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The adoption of digital technology has not been able to overcome the problem of patient healthcare service quality in Indonesian hospitals, especially in lower middle-class hospitals that are widely distributed in the regions, because its utilization has not been well coordinated. This research explores the influence of Digital Adoption Capability (DAC) on Hospital Performance (HP) for these service problems.

This research used a quantitative methodology design approach. Survey data were collected from 285 leaders of class C and D hospitals throughout Indonesia, who were selected at simple random from March to August 2023. Data analysis was carried out using the structural equation modeling method with the help of LISREL version 8.80 software.

The research found a positive and significant influence of DAC on HP. Digital Leadership (DL) plays an important role in performance, both directly and indirectly. ICT Literacy (ICT) and Patient-Centric (PC) do not have a direct influence on HP but provide significant results through DAC. This research also found Environmental Dynamism (ED) factors that significantly drive the need to improve performance through digital adoption.

Providing insight into increasing the role of digital technology to connect healthcare workers and patients to produce safe and quality healthcare services in an ever-changing environmental condition.

This model is very important for the management of small hospital organizations in the context of adopting digital technology to be able to provide better services to patients and improve hospital performance.

This paper aims to examine the mediating role of occupational stress in addressing the missing link between organisational intelligence (OI) traits and digital government service quality and propose relevant strategies in sustaining the digital government service quality whilst enhancing the psychological well-being of the service providers.

This paper utilises a triangulation design approach to interpret the findings of the study and propose pertinent strategies. Firstly, we examined the mediating role of occupational stress in addressing the link between OI traits, and digital government service quality. Next, we examined the priority factors of OI traits and occupational stress to sustain the quality of digital government services via the Importance-Performance Map Analysis (IPMA). These findings were cross-examined with the code’s percentage generated from participants’ open-ended survey feedback on aspects that requires improvement in sustaining service quality.

In principle, occupational stress mediates the relationship between OI traits at the third-order component level and digital service quality. Analysis at the lower component level shows that the mediation effect of occupational stress is only significant in the presence of employee-oriented OI traits and “Alignment and Congruence”. Accordingly, the IPMA exhibited the importance of “Job engagement”, “Alignment and Congruence” and “Occupational Stress” in sustaining service quality. Conversely, code’s percentage analysis demonstrated the role of other insignificant traits such as “Leadership” and Appetite for Change and Knowledge Deployment’ in ensuring the sustainability of digital service quality.

By integrating the Organisational Model of Stress with Public Service-Dominant Logic, this paper rejuvenates the stressors utilised in a traditional work setup and widens the perspective of individual job performance to organisational level performance, to reflect the context of today’s public service delivery. We triangulated the outcome from mediation analysis, IPMA as well as open-ended feedback analysis and propose prioritisation on the aspects of “Employee-oriented traits”, “Psychological Well-being”, “Alignment and Congruence”, “Leadership” and “Appetite for Change and Knowledge Deployment” aspects for sustaining digital government service quality. Considering the significance of occupational stress in sustaining service quality in both quantitative and qualitative analysis, this paper also takes the approach of proposing a stress intervention program at the individual and organisational levels to manage the psychological well-being of the service providers.