ANALYSIS OF TRANSFORMATIONAL LEADERSHIP AND ORGANIZATIONAL CULTURE IN PROMOTING NURSING INNOVATION THROUGH KNOWLEDGE SHARING: A QUALITATIVE STUDY IN THE MAKKAH HEALTH CLUSTER, SAUDI ARABIA

Khadija Lafi Aljarary; Hafizah Che Hasan

doi:10.62567/micjo.v3i3.2511

Authors

Khadija Lafi Aljarary Lincoln University College
Hafizah Che Hasan Lincoln University College

DOI:

https://doi.org/10.62567/micjo.v3i3.2511

Keywords:

Transformational Leadership, Organizational Culture, Knowledge Sharing, Nursing Innovation, Qualitative Research, Makkah Health Cluster

Abstract

Transformational leadership and organizational culture are key determinants of nursing innovation in complex healthcare systems. However, limited qualitative evidence exists regarding how these factors interact with knowledge-sharing practices to foster innovation, particularly within healthcare organizations undergoing transformation in Saudi Arabia. This study aims to explore how transformational leadership and organizational culture influence nursing innovation through knowledge-sharing practices in the Makkah Health Cluster, Saudi Arabia. A qualitative exploratory design was conducted within six hospitals in the Makkah Health Cluster. The study included King Abdullah Medical City, Noor Specialist Hospital, Maternity and Child Hospital, King Abdulaziz Hospital, Hiraa General Hospital, and King Faisal Hospital. A total of 48 participants, including nursing managers, ICU head nurses, and clinical nurses with at least two years of experience, were selected using purposive sampling until data saturation was reached. Data were collected between January and March 2026 through semi-structured interviews, focus group discussions (FGDs), non-participant observations, and document analysis. All interviews and FGDs were audio-recorded, transcribed verbatim, and conducted in English or Arabic based on participant preference. Data were analyzed using Braun and Clarke’s thematic analysis approach, and study rigor was ensured through triangulation, member checking, and audit trail procedures following COREQ guidelines. Four key themes emerged: (1) transformational leadership as a catalyst for psychological safety and innovation engagement, (2) organizational culture characterized by a dual structure of collaboration and hierarchy, (3) knowledge sharing as a mechanism for collective clinical learning and problem-solving, and (4) nursing innovation as an emergent, practice-based, and collaborative process. Findings indicate that transformational leadership enhances nurses’ motivation and openness to innovation, while organizational culture shapes the environment for collaboration. Knowledge sharing functions as a critical process that transforms clinical experience into practical innovation in nursing care. Nursing innovation in the Makkah Health Cluster is a socially constructed and dynamic process shaped by the interaction of transformational leadership, organizational culture, and knowledge-sharing practices. Strengthening leadership capacity, fostering collaborative organizational culture, and developing structured knowledge management systems are essential to sustain nursing innovation and improve healthcare service quality.

Downloads

Download data is not yet available.

References

Afsar, B., Badir, Y., & Bin Saeed, B. (2016). Transformational leadership and innovative work behavior: The role of motivation to learn. Industrial Management & Data Systems, 116(5), 977–998.

Alatawi, M., Niessen, C., & Khan, M. (2020). Transformational leadership and knowledge sharing in healthcare organizations. Journal of Nursing Management, 28(6), 1231–1240.

Albagawi, B., Laput, V., & Pacis, C. (2017). Nurses’ perceptions of leadership styles in Saudi Arabia. Journal of Nursing Management, 25(7), 549–555.

Alboliteeh, M., Alrashidi, M., Alrashedi, N., Gonzales, A., & Pasay-an, E. (2023). Knowledge management and sustainability performance in healthcare organizations. Sustainability, 15(1), 1–15.

Alharbi, K., Bakarman, S., & Alqahtani, N. (2021). Leadership styles and job satisfaction among nurses in Saudi hospitals. BMC Nursing, 20(1), 1–10.

Almutairi, A., McCarthy, A., & Gardner, G. (2020). Understanding cultural competence in Saudi Arabian nursing practice. Nursing Inquiry, 27(1), 1–9.

Banakhar, M., Miah, S., & Syed, A. (2021). Transformational leadership and healthcare innovation in Saudi Arabia. Healthcare, 9(11), 1–12.

Banaser, M., Al-Soqair, A., & Al-Feher, A. (2021). Knowledge sharing and organizational innovation in healthcare. International Journal of Healthcare Management, 14(4), 1253–1261.

Boamah, S., Laschinger, H., Wong, C., & Clarke, S. (2018). Effect of transformational leadership on job satisfaction and patient safety outcomes. Nursing Outlook, 66(2), 180–189.

Choi, S., Kim, K., Ullah, S., & Kang, S. (2016). How transformational leadership facilitates innovative behavior. Personnel Review, 45(3), 459–479.

Cummings, G., Tate, K., Lee, S., Wong, C., & Paananen, T. (2018). Leadership styles and outcome patterns for the nursing workforce. International Journal of Nursing Studies, 85, 19–60.

Donate, M., & de Pablo, J. (2015). The role of knowledge-oriented leadership in knowledge management practices and innovation. Journal of Business Research, 68(2), 360–370.

Elmorshedy, H., El-Refae, G., & Hassan, M. (2020). Organizational communication and innovation in healthcare settings. Healthcare Management Forum, 33(3), 125–130.

Gagné, M., Tian, A., Soo, C., Zhang, B., & Ho, K. (2019). Different motivations for knowledge sharing. Journal of Knowledge Management, 23(3), 484–500.

Hughes, D., Lee, A., Tian, A., Newman, A., & Legood, A. (2018). Leadership, creativity and innovation. The Leadership Quarterly, 29(5), 549–569.

Kamel, N., & Aref, M. (2017). Transformational leadership and innovation in healthcare organizations. International Journal of Healthcare Management, 10(3), 158–165.

Kim, E., & Park, S. (2020). Transformational leadership, knowledge sharing and organizational learning. Leadership & Organization Development Journal, 41(6), 761–775.

Kim, S., & Park, M. (2017). Leadership, knowledge sharing and nurses’ innovative behavior. Journal of Nursing Administration, 47(12), 615–621.

Kiptulon, E., Elmadani, M., & Limungi, G. (2024). Organizational culture and nursing work environments. BMC Health Services Research, 24(1), 1–12.

Labrague, L., & Toquero, C. (2023). Leadership practices and innovation among nurses. Journal of Nursing Management, 31(2), 245–253.

Lee, H., & Choi, B. (2017). Knowledge management enablers and innovation. Journal of Management Information Systems, 20(1), 179–228.

Lin, H. (2017). Knowledge sharing and organizational innovation capability. International Journal of Manpower, 38(1), 101–117.

Mittal, S., & Dhar, R. (2016). Transformational leadership and employee creativity. Management Decision, 53(5), 894–910.

Mohanty, R., Saini, R., Rampal, S., & Mane, A. (2024). Transformational leadership and healthcare quality improvement. Health Leadership and Quality of Life, 3, 365–378.

Nazir, S., Shafi, A., Qun, W., & Nazir, N. (2018). Influence of organizational rewards on organizational commitment. Employee Relations, 40(2), 235–253.

Northouse, P. (2021). Leadership: Theory and practice (9th ed.). Sage.

Podsakoff, P., MacKenzie, S., & Bommer, W. (2016). Transformational leader behaviors and leadership outcomes. Leadership Quarterly, 27(4), 634–646.

Schein, E. (2017). Organizational culture and leadership (5th ed.). Jossey-Bass.

Scott, S., & Bruce, R. (2016). Determinants of innovative behavior. Academy of Management Journal, 37(3), 580–607.

Shateri, K., & Hayat, A. (2020). Knowledge sharing and innovation in healthcare organizations. Journal of Knowledge Management, 24(9), 2179–2198.

Singh, S., Gupta, S., Busso, D., & Kamboj, S. (2021). Top management knowledge value and innovation capability. Journal of Knowledge Management, 25(3), 623–642.

Sung, S., & Choi, J. (2018). Human resource development and innovation. Human Resource Management, 53(4), 587–611.

Wang, S., & Noe, R. (2020). Knowledge sharing: A review and directions for future research. Human Resource Management Review, 30(2), 100–112.

West, M., & Farr, J. (2017). Innovation at work. European Journal of Work and Organizational Psychology, 26(3), 1–14.

Wong, C., & Cummings, G. (2017). The relationship between nursing leadership and patient outcomes. Journal of Nursing Management, 25(5), 508–521.

Xerri, M., & Brunetto, Y. (2018). Fostering innovative behaviour in healthcare organizations. Public Management Review, 20(3), 1–17.

Yoo, S., Lee, J., & Park, S. (2019). Knowledge sharing and innovative behavior in nursing organizations. Journal of Nursing Management, 27(5), 1049–1057.

Zhang, X., & Bartol, K. (2017). Linking empowering leadership and employee creativity. Academy of Management Journal, 60(1), 107–128.

Zhou, J., & Hoever, I. (2020). Research on workplace creativity and innovation. Annual Review of Organizational Psychology and Organizational Behavior, 7, 333–359.