Enhancing Sustainable Performance in Healthcare: The Role of TQM, IT, and GSCM Practices, and the Moderating Influence of Management Commitment

This study examines how Total Quality Management (TQM), Information Technology (IT), and Green Supply Chain Management Practices (GSCMP) drive sustainability performance in healthcare, with management initiative as a moderator. Using survey data from 231 Indonesian hospitals and a hybrid SEM-ANN approach, we find that all three practices significantly enhance sustainability performance. However, management initiative plays a nuanced role: it strengthens IT's impact but weakens TQM's influence, and shows no significant effect on GSCMP. ANN analysis reveals GSCMP as the most critical driver, followed by IT and TQM. These findings challenge the assumption that leadership is uniformly beneficial, showing instead that effective management must adapt its approach to the practice it supports. For healthcare managers, prioritizing green supply chain practices yields the greatest returns, while leadership should be directive for IT but empowering for TQM.