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Purpose Following an “employee-centric” approach, the purpose of this paper is to examine the effects of high-performance work systems (HPWS) on employees’ work engagement and job satisfaction, and the mediating effect of these variables on employees’ affective commitment and intention of leaving their hospital. Design/methodology/approach Structural equation modeling was used on a sample of 296 clinicians (doctors and nurses) across seven Greek regional hospitals. Findings The findings indicate a strong positive effect of HPWS on employees’ job satisfaction, affective commitment, and work engagement and a negative effect on their intention to leave. In addition, employees’ engagement and job satisfaction positively mediate the HPWS effects on employees’ affective commitment and negatively on their intention to leave. Practical implications The findings not only validate previous studies’ conclusions, but also provide evidence for the potential fruitfulness of the HPWS approach in improving employees’ outcomes and well-being in turbulent times. Originality/value Although the argument that HPWS has a positive effect on organizational performance and productivity is well established, there are considerably fewer studies that examine the positive effects of HPWS specifically on employees’ job attitudes and outcomes, and the processes through which HPWS influences health-related outcomes. 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.
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