<![CDATA[Public hospitals were required to improve organizational performance while adapting to continuous organizational transformation. In this context, implementing a High Performance Work System (HPWS) became essential for strengthening human resource management and service quality. This study aimed to examine the effects of Readiness to Change and Work Engagement on High Performance Work System by investigating the mediating role of Learning Orientation among employees of Madiun City Regional General Hospital. A quantitative explanatory design was employed using a survey of 152 employees selected through proportionate random sampling. Data were collected using structured questionnaires and analyzed with Partial Least Squares–Structural Equation Modeling (PLS-SEM) using SmartPLS 4. The findings indicated that Readiness to Change, Work Engagement, and Learning Orientation positively and significantly affected High Performance Work System. In addition, Readiness to Change and Work Engagement significantly influenced Learning Orientation, which partially mediated their effects on High Performance Work System. These findings suggested that strengthening employees' readiness for change, work engagement, and learning orientation was essential for enhancing HPWS implementation and improving organizational performance in public hospitals.  ]]>
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