Leadership Commitment and Effective AI Initiative Implementation in Saudi Healthcare Administration: The Mediating Role of Change Management

Abstract

Effective AI initiative implementation in healthcare administration requires more than the technical deployment of digital tools; it depends on sustained leadership commitment, structured change capability, and institutional alignment. This paper examines the leadership pathway through which leadership commitment contributes to effective AI initiative implementation in Saudi healthcare administration, with change management tested as the mediating mechanism. The study used a quantitative survey design based on 267 usable responses from healthcare administrators in the Tabuk Health Cluster. The analysis followed the reported PLS-SEM procedure, including descriptive statistics, reliability assessment, measurement-model evaluation, structural path analysis, and mediation testing. The verified results show that leadership commitment had a significant direct effect on effective AI initiative implementation (beta = 0.199, t = 2.072, p = 0.003) and a stronger direct effect on change management (beta = 0.559, t = 5.715, p = 0.000). Change management had the strongest effect on effective AI initiative implementation (beta = 0.945, t = 13.457, p = 0.000), while the indirect effect of leadership commitment through change management was also significant (beta = 0.528, t = 5.372, p = 0.000). These findings indicate partial mediation and show that leadership commitment improves AI implementation both directly and by strengthening structured change management. Theoretically, the results position change management as the operational mechanism that translates strategic leadership support into AI implementation effectiveness. Practically, Saudi healthcare organizations should combine visible leadership sponsorship with disciplined transition systems that prepare staff, align resources, manage resistance, and institutionalize AI-enabled administrative practices.