The organization's presence and social significance are evident in its large membership and the leadership's influence on national policies, including those in Indonesia. Among them is Muhammadiyah, which contributes significantly to the Unitary State of the Republic of Indonesia and plays an important role in many aspects of human life. This study aims to determine how managerial cognitive ability affects sustainable performance in Muhammadiyah Hospitals in Central Java through organizational change capability and effective leadership. The study used 42 Muhammadiyah-owned hospitals in Central Java as the unit of analysis. The interview involved 42 Muhammadiyah hospitals' directors and deputy directors using a total sampling design. The study surveyed and interviewed the 42 hospital directors and deputy directors using KoboToolbox, both online and over the phone. Structural equation modeling (SEM) was used in this study's data analysis with SmartPLS software. The findings indicated that the direct effect of managerial cognitive capability on leadership effectiveness is positive and has the largest coefficient (0.581), with a t-value of 4.538 and a p-value of 0.000. Additionally, regarding sustainable performance, organizational change capability has a stronger indirect effect on managerial cognitive capability, but in the negative direction. In the model of managerial cognitive capability in relation to sustainable performance, organizational change capability has an indirect effect with a coefficient of -0.175, a t-value of 2.000, and a p-value of 0.046.
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Fauzi et al. (2026) studied this question.
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