" Sustainability Practices as Drivers of Operational Efficiency in Healthcare Facilities: The Mediating Effects of Organizational Culture and Employee Engagement"

Purpose This study aims to investigate the relationships between sustainability practices and operational efficiency in Egyptian healthcare facilities, examining the mediating roles of organizational culture and employee engagement. The research seeks to understand how these variables interact in a developing healthcare context. In this study, research questions are: Investigate how sustainability practices are related to healthcare operational efficiency, firstly: What is the mediating role of the organizational culture on the relationships between sustainability practices and operational efficiency in Egyptian healthcare facilities? Secondly: How does the employee engagement affect these relationships? Such variables, when identified can be used to determine how these variables work in a developing healthcare context.
Methodology The study employed a quantitative approach using stratified random sampling. Data was collected from 16,599 respondents across Egyptian healthcare facilities using a structured questionnaire with validated scales. The included measurement instruments were sustainability practices (4 items), operational efficiency (7 items), organizational culture (8 items) and employee engagement (8 items) all on a 5 Likert point scale. Structural equation modeling was used to conduct the conceptual model test using SmartPLS; on the other hand, descriptive statistics were analyzed using SPSS.
Findings The results revealed that sustainability practices have a significant positive direct effect on operational efficiency (β=0.009, p≤0.001) and a significant negative effect on organizational culture (β=0.093, p≤0.05). Employee engagement emerged as a significant mediator between organizational culture and operational efficiency (β=0.017, p≤0.001), while organizational culture showed a strong positive influence on employee engagement (β=0.019, p≤0.001). Unexpectedly, employee engagement demonstrated a negative relationship with operational efficiency (β=0.021, p≤0.001).
Originality The current research contributes new knowledge to understanding multiple links between sustainability management concerning healthcare systems and organizational performance improvement in developing countries, especially Egypt. It extends current theoretical theorizations by identifying novel connections between organizational culture, engagement, and performance thereby advancing current knowledge about how sustainability can be promoted appositely in evolving healthcare settings in developing countries.