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Proactive Environmental Strategies in Healthcare Organisations: Drivers and Barriers in Italy

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Abstract

This study sheds new light on why healthcare organisations are having difficulty responding to the growing pressure from stakeholders to proactively address their responsibility to deliver high-quality services without harming the environment. Basing our work on past research on stakeholder pressure and environmental barriers, we conceptualise and empirically test the effect of the interplay between stakeholder pressure and internal barriers on healthcare organisations’ adoption of proactive environmental strategies (PESs). To test the proposed hypotheses, a survey was carried out among medical directors of Italian healthcare organisations in 2012. Our results show that the lack of commitment to environmental issues within the organisation represents the main barrier to healthcare organisations’ implementing PESs. Furthermore, the difficulties in evaluating the impacts of advanced environmental practices negatively moderate the influence of stakeholders on developing PESs. Our findings contribute to extending previous knowledge on PESs in two ways: (i) focusing on the healthcare sector, our study investigates the phenomenon in a research context that has been largely overlooked in the sustainability literature; and (ii) cross-cutting previous research on stakeholder pressure and internal barriers, the study conceptualises and tests a more complete framework for understanding the adoption of PESs.

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Authors and Affiliations

  1. Dipartimento di Ingegneria Gestionale, Politecnico di Milano, Via Lambruschini 4/b, 20156, Milan, Italy

    Marta Pinzone, Emanuele Lettieri & Cristina Masella

Authors
  1. Marta Pinzone
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  2. Emanuele Lettieri
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  3. Cristina Masella
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Corresponding author

Correspondence to Marta Pinzone.

Appendix

Appendix

Proactive Environmental Strategy

Please indicate, on a scale ranging from (1) “strongly disagree” to (7) “strongly agree”, to what extent you agree with each of the following statement.

  1. (a)

    Environmental goals are clearly defined in my organisation,

  2. (b)

    My organisation adopts technologies that prevent pollution and minimize environmental impact,

  3. (c)

    Employees are trained in environmental issues in my organisation,

  4. (d)

    In my organisation, responsibilities on environmental matters are clearly defined and assigned,

  5. (e)

    My organisation periodically reports its environmental performance to its stakeholders,

  6. (f)

    My organisation requires its suppliers to hold an environmental certification (e.g., EMAS, ISO14001),

  7. (g)

    In my organisation, a significant part of improvement expenses are dedicated to environmental-oriented projects.

Stakeholder Pressure

Please indicate, on a scale ranging from (1) “extremely low” to (7) “extremely high”, the degree of pressure each of the following stakeholder exert on your organisation to address environmental issues.

  1. (a)

    Local institutions,

  2. (b)

    Regional institutions,

  3. (c)

    National institutions,

  4. (d)

    Employees,

  5. (e)

    Professional associations,

  6. (f)

    Patients,

  7. (g)

    Patients’ associations,

  8. (h)

    Other healthcare organisations,

  9. (i)

    Local community,

  10. (j)

    Suppliers,

  11. (k)

    The media.

Internal Barriers

Please indicate, on a scale ranging from (1) “not at all important” to (7) “extremely important”, how important each of the following barrier is in hindering the implementation of environmental programmes and initiatives in your organisation.

  1. (a)

    Limited financial capability for environmental investments,

  2. (b)

    Lack of human resources to dedicate to environmental activities,

  3. (c)

    High cost of environmental services and technologies,

  4. (d)

    Difficulty in protecting the environment without increasing costs,

  5. (e)

    Limited knowledge of environmental problems among employees,

  6. (f)

    Limited knowledge of environmental problems among directors,

  7. (g)

    Limited interest in environmental issues among employees,

  8. (h)

    Limited interest in environmental issues among directors,

  9. (i)

    Unfavourable attitude of the employees due to other priorities,

  10. (j)

    Unfavourable attitude of the directors due to other priorities,

  11. (k)

    Difficulties in evaluating the financial benefits of environmental investments,

  12. (l)

    Difficulties in evaluating environmental activities’ impacts on non clinical processes,

  13. (m)

    Difficulties in evaluating environmental activities’ impacts on clinical pathways,

  14. (n)

    Difficulties in evaluating intangible impacts of environmental activities (e.g., reputation in the community, image as a great place to work).

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Pinzone, M., Lettieri, E. & Masella, C. Proactive Environmental Strategies in Healthcare Organisations: Drivers and Barriers in Italy. J Bus Ethics 131, 183–197 (2015). https://doi.org/10.1007/s10551-014-2275-8

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