From Leadership to Innovation: A Path Analysis of Organizational Change Drivers in Lebanese Healthcare from the Viewpoint of Nurses and Frontline Managers

Abstract

Lebanon’s private healthcare sector is grappling with overlapping crises—the economic collapse, the COVID-19 pandemic, and the Beirut port explosion—demanding urgent strategic transformation and innovation. Despite this, empirical research remains fragmented, with no integrated model capturing the combined effects of leadership, planning, governance, and service delivery on organizational change. This study introduces a novel path model tailored for post-crisis healthcare systems, grounded in Kotter’s and Lewin’s change frameworks, and informed by Contingency and Complexity theories. Based on a survey of 211 healthcare professionals from private hospitals across Lebanon, the model was tested using recursive path analysis to explore the relationships among four key constructs: Change Leadership and Employee Empowerment, Operational Planning and Accountability, Specialized Clinical Service Provision, and External Governance and Policy Alignment.
Findings indicate that Specialized Clinical Service Provision and Change Leadership have the strongest direct effects on Strategic Change Management and Innovation. Operational Planning plays a mediating role, amplifying or shaping the impact of leadership and service delivery. Interestingly, External Governance showed no significant direct influence and was excluded from the final model—emphasizing the dominant role of internal organizational factors in crisis-driven innovation. This study offers the first evidence-based, context-specific change model for Lebanon’s healthcare sector, bridging a critical gap in the literature. It provides policymakers and hospital leaders with a practical roadmap for fostering resilience and adaptability, while also laying the groundwork for future research into dynamic change models applicable to fragile healthcare systems globally.