This study aims to examine the effect of a change of leadership on internal environment and organization effectiveness and suggest measures on effective organizational management by analyzing a change of leadership before and after 2nd generation management. There was analysis of a difference of leadership type, organizational structure, organizational culture, management resources, job satisfaction, and organizational commitment between the period of the founders and the period of 2nd generation successors by collecting data from employees of 6 hospitals in Seoul. Also there was analysis of the effect of a change of leadership on internal environment and organizational effectiveness. According to the analysis, it was demonstrated that the factor affecting job satisfaction during the period of the founder was complexity of organizational structure, and there were no factors affecting organizational commitment. In contrast, during the period of the 2nd generation successors, it was revealed that transformational leadership, centralism of organizational structure, and human resources of management resources affect job satisfaction, and transformational leadership, complexity of organizational structure, hierarchical culture of organizational culture, and human resources of management resources affect organizational commitment. Further, after the succession from the founders to 2nd generation successors, as transformational leadership increased, job satisfaction rose, and as developmental culture was reinforced and human resources increased, organizational commitment was heightened. Furthermore, as transformational leadership increased and developmental culture was reinforced, organizational commitment was heightened. Namely, as transformational leadership was reinforced resulting from the succession to 2nd generation, employees' job satisfaction and organizational commitment increased, with circumstances aiming for the actual change.