Journal of healthcare management / American College of Healthcare Executives · 2026
Fostering Innovation in Nursing Teams: Entrepreneurial Leadership, Intrapreneurship, and Innovative Behaviors in Healthcare.
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Martins Maria de Lurdes da Costa, Teixeira Jorge Miguel Guedes, Carvalho Rui Miguel Barros Cunha, Marta Lília Marisa Gonçalves
Аннотация
GOAL: This study examines how entrepreneurial leadership influences intrapreneurship among registered nurses through the mediating roles of innovative leader behavior and individual entrepreneurial orientation. The study also aims to clarify the mechanisms through which leadership promotes innovation within healthcare organizations.
METHODS: A cross-sectional study was conducted with 760 registered nurses working in public and private healthcare institutions in Portugal. Data were collected through an anonymous online survey. Entrepreneurial leadership, innovative leader behavior, individual entrepreneurial orientation, and intrapreneurship were measured using validated instruments. Partial least squares structural equation modeling (PLS-SEM) was used to test the hypothesized relationships and mediation effects.
PRINCIPAL FINDINGS: Entrepreneurial leadership was positively associated with innovative leader behavior and individual entrepreneurial orientation. Innovative leader behavior emerged as the strongest predictor of intrapreneurship. Innovative leader behavior and individual entrepreneurial orientation significantly mediated the relationship between entrepreneurial leadership and intrapreneurship. The findings indicate that entrepreneurial leadership promotes intrapreneurship primarily through leaders' visible innovative actions, while individual entrepreneurial orientation provides an additional, though smaller, contribution.
PRACTICAL APPLICATIONS: Healthcare executives and nurse managers can strengthen intrapreneurship by fostering entrepreneurial leadership and encouraging leaders to model innovative behaviors. Leadership development programs should emphasize innovation, autonomy, experimentation, and opportunity recognition. Creating psychologically safe work environments and recognizing innovative contributions may enhance nurses' entrepreneurial engagement and support organizational adaptability, service improvement, and long-term innovation capacity.
METHODS: A cross-sectional study was conducted with 760 registered nurses working in public and private healthcare institutions in Portugal. Data were collected through an anonymous online survey. Entrepreneurial leadership, innovative leader behavior, individual entrepreneurial orientation, and intrapreneurship were measured using validated instruments. Partial least squares structural equation modeling (PLS-SEM) was used to test the hypothesized relationships and mediation effects.
PRINCIPAL FINDINGS: Entrepreneurial leadership was positively associated with innovative leader behavior and individual entrepreneurial orientation. Innovative leader behavior emerged as the strongest predictor of intrapreneurship. Innovative leader behavior and individual entrepreneurial orientation significantly mediated the relationship between entrepreneurial leadership and intrapreneurship. The findings indicate that entrepreneurial leadership promotes intrapreneurship primarily through leaders' visible innovative actions, while individual entrepreneurial orientation provides an additional, though smaller, contribution.
PRACTICAL APPLICATIONS: Healthcare executives and nurse managers can strengthen intrapreneurship by fostering entrepreneurial leadership and encouraging leaders to model innovative behaviors. Leadership development programs should emphasize innovation, autonomy, experimentation, and opportunity recognition. Creating psychologically safe work environments and recognizing innovative contributions may enhance nurses' entrepreneurial engagement and support organizational adaptability, service improvement, and long-term innovation capacity.