Impact of high-performance work practices on efficiency and effectiveness of multispecialty healthcare service delivery in an emerging economy – role of relational coordination

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.