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High performance work systems: the gap between policy and practice in health care Background Studies of high-performing organisations have consistently reported a positive relationship between high performance work systems (HPWS) and performance outcomes. Although many of these studies have been conducted in manufacturing, similar findings of a positive correlation between aspects of HPWS and improved patient outcomes have been reported in international health care studies. Aim The aim of this paper is to bring together the results from a series of studies conducted within Australian health care organisations. First, we demonstrate the link we have found between high performance work systems and organisational performance, including the perceived quality of patient care. Second, we show that the hospitals we studied do not have the necessary aspects of HPWS in place. Method