FROM CULTURE TO STRATEGY: UNVEILING THE MEDIATING ROLE OF INFORMATION SYSTEMS IN SAUDI HEALTHCARE

Abstract

This study examines whether information systems (IS) mediate the relationship between organizational culture and strategy implementation (SI) in Saudi public hospitals during the national health transformation. Using a cross-sectional survey of staff in Tabuk Ministry of Health hospitals and partial least squares structural equation modeling with bootstrapped mediation, the studymodels culture types—Clan, Hierarchy, Market, and Adhocracy, alongside IS capability and effectiveness and strategy implementation. Findings show that the systems pathway is the dominant channel through which culture becomes execution. Clan and Market cultures improve implementation chiefly by strengthening IS. Adhocracy contributes both through the systems pathway and via a direct route to execution, and Hierarchy offers limited explanatory power. Measurement diagnostics and robustness checks, including alternative scoring, robust standard errors, rank-based specifications, and outlier trimming, converge on the same qualitative story. The study advances a culture–systems–execution nexus and offers actionable guidance: invest in interoperability, data quality, and user support; embed mentoring, teamwork, targets, and feedback inside digital workflows; protect pilot-and-learn initiatives linked to system monitoring; and align incentives with metrics visible in national platforms to scale implementation gains across the healthcare system.