PSYCHOLOGICAL SAFETY, STRATEGIC HR PRACTICES, AND EMPLOYEE ENGAGEMENT: EVIDENCE FROM HEALTHCARE ORGANIZATIONS
DOI:
https://doi.org/10.29121/shodhkosh.v7.i7s.2026.7931Keywords:
Psychological Safety, Strategic Hr Practices, Employee Engagement, Healthcare Organizations, Work EnvironmentAbstract [English]
This study examines the role of psychological safety in linking strategic human resource (HR) practices with employee engagement in healthcare organizations. The research adopts a cross-sectional, quantitative design grounded in organizational psychology. Data were collected through a survey of employees working in hospitals and clinics under the Ghana Health Service and the Christian Health Association of Ghana. A total of 213 valid responses were analyzed using descriptive statistics, regression analysis, and mediation testing.
The findings reveal that strategic HR practices are positively correlated with employee engagement and have a significant positive effect on employees’ perceptions of psychological safety. Psychological safety is identified as a strong predictor of employee engagement and partially mediates the relationship between strategic HR practices and engagement. These results suggest that HR practices enhance engagement levels, particularly when they foster a psychologically safe work environment where employees feel comfortable sharing ideas, concerns, and opinions without fear of negative consequences.
The study contributes to the field of organizational psychology by highlighting psychological safety as a key psychosocial mechanism linking organizational practices and employee attitudes, especially within high-demand healthcare settings.
References
Abu‐Farha, R. K., Alzoubi, K. H., Al Safadi, A. a., Alsous, M. M., Nawasreh, A., El‐zubi, M. K., & Al‐Ashwal, F. Y. (2026). Exploring Physicians' Willingness to Integrate Artificial Intelligence in Clinical Practice: Ethical and Practical Insights From a Jordanian Cross‐Sectional Survey. Health Science Reports, 9(3), e71994.
Adekanmbi, F., & Ukpere, W. (2022). Sustaining organizational performance and employee wellbeing in the 4IR: the impact of leadership 4.0, PSYCAP, and high-performance HR practices. EUREKA: Social and Humanities. https://doi.org/10.21303/2504-5571.2022.002403
Afram, K. O.-A. O. (2021). Effect of Human Resource Development (HRD) Initiatives on Organizational Performance. A Case Study of the National Health Insurance Authority, Ghana. Journal of Resources Development and Management. https://doi.org/10.7176/jrdm/81-04
Alkasasbeh, A. M., Jarrah, S. S., Alhusamiah, B. K., & Tarawneh, F. S. (2025). Factors influencing the utilization and adoption of electronic health records among nurses in Jordanian hospitals. Jordan Journal of Nursing Research, 4(1), 68-80.
Alolayyan, M. N., Alyahya, M. S., & Omari, D. A. (2021). Strategic human resource management practices and human capital development: The role of employee commitment. Problems and Perspectives in Management, 19, 157-169. https://doi.org/10.21511/ppm.19(2).2021.13
Aman‐Ullah, A., Ibrahim, H., Aziz, A., & Mehmood, W. (2022). Impact of workplace safety on employee retention using sequential mediation: evidence from the health-care sector. RAUSP Management Journal. https://doi.org/10.1108/rausp-02-2021-0043
Annan-Prah, E., & Andoh, R. (2023). Effects of customised capacity building on employee engagement, empowerment, and learning in Ghanaian local government institutions. Public Administration and Policy. https://doi.org/10.1108/pap-06-2022-0068
Ansoglenang, G. (2020). Exploring Recruitment and Selection Practices of Ghanaian Organisations. European Journal of Business and Management, 12, 12-20. https://doi.org/10.7176/ejbm/12-12-02
Arthur-Mensah, R., Paintsil, G. P., Delali, A. A., & Kyei, A. (2022). Mental Health Outcomes and Mental Hygiene in the COVID-19 Era: A Cross-Sectional Study Among Healthcare Workers from a Regional Hospital in Ghana. Psychology Research and Behavior Management, 15, 21-30. https://doi.org/10.2147/prbm.s337740
Bahadurzada, H., Edmondson, A., & Kerrissey, M. (2024). Psychological Safety as an Enduring Resource Amid Constraints. International Journal of Public Health, 69. https://doi.org/10.3389/ijph.2024.1607332
Beltrán‐Martín, I., Guinot-Reinders, J., & Rodríguez-Sánchez, A. (2022). Employee psychological conditions as mediators of the relationship between human resource management and employee work engagement. The International Journal of Human Resource Management, 34, 2331-2365. https://doi.org/10.1080/09585192.2022.2078990
Daniels, K., Watson, D., Nayani, R., Tregaskis, O., Hogg, M., Etuknwa, A., & Semkina, A. (2021). Implementing practices focused on workplace health and psychological wellbeing: A systematic review. Social science & medicine, 277, 113888. https://doi.org/10.1016/j.socscimed.2021.113888
Daraojimba, A. I., Jason, A., Kess, M., Tubokirifuruar, S., Bello, B. G., & Omotoye, G. B. (2024). Strategic human resource management in the 21st century: A review of trends and innovations. World Journal of Advanced Research and Reviews. https://doi.org/10.30574/wjarr.2024.21.1.0105
Darko, J. O., Bediako, V. A., & Tawiah, H. O. (2023). Impacts of Emotional Labour on Employee Retention in The Health Sector. Organization and Human Capital Development. https://doi.org/10.31098/orcadev.v2i2.1817
Darko, R., Oppong, N., & Mensah, A. O. (2020). Health and Safety Practices and Work Attendance in a Ghanaian Health Service. Journal of Business and Enterprise Development. https://doi.org/10.47963/jobed.2020.03
Fu, Q., Cherian, J., Ahmad, N., Scholz, M., Samad, S., & Comite, U. (2022). An Inclusive Leadership Framework to Foster Employee Creativity in the Healthcare Sector: The Role of Psychological Safety and Polychronicity. International Journal of Environmental Research and Public Health, 19. https://doi.org/10.3390/ijerph19084519
Gile, P., Van De Klundert, J., & Buljac-Samardžić, M. (2022). Strategic human resource management and performance in public hospitals in Ethiopia. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.915317
Grailey, K., Murray, E., Reader, T., & Brett, S. (2021). The presence and potential impact of psychological safety in the healthcare setting: an evidence synthesis. BMC Health Services Research, 21. https://doi.org/10.1186/s12913-021-06740-6
Hu, Q., Dollard, M., & Taris, T. (2022). Organizational context matters: Psychosocial safety climate as a precursor to team and individual motivational functioning. Safety Science. https://doi.org/10.1016/j.ssci.2021.105524
Hunt, D., Bailey, J., Lennox, B., Crofts, M., & Vincent, C. (2021). Enhancing psychological safety in mental health services. International Journal of Mental Health Systems, 15. https://doi.org/10.1186/s13033-021-00439-1
Jones, A., Blake, J., Adams, M., Kelly, D., Mannion, R., & Maben, J. (2021). Interventions promoting employee "speaking-up" within healthcare workplaces: A systematic narrative review of the international literature. Health policy. https://doi.org/10.1016/j.healthpol.2020.12.016
Keltu, T. T. (2024). The effect of human resource development practice on employee performance with the mediating role of job satisfaction among Mizan Tepi University's academic staff in Southwestern Ethiopia. Heliyon, 10. https://doi.org/10.1016/j.heliyon.2024.e29821
Li, M., Fu, N., Chadwick, C., & Harney, B. (2023). Untangling human resource management and employee wellbeing relationships: Differentiating job resource HR practices from challenge demand HR practices. Human Resource Management Journal. https://doi.org/10.1111/1748-8583.12527
Lintanga, A. J. B. J., & Rathakrishnan, B. (2024). The impact of psychosocial safety climate on public sector job satisfaction: the moderating role of organizational climate. BMC Psychology, 12. https://doi.org/10.1186/s40359-023-01513-8
Lu, Y., Zhang, M., Yang, M., & Wang, Y. (2022). Sustainable human resource management practices, employee resilience, and employee outcomes: Toward common good values. Human Resource Management. https://doi.org/10.1002/hrm.22153
McClintock, A., & Fainstad, T. (2022). Growth, Engagement, and Belonging in the Clinical Learning Environment: the Role of Psychological Safety and the Work Ahead. Journal of General Internal Medicine, 37, 2291-2296. https://doi.org/10.1007/s11606-022-07493-6
Miao, R., Lu, L., Cao, Y., & Du, Q. (2020). The High-Performance Work System, Employee Voice, and Innovative Behavior: The Moderating Role of Psychological Safety. International Journal of Environmental Research and Public Health, 17. https://doi.org/10.3390/ijerph17041150
Mitterer, D., & Mitterer, H. (2023). The Mediating Effect of Trust on Psychological Safety and Job Satisfaction. Journal of Behavioral and Applied Management. https://doi.org/10.21818/001c.73642
Molnár, C., & Papp, I. C. (2023). Review of Human Resource Management Practices Supporting the Development of Employee Wellbeing. Új Munkaügyi Szemle. https://doi.org/10.58269/umsz.2023.3.2
Muah, P., Adu, I. N., Kyei-Frimpong, M., & Boakye, A. (2021). Explaining How Management Safety Practices and Safety Programs Influence Job Safety and Employee Commitment. SEISENSE Business Review. https://doi.org/10.33215/sbr.v1i3.709
Obeng, A. F., Zhu, Y., Quansah, P. E., Ntarmah, A., & Cobbinah, E. (2021). High-Performance Work Practices and Turnover Intention: Investigating the Mediating Role of Employee Morale and the Moderating Role of Psychological Capital. SAGE Open, 11. https://doi.org/10.1177/2158244020988557
Obeng, H., Arhinful, R., Tessema, D. H., & Nuhu, J. A. (2025). The mediating role of organisational stress in the relationship between gender diversity and employee performance in Ghanaian public hospitals. Future Business Journal. https://doi.org/10.1186/s43093-025-00463-4
Othman, E. H., Alosta, M. R., Nofal, B., Masadeh, A., Darawad, M. W., Sabra, M. A. A., & Alshareef, A. (2025). Shift work and health behaviors: Cross-sectional analysis of sleep quality, physical activity, and dietary patterns. Acta Biomedica, 96(2).
Özdemir, Ş., & Şahin, N. (2024). THE MEDIATING ROLE OF PERCEIVED PSYCHOLOGICAL SAFETY IN THE EFFECT OF HEALTH-ORIENTED LEADERSHIP ON ORGANIZATIONAL COMMITMENT: A HOSPITAL SAMPLE. Kafkas Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi. https://doi.org/10.36543/kauiibfd.2024.017
Platania, S., Morando, M., Caruso, A., & Scuderi, V. (2022). The Effect of Psychosocial Safety Climate on Engagement and Psychological Distress: A Multilevel Study on the Healthcare Sector. Safety. https://doi.org/10.3390/safety8030062
Prabakar, S. (2023). The Role of Human Resource Management in Talent Acquisition and Retention in the Healthcare Sector. Journal of Informatics Education and Research. https://doi.org/10.52783/jier.v3i2.279
Rabiul, M. K., Mohamed, A., Patwary, A. K., Yean, T. F., & Osman, S. Z. (2021). Linking human resources practices to employee engagement in the hospitality industry: the mediating influences of psychological safety, availability and meaningfulness. European Journal of Management and Business Economics. https://doi.org/10.1108/ejmbe-12-2020-0347
Saleh, N., Rizik, M., Zawiah, M., & Abu-Farha, R. K. (2026). Community pharmacists’ perceptions of mental health care: A qualitative study on stigma and barriers. Journal of Health Psychology, 31(1), 41-51.
Subih, M., Rababa, M., Aryan, F. S., Alnaeem, M., AlRahahleh, M. H., Al Niarat, T. F., Saleh, Z. T., Alsulami, G. S., Almagharbeh, W. T., & Elshatarat, R. A. (2025). Factors influencing nurses’ knowledge and competence in warfarin-drug and nutrient interactions and patient counseling practices. BMC Medical Education, 25(1), 540.
Tawiah, P., Appiah-Brempong, E., Okyere, P., Adu-Fosu, G., & Ashinyo, M. (2024). Prevalence, risk factors and psychological consequences of workplace violence among health workers in the Greater Accra region, Ghana: a cross-sectional study. BMC Public Health, 24. https://doi.org/10.1186/s12889-024-17962-8
Tenza, I., Attafuah, P., Abor, P., Nketiah-Amponsah, E., & Abuosi, A. (2022). Hospital managers’ views on the state of patient safety culture across three regions in Ghana. BMC Health Services Research, 22. https://doi.org/10.1186/s12913-022-08701-z
Tetteh, I., Jones, A., Kelly, D., & Courtier, N. (2022). Speaking-up for patient safety: A scoping narrative review of international literature and lessons for radiography in Ghana and other resource-constrained settings. Radiography, 28 4, 919-925. https://doi.org/10.1016/j.radi.2022.06.018
Wang, W., Kang, S.-W., & Choi, S. (2022). Servant Leadership and Creativity: A Study of the Sequential Mediating Roles of Psychological Safety and Employee Well-Being. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.807070
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Michael K. Mickson, Emmanuel Asamoah, Dr. Michael Kubi, Timothy Kwabla Zilevu

This work is licensed under a Creative Commons Attribution 4.0 International License.
With the licence CC-BY, authors retain the copyright, allowing anyone to download, reuse, re-print, modify, distribute, and/or copy their contribution. The work must be properly attributed to its author.
It is not necessary to ask for further permission from the author or journal board.
This journal provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge.






















