Unboxing the high-performance work systems causal chain in promoting healthcare quality: empirical evidence from Indian healthcare

Purpose Underscoring the importance of employee centred high-performance work systems (HPWS) research and the dynamic healthcare service environments, this study aims at examining the effect of HPWS on quality of care (QC) in a HR causal chain process. Highlighting the need for exploring HPWS black-box in the healthcare settings, a comprehensive framework with the mediating roles of employee attitudes and behaviours in the HPWS–QC relationship is studied in the Indian healthcare context. Design/methodology/approach Several Partial Least Squares – Structural Equation Modelling (PLS-SEM) techniques have been applied on a sample of 407 medical professionals of six Indian tertiary care hospitals. Findings From the empirical evidence, it is found that HPWS has a positive and significant impact on QC. Two paths in the HPWS–QC relationship passing via work engagement, affective commitment and Organizational Citizenship Behaviour (OCB) have partially mediated in a serial path, whereas the path via job satisfaction and OCB is insignificant. Originality/value As a pioneering HPWS study in the Indian healthcare industry, the study provides empirical evidence that helps in promoting the healthcare quality by unravelling the underlying causal relationships in HPWS black-box mechanism in a HR causal chain process.