Purpose: This study examines the effect of organizational culture and service quality on patient loyalty, with patient satisfaction as a mediating variable. The research focuses on Siloam Kupang General Hospital, where improving service quality and cultivating a strong culture are essential for sustaining patient loyalty in a competitive healthcare environment. Methodology: A quantitative approach using Partial Least Squares–Structural Equation Modeling (PLS-SEM) was applied to data collected from 200 outpatients through structured questionnaires. Four latent variables organizational culture, service quality, patient satisfaction, and patient loyalty were analyzed using SmartPLS 4. Results: The findings reveal that both organizational culture (? = 0.293; p < 0.001) and service quality (? = 0.306; p = 0.001) significantly influence patient loyalty. Patient satisfaction also has a significant effect on loyalty (? = 0.294; p = 0.001) and mediates the relationships between organizational culture and loyalty (? = 0.141; p = 0.006), as well as between service quality and loyalty (? = 0.097; p = 0.034). The model demonstrates substantial explanatory power (R² = 0.633) and high predictive relevance (Q² = 0.462). Conclusion: Strengthening organizational culture and improving service quality are key strategies to enhance patient satisfaction and loyalty. Hospitals should prioritize patient-centered values, effective communication, and responsive services to build lasting trust. Limitations: The study is limited to a single hospital and a specific patient group, restricting generalizability. Contribution: This research extends the understanding of mediating mechanisms between culture, service quality, and loyalty, offering managerial insight for hospital service excellence and patient retention strategies.

Purpose: This study aims to analyze the challenging factors in the digital transformation of public service complaint management through the SP4N-LAPOR! Application at the Ombudsman of the Republic of Indonesia. Methodology/approach: The research adopts a quantitative approach, collecting data through interviews and questionnaires from employees/assistant managers of SP4N-LAPOR! at the Ombudsman of the Republic of Indonesia. Exploratory Factor Analysis (EFA) serves as the analytical method to identify the primary factors influencing difficulties and challenges in the digital transformation process. Results/findings: The analysis reveals several challenging factors in the digital transformation of managing public service complaints through the SP4N-LAPOR! Application at the Indonesian Ombudsman. The identified challenge factors, ranging from the most dominant to less prominent, include Digital Capability, Information Network Systems, Complaint Management, Digital Solutions, Leadership 4.0, Business Ecosystem, Integrated Regulation, Digital Talent, Digital Conversion and Digital Implementation. Conclusion: Digital transformation of complaint management at the Ombudsman of Indonesia faces major challenges, notably limited digital capability (34.93%), hindering SP4N-LAPOR! implementation effectiveness and overall public service efficiency. Limitations: This research aimed to identify factors challenging the digital transformation of public service complaint management, providing a foundation for future studies to develop effective strategies for improvement. However, the study’s respondents were limited to employees or assistants of the Ombudsman of the Republic of Indonesia, restricting broader generalization. Contribution: This article contributes to a comprehensive understanding of critical aspects essential for improving the implementation of digital transformation in managing public service complaints.