How strategic communication links strategy implementation to organizational performance: evidence from private hospitals

Introduction: Strategic communication is widely considered crucial for effective strategy implementation, yet empirical evidence showing how it translates implementation efforts into measurable performance outcomes in healthcare settings remains limited. Drawing on behavioral decision theory and contemporary management approaches, this study addresses this gap by examining the mechanism through which communication contributes to performance during strategy execution. Objective: To analyze the mediating role of strategic communication in the relationship between strategy implementation and organizational performance in healthcare organizations. Methods: A quantitative design was employed. Face-to-face and online surveys were administered to 344 healthcare personnel working in different healthcare institutions. The proposed structural model was tested using AMOS v.26 and structural equation modeling. Results: Strategy implementation was positively associated with organizational performance, particularly through the sub-dimensions of participation and sharing and feedback and collaboration. Strategic communication also showed a significant positive relationship with organizational performance. Mediation analyses indicated a partial mediating effect of strategic communication: the impacts of participation/sharing and feedback/collaboration on performance were partially transmitted via organizational trust, communication channels and openness, and direction and frequency of communication. Conclusion: Strategic communication is not a peripheral managerial tool but a central mechanism that links strategy implementation practices to performance improvements in healthcare organizations. The study contributes to the literature by clarifying the mediating pathways through which strategic communication supports organizational performance during strategy implementation in the healthcare context.