, S.-W. (2021). How leaders’ positive feedback influences employees’ innovative behavior: The mediating role of voice behavior and job autonomy. Sustainability, 13(4), 1901. https://doi. org/10.3390/su13041901 Le, P. B., & Lei, H. (2019). Determinants of innovation capability: The roles of transformational leadership, knowledge sharing and perceived organizational support. Journal of Knowledge Management, 23(3), 527–547. https://doi.org/10.1108/jkm-09-2018-0568 Ma, X., & Jiang, W. (2018). Transformational leadership, transactional leadership, and employee creativity in entrepreneurial firms. The Journal of Applied Behavioral Science, 54(3), 302–324. https://doi.org/10. 1177/0021886318764346 Mittal, R. (2015). Charismatic and transformational leadership styles: A cross-cultural perspective. International Journal of Business & Management, 10 (3). https://doi.org/10.5539/ijbm.v10n3p26 MOH Annual Report. (2019). Annaual statistical report. MOH. Retrieved April 22, 2021, from https://www. moh.gov.jo/ebv4.0/root_storage/ar/eb_list_page/% D8%A7%D9%84%D8%AA%D9%82%D8%B1%D9% 8A%D8%B1_%D8%A7%D9%84%D8%A7%D8%AD% D8%B5%D8%A7%D8%A6%D9%8A_%D8%A7%D9% 84%D8%B3%D9%86%D9%88%D9%8A_%D9%84% D9%88%D8%B2%D8%A7%D8%B1%D8%A9_%D8% A7%D9%84%D8%B5%D8%AD%D8%A9 Mokhber, M., Wan Ismail, W. K., Vakilbashi, A., Abdul Rasid, S. Z., & Tan, G. (2015). Towards understanding the influence of entrepreneurial leadership on organization demand for innovation. Advanced Science Letters, 21(5), 1481–1484. https://doi.org/10.1166/asl.2015.6078 Muterera, J., Hemsworth, D., Baregheh, A., & Garcia-Rivera, B. R. (2016). The leader–follower dyad: The link between leader and follower perceptions of transformational leadership and its impact on job satisfaction and organizational performance. International Public Management Journal, 21(1), 131–162. https://doi.org/ 10.1080/10967494.2015.1106993 Myricks, S. P. (2021). Relationships between perceived leaders’ transformational leadership, employees’ core self -evaluations, and employee outcomes [Dissertation]. Grand Canyon University Phoenix, Naguib, H. M., & Naem, A. E.-H. (2018). The impact of transformational leadership on the organizational innovation. The International Journal of Social Sciences and Humanities Invention, 5(1), 4337–4343. https://doi.org/10.18535/ijsshi/v5i1.15 Naranjo-Valencia, J. C., Jiménez-Jiménez, D., & Sanz-Valle, R. (2016). Studying the links between organizational culture, innovation, and performance in Spanish companies. Revista Latinoamericana de Psicología, 48 (1), 30–41. https://doi.org/10.1016/j.rlp.2015.09.009 Northouse, P. (2016). Leadership (7th ed.). SAGE. Notgrass, D. (2014). The relationship between followers’ perceived quality of relationship and preferred leadership style. Leadership & Organization Development Journal, 35(7), 605–621. https://doi.org/10.1108/lodj- 08-2012-0096 O’Brien, A., & Mattison, J. E. (2016). Emerging roles in health and healthcare. Health Informatics, 199–217. https://doi.org/10.1007/978-3-319-20765-0_12 Odoardi, C., Battistelli, A., Montani, F., & Peiró, J. M. (2019). Affective commitment, participative leadership, and employee innovation: A multilevel investigation. Revista De Psicología Del Trabajo y De Las Organizaciones, 35(2), 103–113. https://doi.org/10. 5093/jwop2019a12 Paulienė, R. (2012). Transforming leadership styles and knowledge sharing in a multicultural context. Business, Management and Education, 10(1), 91–109. https://doi.org/10.3846/bme.2012.08 Rahi, S. (2017). Research design and methods: A systematic review of research paradigms, sampling issues and instruments development. International Journal of Economics and Management Sciences, 06(2). https://doi.org/10. 4172/2162-6359.1000403 Raoush, A. (2022). Relationship between adopting servant leadership style and employee commitment: Empirical evidence from Jordanian governmental hospitals. Problems and Perspectives in Management, 20(1), 299–309. https://doi.org/10.21511/ppm.20(1).2022.25 Robinson, R. A. (2020). Influence of transformational and servant leadership on organizational citizenship behavior and follower innovation: a leader’s perspective. [Dissertation]. ProQuest LLC. Schneider, W. (2017). Lead right for your company’s type: How to connect your culture with your customer promise. AMACOM. Scott, S. G., & Bruce, R. A. (1994). Determinants of innovative behavior: A path model of individual innovation in the Raoush, Cogent Business & Management (2023), 10: 2265606 https://doi.org/10.1080/23311975.2023.2265606 Page 15 of 16 workplace. Academy of Management Journal, 37(3), 580–607. https://doi.org/10.2307/256701 Sekaran, U., & Bougie, R. (2016). Research methods for business: A skill-building approach (7th ed.). Wiley & Sons, West Sussex. Sinha, S., Priyadarshi, P., & Kumar, P. (2016). Organizational culture, innovative behaviour and work related attitude. Journal of Workplace Learning, 28(8), 519–535. https://doi.org/10.1108/jwl-06-2016-0055 Škerlavaj, M., Černe, M., Dysvik, A., Nerstad, C. G. L., & Su, C. (2017). Riding two horses at once: The combined roles of mastery and performance climates in implementing creative ideas. European Management Review, 16(2), 285–302. https://doi.org/10.1111/emre.12151 Son, T. T., Phong, L. B., & Loan, B. T. (2020). Transformational leadership and knowledge sharing: Determinants of firm’s operational and financial performance. SAGE Open, 10(2), 215824402092742. https://doi.org/10.1177/2158244020927426 Tang, G. X., Park, K., Agarwal, A., & Liu, F. (2020). Impact of innovation culture, organization size and technological capability on the performance of SMEs: The case of China. Sustainability, 12(4), 1355. https://doi. org/10.3390/su12041355 Ullah, R., Latif, K. F., & Alam, W. (2018). Role of transformational leadership style on employee job performance among high and low ranking institutions of higher education of Khyber Pakhtunkhwa. City University Research Journal, 8(2), 168–189. http:// cusitjournals.com/index.php/CURJ/article/view/134 Vaccaro, I. G., Jansen, J. J., Van Den Bosch, F. A., & Volberda, H. W. (2012). Management innovation and leadership: The moderating role of organizational size. Journal of Management Studies, 49(1), 28–51. https://doi.org/10.1111/j.1467-6486.2010. 00976.x Walumbwa, F. O., Orwa, B., Wang, P., & Lawler, J. J. (2005). Transformational leadership, organizational commitment, and job satisfaction: A comparative study of Kenyan and U.S. financial firms. Human Resource Development Quarterly, 16(2), 235–256. https://doi.org/10.1002/hrdq.1135 Wang, X., & Cheng, Z. (2020). Cross-sectional studies. Chest, 158(1), S65–S71. https://doi.org/10.1016/j. chest.2020.03.012 WHO. (2007). World alliance for patient safety report on the web based modified Delphi survey of the International classification for patient safety. Yang, Y. T., & Chen, B. (2015). Governing GMOs in the USA: Science, law and public health. Journal of the Science of Food and Agriculture, 96(6), 1851–1855. https:// doi.org/10.1002/jsfa.7523 Yi, H., Berry, F. S., & Chen, W. (2018). Management innovation and policy diffusion through leadership transfer networks: An agent network diffusion model. Journal of Public Administration Research and Theory, 28(4), 457–474. https://doi.org/10.1093/jopart/ muy031 Zhang, Y., Zheng, J., & Darko, A. (2018). How does transformational leadership promote innovation in construction? The mediating role of innovation climate and the multilevel moderation role of project requirements. Sustainability, 10(5), 1506. https://doi. org/10.3390/su10051506 Raoush, Cogent Business & Management (2023), 10: 2265606 https://doi.org/10.1080/23311975.2023.2265606 Page 16 of 16