High performance work systems HPWS are integrated human resource approaches designed to enhance employees' skills and efforts, resulting in higher levels of performance and productivity (Zhu, et al., 2018). The major components of HPWS include selective hiring procedures, employment security, decentralization of decision-making, extensive training, information exchange, and fair paying, all of which are interconnected and work in concert (Zhang et al., 2019). Performance is increased when HPWS is employee service-oriented, while morale and employee retention ER are increased when HPWS is creativity-oriented (Jo et al., 2023). HPWS is more efficient than traditional organizational systems, nevertheless, it is yet unclear how this happens. Multiple studies have produced conflicting findings, and some even contend that HPWS may increase employee effort and stress (Jensen et al., 2022; Cooke et al., 2019). There is a gap on previous researches explaining how HPWS can help translate EPB, JE, and EP into better ER outcomes and whether this relationship differs depending on the organizational setting or the industries, these connections need to be explored further in order to find practical methods improve organizational capacity for employee retention. In accordance with Vision 2030 and the (National Transformation Program) the Saudi government is increasing the private sector's contribution to the nation's healthcare system (Rahman & Al-Borie, 2021).Even though a lot of work has been put into HPWS, there are still large research gaps in Saudi Arabia.So this study is enhancing the current knowledge by examining possible mediators (i.e., EPB, JE, and EP) between HPWS and ER helps further knowledge of the function of HPWS in the Saudi Arabian healthcare system in light of Vision 2030. Keywords: High performance work system, Employee Proactive Behaviour, Job engagement, Employee performance, Employee retention
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