Organisational change in any organisation, including the healthcare industry, implies a change in organisational culture. The concept of organisational culture refers to those values and norms within an organisation that are prescribed by both the employer and the employees as to how to behave. However, organisational culture should not be viewed in isolation, as culture and leadership are intertwined. Transformational leadership within an organisational culture serves to achieve its goal, missions and aims by influencing, motivating and creating a mutual relationship between employees and employers, which brings about effective organisational change. The alignment of organisational culture and leadership with a hospital’s vision is important to ensure optimal healthcare delivery and organisational change outcomes. A positivistic research paradigm, with a quantitative, explorative, descriptive and contextual approach, was used to conduct the research study. The research study explored whether a supportive organisational culture, transformational leadership and organisational change outcomes were prevalent in public intensive care units. Secondly, the study aimed to investigate the relationship between organisational culture, transformational leadership and organisational change outcomes in public intensive care units in the Nelson Mandela Bay. Data was collected by means of a structured and previously validated questionnaire with a Cronbach’s alpha of more than 0.80. The target population was registered nurses who work in the intensive care units in the public hospitals. The sample was composed of 56 registered nurses and 4 enrolled nurses who were selected from public hospital intensive care units in Nelson Mandela Bay. Descriptive statistics, linear regression analysis, correlation and a Chi-square test were used to describe the hypothesised relationship between organisational culture and transformational leadership (independent) with organisational change outcomes (dependent variable). The results of this study revealed that the alternative hypothesis was accepted as the P value, was less than 0.05 in all variables. This proved that there was a significant relationship between organisational culture, transformational leadership and organisational change outcomes in the public intensive care units which were sampled. Recommendations are made as to how organisational culture can enhance and support transformational leadership and organisational change outcomes to promote a positive change outcome in public intensive care units. Ethical considerations were maintained throughout the research study.