Abstract

Problem Statement: Organisational change research has largely treated time as linear and homogeneous, ignoring the rhythmic, socially constructed nature of temporal processes. In healthcare, multiple overlapping rhythms (shift cycles, patient flows, reporting deadlines) create complex temporal landscapes. The degree to which leadership behaviours align with existing cultural rhythms may determine the success or failure of transformation, yet this mechanism remains unexplored. This protocol describes a planned longitudinal investigation designed to address this gap.

Aims: This study protocol aims to examine whether leadership-cultural entrainment, the degree of temporal coordination between leadership behaviours and culture emergence, predicts transformation outcomes in a healthcare Complex Adaptive System (CAS). The study tests five hypotheses about entrainment measurement, entrainment-outcome relationships, mis-entrainment consequences, critical windows for intervention timing, and entrainment evolution over time.

Methods: We will implement a 24-month longitudinal time-series design in a Malaysian private healthcare organisation (n = 200 staff). We will administer the MLQ-5X and OCAI every 8 months (4 waves). We will collect temporal rhythm diaries during two-week periods preceding each wave. Semi-structured interviews (n = 30 per wave, approximately 120 total) will capture perceived changes in rhythm. Spectral analysis, wavelet transform, and phase synchronisation analysis will identify entrainment patterns, with cross-correlation and Random-Intercept Cross-Lagged Panel Models (RI-CLPM) serving as primary analytical techniques for the four-wave data.

Anticipated Findings: Higher leadership-cultural entrainment (phase synchronisation, periodicity matching) is expected to predict greater cultural adaptability. The 8-month measurement cadence is designed to align with natural entrainment points (e.g., strategic planning cycles), enabling the detection of critical windows when interventions produce amplified effects. Miss-entrainment is expected to generate resistance and change fatigue.

Conclusion: This protocol proposes temporal entrainment as a CAS mechanism linking leadership to cultural emergence. If the hypothesised relationships are supported, developing temporal leadership competencies may improve transformation outcomes in complex healthcare environments. The planned empirical investigation will provide the longitudinal test of these propositions.

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