Abstract:The adoption of formal environmental management systems (EMS) according to EMAS (Eco-Management and Audit Scheme) represents a voluntary approach that aims to increase corporate environmental performance. Though EMAS can offer several advantages for organizations, registration numbers are falling. In the hospital sector, the dissemination of EMAS is low. The question arises as to what hinders hospitals when planning, implementing, and maintaining such voluntary environmental management initiatives. The results from interviews with environmental managers in EMAS registered hospitals reveal problems such as high initial effort for creation of the required documents, or lacking knowledge and staff awareness. The barriers are presented in a model synthesizing the problems chronologically on the organizational, group, and individual level. The challenges for the adoption of EMAS as a voluntary environmental management approach in hospitals are discussed. This paper contributes by creating an understanding of the barriers organizations might face when implementing an EMS. Thus, measures to actively manage and overcome barriers can be developed by organizations, consultants, reviewers, policy makers, and researchers.
Background Life cycle assessment (LCA) is an environmental accounting tool aimed at determining environmental impacts of products, processes, or organizational activities over the entire life cycle. Although this technique already provides decision-makers in other sectors with valuable information, its application in the health care setting has not yet been examined. Purpose The aim of this study was to provide a comprehensive overview of scientific research on the application of LCA in hospitals and its contribution to management decision-making. Method We perform a systematic literature review by searching a range of databases with synonyms of “LCA” in combination with the term “hospital” in order to identify peer-reviewed studies. The final sample of 43 studies were then subjected to a content analysis. Results We categorize existing research and show that single and multi-indicator LCA approaches are used to examine several products and processes in hospitals. The various approaches are favored by different scientific communities. Whereas researchers from environmental sciences perform complex multi-indicator LCA studies, researchers from health care sciences focus on footprints. The studies compare alternatives and identify environmental impacts and harmful hotspots. Practice Implications LCA results can support health care managers’ traditional decision-making by providing environmental information. With this additional information regarding the environmental impacts of products and processes, managers can implement organizational changes to improve their environmental performance. Furthermore, they can influence upstream and downstream activities. However, we recommend more transdisciplinary cooperation for LCA studies and to place more focus on actionable recommendations when publishing the results.
The voluntary implementation of environmental management systems (EMS) according to Eco‐Management and Audit Scheme (EMAS) is a proactive and comprehensive management initiative aiming to improve corporate environmental performance. EMS implementation and connected communication activities are seen as a possibility to strengthen stakeholder relationships. However, EMS development and implementation consumes significant time and financial resources. Therefore, in this empirical study with hospital managers, it is questioned if and to what extent hospital managers perceive stakeholders valuing the implementation of an EMS according to EMAS. The results show that only internal stakeholder pressure from owners and the management board exists. Other stakeholders know little and care less about EMAS, suggesting that they have other priorities and do not see a necessity for hospitals to engage in environmental management efforts. This low stakeholder interest reduces the value of EMAS registration for hospitals and limits future environmental management efforts. This could hinder sustainable development within the healthcare sector.
This paper analyzes organizational environmental performance and environmental management approaches in German hospitals. Based on data from an online survey and a subsequent cluster analysis, three groups of hospitals are identified: traditionalists, pragmatists, and environmentalists. The clusters differ regarding their organizational environmental performance, i.e., the environmental management elements adopted (policy, goals, structures, processes, and monitoring) and the environmental issues addressed (energy, water, material consumption, waste, emissions into water and air). The environmental management approaches hospitals adopt range from least to most active. Despite perceived stakeholder pressure being generally low, differences between the clusters can be observed. The most relevant stakeholders are internal ones, i.e., management and owners, rather than external ones. Furthermore, some organizational characteristics distinguish the clusters. This paper adds knowledge in the under-researched setting of hospitals and discusses managerial possibilities for the types of hospitals to increase their organizational environmental performance and to pursue a more holistic environmental approach.
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