PURPOSE: This paper aims to explore the attitudes of managers and employees to high performance work practices (HPWS) in a medium sized rural Australian hospital. DESIGN/METHODOLOGY/APPROACH: The study consists of two stages. Stage one involved a qualitative investigation consisting of interviews and focus group sessions with senior, middle and line management at the hospital. Bowen and Ostroffs framework was used to examine how strategic HRM was understood, interpreted and operationalised across the management hierarchy. Stage one investigates the views of managers concerning the implementation of strategic HRM/HPWS. Stage two consisted of a questionnaire administered to all hospital employees. The mediation effects of social identification on the relationship between high performance work systems and affective commitment and job satisfaction are examined. The purpose of stage two was to investigate the views and effects of SHRM/HPWS on employees. It should be noted that HPWS and strategic HRM are used inter-changeably in this paper. FINDINGS: At the management level the importance of distinctiveness, consistency and consensus in the interpretation of strategic HRM/HPWS practices across the organization was discovered. Findings indicate that social identification mediates the relationship between HPWS and affective commitment and also mediates the relationship between HPWS and job satisfaction. PRACTICAL IMPLICATIONS: High performance work systems may play a crucial role facilitating social identification at the unit level. Such practices and management support is likely to provide benefits in terms of high performing committed employees. ORIGINALITY/VALUE: The paper argues that team leaders and managers play a key role in building social identification within the team and that organizations need to understand this role and provide recognition, reward, education and support to their middle and lower managers.