Healthcare institutions have been working to improve the efficiency and effectiveness of the service delivered. The literature has argued that their capabilities have a direct effect on service outcomes. Research has explained how their capabilities can be enhanced by implementing high-performance work practices (HPWP) bundles and how these bundles can impact performance through relational coordination. However, this previous research has focused primarily on single-specialty healthcare institutions in a developed country. Inherent characteristics of multispecialty healthcare institutions (e.g., inability to standardize) and emerging economy context (e.g., absence of case manager role) motivate further investigation in this setting. Therefore, in our research, we study the impact of HPWP on the overall performance, efficiency, and effectiveness of healthcare service delivered and how this linkage is moderated by relational coordination. We analyzed 605 valid responses from different healthcare institutions located in the southern Tamil Nadu state of India using structural equation modeling. In alignment with past research, our results show that HPWP improves the overall performance and effectiveness and this linkage is moderated by relational coordination. However, HPWP's impact on efficiency and its moderation by relational coordination is insignificant. We explain the results by anchoring them to the characteristics of the multispecialty and emerging economy context.

The growing demand for sustainable materials has driven interest in natural fiber-reinforced composites. Aloe vera fiber is biodegradable and abundant but suffers from poor adhesion with polymer matrices, limiting its structural use. This study aimed to enhance the interfacial bonding of aloe vera fiber-reinforced polyester composites through chemical surface modifications. Fibers were subjected to alkali treatment using sodium hydroxide and subsequently benzoylated with benzoyl chloride at concentrations of 5, 10, 15, and 20 %. The composites were evaluated for hardness, tensile, flexural, impact, and shear strengths, along with water absorption and thermal conductivity. Results showed that alkali treatment improved adhesion and reduced moisture uptake, while benzoylation further enhanced mechanical performance. The AVF-B20 composite exhibited superior properties, including a hardness of 66.98, impact strength of 6.62 J, tensile strength of 67.30 MPa, tensile modulus of 4.9 GPa, flexural strength of 88.68 MPa, flexural modulus of 4.05 GPa, shear strength of 13.96 MPa, and the lowest water absorption of 3.62 percent. A slight rise in thermal conductivity was observed with increasing benzoylation levels. Overall, combined alkali and benzoylation treatments effectively improved the strength, durability, and dimensional stability of Aloe Vera fiber composites, making them suitable for sustainable engineering applications.