Enhancing environmental performance in healthcare organizations through digital leadership: the roles of digital transformation, AI change readiness, and organizational agility

Purpose This study examines how digital leadership drives environmental performance through digital transformation and green innovation in healthcare organizations, while considering the moderating roles of artificial intelligence (AI) change readiness and organizational agility. Design/methodology/approach Drawing on dynamic capability theory and the resource-based view, this study proposes and empirically tests a moderated mediation model using data collected from 480 healthcare professionals in Guangzhou, China. Partial least squares structural equation modeling (PLS-SEM) was employed to analyze the data and test the hypothesized relationships. Findings The findings reveal that digital leadership significantly enhances digital transformation and green innovation. Digital transformation partially mediates the relationship between digital leadership and green innovation. Furthermore, green innovation significantly improves environmental performance. AI change readiness positively influences digital transformation; however, it does not significantly moderate the relationship between digital leadership and digital transformation. In addition, organizational agility significantly strengthens the relationship between digital transformation and green innovation. Practical implications The findings provide important implications for healthcare managers and policymakers seeking to improve environmental performance through digital initiatives. Healthcare organizations should strengthen digital leadership capabilities, promote agile organizational practices, and foster green innovation to enhance environmental performance. Originality/value This study contributes to the healthcare management and sustainability literature by integrating digital leadership, digital transformation, and environmental performance into a unified framework. It further extends the understanding of the conditional roles of AI change readiness and organizational agility in healthcare organizations.