The Saudi Journal of Health Systems Research · Published 2026-06-22 · DOI 10.1159/000553225
Khalid Saad Alshahrani, Lujain Alotaibi, Mudathir Adebusuyi Adewole
Introduction: Effective leadership is critical to improving healthcare quality, and key performance indicators (KPIs) are increasingly used as strategic tools to enhance accountability, efficiency, and decision-making. This study explores the impact of KPI-driven leadership on healthcare quality in a newly established secondary hospital in Saudi Arabia, using Donabedian’s Structure–Process–Outcome (SPO) framework. Methods: A qualitative study design was employed using semi-structured interviews with 15 healthcare professionals from internal medicine, surgery, emergency, and critical care departments. Data were analyzed thematically to identify patterns related to the structural, procedural, and outcome-related effects of KPI implementation. Results: Four key themes emerged: the influence of KPI-driven leadership on healthcare structure, its effects on care processes, challenges associated with KPI implementation, and opportunities for improvement. KPIs were found to enhance resource allocation, staff performance, service efficiency, and data-driven decision-making. However, participants also reported challenges, including resistance to change, limited understanding of KPIs, and concerns about overemphasis on numerical targets at the expense of patient-centered care. Conclusion: KPI-driven leadership can positively influence healthcare quality by strengthening organizational structures and care processes when implemented thoughtfully. A balanced approach that integrates quantitative and qualitative indicators, continuous staff engagement, digital systems, and ongoing evaluation is essential to maximize benefits and minimize unintended consequences. Further research across diverse healthcare settings is recommended to assess long-term impacts and incorporate patient perspectives.
Abstract from DOAJ. Public domain (CC0 1.0).
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Alshahrani, K., Alotaibi, L., Adewole, M. (2026). Impact of Key Performance Indicator-Driven Leadership on the Quality of Care in a New Secondary Hospital: A Qualitative Study. The Saudi Journal of Health Systems Research. https://doi.org/10.1159/000553225