This study examines how adaptive leadership (AL) affects employee performance (EP) in Saudi Arabian healthcare organizations. It also explores how leaders can effectively manage employees during the major changes expected as part of Saudi Arabia's Vision 2030 and the Health Sector Transformation Program. The research looks at how occupational self-efficacy (OSE), acceptance of change, and innovative work behavior (IWB) mediate the relationship between AL and EP. Data was gathered from 456 healthcare workers in Saudi Arabia. SPSS-28 and SmartPLS4 were used to analyze the data and test the hypotheses. Reliability was assessed through Cronbach's Alpha, rho_A, and composite reliability, while validity was tested using AVE, Heterotrait-Monotrait (HTMT), and the Fornell-Larcker criterion. Descriptive statistics, Pearson correlation analysis, and Structural Equation Modeling (SEM) were applied to confirm the measurement model and test the hypotheses. The model evaluation included the adjusted R2, normed fit index, standardized root mean square residual, and Q2predict. The findings show that AL positively impacts EP in healthcare organizations in Saudi Arabia. OSE, acceptance of change, and IWB also influence this relationship. The study emphasizes the importance of AL in healthcare organizations facing ongoing change, as it helps empower employees and improve their creativity, performance, and well-being. Training in AL and change management strategies can be used to promote resilience, communication, and innovation, fostering a positive organizational culture during periods of transition.
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