The Effect of Situational Leadership on Healthcare Service Quality Through Crisis Management and Resources Availability: The Moderating Role of Leader Experience

Abstract: Healthcare organizations operating in fragile and conflict-affected environments face persistent challenges in maintaining service quality due to recurrent crises and severe resource constraints. In such contexts, leadership adaptability becomes a critical determinant of organizational resilience and service performance. Drawing on Situational Leadership Theory, this study examines the effect of situational leadership on healthcare service quality in private hospitals in Sana’a, Yemen, while exploring the mediating roles of crisis management and resource availability, and the moderating role of leader experience. A quantitative, cross-sectional design was employed using a stratified sampling approach. The data were collected from 319 healthcare professionals working in private hospitals in Sana’a using a structured questionnaire. Partial Least Squares Structural Equation Modeling (PLS-SEM) was applied to test the hypothesized relationships, including direct, mediating, and moderating effects. The results indicate that situational leadership has a strong and statistically significant direct effect on healthcare service quality (β = 0.52, p < 0.001). Situational leadership also significantly enhances crisis management (β = 0.61, p < 0.001) and resource availability (β = 0.47, p < 0.001). Both crisis management (β = 0.36, p < 0.001) and resource availability (β = 0.21, p < 0.01) positively influence service quality, with crisis management demonstrating a stronger mediating effect. Leader experience significantly moderates the relationship between situational leadership and service quality (β = 0.14, p < 0.05), such that the relationship is stronger among more experienced leaders. The model explains a substantial proportion of variance in healthcare service quality ( R2 = 0.48), indicating strong explanatory power. This study contributes to leadership and healthcare management literature by extending situational leadership theory to a fragile, resource-constrained healthcare context and by highlighting crisis management as a critical mechanism linking leadership to service quality. Practically, the findings underscore the importance of developing adaptive leadership capabilities, strengthening crisis management systems, and leveraging leader experience to enhance healthcare service quality in conflict-affected settings. Keywords: situational leadership, healthcare service quality, crisis management, resource availability, leader experience, Yemen