Digital leadership and AI readiness in healthcare organizations: Implications for service quality

Abstract

This study examines how digital leadership shapes organizational readiness for artificial intelligence (AI) adoption in healthcare organizations and how this readiness influences perceived service quality. Using a mixed-methods design, the research combines a cross-sectional survey of healthcare professionals in Canada across public hospitals, private hospitals and outpatient care organizations with semi-structured interviews conducted with senior managers and clinical leaders in 2025. Quantitative data from 312 respondents were analyzed using partial least squares structural equation modelling to test hypothesized relationships and mediation effects, while qualitative data from 18 interviews were analyzed thematically to explore leadership practices and governance mechanisms influencing AI implementation. The findings reveal that digital leadership has a strong positive effect on organizational AI readiness, which in turn is positively associated with service quality outcomes such as responsiveness, reliability and patient-centred care. Mediation analysis shows that AI readiness partially mediates the relationship between digital leadership and service quality, indicating that readiness functions as a key organizational capability translating leadership practices into performance outcomes. The study provides practical guidance for healthcare managers by presenting an actionable framework for strengthening AI readiness through leadership development, workforce upskilling and the establishment of governance and ethical oversight structures. The proposed AI Leadership Readiness Framework and AI Readiness Maturity Matrix support alignment between digital strategy, service quality and regulatory requirements. By conceptualizing digital leadership as a higher-order capability that develops organizational AI readiness across technological, human and governance dimensions, this research extends leadership and digital transformation theory in healthcare and offers new insights into how AI-enabled transformation can enhance healthcare service quality.