The Effect of High-Performance systematic Work Systems Practices on Patient Care Quality, Given the Mediating Role of Social Identity and Trust in Organization Mechanisms

Articles in Press

Document Type : Research Article

Authors

samaneh sadeghian ¹

seyedeh zahra fatemi ²

¹ Assistant Professor of Department of Management, Faculty of Economics and Administrative Sciences, Ferdowsi University of Mashhad, Mashhad, Iran

² Assistant Professor of Management, Management Department, Tabaran Institute of Higher Education, Mashhad, Iran

10.22067/jstinp.2026.95468.1183

Abstract

In the healthcare sector, patient care quality is a key factor in service differentiation and depends on the workforce that delivers the service. Using a systems-theory lens, this study examines how HPWS, group identity, and organizational trust interact through endogenous feedback to influence patient care quality across hospital subsystems. The study was conducted to measure the impact of human resource practices on the quality of services provided to patients. The study population consisted of 4,352 nurses working in eight major hospitals in Mashhad. Using Cochran’s formula for a finite population, a sample size of 353 was determined. Data were collected using questionnaires distributed among nurses selected through cluster sampling. The instruments included the HPWS index of Zacharatos et al. (2005), the Group Identity Scale of Hinkle et al. (1989), the trust measure of Gabarro and Athos (1976), and the patient care quality scale of Boquiren et al. (2015). Structural equation modeling (SEM) was used to test the hypotheses. The results showed that HPWS had a significant effect on group identity and trust, and that both group identity and trust influenced patient care quality. Overall, HPWS affected patient care quality both directly and indirectly through group identity and trust.

Keywords

High-Performance Work Systems (HPWS)

Trust in Organization

social (group) identity

patient care quality

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