AI-driven agility as a pathway from strategic alignment to organizational performance: evidence from the UAE healthcare sector

Purpose Artificial intelligence (AI) is reshaping the healthcare sector; however, many hospitals struggle to convert AI investments into performance gains owing to misalignment and limited agility. This study examines the association between strategic alignment (SA) and perceived organizational performance (POP) in the private healthcare sector in the United Arab Emirates (UAE). Moreover, it examines the mediating role of AI-driven organizational agility (ADOA) in this association. It also investigates the moderating role of environmental dynamism (ED) on the link between ADOA and perceived organizational performance and on the indirect association between strategic alignment and POP through ADOA. Design/methodology/approach A cross-sectional, self-administered, online questionnaire yielded 346 usable employee responses. Covariance-based structural equation modeling (CB-SEM) was used to analyze the data and test the hypothesized model. Findings Strategic alignment was positively associated with ADOA and perceived organizational performance, while ADOA partially mediated the SA–POP relationship. Environmental dynamism attenuated the ADOA–POP association; however, the index of moderated mediation was non-significant, indicating that the indirect effect did not differ significantly across levels of environmental dynamism. Originality/value This study contributes by integrating four-dimensional strategic alignment, AI-driven organizational agility, and environmental dynamism in a moderated mediation model in the under-researched setting of UAE private healthcare, while explicitly interpreting the outcome as perceived organizational performance, offering avenues of research directions for practitioners and scholars.