Balancing Strategic Paradoxes through Paradoxical Leadership: Empirical Evidence from Digitizing Hospitals in Indonesia
DOI:
https://doi.org/10.59784/glosains.v7i1.674Keywords:
digital transformation, paradoxical leadership, organizational agility, strategic renewal, indonesian hospitalAbstract
Background: Indonesian hospitals are under intensifying pressure to digitalize, yet digital transformation (DT) does not automatically yield organizational agility a paradox that challenges conventional technology adoption frameworks. Despite government mandates such as Ministry of Health Regulation No. 24/2022 requiring electronic medical records, many hospitals remain trapped in administrative digitization without achieving strategic renewal.
Objective: This study investigates the roles of Digital Transformation (DT) and Paradoxical Leadership (PL) in promoting Organizational Agility (OA) and Strategic Renewal (SR) in Indonesian hospitals, with OA as a mediator and PL as a moderator in the DT–OA relationship.
Methods: A quantitative explanatory approach was employed using Partial Least Squares Structural Equation Modeling (PLS-SEM). Primary data were collected via structured questionnaire from 400 hospital managers and clinical administrators across Indonesian healthcare organizations, selected through purposive sampling.
Results: The analysis reveals that DT does not directly influence OA, indicating structural limitations that hinder organizational agility. However, PL plays a significant moderating role that amplifies DT's effect on OA, demonstrating that leadership capability is crucial in managing strategic contradictions and facilitating technology adoption. Furthermore, OA proves to be the primary determinant of SR, enabling adaptive business model reconfiguration in the JKN era.
Conclusion: The study confirms that the strategic success of healthcare institutions depends on the synergy between digital capabilities and managerial leadership capability in navigating organizational complexities. Paradoxical leadership is not merely a management style but a driving force that transforms digital investment into sustainable strategic renewal.
References
Aidoo, S. O., Agyapong, A., Acquaah, M., Yaw, S., & Akomea. (2021). The performance implications of strategic responses of SMEs to the covid-19 pandemic: Evidence from an African economy. Africa Journal of Management, 7(1). https://doi.org/10.1080/23322373.2021.1878810
Aisyah, D. N., Setiawan, A. H., Lokopessy, A. F., Faradiba, N., Setiaji, Manikam, L., & Kozlakidis, Z. (2024). The Information and Communication Technology Maturity Assessment at Primary Health Care Services Across 9 Provinces in Indonesia: Evaluation Study. JMIR Medical Informatics, 12. https://doi.org/10.2196/55959
Batool, U., Raziq, M. M., & Sarwaz, N. (2023). The paradox of paradoxical leadership: A multi-level conceptualization. Human Resource Management Review, 33(4). https://doi.org/10.1016/j.hrmr.2023.100983
Bharadwaj, A., Sawy, O. A. El, Pavlou, P. A., & Venkatraman, N. V. (2016). Digital Business Strategy: Toward a Next Generation of Insights. MIS Quarterly, 37(2).
Christofi, K., Chourides, P., & Papageorgiou, G. (2023). Cultivating strategic agility– An empirical investigation into best practice. Global Business and Organizational Excellence. https://doi.org/10.1002/joe.22241
Clauss, T., Abebe, M. A., Tangpong, C., & Hock, M. (2019). Strategic Agility, Business Model Innovation and Firm Performance: An Empirical Investigation. IEEE Transactions on Engineering Management. https://doi.org/10.1109/TEM.2019.2910381
Cousins, K., Hertelendy, A. J., Chen, M., Durneva, P., & Wang, S. (2023). Building resilient hospital information technology services through organizational learning: Lessons in CIO leadership during an international systemic crisis in the United States and Abu Dhabi, United Arab Emirates. International Journal of Medical Informatics, 176. https://doi.org/10.1016/j.ijmedinf.2023.105113
Cresswell, J. W., & Creswell, J. D. (2017). Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. Sage Publications.
Crossan, M. M., & Berdrow, I. (2003). Organizational learning and strategic renewal. Strategic Management Society. https://doi.org/10.1002/smj.342
Dióssy, K., Losonci, D., Aranyossy, M., & Demeter, K. (2025). The role of leadership in digital transformation–a paradox way to improve operational performance. Journal of Manufacturing Technology Management, 36(9), 88-113. https://doi.org/10.1108/JMTM-07-2024-0386
Fita Rusdian Ikawati, & M. Syauqi Haris. (2024). Challenges in Implementing Digital Medical Records in Indonesian Hospitals: Perspectives on Technology, Regulation, and Data Security. Proceeding of The International Conference of Inovation, Science, Technology, Education, Children, and Health, 4(2). https://doi.org/10.62951/icistech.v4i2.70
Fornell, C., & Larcker, D. F. (1981). Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 18(1). https://doi.org/10.2307/3151312
Förster, C., Paparella, C., Duchek, S., & Güttel, W. H. (2022). Leading in the Paradoxical World of Crises: How Leaders Navigate Through Crises. Schmalenbach Journal of Business Research, 74. https://doi.org/10.1007/s41471-022-00147-7
Hair, J. F., Hult, G. T. M., Ringle, C. M., & Sarstedt, M. (2021). A Primer on Partial Least Squares Structural Equation Modeling (PLS-SEM) (Third). Sage Publications.
Jorfi, S., & Winkler, T. J. (2025). Translating IT capabilities: Linking enabling infrastructure to digital transformation in hospitals—Sustainable digital enablement framework. Sustainable Technology and Entrepreneurship, 4. https://doi.org/10.1016/j.stae.2025.100117
Kludacz-Alessandri, M., Hawryzsz, L., Zak, K., & Zhang, W. (2025). The impact of digital transformational leadership on digital intensity among primary healthcare entities: a moderated mediation model. BMC Health Services Research, 25(117).
Koch, F., Kock, A., & Konrad, E. D. (2025). How founding team members respond to exploration and exploitation behaviors by mimicking and switching. Journal of Small Business Management, 63(2). https://doi.org/10.1080/00472778.2024.2322993
Li, W., & Yang, C.-C. (2025). Exploring the possibility of cautious innovation: the impact of perceived paradoxical leadership on innovative work behavior among collegiate teachers. Cogent Education, 12(1). https://doi.org/10.1080/2331186X.2024.2447567
Madaan, K., & Sharma, H. (2025). Navigating contradictions for performance: a resource-based perspective on paradoxical leadership, role-breadth self-efficacy, and employee work behaviors. Journal of Hospitality and Tourism Horizons. https://doi.org/10.1108/JHTH-03-2025-0041
Prashar, A. (2024). Modeling enablers of agility of healthcare organizations. International Journal of Quality & Reliability Management, 41(1). https://doi.org/10.1108/IJQRM-11-2022-0322
Schad, J., Lewis, M. W., Raisch, S., & Smith, W. K. (2016). Paradox Research in Management Science: Looking Back to Move Forward. The Academy of Management Annals, 10(1). https://doi.org/10.1080/19416520.2016.1162422
Somwethee, P., Ru-zhue, J., & Aujirapongpan, S. (2025). Social Sciences & Humanities Open Developing social entrepreneurial capability in Thai community enterprises : The roles of intellectual capital , creating shared value , and organizational agility on sustainability. Social Sciences & Humanities Open, 11(July 2024), 101269. https://doi.org/10.1016/j.ssaho.2024.101269
Su, Y., Khan, M. T., & Dangwal, A. (2025). Steering the digital transformation: How paradoxical leadership juggles innovation culture and organizational agility. Human Systems Management. https://doi.org/10.1177/01672533251372833
Teece, D. J. (2007). Explicating dynamic capabilities: the nature and microfoundations of (sustainable) enterprise performance. Strategic Management Journal. https://doi.org/10.1002/smj.640
Tenggono, E., Soetjipto, B. W., & Sudhartio, L. (2024). Managing digital transformations: the intermediary function of digital readiness in facilitating strategic renewal within the healthcare industry. Cogent Business & Management, 11(1). https://doi.org/10.1080/23311975.2024.2423276
Torp, S., Lien, R., Gil, M., & Ramirez-Solis, E. R. (2025). Strategic renewal influenced by the perception of gender issues and stakeholder pressure: a managerial cognition perspective. Baltic Journal of Management, 20(1). https://doi.org/10.1108/BJM-05-2024-0262
Verhoef, P. C., Broekhuizen, T., Bart, Y., Bhattacharya, A., Dong, J. Q., Fabian, N., & Haenlein, M. (2021). Digital transformation: A multidisciplinary reflection and research agenda. Journal of Business Research, 122. https://doi.org/10.1016/j.jbusres.2019.09.022
Vial, G. (2019). Understanding digital transformation: A review and a research agenda. Journal of Strategic Information Systems, 28(2), 118–144. https://doi.org/https://doi.org/10.1016/j.jsis.2019.01.003
Warner, K. S. R., & Wäger, M. (2019). Building dynamic capabilities for digital transformation: An ongoing process of strategic renewal. Long Range Planning, 52(3). https://doi.org/10.1016/j.lrp.2018.12.001
Wu, X., Luo, Z., & Ma, M. (2025). Executives’ paradoxical leadership and digital transformation: role of resource orchestration. Management Decision. https://doi.org/10.1108/MD-05-2024-1173
Zhang, M. J., Zhang, Y., & Law, K. S. (2017). Paradoxical Leadership and Innovation in Work Teams:The Multilevel Mediating Role of Ambidexterity and Leader Vision as a Boundary Condition. Academy of Management Journal.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Mombang Sihite, Aisyah Pia Asrunputri
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-ShareAlike 4.0 International (CC-BY-SA). that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
