Abstract
The purpose of this study is to empirically test the effects of high-performance work systems (HPWS) on employee attitude, service quality, customer satisfaction, and customer loyalty in health-care organisations. The proposed research model was tested using structural equation modelling for hypotheses, based on data collected from 196 pairs of employee–customer respondents in four selected hospitals with more than 500 beds. The results indicate that hospitals can improve customer satisfaction and loyalty through efficient operations, employee engagement, and service quality. One of the key findings of our study is that HPWS in health-care organisations influence employee reaction and service quality.