<![CDATA[The post-pandemic healthcare transformation demands that hospitals consistently maintain the quality of inpatient services amidst increasing patient needs and healthcare workforce dynamics. As a referral center in North Toraja, Elim Rantepao Hospital faces challenges regarding high Bed Occupancy Rates (BOR) and patient complaints, highlighting the crucial need to balance workload management with nurse competency enhancement. This study aims to examine and analyze the direct and indirect effects of nurse workload and competency-based training on the quality of inpatient services, with organizational commitment serving as an intervening variable. A quantitative causal-associative approach with a cross-sectional design was employed. The study population comprised 117 inpatient nurses at Elim Rantepao Hospital, from which a sample of 91 nurses was selected using simple random sampling via Slovin’s formula. Primary data were collected through structured questionnaires using a 1–5 Likert scale. Data analysis was executed using Variance-Based Structural Equation Modeling (PLS-SEM) via SmartPLS version 4.1.6.6. Structural model analysis revealed that Competency-Based Training has a positive and highly significant direct effect on Service Quality (; ; ; ). Conversely, Nurse Workload showed no significant effect on Service Quality (; ), nor did Organizational Commitment (; ). Furthermore, neither Workload nor Competency-Based Training significantly influenced Organizational Commitment, and Organizational Commitment failed to act as a mediating variable in the structural framework. The quality of inpatient care at Elim Rantepao Hospital is overwhelmingly driven by nurses' clinical capabilities and professional skills developed through targeted training, rather than routine workload levels or organizational commitment. Consequently, hospital management should prioritize a structured competency training roadmap to sustain high-quality patient care.]]>
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