Modeling patient care quality: an empirical high-performance work system approach

Purpose Following a social identity approach focussed in the Greek healthcare sector, the purpose of this paper is to investigate the mediating effects of social identification on the relationship between high-performance work systems (HPWS) and psychological empowerment, and the mediating role of psychological empowerment between HPWS and quality of patient care. Design/methodology/approach Partial least squares-structural equation modeling was used in a sample of 297 nurses, doctors, and allied health professionals across seven hospitals in Greece. Findings The findings suggest that HPWS has a strong effect on healthcare professionals’ social identification, which in turn partially mediates the relationship between HPWS and psychological empowerment. In addition, psychological empowerment indirectly mediates the relationship between HPWS and quality of patient care. Practical implications The findings not only validate previous studies’ conclusions, but also provide evidence for the potential fruitfulness of the HPWS approach from a social identity perspective. In addition, it is also confirmed that without the presence of psychological empowerment, HPWS may have limited impact on the quality of patient care. Originality/value Although HPWS have been generally connected with positive employee attitudes and behaviors, few studies choose to follow a social identity approach in examining these relationships. Finally, this study confirms the argument that HPWS can be a fruitful approach even in a country severely affected by Europe’s debt crisis over the last five years.