Dynamics of leadership, interpersonal relations and commitment to change in the Tunisian healthcare context: toward effective transformation of healthcare institutions?

Purpose This article aims to elucidate the effect of transformational leadership on commitment to change, assuming the existence of mediating variables (Leader–Member Exchange) influencing this relationship. Design/methodology/approach Data was collected through a survey based on a sample of 240 observations (Tunisian context with respondents from the healthcare sector). These findings were processed using SPSS and AMOS 23 software, employing exploratory factor analysis and structural equation modeling. Findings Research results affirm that leader–member exchange plays a mediating role between leadership styles and commitment to change. Research limitations/implications Methodologically, the sample choice lacked diversity. Only hospitals were encompassed in this study. Hence, the generalizability of the results might be questioned. It is crucial to acknowledge that outcomes could vary based on culture and organizational type (Yu et al. , 2002; Hechanova and Cementina-Olpoc, 2013). Moreover, our assessment of commitment to change relies on a unidimensional measurement scale focused on affective commitment. However, a multidimensional approach (Herscovitch and Meyer, 2002) could provide a more detailed understanding of the relationship between transformational leadership and different dimensions of commitment to change, including affective, normative and continuance commitment. Practical implications On a practical level, the outcomes of this study hold significance for the healthcare domain, especially concerning change management and leadership within healthcare institutions. Grasping how transformational leadership can positively influence commitment to change through leader–member exchange offers healthcare managers concrete strategies to foster employee adherence to change initiatives. This understanding can be particularly crucial in a constantly evolving environment, where practices and protocols need adaptation to meet new requirements and medical advancements. Originality/value This research clarifies how transformational leadership influences commitment to change through leader–member exchange. Furthermore, this study guides organizations toward cultivating transformational leaders. The strength of transformational leadership lies in its ability to channel and transform energies to evoke enthusiastic motivation for achieving anticipated goals (Bass, 1985). However, it's pivotal to recognize that transitioning from a manager-directed approach to an empowerment approach presents inherent challenges (Manz et al. , 1990). Investing in leadership development, as underscored by this study, can yield tangible enhancements in commitment to change.