HPWS and Employee Outcomes among Healthcare Professionals: The Moderating Role of Organizational Justice, and the Mediating Role of Employee Engagement in Shaping Employee Performance and OCB

Abstract

In an ever-evolving, high-demand, and resource-constrained healthcare environment, it is imperative that healthcare administrators and policy makers understand both theoretically and practically the influence of organizational practices on employees’ behaviour. This study, drawing on Resource-Based View (RBV), AMO-Framework, JD-R Model, and Social Exchange Theory (SET), examines the impact of High-Performance Work Systems (HPWS) on healthcare professionals’ performance and organizational citizenship behaviour (OCB), with employee engagement serving as a mediating mechanism. Furthermore, the moderating effects of organizational justice on the relationship between HPWS and employee engagement. The research contributes to achieving SDG 3, SDG 8, SDG 10, and SDG 16. The survey Data was collected from a sample of 500 healthcare professionals (medical doctors and nurses) across public and private hospitals in five purposively selected cities of Pakistan. The test of hypothesized relationships was performed using PLS-SEM method and applying SmartPls 4 software. The results revealed that employee engagement significantly partially mediates the relationship between HPWS and both employee performance and OCB. Additionally, the strength of HPWS-Engagement link is contingent upon organizational justice, suggesting that justice-driven engagement enables HPWS to foster employees’ performance and citizenship behaviour. The study findings contribute to SHRM and OB literature by foregrounding the underlying socio-psychological mechanism through which HPWS drives sustainable employee behaviours in healthcare settings. It further highlights the role of strategic HR practices in advancing the UN 2030 Agenda, linking inclusive management, employee well-being, and institutional stability supporting the SDG 3, SDG8, SDG 10, and SDG 16.