Impact of Application of Governance Principles and Performance Management System on the Organization Performance: Study on Saudi Healthcare System
DOI:
https://doi.org/10.24203/2t58ce41Keywords:
Strategic management, Effectiveness, Corporate Governance, Performance and Private Companies, Organization and PerformanceAbstract
This study investigates the impact of integrating governance structure and performance management systems on the organization performance in Saudi Arabia’s healthcare sector. The research employs a causal investigative approach, grounded in agency theory, resource-dependency theory, and balanced scorecard principles, to explore how these systems enhance decision-making, accountability, and resource utilization. Primary data were collected through cross-sectional surveys targeting healthcare professionals across key regions in Saudi Arabia, supplemented by comprehensive literature reviews. The findings reveal a significant positive relationship between governance structures, performance management systems and organizational performance, with employee engagement and commitment as key mediators. With moderators such as organizational size and compliance with local regulations significantly influence this relationship. This integration fosters operational transparency, enhances patient satisfaction, and improves adaptability to the evolving Saudi healthcare market. It will have clear academic contribution as it addresses a significant gap in the existing literature concerning the integration of performance management and organizational governance systems within Saudi Arabia’s healthcare sector. In addition, it will provide Practical Implications as this study focuses on specific challenges and gaps in integrating governance and performance management systems. It provides actionable recommendations which will promote accountability, transparency, and efficient resource allocation. By leveraging digital tools like Hospital Information Systems, these systems enable real-time performance tracking and data-driven decision-making. The study will act as supportive tool to healthcare leaders and policymakers to cultivate a culture of performance excellence, optimize resource allocation, and achieve sustainable strategic objectives which will reflect on improving patient outcomes which will be aligned with the Saudi Arabia’s Vision 2030.
References
[1] Alasiri, A. A., & Mohammed, V. (2022). Healthcare Transformation in Saudi Arabia: An Overview Since the Launch of Vision 2030. Health Services Insights, 15(1), 117863292211212. https://doi.org/10.1177/11786329221121214
[2] Alharbi, & F, M. (2018). An investigation of the Saudi healthcare system’s readiness for change in the light of Vision 2030: The role of transformational leadership style. Journal of Health Sciences, 6(1), 45–53.
[3] Alotaibi, A, Saleh, M, W., Abdulbaqi, H, A., & Alosaimi. (2022). Setting the health research priority agenda for the Ministry of Health, Kingdom of Saudi Arabia 2020–2025. Journal of Epidemiology and Global Health, 12(4), 413–429. https://doi.org/10.1007/s44197-022-00061-5
[4] Althuwaybi, M. A., Alshammari, T. M., Shabana Tharkar, Alodhayani, A. A., Al-Muammar, M., Mahmoud Abulmeaty, & Almutari, K. M. (2025). National Healthcare Transformation Program in Saudi Arabia: Awareness of the New Models of Care Among Health Professionals. Risk Management and Healthcare Policy, Volume 18, 2259–2274. https://doi.org/10.2147/rmhp.s509155
[5] Damschroder, L. J., Reardon, C. M., Widerquist, M. A. O., & Lowery, J. (2022). The updated Consolidated Framework for Implementation Research based on user feedback. Implementation Science, 17(1), 1–16. https://doi.org/10.1186/s13012-022-01245-0
[6] Dicuonzo, G., Galeone, G., Shini, M., & Massari, A. (2022). Towards the Use of Big Data in Healthcare: A Literature Review. Healthcare, 10(7), 1232. https://doi.org/10.3390/healthcare10071232
[7] E. S, A., K. E, A., & D. E, E. (2021). Data collection techniques in organizational research. International Journal of Research and Innovation in Social Science, 5(9), 563–571. https://www.ahrq.gov/research/data/primary-data.html
[8] Endalamaw, A., Khatri, R. B., Mengistu, T. S., Erku, D., Wolka, E., Zewdie, A., & Assefa, Y. (2024). A scoping review of continuous quality improvement in healthcare system: Conceptualization, models and tools, barriers and facilitators, and impact. BioMed Central Health Services Research, 24(1), 487. https://doi.org/10.1186/s12913-024-10828-0
[9] Fuertes, G. (2020). Conceptual Framework for the Strategic management: a Literature Review—descriptive. Journal of Engineering, 2020(6253013), 1–21. https://doi.org/10.1155/2020/6253013
[10] Gebremedhin, M., Gebrewahd, E., & Stafford, L. K. (2022). Validity and reliability study of clinician attitude towards rural health extension program in Ethiopia: exploratory and confirmatory factor analysis. BMC Health Services Research, 22(1). https://doi.org/10.1186/s12913-022-08470-9
[11] Gulin Gedik, Jalal, A., Gohar Wajid, Awad Mataria, Hajjeh, R., & Al‐Mandhari, A. (2024). Health workforce in the Eastern Mediterranean Region: From COVID‐19 lessons to actions. The International Journal of Health Planning and Management. https://doi.org/10.1002/hpm.3756
[12] Hala Muaddi, Lovrics, O., Walker, R. J., Mestral, C. de, Nathens, A., Stukel, T. A., & Karanicolas, P. J. (2024). Research methodologies for eliciting patients’ preferences in invasive procedures: a scoping review. Langenbeck S Archives of Surgery, 409(1). https://doi.org/10.1007/s00423-024-03520-8
[13] Lorenzini, E., Oelke, N. D., & Marck, P. B. (2021). Safety culture in healthcare: mixed method study. Journal of Health Organization and Management, ahead-of-print(ahead-of-print). https://doi.org/10.1108/jhom-04-2020-0110
[14] Ministry of Finance. (2023). Budget Performance Reports for 2023. Mof.gov.sa. https://www.mof.gov.sa/en/financialreport/2023/Pages/default.aspx
[15] OECD. (2023). Health at a Glance 2023: OECD Indicators. In Health at a glance. OECD Publishing. https://doi.org/10.1787/7a7afb35-en
[16] Petersen, E. E., Lyng, H. B., Ree, E., & Wiig, S. (2021). Relationship between management and resilience in healthcare: a study protocol for a systematic review. BMJ Open, 11(7), e047855. https://doi.org/10.1136/bmjopen-2020-047855
[17] Rousseaut, D. M., & Have, S. ten. (2022). Evidence-based Change Management. Organizational Dynamics, 51(3), 1–13. ScienceDirect. https://doi.org/10.1016/j.orgdyn.2022.100899
[18] Shi, J., & Norgeot, B. (2022). Learning Causal Effects from Observational Data in Healthcare: A Review and Summary. Frontiers in Medicine, 9. https://doi.org/10.3389/fmed.2022.864882
[19] Taherdoost, H. (2016). Sampling Methods in Research Methodology; How to Choose a Sampling Technique for Research. International Journal of Academic Research in Management, 5(2), 18–27. https://doi.org/10.2139/ssrn.3205035
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