Qu Luo
Purpose: This study examines the impact of transformational leadership (TL) on employee well-being (EWB) in Chinese public hospitals, with a focus on the mediating role of organizational commitment (OC).Design/methodology/approach: A quantitative, cross-sectional survey was conducted among 377 employees from four tertiary public hospitals in Sichuan Province, China. Transformational leadership was measured across its four dimensions, namely Idealized Influence (II), Inspirational Motivation (IM), Intellectual Stimulation (IS), and Individualized Consideration (IC), using the Multifactor Leadership Questionnaire (MLQ-5X). Organizational commitment was assessed using the Three-Component Model scale, and employee well-being was measured using a validated three-dimensional scale. Structural equation modeling (SEM) with bootstrapping was employed to test direct and mediation effects.Findings: All four TL dimensions significantly predicted both EWB and OC. Idealized Influence had the strongest direct effect on EWB (β = 0.346), while Intellectual Stimulation was the strongest predictor of OC (β = 0.398). Organizational commitment exhibited the largest direct effect on EWB (β = 0.399) and partially mediated all four TL–EWB relationships. The structural model explained 86.9% of the variance in EWB.Originality/value: This study extends transformational leadership theory to the under-researched context of Chinese public hospitals, providing dimension-level evidence of TL's differential effects on well-being and commitment. By integrating transformational leadership theory with evidence-based management, the study demonstrates how organizational commitment functions as a key mechanism through which leadership decisions enhance employee well-being. The findings also provide practical decision support for hospital managers seeking to improve organizational performance under resource constraints.