Adhocracy Culture Drives Hospital Resilience: A Multivariate Analysis of Healthcare Staff Adaptation During the COVID-19 Pandemic in Surabaya

Background: The COVID-19 pandemic demanded rapid organizational adaptation in healthcare. Understanding how organizational culture influences institutional resilience and staff adaptability is critical for future crisis preparedness. Objective: To identify dominant organizational culture types and evaluate their multivariate impact on healthcare professionals' adaptability across hospitals in Surabaya. Methods: A descriptive observational study with a cross-sectional design, strictly adhering to STROBE guidelines, was conducted involving 850 doctors and nurses from seven hospitals. Data were collected using the validated Organizational Culture Assessment Instrument (OCAI) based on the Competing Values Framework. Multivariate logistic regression was employed to determine significant predictors of high adaptive performance. Results: Adhocracy culture emerged as the overwhelmingly dominant profile across all hospitals, accounting for the highest overall score (27.26%). Multivariate analysis revealed that an adhocracy-oriented environment significantly predicted high staff adaptability and crisis responsiveness (Adjusted OR = 3.45, 95% CI: 2.12–5.61, p < 0.001). Conversely, rigid hierarchical traits demonstrated an inverse association with rapid innovation adoption. Conclusion: Adhocracy culture serves as the primary catalyst for organizational resilience during acute health crises. Healthcare policymakers and hospital administrators must prioritize innovative leadership and flexible management frameworks to sustain adaptive capacities, ensuring continuous, high-quality patient care and optimal institutional performance in future public health emergencies.