Healthcare Analytics 2 (2022) 100046 Contents lists available at ScienceDirect Healthcare Analytics journal homepage: www.elsevier.com/locate/health Social capital and organizational performance: The mediating role of innovation activities and intellectual capital Ayse H. Ozgun a , Mehves Tarim a , Dursun Delen b,d,∗ , Selim Zaim c a Department of Health Administration, Marmara University, Istanbul, Turkey b Department of Management Science, Oklahoma State University, Tulsa, OK, USA c School of Engineering and Natural Sciences, Istanbul Sabahattin Zaim University, Istanbul, Turkey d Faculty of Engineering and Natural Sciences, Istinye University, Istanbul, Turkey ARTICLE INFO Keywords: Organizational performance Social capital Innovation Intellectual capital Healthcare SEM ABSTRACT While the positive influence of intellectual capital on innovation is well-established in the extant literature, re- search on how innovation activities affect intellectual capital is relatively scarce. Moreover, even though there is ample research showing the positive relationship between social capital and organizational performance, its significance is generally underappreciated by practitioners. This paper aims to contribute to the literature by investigating the influence of innovation activities on the depth of intellectual capital and the role they play in the relationship of social capital and organizational performance, using Turkish public hospitals as an exemplary application case. We argue that the activities carried out in these institutions during the innovation implementation process contribute to intellectual capital internally, with positive impacts on organizational performance. We hypothesize that social capital plays a vital role in this relationship by enhancing social interaction while fostering trust and cooperation. We formalize these ideas in a structural equation modeling framework in which innovation activities and intellectual capital serially mediate the relationship between social capital and performance and show that the implications of our model are supported by data from Turkish public hospitals. We find no evidence of a direct link between social capital and performance or between innovation activities and performance and determine that intellectual capital is the crucial link between social capital and organizational performance. 1. Introduction Attaining and sustaining superior performance is the goal of every organization, even public institutions whose ultimate goal is not neces- sarily to make a profit. The strategic management field has a plethora of theories, views, and recommendations about how to improve orga- nizational performance, and studies demonstrating the impact of the social aspects of organizations on organizational performance are by no means new, and yet we believe that they generally go unrecognized. This is true for hospitals as well, which are typically more reluctant to catch up with the developments in management systems especially if these are intangible and harder to measure [1,2]. Motivated by the inadequate attention paid to the social determi- nants of organizational performance by organizational leaders, man- agers, and policy-makers, our research investigates the influence of the social side of the organization, in other words, social capital on organizational performance and how and via which mechanism this effect is realized, in the context of hospitals operating in a union. ∗ Correspondence to: Department of Management Science and Information Systems Spears School of Business, Oklahoma State University, USA. E-mail addresses: Ayse.Ozgun@jacobs.com (A.H. Ozgun), mtarim@marmara.edu.tr (M. Tarim), dursun.delen@okstate.edu, dursun.delen@istinye.edu.tr (D. Delen), selim.zaim@izu.edu.tr (S. Zaim). URL: http://spears.okstate.edu/delen (D. Delen). To that end, we also include organizational intellectual capital and activities involved in the implementation of innovations (innovation activities) in our model, as they are important drivers of organizational performance and related to the social side of the organization. Our research is built upon and it extends on Nahapiet and Ghoshal’s [3] research on the relationship between social capital, intellectual capital, and organizational performance. We conduct our research in a union of Ministry of Health (MoH) hospitals in Turkey and investigate the influence of social capital on organizational performance and the role innovation activities and intellectual capital play in this relationship. We argue that social cap- ital will positively influence organizational performance via the serial multiple-mediation of innovation activities and intellectual capital. In Turkish MoH hospitals, even though there are some employee-initiated innovation projects and employees are encouraged to innovate, inno- vations are predominantly government-initiated. Government-initiated innovations are typically policy-led, are not internally motivated, and https://doi.org/10.1016/j.health.2022.100046 Received 24 February 2022; Received in revised form 20 March 2022; Accepted 28 March 2022 Available online xxxx 2772-4425/© 2022 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).