Public referral hospitals in Kenya face persistent performance challenges, including inefficient service delivery, resource constraints, and staff shortages that undermine their healthcare mandate. This study assessed the influence of management strategies, leadership style, strategic orientation, staff competencies, and technology integration, on the organizational performance of Kenyatta National Hospital (KNH). Using a descriptive research design, data were collected from a sample of 357 respondents and analyzed using descriptive, correlation, and regression techniques. The results revealed that all four management strategies positively influenced performance, with strategic orientation emerging as the strongest predictor, followed by staff competencies, technology integration, and leadership style. Collectively, the variables explained 53.8% of the variance in performance. The study concludes that a synergistic approach to strengthening these strategies is crucial for improving hospital efficiency and service quality. It recommends blended leadership styles, evidence-based strategic planning, capacity building, and digital transformation to enhance institutional performance.