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This study aims to determine hospital management responses in implementing transformational leadership style, organizational commitment, budget business plan, work motivation, uniqueness of resources, and hospital performance.

The method used in this research is a quantitative research method with a deductive mindset approach. The population in this research is all organizational units under the Regional Public Hospital Dr. Zainoel Abidin with its observation unit. The obtained data will be processed by using inferential statistics, namely Structural Equation Modelling (SEM) by using Smart Partial Least Square (Smart PLS) software.

The overall results of the performance appraisal using the Balanced Scorecard approach seen from the financial, internal business, customer, and training and learning perspectives are right. Regional public Hospital Dr. Zainoel Abidin has provided excellent services, and the performance of its departments has generated the expected outcome and is realized by the hospital.

This research contains some innovation. First, the predictor variables used are transformational leadership, organizational commitment, budget business plans and the implementation of unique resources. Second, the response variable used is a performance in the service industry associated with hospital outpatient units (especially organizational units) and inpatient classes of public hospital hospitals. Third, the research location is at Dr. Hospital. Zainoel Abidin, Indonesia. The combination of the three originalities has never been done in previous studies. The object of research to be examined is hospital management, especially the management of outpatient and inpatient units in hospitals. So far, only employees in business units and educational institutions have been studied, and it only has been partially examined variables that affect leadership, resources, and organizational commitment.