Healthcare digital transformation is increasingly central to modernising health systems, yet technology investment alone does not guarantee better service quality. This study investigates the organisational mechanism through which digital transformation contributes to healthcare service quality, focusing on the mediating role of change management at King Abdulaziz University Hospital in Jeddah, Saudi Arabia. Drawing on the Technology-Organization-Environment (TOE) framework and established change-management perspectives, the study examines the direct effect of Healthcare Digital Transformation (HDT) on Healthcare Service Quality (HSQ), the effect of HDT on Change Management (CM), the effect of CM on HSQ, and the mediating role of CM in the HDT-HSQ relationship. We conducted a quantitative, cross-sectional survey using stratified random sampling. Of 400 questionnaires distributed, 358 were returned, and 340 were usable. We analysed the data using Partial Least Squares Structural Equation Modelling (PLS-SEM) with SmartPLS 4 and 5,000 bootstrap resamples. The results show significant positive effects of HDT on HSQ (? = 0.383, p < .001), HDT on CM (? = 0.539, p < .001), and CM on HSQ (? = 0.461, p < .001). The indirect effect of HDT on HSQ through CM is also significant (? = 0.248, p < .001), while the direct effect remains significant, indicating partial mediation. The model explains 62% of the variance in HSQ, and the reported VAF of 39.3% indicates a substantial mediating contribution by change management. The study demonstrates that digital transformation creates value through both technological improvements and organisational processes that enable workforce adaptation, communication, training, and workflow redesign.
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