International Journal of Heritage, Tourism and Hospitality Vol. (12), No. (3/2) Special issue on papers of the 11 th ICTH (2018) organized by Faculty of Tourism and Hotels, Fayoum University 145 Antecedents and Consequences of Food Quality in Egyptian Healthcare Karam Zaki Mohamed Ahmed Faculty of Tourism and Hotels, Fayoum University Abstract This research examined food production/service quality mediating effect in the relationship between the innovative human resource management practices (IHRMPs) and patient satisfaction in Egyptian healthcare. Case study strategy applied in two Egyptian hospitals. Structural equation modelling (SEM) was used. A convenient sample included 252 hospital patients and 108 kitchen staff was selected. Findings indicated a strong positive IHRMP effects on patient satisfaction. According to SEM analysis, food service quality factor was fully mediated the direct relationship between IHRMPs and the patient satisfaction. While food production quality factor was not mediated the relationship between IHRMPs and patient satisfaction. The article identifies opportunities to use comprehensive IHRMPs effectively and to develop other food quality indicators that may affect patient satisfaction. This article is among the few studies offering a framework to identify service quality mediation effect in the relationship between IHRMPs and patient satisfaction in Egyptian healthcare. This framework is based on social exchange theory in which quality knowledge perceptions in hospitals could come from IHRMPs, which consequently promotes patient satisfaction. Keywords Quality, Patient satisfaction, Social exchange theory, Healthcare, Egypt Introduction The largest healthcare component is human resources (Nayeri et al., 2005). Healthcare depends on the human resources as it is labour intensive, which has posed particular challenges for ensuring patient satisfaction and business outcomes. Indeed, a great challenge faces Arab countries, especially Egypt, is to provide sufficient human resources to deliver high-quality services (Budhwar and Mellahi, 2007). Patient satisfaction is considered a key performance indicator in healthcare business (Ahmed et al., 2015). Many scholars highlighted the relationship between human resource management (HRM) practices and healthcare food production/service quality (Haynes and Fryer, 2000; Amin et al., 2017). However, research related to HRM practices and its relationship to patient satisfaction is not sufficient (Pulce, 2003; Huang, 2017). In addition, the food production/service quality mediating effect in the relationship between Innovative Human Resource Management Practices (IHRMPs) and patient satisfaction in the Egyptian healthcare sector still needs more investigation. Moreover, the healthcare literature has not presented a comprehensive IHRMPs overview, which affects food production/service quality to ensure satisfied patients (Cho et al., 2006; Bhanugopan et al., 2013). Accordingly, we explored patient satisfaction with food production/services and measured kitchen staff perspectives on IHRMPs to elucidate the relationship between these factors. Literature review Healthcare in Egypt Healthcare managers are forced to find innovative tools to remain competitive and to provide patients with satisfactory services (Sargeant, 2010). Healthcare managers look for potential in their performance to achieve their goals (Aiello et al., 2010). The healthcare system in Egypt is complex with many entities and bodies involved in management hierarchy, financing and care provision (WHO, 2010; Farahat et al., 2018). In Egypt, healthcare is delivered through different systems, including private, public or governmental and university hospitals (Mostafa, 2005).