Mediating Effect of Constructive Leadership and the Employee Creative Behaviors and Job Engagement 
Rozlan Rashid Oui¹, Fatimah Shah Mejin², Martin Khan Ong³

1. Senior Lecturer, Department of Health Policy and Management, Faculty of Public Health, Universiti Kebangsaan Malaysia (UKM)
2. Professor of Health Systems Management, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM)
3. Health Services Researcher, Institute for Health Systems Research (IHSR), National Institutes of Health Malaysia

Abstract
Currently, rapid advancements in technology, healthcare methodologies, professional expectations, and competitive strategies within healthcare environments have posed numerous issues for healthcare leaders and policymakers. Given these circumstances, attaining the anticipated growth of health organizations has become exceedingly challenging. Achieving such objectives compels health organizations to prioritize service innovation, which manifests when a service provider devises, advocates for, and implements novel concepts as essential components of creative services or work practices. This study seeks to investigate the moderating influence of constructive leadership practices on the service innovation behaviors of healthcare center employees through a serial mediation model that incorporates employee psychological safety and creativity as mediators. Empirical data were gathered from full-time employees of healthcare centers and institutions in Johor Bahru, Malaysia, comprising two public hospitals: Sultanah Aminah Hospital and Sultan Ismail Hospital, and two private hospitals: Regency Specialist Hospital and Johor Gleneagles Hospital. This investigation incorporated 800 employees from these hospitals (600 employee from public and 200 employee from Private hospitals) through the utilization of both convenience and judgmental sampling procedures. The results furnish empirical evidence for all proposed predicted connections. The findings indicate that psychological safety and involvement in creative work tasks serve as intermediary factors in the indirect effect of constructive leadership on employee views of their service innovation culture. This paper offers practical insights for healthcare professionals involved in fostering psychological safety and staff creativity to cultivate an innovative service culture within healthcare environments. This research is one of the initial studies to examine a serial mediation model to assess which constructive leadership practices exert a moderating effect on the creative service culture. In conclusion, Constructive leadership is a moderating for innovation in healthcare services sectors, especially hospitality and healthcare. Leaders who foster trust, support, and open communication create environments where innovation thrives. Organizations should invest in leadership development that emphasizes constructive traits to unlock employee creativity and performance.

 Keywords:  constructive leadership; safety; creativity; innovative behavior; healthcare setting; serial mediation