The purpose of this paper is to examine the mechanisms through which change-oriented leadership in hospitals influences job performance and employee job satisfaction. The authors examine the direct and the mediating effects of perceived learning demands and job involvement.This cross-sectional study is based on a survey of four public hospitals in a regional health authority in Norway.The findings illustrate how change-oriented leadership directly and indirectly influences work performance and job satisfaction. Learning demands and job involvement play mediating roles. Higher levels of change-oriented leadership decrease learning demands and increase job involvement, work performance and job satisfaction. Learning demands have a negative influence on work performance and job satisfaction. Job involvement has a positive influence on work performance and job satisfaction. The strongest relationship in the structural modelling is between change-oriented leadership and job involvement.This study is based on cross-sectional data. Future studies should therefore explore this further using a longitudinal design.The practical implication of the study is to show how leaders by change-oriented behaviour can influence work performance and job satisfaction by reducing learning demands and increasing job involvement.This study illustrates different paths towards influencing job performance and job satisfaction from change-oriented leadership. It is important to use the potential of reducing learning demands and increasing job involvement, to improve job performance and job satisfaction.The authors have developed and validated a new theoretical mediational model explaining variance in job performance and job satisfaction, and how this is related to change-oriented leadership, job involvement and learning demands. This knowledge can be used to increase the probability of successful change initiatives.