Enhancing Organizational Social Sustainability: Exploring the Effect of Sustainable Leadership and the Moderating Role of Micro-Level CSR

Abstract

Managers face challenges in leveraging people as a source of competitive advantage due to advancements in technology and the widespread availability of information, which have rendered other sources of competitive advantage less effective. In this context, social sustainability within an organization refers to the enduring relationships between employees and the organization, as well as their collective contribution to organizational goals. Strengthening social sustainability provides opportunities to achieve desired objectives through the efforts of employees. This study presents empirical findings that support the assumptions that sustainable leadership enhances social sustainability, and that micro-level corporate social responsibility (CSR) moderates this relationship. The data were gathered from a randomly selected sample of 516 employees in the healthcare industry, and regression analysis using structural equation modeling (SEM) was employed to test the hypotheses. The results demonstrate a significant role of sustainable leadership on the establishment and development of social sustainability, with micro-level CSR positively influencing this relationship as a moderator. These findings hold both theoretical and practical implications. Given the labor-intensive nature of the healthcare industry and the interconnectedness of the three variables examined in this study, no prior research investigating these connections was found in the literature. Therefore, the research model proposed in this study and its subsequent findings represent a valuable contribution to the existing body of knowledge. The findings offer guidance to hospital administrators, emphasizing the importance of focusing on sustainable leadership and micro-level CSR to reduce turnover rates and cultivate long-term relationships with employees, thereby enhancing organizational effectiveness.

1. Introduction

Sustainability encompasses social, economic, and environmental dimensions, while social sustainability serves as a vital component of overall sustainability. Within organizations, social sustainability refers to employees’ collective contributions toward the organization’s greater purpose and the development of enduring relationships [1]. It is a critical factor for organizational well-being and a unique resource for attaining sustainable competitive advantage [2]. Notably, social sustainability holds equal importance for non-profit organizations and proves particularly crucial in service industries and labor-intensive organizations, where employee performance directly influences success [2,3]. In today’s technology-driven landscape, where resource accessibility is relatively equal among organizations, successful entities rely on their employees’ competence and citizenship behaviors to anchor their competitive strategies.

Organizations exhibit various leadership styles, each yielding distinct outcomes [4]. Leaders display diverse behaviors such as autocratic, democratic, task oriented, people oriented, charismatic, and ethical, with their significance depending on the context and organizational needs [5]. Sustainable leadership has emerged as an increasingly important concept, with contemporary organizations striving to transform their leadership styles accordingly [5,6]. Sustainable leaders transcend immediate interests and short-term goals, instead focusing on future opportunities within a broader context. Consequently, their leadership practices generally foster organizational sustainability, including social sustainability [7].

Corporate social responsibility (CSR) represents an organizational phenomenon wherein managers integrate corporate, social, and environmental roles into their management processes [8]. CSR extends beyond economic gains and encompasses contributions to social causes, including employee welfare and society at large [9]. Traditionally, CSR is classified into economic, environmental, philanthropic, and ethical responsibilities. While CSR is often studied at the institutional and macro levels, contemporary research explores individual or micro-levels, documenting the role of each employee in CSR initiatives. Micro-level CSR provides a deeper understanding of CSR’s impact [10]. At the micro-level, CSR serves as a strategy that encourages individuals, specifically employees, to engage in roles that contribute to sustainable futures [11].

Sustainable leadership involves creating a positive work environment, nurturing employee well-being, and fostering a culture of inclusivity, diversity, and equal opportunities [12]. Social sustainability promotes fair labor practices, work–life balance, and the overall welfare of employees [13]. When organizations prioritize both sustainable leadership and social sustainability, they enhance employee engagement, satisfaction, and productivity, leading to better overall performance. The relationship between sustainable leadership and social sustainability is important because it integrates social considerations into sustainability strategies, engages stakeholders, enhances employee well-being, builds reputation, ensures long-term viability, and drives positive societal impact. By prioritizing both concepts, organizations can create a more equitable, just, and sustainable future.

Considering the critical role of social sustainability in the healthcare sector, this study focuses on elucidating social sustainability by examining the role of sustainable leadership and micro-level corporate social responsibility. Th existing literature suggests that sustainable leadership fosters a sustainable future, implying that sustainable employee behavior shapes organizational social sustainability. Similarly, micro-level CSR activities significantly impact stakeholder welfare, including that of employees. As employees generally prefer environments that prioritize their well-being, the presence of micro-level CSR activities is expected to attract employees and enhance organizational social sustainability. Consequently, this study empirically examines the effect of sustainable leadership on organizational social sustainability, with the moderating role of micro-level CSR.

2. Literature Review

The amiability and geniality of the association between the employees and an organization are referred to as organizational social sustainability [14]. An organization becomes socially sustainable when it has a long-term and productive relationship with its employees [15]. Gaining social sustainability is achieving effectiveness and importance in society, environment and economy as the primary approach to managing the global challenges of the future [16]. Contemporary managers are increasingly focusing on how to align the socially sustainable capabilities of an organization with sustainable competitiveness [17]. The resource that equips an organization with a sustainable competitive advantage is the competent and motivated employees who maintain the long-term association [18]. Thus, managers seek sustainable competitive advantage through a sustainable workforce. Therefore, to gain social sustainability managers should make sure human development includes training, a conducive work environment, financial benefits, safety and sustainable leadership within a strong corporate culture [19,20].

Sustainable leadership is when leaders manage the pressures of short-term goals and the present organizational demands while keeping in mind long-term preferences [21]. Sustainable leadership is called relationship building, and it refers to understanding employees across different cultures and all over the planet. Leaders who hail from a diverse background, have knowledge and experience of diverse cultures in emerging economies and markets and are more expected to adopt environmental and social roles in leadership that benefit the economic structure of developing countries [22,23].

Sustainability requires managers to introduce radical change to transform from just being green to high-level performers [24]. For example, presently sustainability is considered a core strategy for futuristic success and long-term survival [25]. Therefore, the healthcare sector needs sustainable leaders who can capitalize on the opportunities that sustainability creates to secure an ideal future [26]. The employees of a sustainable organization are more satisfied and this is considered a key performance indicator [27]. Generally, sustainable leadership practices produce overall employee satisfaction aiming to gain sustainability [28]. Additionally, most sustainable leadership practices influence employees directly and since long employees have been considered the most crucial asset of the organization, employee satisfaction can be a vital indicator of organizational sustainability [29]. Iqbal, Ahmad, Nasim and Khan [30] explain that sustainable leadership practices are encompassed by multiple management systems, processes and values that can create a long-run organizational performance. In short, sustainable leadership practices can enhance employee satisfaction with the job and organization and also contribute to high organizational performance [31]. Healthcare organizations usually face high employee turnover which creates a greater threat to healthcare service delivery [31]. Employee turnover intentions negatively affect organizational performance as well as the competence and commitment of employees. According to Acker [31], the turnover of competent and motivated will cause intangible losses. In addition, the replacement of senior employees brings a loss of expertise and competence. That is why Jimoh and Thomas [32] mentioned that sustainable leadership practices are the strategies to decrease turnover intentions, particularly in the healthcare industry. Therefore, an appropriate leadership style is the main instrument to minimize employee turnover intentions and enhance employee satisfaction in the organization. Sustainable leadership practices aim at developing internal employees instead of hiring outsiders as much as possible [33]. The objective of in-house development and promotion of employees create a sense of affiliation among employees and to reduce turnover intention. Apart from this, employee retention can produce a sustainable competitive advantage for an organization, obtained from the long-term linkages that encourage employees to share their ideas and skill [34]. Thus, in the presence of sustainable leadership, employees may avoid turnover intentions and enhance productivity to add to the organizational value. Most employee behavior including job satisfaction, turnover intentions, commitment, and loyalty can be classified as moral and ethical issues that take place in an organization [35]. The healthcare sector also frequently experience difficult challenges not only of a technical nature but of a moral nature too such as unethical practices among healthcare professionals [36]. Thus, the implementation of sustainable leadership practices may provide sustainable solutions to these unethical and moral issues.

Sustainable leadership encourages creativity, sharing ideas, focuses continuous improvement through learning and takes errors in a non-punitive way [37,38]. The relationship between sustainable leadership and Corporate Social Responsibility (CSR) is fundamentally intertwined [39,40]. Both concepts are concerned with integrating social, environmental, and economic considerations into organizational decision-making to achieve long-term sustainable outcomes [41]. Sustainable leaders champion CSR initiatives, while CSR practices align with the values and goals of organizational sustainability, creating a positive impact on businesses, society, and the environment [42]. Sustainable leadership enhances environmental performance and economic and social sustainability [43,44].

The existing literature in the field of sustainability takes sustainability as an institutional-level phenomenon and is dealt with as a macro or meso-level concept [45]. Though consensus-based and specific definitions of sustainability are not available, researchers at large mention three interconnected dimensions of sustainability. These dimensions include economic, social and environmental sustainability [15,46]. However, much research work has been done on economic and environmental concerns [26,47,48], while minimum attention has been given to the social aspect [49,50]. Research on macro-level sustainability is now increasingly paying attention to the social aspect of sustainability [51,52,53]. The norm of reciprocity builds social sustainability by increasing trust and cooperation in any group of people and explains this complex relationship [15]. The social sustainability of an organization is the ability of employees’ collective and individual contribution under any kind of circumstances. Thus, the important facet of the sustainability in an organization is the employees’ integration [53]. An organization cannot become multi-faceted and sustainable if the workforce fails to integrate and maintains individuality [54]. Similarly, any effort to integrate employees within a company without proper development of individual employees will not guarantee sustainability but create a traditional way of collaboration instead and they will have nothing novel to share [55]. Firstly, members of an organization should nurture complex in their ideas and actions and make their performance meaningful and worth the effort. Secondly, the employees should have the ability to learn collectively and become effectively incorporated into groups, with complex cognitive models and work patterns [55]. To form this kind of social sustainability there is a need for a network of interactive individual employees whose growth goes together [56].

3. Theoretical Framework

This study is built upon the theoretical foundations of stakeholder theory, which underscores the interconnectedness between an organization and its stakeholders, such as shareholders, customers, suppliers, and employees [57]. According to this theory, organizations should prioritize value creation for all stakeholders, not solely focusing on shareholders [58]. A key principle of stakeholder theory is the ethical governance of relationships with various stakeholders, including employees [59]. The thesis of the theory posits that by creating value for stakeholders, especially employees, organizations can secure unwavering contributions that ultimately lead to success [60]. In the context of this study, stakeholder theory provides valuable insights into the correlation between sustainable leadership, micro-level corporate social responsibility, and the development of social sustainability for employees. Consequently, this study’s hypotheses center on examining the interplay among leaders, employees, and social sustainability.

3.1. Definition of Variables

Social sustainability is the collected connectedness of the employees and collective contribution towards organizational effectiveness [61]. Social sustainability takes place when employees develop cordial relationships with the organization on a relatively long-term basis [3]. Social sustainability is taken as the criterion variable in this research model.

Sustainable leadership refers to leadership behaviors having futuristic directions [22]. A sustainability leader is someone who inspires and supports action towards a better world [21]. Sustainable leaders envision organizational sustainability and long-term orientations. Sustainable leaders aim at achieving sustainable competitive advantage [62].

Micro-level corporate social responsibility refers to CSR activities performed by an individual employee of the organization [62]. Micro-level CSR activities promote employees at the workplace to be engaged in pro-environmental, ethical, philanthropic and economic performances [11,45].

3.2. Hypotheses

Sustainable leadership and social sustainability are much interconnected as both present futuristic orientations [22]. A sustainable leader works for achieving short-term goals as well as extends its strategies for future gains and long-term goals [63]. In the same way, social sustainability presents employees’ long-term engagement with the organization [3]. The literature reflects that satisfied, happy and motivated employees maintain a long-term relationship with the organization and form social sustainability [51,63,64]. So, sustainable leadership positively impacts job satisfaction, work engagement, OCB, loyalty, and commitment and negatively impacts turnover intention and workplace deviance [65,66]. Sustainable leadership plays a profound role in reducing workplace incivility [67]. Keeping these research findings in view this research goes a step ahead and conjectures the following hypothesis:

Hypothesis 1.

Sustainable leadership behaviors strengthen organizational social sustainability.

Corporate social sustainability has been extensively studied and its effects on various organizational and societal phenomena have been widely investigated [16]. CSR activities usually produce positive and enduring outcomes for both organization and the stakeholders. CSR activities are recognized for having a profound and positive impact on the environment, economic, ethical and social aspects of an organization [68]. CSR has also been found to play a key role in organizational performance. Micro-level CSR has also been found to have favorable results for an organization and its stakeholders [45]. Sustainable leadership enhances CSR activities at both institutional and individual levels and consequently, micro-level CSR produces sustainability in the workforce as well as in organizations [11,45]. In the same vein, micro-level CSR positively effects job satisfaction, motivation, commitment, job engagement, and loyalty and negatively effect turnover intentions and workplace deviance and incivility [69]. Thus, keeping in view these findings, we expect a moderating role of micro-level CSR on sustainable leadership and social sustainability (Figure 1). Thus, we propose that:

Hypothesis 2.

Micro-level CSR mediates the relationship between sustainable leadership and organizational social sustainability.

4. Materials and Methods

This paper presents the results of an explanatory, quantitative, cross-sectional, and deductive research study. The data were collected through a survey conducted in four tertiary hospitals located in Bahrain. The selection of these hospitals was based on the accessibility of their employees’ lists, allowing for a random sampling approach. Prior to data collection, necessary permissions were obtained from the administrators of each hospital, ensuring adherence to ethical standards. Written declarations were also submitted to demonstrate the commitment to ethical research practices. Furthermore, all respondents provided informed consent willingly and voluntarily before participating in the survey. The data collection process followed the ethical standards and guidelines outlined in the Helsinki Declaration [70].

4.1. Sample and Demographics

This study encompassed employees from four tertiary hospitals, constituting the population under investigation. Due to the homogeneous employment structures across these hospitals, slight variations were expected among the subjects. The inclusion of multiple hospitals aimed to enhance the representativeness of the sample and improve generalizability. We obtained a list of employees from the human resource department of each hospital, comprising doctors, nurses, paramedics, and administrative staff. To create our sample, we adopted a methodology akin to stratified random sampling, classifying the population into four distinct strata based on the aforementioned job categories. Subsequently, we administered close-ended questionnaires to 150 randomly selected subjects from each stratum. So a total of 600 questionnaires were administered in these hospitals, resulting in 531 questionnaires being received and 500 of them were selected for analysis. Data collection spanned three months, commencing in February and concluding in May 2022. The respondents comprised 47.92% male and 55.08% female. Regarding job roles, there were 238 doctors, 78 paramedics, 125 nurses, and 59 ancillary staff, including HR employees. In terms of age distribution, 9% were below 22 years, 41% fell within the 24–30 years range, 37% were aged 31–40 years, and 13% were between 41–59 years old. With respect to experience, 12% had 1–2 years, 22% had 2–6 years, 36% had 8–20 years, and 30% had 20–34 years of experience.

4.2. Measurement Scales

Operationalization of construct is a critical issue in the social sciences research. The authors made a sensible decision by employing already established measures to operationalize the latent constructs in the current study. One of the advantages of utilizing pre-existing instruments is that they come with pretested reliability and validity [71]. Consequently, the authors adopted the pre-established ML-CSR scale from Turker [72], consisting of twelve statements. For instance, one sample statement read, ‘This hotel encourages its employees to participate in voluntary activities’. The scale to measure the construct of sustainable leadership was adapted from Slankis [73] containing 10 items. For example, one statement says ‘My leader acts in a sustainable socially responsible manner’. Lastly, the scale of Cella-De-Oliveira having seven items was adapted to measure social sustainability [74]. A sample item to measure social sustainability is ‘The organization has policies of collaborator inclusion, valuing diversity: people with special needs, immigrants, and minorities. All the items were scored on a five-point Likert scale (see Appendix A).

4.3. Analysis of Data

Inferential statistics including correlation and regression analysis were applied to analyze the data collected. Partial least square (PLS) was used for structural equation modeling (SEM). This method enables statisticians and researchers to analyze the factor model (measurement components) and path model (structural components) in a singly model simultaneously [75]. Thus, SEM provides an all-inclusive picture of reliability, validity and causality [76]. Cronbach’s Alpha, composite reliability, AVE and construct validity tests were done to verify the health of the data. Multiple regression tests were carried out to test the hypotheses.

In our research, we emphasize a particular characteristic of our chosen analytical tool, SMART-PLS, which is a variance-based variant of structural equation modeling (SEM), in contrast to covariance-based SEM tools like AMOS. Each tool has its unique strengths and suitability, depending on the research context and the data’s nature. We specifically opted for SMART-PLS due to its increasing popularity among contemporary researchers, as it excels in handling complex models with numerous constructs and indicators. It has proven to be particularly effective when the research aims at prediction and theory development. Unlike AMOS, which allows for alternative model specifications, SMART-PLS operates on a different analytical framework and traditionally does not require or support such alternative specifications. However, it is crucial to note that this distinction does not diminish the robustness of the findings generated through SMART-PLS 3.0.

We meticulously selected the statistical measures based on the specifics of our research question, the data type collected, and our set objectives. Our primary aim was to explore relationships between constructs, leading us to employ the SMART-PLS 3.0 software utilizing the partial least squares structural equation modeling (PLS-SEM) approach. PLS-SEM was preferred due to its capacity to handle intricate models and its suitability for prediction and theory development, which were pivotal to our study. This approach enabled us to model latent variables and their interconnections, providing a robust framework for testing our research hypotheses. Additionally, PLS-SEM, being a non-parametric technique, imposed fewer assumptions on the data. This aspect was well suited for our study, where the data might not strictly adhere to the normal distribution assumption required by other methods. Furthermore, the selection of SMART-PLS as our statistical tool and the subsequent measures employed were based on a significant body of related research in the field, which supported our decision. The impact of our chosen statistical measures primarily affected the construct validation and relationships in this study. By employing the PLS-SEM method, we could successfully identify and validate the underlying constructs, while also quantifying the strength and direction of the relationships between these constructs. As a result, we were able to draw meaningful and substantial conclusions from our data.

5. Results

5.1. Reliability

Before testing the hypotheses, confirmatory factor analysis (CFA) and reliability tests were carried out (see

Table 1. Construct reliability and validity.

	Cronbach’s Alpha	rho_A	Composite Reliability	Average Variance Extracted (AVE)
MCSR	0.893	0.897	0.912	0.511
SL	0.908	0.910	0.924	0.549
SOS	0.858	0.858	0.891	0.540

). All three variables proved to be reliable, as Chronbach’s alpha values for all the variables were higher than the cut-off value of 0.70 as indicated by [77]. In the same way composite reliability values were also higher than the threshold value which is 0.70 as suggested by Abdullah and Musa [78]. Thus, the reliability of the instrument is established.

5.2. Validity

Convergent validity was verified through average values extracted (AVE) values as all the values were higher than 0.50 which is suggested by Shrestha [79] as the threshold point (see Table 1). The Fornell–Larcker criterion [77] was used to assess discriminant validity and the Heterotrait–Monotrait (HTMT) ratio, as suggested by Henseler, Ringle [80] was also used for the same purpose. According to Fornell and Larcker [81] a latent variable should explain the variation in its indicators greater than the variance of other latent variables in the model. Hence, as per the Fornell–Larcker criterion, each latent variable in the model has a higher value than the correlations of other latent variables, founding high discriminant validity (

Table 2. Discriminant validity (Fornell–Larcker criterion).

	MCSR	SL	SOS
MCSR	0.715
SL	0.700	0.743
SOS	0.684	0.740	0.735

). According to the HTMT ratio, the values below 0.90 show a confirmation of discriminant validity [77], and all the values in

Table 3. Discriminant validity (HTMT ratio).

	MCSR	SL	SOS
MCSR
SL	0.772
SOS	0.774	0.838

are below 0.90.

5.3. Structural Equation Modeling (Hypotheses Testing)

The correlation matrix exhibits positive associations between the variables of the model. Sustainable leadership (SL) and micro-level CSR (MCSR) are significantly associated with organizational social sustainability (SOS). Since all the correlation coefficients are below 0.90, that rules out the existence of autocorrelation though the data is not time series data (

Table 4. Correlation matrix.

	MCSR	SL	SOS
MCSR	1
SL	0.700	1
SOS	0.684	0.743	1

).

The coefficient of determination (R Square) exhibits the cause-and-effect relationship. R² exhibits that 61.9% variation in the criterion variable (SOS) is caused by independent variables which are (SL and MCSR) as shown in

Table 5. Coefficient of determination.

	R Square	R Square Adjusted
SOS	0.619	0.615

.

Using SmartPLS 3.0, two types of structural modeling were performed to test the hypotheses. The coefficient path revealed that SL and MCSR significantly predict the variation in the dependent variable (

Table 6. Path coefficient.

	Original Sample (O)	Sample Mean (M)	Standard Deviation (STDEV)	T Statistics (|O/STDEV|)	p Values
MCSR → SOS	0.351	0.356	0.071	4.913	0.000
Moderating Effect → SOS	0.091	0.093	0.035	2.623	0.009
SL → SOS	0.531	0.526	0.072	7.335	0.000

). Firstly, the positive association of sustainable leadership (SL) with organizational social sustainability (OSS) remained significant at β = 0.531, T statistics = 7.335 and p value 0.000. β = 0.531 shows a significant relationship between the independent variable and the dependent variable while T statistics = 7.335 provides significant evidence against the null hypothesis and indicates the significance of outer model loading. p = 0.000 determines that the relationship is statistically significant, hence the first hypothesis is proved. The statistics also show a direct association of micro-level CSR (MCSR) with the dependent variable (SOS). β = 0.351 shows that MCSR was moderately associated with SOS, and T statistics = 4.913 provides sufficient evidence against the null hypothesis and establishes the significance of outer model loading. The p value (0.000) confirms the relationship between MCSR and SOS.

Furthermore, the author introduced MCSR as a key moderator in the relationship between SL and SOS. To assess this moderating effect, the bootstrapping method was employed. The results of the evaluation indicated a moderate, yet positive, moderation of MCSR on the SL-SOS relationship. The path coefficient (β = 0.091) demonstrated a weak but favorable moderation effect. Notably, the strong T statistics value of 2.623 provided compelling evidence against the null hypothesis, while the p value of 0.009 further supported the hypothesis. Consequently, it can be concluded that MCSR plays a constructive role in moderating the relationship between the independent and dependent variables, albeit with a moderate intensity.

6. Discussion

The correlation between sustainable leadership and sustainability is widely acknowledged, and the literature also reveals an evident connection of CSR with both these constructs. However, the specific association of sustainable leadership with the social aspect of sustainability remains relatively less explored. Similarly, micro-level CSR has not yet received extensive attention from researchers in terms of various perspectives. This research endeavors to fill this gap by examining these aspects. The configuration of the model used in this study presents a distinct and novel perspective. Overall, the findings confirm the interconnectedness of these constructs, with varying degrees of intensity in their relationships.

Organizational social sustainability stands as a widely recognized concept, exerting the greatest influence on organizational settings [41,50]. Successful organizations prioritize their strategies and competitiveness based on their employees, rather than solely relying on technology and finance [17]. The cognitive and affective attachment of employees to their organizations forms the bedrock of organizational sustainability. It represents a long-term relationship in which employees willingly contribute their unique intrinsic capabilities, which are neither easily found in the market nor imitable [15]. Consequently, managers face a subjective, gradual, and arduous task in building and enhancing social sustainability within their organizations. However, the existing literature on social sustainability within the specific population remains limited. Likewise, micro-level corporate social responsibility is the least understood and practiced phenomenon within the studied population. While sustainable leadership is a well-known concept, its relationship with social sustainability remains unexplored. This study aims to address these dual research gaps by investigating these variables within the specific population, where such studies are scarce, and by proposing a novel model configuration.

The first hypothesis, which examines the relatedness of sustainable leadership with social sustainability, has been supported and demonstrates a statistically significant relationship. Sustainable leadership yields a variety of effects on different organizational factors. For instance, it positively influences employee engagement, commitment, job satisfaction, development, individual and organizational productivity, while negatively impacting turnover intentions, workplace deviance, workplace bullying, workplace incivility, and absenteeism [15,51]. The findings of this study establish a strong influence of sustainable leadership on social sustainability. A sustainable leader is primarily people oriented and focuses on developing human resources, fostering emotional and cognitive attachment of employees to the organization. Consequently, the hypothesis is substantiated, contributing a novel understanding to the existing literature.

Data analysis reveals a positive influence of micro-level corporate social responsibility (CSR) on social sustainability, although this relationship was not explicitly hypothesized. Similarly, micro-level CSR is a relatively new concept in the given context, and empirically testing the relationship between micro-level CSR and social sustainability represents groundbreaking research. The second hypothesis, which proposes a moderating effect of micro-level CSR on the relationship between sustainable leadership and organizational social sustainability, is empirically supported. The findings indicate a mild moderating effect, with a coefficient of 0.091 suggesting a weak relationship. However, the T statistics and p value substantiate the hypothesis, even though the strength of the relationship is not particularly robust. Thus, the findings reveal that in an environment where individuals engage in CSR, the sustainable behavior of leaders becomes a more effective catalyst for organizational social sustainability.

6.1. Recommendations

Based on this study’s findings, several important insights have emerged that are directly related to organizational success. In light of these results, the following recommendations are put forth:

• Recognize the Significance of CSR: The satisfaction and happiness of stakeholders play a vital role in determining organizational success. Both overall corporate social responsibility (CSR) and specifically, social CSR, significantly influence stakeholders’ perception of organizational performance. Managers should understand the importance of CSR and ensure that employees are actively involved in all types of CSR activities.
• Foster Sustainable Leadership: Organizations should cultivate leaders who exhibit sustainable behaviors and prioritize future endeavors with a forward-thinking approach. It is equally important for leaders to understand that demonstrating sustainable behaviors is in the best interest of both employees and the organization.
• Promote Social Sustainability: Within the given context, social sustainability remains relatively unfamiliar. It is crucial to recognize its importance and for managers to actively work on fostering and promoting organizational social sustainability. By doing so, organizations can achieve sustainability and gain a competitive advantage that endures over time.
• Acknowledge the Role of Human Capital: Service industries, such as healthcare organizations, heavily rely on the knowledge, skills, and motivation of their employees to deliver high-quality services to customers. Therefore, sustainable leadership, CSR, and social sustainability directly influence both individual and collective human behavior within the organization. It is imperative to understand and leverage these factors to enhance overall organizational performance.

By implementing these recommendations, organizations can pave the way for sustained success by prioritizing stakeholder satisfaction, developing sustainable leadership, embracing social sustainability, and recognizing the pivotal role of human capital in service industries.

6.2. Implications

This study’s findings carry significant implications for both theory and practice, offering valuable insights that hold great relevance for healthcare administrators. Notably, the research sheds light on a crucial yet often overlooked aspect in the healthcare sector, which is the importance of social sustainability. It highlights how sustainable practices that benefit the social and environmental aspects of healthcare operations can have a profound impact on the overall success and well-being of healthcare organizations.

In particular, the findings emphasize the significance of corporate social responsibility (CSR) at the employee level and its outcomes. They reveal that fostering a culture of CSR among employees can lead to positive outcomes for both the organization and the employee. Moreover, this study underscores the pivotal role played by sustainable leadership behaviors in promoting and enhancing social sustainability within healthcare organizations. Leaders who prioritize sustainability initiatives and integrate social responsibility into their decision-making processes can effectively inspire their teams and influence positive change.

While this study acknowledges that micro-level CSR activities also contribute to social sustainability, their impact is comparatively less pronounced compared to sustainable leadership. However, the research identifies an important interplay between the two factors, indicating that the presence of CSR activities at the micro-level can moderate the effectiveness of sustainable leadership in fostering collective employee contributions. This highlights the importance of creating a comprehensive sustainability strategy that incorporates both macro and micro-level initiatives to maximize positive outcomes.

Furthermore, this study emphasizes the importance of fostering enabling behaviors, such as sustainable leadership and micro-level CSR, to create a supportive and socially responsible work environment. By encouraging leaders to exhibit sustainable practices and empowering employees to engage in CSR activities, healthcare organizations can foster a culture of collective responsibility and contribute positively to society while also achieving their strategic objectives.

In conclusion, this study’s comprehensive findings highlight the critical role of social sustainability, employee-level CSR, and sustainable leadership in the healthcare sector. By acknowledging and incorporating these insights into their strategies and practices, healthcare administrators can pave the way for a more sustainable and socially responsible future for their organizations.

7. Conclusions

The research topic of organizational social sustainability and micro-level corporate social responsibility (MCSR) has gained significant attention in European and other advanced countries. However, it remains a relatively emerging concept in developing countries such as Bahrain. The existing literature has established the crucial role of organizational social sustainability (SOS), MCSR, and sustainable leadership (SL) in achieving organizational goals, with a particular emphasis on their importance in service industries such as healthcare.

Sustainable leadership influences employees to actively contribute to organizational sustainability, which is a primary concern for contemporary managers. Corporate social responsibility (CSR) is a multidimensional phenomenon encompassing economic, social, philanthropic, and environmental aspects. It positively influences organizational profitability, enhances brand reputation, and promotes stakeholder satisfaction. Given that these terms are relatively new in the given context, the author aimed to investigate the relationship between sustainable leadership, organizational social sustainability, and the potential moderating effect of micro-level CSR.

A quantitative, cross-sectional, and explanatory research design was employed to test the hypotheses, focusing specifically on the healthcare sector. This study’s findings revealed the significant association of sustainable leadership with the formation and improvement of organizational social sustainability, with micro-level CSR playing a mild moderating role. However, due to the limited understanding and infrequent practice of micro-level CSR within the studied population, its moderating effect was not as prominent.

This study suggests that managers should prioritize the implementation of CSR practices, particularly at the individual level, to achieve the multidimensional outcomes associated with CSR. Additionally, leaders should exhibit sustainable behaviors and actively consider social sustainability. Given the defining role of social sustainability, especially in the healthcare sector, managers should focus on managing factors that influence it, including sustainable leadership and organizational social sustainability.

These findings contribute incrementally to the existing literature in developed countries and hold seminal value within the context where this study was conducted. The conceptual model and variable configuration utilized in this study are novel to the best of the researcher’s knowledge, further enriching the understanding of this field.

Limitations and Potential Research

This study, while valuable, acknowledges its limitations, which in turn present opportunities for further research. It is important to note that the sample of this study exclusively focused on tertiary hospitals, while the healthcare sector predominantly comprises primary and secondary healthcare facilities. As a result of distinct structures and functions, the generalizability of the findings to the entire healthcare setting may be limited. Additionally, the data collection process only involved doctors, nurses, and paramedics, excluding other important stakeholders such as medical students, pharmacists, and trainees. This omission restricts the representativeness of the samples. To enhance the inclusiveness and validity of future studies, it is recommended that researchers expand the inclusion criteria to encompass a broader range of participants.

Another limitation of this study pertains to the use of cross-sectional data, which inherently restricts the ability to establish causality between variables. To gain a comprehensive understanding of the cause-and-effect relationships and temporal effects, future researchers are encouraged to conduct longitudinal studies. By employing a longitudinal approach, a more accurate and nuanced portrayal of the relationships can be achieved.

This study’s scope is limited to the health sector of Bahrain, which restricts the generalizability of its findings. Similar research conducted in different sectors and geographic contexts may produce varied results. The authors recognize the importance of expanding similar studies to encompass diverse organizational, geographic, and economic settings to gain a deeper understanding of how these variables interact under different conditions.

Furthermore, this study reveals a relatively weak moderating effect of micro-level CSR on the relationship between sustainable leadership and social sustainability. This suggests the necessity for further exploration of this relationship. It indicates the potential involvement of other moderators, such as organizational culture, leadership styles, and organizational structure, which should be investigated in future research.

As the current study specifically focuses on exploring how micro-level CSR moderates the connection between sustainable leadership and organizational social sustainability, it would be highly valuable to include other dimensions of CSR, including environmental, economic, and philanthropic aspects. Incorporating these additional dimensions can provide a more comprehensive understanding of organizational social sustainability and the moderating factors at play.

In conclusion, this study acknowledges the limitations of its scope and encourages future research to expand into diverse contexts to enhance the applicability of its findings. Additionally, the exploration of other potential moderators and the inclusion of various CSR dimensions can contribute to a more holistic and robust understanding of organizational social sustainability and its underlying mechanisms.