ABSTRACT This study examines the impact of green transformational leadership, green human resource management, and pro‐environmental behavior on sustainable performance. Despite the increasing emphasis on environmental sustainability, the mechanisms through which organizational practices translate into sustainable outcomes remain insufficiently understood. Employing a mixed‐methods design, the study combines qualitative interviews with healthcare managers in Palestine and a quantitative survey analyzed using partial least squares structural equation modeling. The findings indicate that green transformational leadership has a direct positive effect on green human resource management, pro‐environmental behavior, and sustainable performance. Furthermore, green transformational leadership enhances sustainable performance indirectly through a sequential mediation process: it promotes green human resource management practices, which encourage pro‐environmental behavior, ultimately leading to improved sustainability outcomes. These results contribute to theory by demonstrating how leadership practices cascade through organizational systems to strengthen environmental performance, and they provide practical implications for advancing sustainability within the healthcare sector.
Mousa et al. (2026) studied this question.