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Sustainability Trends in Public Hospitals: Efforts and Priorities
Abstract
Purpose:
The purpose of this study is to examine the previous and the current efforts and the priorities of sustainability initiatives in the public sector.
Design/methodology/approach:
This study has been conducted in one industry, overcoming contextual bias as a judgmental sampling was used to select the public hospitals that were studied. Only knowledgeable key informants were approached and used.
Findings:
The examination of the previous and the current efforts and the priorities of the sustainability initiatives revealed in this study indicate the existence of different trends in the public hospitals studied.
Research limitations/implications:
The results report the key trends that were disclosed in the public hospitals studied in their efforts towards sustainability. In particular, the results show that there appears to be a lack of guidelines and homogeneity in sustainability planning in public hospitals in Spain, accompanied by the near universal absence of the evaluation phase in respect to the outcomes of the sustainability initiatives that have been put in place in these organizations.
Managerial implications:
The multi-dimensional factors of sustainability initiatives provide managerial guidance to assess the previous and the current efforts and priorities. These factors also provide organizational guidance to assess the trends of an organization through time.
Originality/value:
This study contributes to a selection of factors regarding the previous and the current efforts and the priorities of sustainability initiatives applicable in public hospitals. It provides a multi-dimensional framework of factors that can be used in order to describe sustainability trends.
... As an expensive but essential public service, the demand for healthcare is increasing alongside economic growth. People have come to recognize that a comprehensive and sustainable health system not only brings significant benefits to the physical and mental health of individuals but also provides the driving force for harmonious, stable, and orderly economic and social development [2]. However, the current difficulties in accessing healthcare and its high costs have seriously constrained the development of medical care in both developed and developing countries lacking a public health system that promotes social justice and equity, constituting a dilemma that has mainly been caused by an uneven distribution of medical resources, the poor equity of and accessibility to healthcare services, and high healthcare costs. ...
... (1) In your opinion, what is the purpose of smart health? (2) What are the three to five characteristics of smart health? (3) How can smart health be achieved? ...
... When interpreting the specific findings of the study, however, the reader must be aware of the following limitations: (1) Our search for peer-reviewed full-text articles may have overlooked conference proceedings, book chapters, and white papers. (2) The unconscious bias of the authors may have influenced the execution of the review and the interpretation of the findings. (3) The panelists were all from China; thus, our findings and framework may need to be adapted to other populations and countries. ...
Smart health is considered to be a new phase in the application of information and communication technologies (ICT) in healthcare that can improve its efficiency and sustainability. However, based on our literature review on the concept of smart health, there is a lack of a comprehensive perspective on the concept of smart health and a framework for how to link the drivers and outcomes of smart health. This paper aims to interweave the drivers and outcomes in a multi-dimensional framework under the input–process–output (IPO) logic of the “system view” so as to promote a deeper understanding of the model of smart health. In addition to the collection of studies, we used the modified Delphi method (MDM) to invite 10 experts from different fields, and the views of the panelists were analyzed and integrated through a three-round iterative process to reach a consensus on the elements included in the conceptual framework. The study revealed that smart health contains five drivers (community, technology, policy, service, and management) and eight outcomes (efficient, smart, sustainable, planned, trustworthy, safe, equitable, health-beneficial, and economic). They all represent a unique aspect of smart health. This paper expands the research horizon of smart health, shifting from a single technology to multiple perspectives, such as community and management, to guide the development of policies and plans in order to promote smart health.
... [5] looked at how the timing of adoption, local implementation techniques, and assimilation processes into everyday practice all interact to shape a large-scale QI intervention's longterm impact and legacy. [6] investigated at previous and present sustainability projects in the public sector, as well as their priorities. [7] performed a comprehensive review of the literature and identified potential gaps that may be addressed in future research. ...
... Future study could focus on the measures and factors of a sustainable strategy from the perspective of local and state governments, which are in responsibility of addressing public healthcare policy in their jurisdiction, according to [6]. According to [7] more in-depth reviews, with a greater number of bases studied and an appraisal of each study's aims, to aid in selecting a method or instrument for an application in the future. ...
... Over such a lengthy period, adoption was a challenging concept to explore retrospectively. 3. Collected most data from two wards in case study hospitals that were chosen at random. 3 [6] There appears to be a lack of standards and standardisation in sustainability planning in Spanish public hospitals, as well as a widespread lack of evaluation of the effects of these organisations' sustainability initiatives. 4 [7] The absence of use of some databases as a result of the databases' articles being unavailable and inaccessible. ...
This study aims to comprehensively assess the literature on healthcare sustainability, covering key aspects of existing publications, limits, and future research opportunities. In two ways, it adds to the body of knowledge. To offer an overview of completed research initiatives, it first classifies the literature based on seven criteria: “year,” “area,” “study technique,” “findings,” “setting,” “constraints,” and “future research orientation.” Second, it identifies a research gap in the present literature and suggests future study topics. The findings suggest that previous research on the subject has struggled to establish a robust theoretical framework. More study will be required to validate the offered ideas, concepts, and frameworks. As a result, little study has been done on sustainability literature, leaving plenty of potential for future research.
... Sustainability has become a key priority for organizations across both the public and private sectors. Recently, it has gained notable attention in the healthcare industry, particularly within hospitals [4][5][6], which serve a vital role in society [7,8]. As providers of essential medical services, hospitals bear the responsibility of ensuring high-quality healthcare for patients [4,9,10], especially for remote areas such as distant islands or other rural and mountainous areas that are difficult to access. ...
... Telemedicine has positively impacted global healthcare and the environment in recent years [5]. In order to comply with the constantly growing demands for healthcare resources without exacerbating climate change [28], the provision of healthcare services must be built on sustainable and low-carbon systems and work models [29]. ...
Background: Sustainability in healthcare has gained increasing importance due to its impact on environmental, financial, and social strategies, as well as on public health, and therefore, relevant policies and actions can also play a significant role in telemedicine services. The establishment of a sustainable telemedicine network at a country level is important to improve access to healthcare, reduce costs, increase convenience, and ensure the continuity of service delivery. However, there are significant environmental, social, technological, human, and governance challenges to meet the sustainability conditions for these networks. Methods: Thus, a narrative literature review was conducted to investigate the telemedicine implementation aspects and the sustainability dimensions in a unified approach and integrated strategy in order to develop a more resilient and equitable healthcare solution, ensuring its long-term integration into healthcare systems. Results: This paper aims to identify critical factors related to the proposed governance model for the National Telemedicine Network in Greece (EDIT) that influence sustainability requirements and interdisciplinary strategies to address relevant challenges. Conclusions: By examining these factors, the paper seeks to propose the fundamental pillars of a sustainable telemedicine framework and the methodology for developing a sustainability plan that will enhance EDIT’s capacities toward a sustainable and resilient operation of telemedicine as a standard practice within the Greek healthcare system.
... Public hospitals, moreover, are not willing to compare their sustainability initiatives with those of other hospitals. This means that there is no opportunity to use benchmarking [4]. This is also true in other countries [19]. ...
... Contributions on sustainability performance in private and public health care organisations are very scarce [4], despite the importance of sustainability in this sector. ...
Health care organisations have broadened their commitment to corporate social responsibility, since, as well as providing health care to patients, their activities negatively affect world pollution. This is a result of the products and technologies they use, the resources they consume, the waste they produce, and the buildings they occupy and operate. This, in turn, affects the health of the community. For this reason, a growing number of health care organisations have become involved in improvements to environmental sustainability, in order to promote public health. These improvements need to be controlled by a system whose effects can be assessed within a process of continuous improvement. This research, therefore, sets out a model constructed by extension to a fuzzy environment of the technique for order preference by similarity to ideal situation (TOPSIS), to assess the environmental responsibility of health care organizations. The weights were obtained from judgements given by both an expert in environmental matters, and a group of patients, and the judgements of both types of stakeholder were combined. The model has been applied in a Spanish public hospital over a period of five years. The closeness coefficients obtained with the judgements from the patient group are on average 6.59% higher than those obtained from the expert, and so it can be said that patients are less demanding on environmental matters. The similarity of the models was assessed, by comparing the model that combines both sets of judgements with the model constructed from the judgements of the expert and the model built from the judgements of the patient groups. The similarity is seen to be high, but it is greater in the case of the ranking obtained from the patient judgements. The results in all cases suggest a low risk of a serious environmental problem in the hospital. Nonetheless, it also implies that there are opportunities for continuous improvement. The use of a model with judgements from a patient group was intended to take into account the increasingly important need to include the judgements and opinions of different stakeholders in decision and assessment processes in the hospital environment.
... Sustainability reporting is of great importance in the healthcare sector, especially for hospitals, as highlighted in studies by Rodriguez et al. (2020) and Singh et al. (2012). Hospitals are increasingly adopting environmentally sustainable practices by choosing environmentally-friendly options when constructing, modernising and refurbishing their facilities, opting for sustainable procurement of equipment and supplies, and managing resources responsibly, as noted by Jones and Mucha (2014). ...
The purpose of the article. This article aims to examine the sustainability disclosure practices of public hospitals within the European Union. It aims to identify the scope and trends in environmental, social and governance (ESG) information reported by these hospitals on their official websites and analyze the influence of national frameworks on these practices. Methodology. The study employs a manual content analysis of the official websites of 50 public hospitals from EU Member States, selected from Newsweek’s The World’s Best Hospitals 2024 list. An ESG Disclosure Index (ESG DI) was developed to evaluate the extent of sustainability information disclosed. The index includes 36 items across various sustainability dimensions. Results of the research. The results show that the surveyed hospitals disclosed an average of 48% of the ESG metrics. Governance issues were disclosed the most (59%), followed by social (52%) and environmental (47%) dimensions. Scandinavian hospitals had a higher level of disclosure than their Southern European counterparts. The study highlights the fragmented nature of sustainability disclosure, which tends to report better performing indicators while selectively omitting others.
... We explore how to elevate service quality and how to optimize patient experiences across all departments. Financial sustainability is also a major concern, especially in the post-pandemic era, where hospitals face challenges and opportunities in maintaining operations [3]. ...
Welcome to Hospitals, a journal dedicated to exploring the essential pillars that drive the success and evolution of hospitals in today’s world [...]
... It is understood as the duty of organizations to maximize their long-term positive effect on society while minimizing the negative impacts of their management (Anagnostopoulos & Shilbury, 2013;Esposito et al., 2023;García-Sánchez et al., 2021). Sustainability has become relevant for all organizations, public and private, operating in different sectors and, in recent years, it has also established itself in the healthcare industry and, in particular, among hospitals (Rodriguez et al., 2020;Singh et al., 2012). In fact, more and more hospitals are pursuing the path of environmental sustainability with eco-friendly solutions in the construction or redevelopment and renovation of existing structures, in the ecologically aware purchase of equipment and supplies and in the responsible management of resources (Jones & Mucha, 2014). ...
Society's growing attention to sustainability has also brought about major challenges for the healthcare sector. In particular, hospitals by virtue of their function are also called to incorporate social and environmental issues in the undertaking of their activities. In this scenario, hospitals must also provide a correct representation of these issues through an adequate sustainability disclosure. However, despite the relevance of the topic, it is still little explored in the academic field. This study aims to fill this important gap by investigating the determinants of online sustainability disclosure through a legitimacy theory perspective. The econometric analysis, conducted on a sample of the best hospitals in the world, highlights a low level of dissemination of sustainability information. Furthermore, it demonstrates a positive impact of the size, public status and teaching status of hospitals on the amount of sustainability information disclosed by these institutions through their website.
... These results may be influenced by the number of participants, their status, age, experience, etc. Using the judgmental sampling method (175) and involvement theory (168) used in Section 4.1.2 of this paper to select EGM participants is a suggested way. ...
Background
With the accelerating trend of global aging, over one billion people need to use one or more types of assistive products. However, the high abandonment rate of current assistive products is affecting the quality of life of the older adults, posing challenges to public health. Accurately capturing the preference factors of the older adults in the design process is an important way to improve the acceptance of assistive products. In addition, a systematic approach is needed to translate these preference factors into innovative product solutions. These two issues are less addressed in existing research.
Methods
First, the evaluation grid method was used to conduct in-depth interviews with users and extract the structure of preference factors for assistive products. Quantification theory type I was used to calculate the weight of each factor. Secondly, universal design principles, TRIZ theory's contradiction analysis techniques, and invention principles were used to translate the preference factors into design guidelines. Then, finite structure method (FSM), morphological chart, and CAD techniques were used to visualize the design guidelines as alternatives. Finally, Analytic Hierarchy Process (AHP) was used to evaluate and rank the alternatives.
Results
A Preference-based Assistive Product Design Model (PAPDM) was proposed. The model includes three stages: definition, ideation, and evaluation. A case study on walking aid demonstrated the execution of PAPDM. The results show that 28 preference factors influence the four psychological needs of the older adults: sense of security, sense of independence, self-esteem, and sense of participation. These psychological needs were reflected in the shape, color, material, universality, user-friendly, reliability, and smart functions of assistive products. The preference factors were transformed into five design guidelines, and three alternatives were generated. Finally, the evaluation concludes that solution C was the optimal solution.
Conclusion
The PAPDM framework provides designers with a transparent, progressive approach to designing assistive products that meet unique needs and preferences of older adults. This enhances objectivity and scientific rigor in assistive product development, avoiding blind design and production. By considering the perspective of older adults from the outset, we can avoid high abandonment rates of assistive products and contribute to promoting active aging.
... Healthcare has a significant environmental burden and accounts for about 7% of the total CO 2 footprint in the Netherlands. However, healthcare has stayed behind in terms of sustainable development compared to other sectors (Rodriguez et al. 2020). Hospitals are significant polluters and account for about 35% of total emissions of health services (Keller et al. 2021). ...
Background:
Healthcare is a highly polluting industry and attention to the need for making this sector more sustainable is growing. The interventional radiology (IR) department is a relatively unique department in the hospital because of its synergetic use of both imaging equipment and medical instruments. As a result, the interventional radiology department causes a significant environmental burden in terms of energy usage, waste and water pollution. The aim of this study was to explore the current state of sustainability within IR by conducting a survey and interviews among IR specialists in the Netherlands.
Results:
The main findings of this study were that there is a high awareness for the need of sustainability within IR, but that there is still limited action. Previous studies point towards the various opportunities in the field of energy, waste and water pollution, yet our study unveils these opportunities are often not implemented because of (1) sustainability not being a priority, (2) a dependency on employees, and (3) factors that simply cannot be changed by an individual IR department or hospital. Generally, our study indicates that there is a willingness to become more sustainable, but that the current system involves a wide range barriers that hinder true change. Furthermore, it seems that no one is currently taking the lead and a leading role from higher management, government, healthcare authorities or professional societies is lacking.
Conclusions:
Despite the hurdles found in our study, IR departments can implement several improvements. An important factor is that sustainability should not lead to lower convenience for employees, which can be ensured by a sufficiently designed waste infrastructure and behavioral nudges. Furthermore, there lies an opportunity in more collaboration between IR departments in knowledge sharing and open innovation.
... The sample allowed for an examination of the challenges and implementation of energy-saving initiatives in these hospitals, as well as the identification of areas for improvement that can be applied to broader hospital management. Sustainability requires taking into account social, environmental and economic concerns (Rodriguez et al., 2020). ...
Purpose
The issue of energy efficiency is becoming increasingly prevalent globally due to factors such as the expansion of the population, economic growth and excessive consumption that is not sustainable in the long run. Additionally, healthcare facilities and hospitals are facing challenges as their operational costs continue to rise. The research aim is to develop strategic frameworks for managing green hospitals, towards energy efficiency and corporate governance in hospitals and healthcare facilities.
Design/methodology/approach
This research employs a qualitative case study approach, with a sample of ten hospitals examined through interviews with senior management, executives and healthcare facilities managers. Relevant data was also collected from literature and analysed through critical appraisal and content analysis. The research methodology is based on the use of grounded theory research methodologies to build theories from case studies.
Findings
The research developed three integrated conceptual strategic frameworks for managing hospitals and healthcare facilities towards energy efficiency, green hospital initiatives and corporate governance. The research also outlined the concepts of green hospitals and energy efficiency management systems and best practices based on the conclusions drawn from the investigated case studies.
Research limitations/implications
The study is limited to the initiatives and experiences of the healthcare facilities studied in the Middle East and North Africa (MENA) region.
Originality/value
The research findings, conclusions, recommendations and proposed frameworks and concepts contribute significantly to the existing body of knowledge. This research also provides recommendations for hospital managers and policymakers on how to effectively implement and manage energy efficiency initiatives in healthcare facilities.
... Therefore, improvements in management practices are positively associated with the mortality level and overall financial performance, measured as income per bed. At the same time, it has been proven that the use of lean management practices positively affects the overall efficiency of health organizations through improvements in productivity and quality [48][49][50][51][52][53][54]. ...
This study aims to investigate efficient practices pursuing the sustainability of healthcare organizations, as the healthcare sector and its activities affect different spheres of social life, the economy, and the state’s performance, highlighting the importance of this subject. To achieve the aim of this study, a systematic review methodology was applied, and the data were obtained from 67 papers published within the scope of the two most cited databases: Scopus and Web of Science. As a result of the analysis, the following efficient practices were suggested to improve the sustainability of healthcare organizations: improvements in management practices, leadership practices, manager selection, the engagement of clinicians in the management, the promotion of organizational culture and management style, the promotion of virtual health communication, environmental supply chain management, rational resource consumption, and waste management.
... In Italy, the phenomenon of social reporting has involved and is currently widespread in various types of public organizations [18][19][20]. In the public healthcare sector, social reporting represents a critical area of interest: through the social reporting documents, public healthcare structures present their activity (list of healthcare services), their results (health outcomes), and the value created in relation to one or more categories of stakeholders in order to satisfy specific information needs [21,22]. ...
Social reporting has become a critical area of interest in healthcare systems, and it has also become increasingly important for the academic community and practitioners in recent decades. Recent studies have found the existence of a slow spread of social reporting initiatives in public hospitals and a lack of guidelines and homogeneity in social reporting documents. This study aims to contribute to the literature, offering updated evidence from Italy. Through a document analysis, we (a) assessed the trends of social reporting initiatives in the Italian public hospital sector; (b) analyzed the current forms, contents, and quality, of social reporting documents, in order to isolate common elements, differentiation and emerging trends; (c) analyzed the informational power of social reporting documents for public hospitals stakeholder. Data were extracted from the public hospital website. The results confirm the scarce dissemination and homogeneity of social reporting documents and highlight the need for non-financial reporting standardization in public hospitals.
... The sample allows the exploration of the challenge and implementation of energy-saving in these hospitals and allows potential improvements to be identified for application in the broader hospital management context. The concept of sustainability intrinsically involves social, environmental and economic care to be considered by the parties involved (Rodriguez et al., 2020). ...
Purpose
Energy-saving is a growing challenge worldwide because of population growth, economic activity and high consumption rates that are unsustainable in the long term. Health-care facilities and hospitals face the challenge of increases in operational costs. This paper aims to appraise challenges to adopting energy-saving policies and proposes a roadmap for sustainability and energy efficiency management in hospitals and health-care facilities.
Design/methodology/approach
Eight hospitals were examined as case studies through qualitative interviews with hospital senior management, executives and health-care facilities managers in addition to collecting relevant data from the literature; there is critical appraisal and content analysis of this data.
Findings
This study established factors influencing implementation and challenges to energy-saving strategies. This study proposed guidelines for efficient energy management in hospitals and health-care facilities. This study concluded that the best performance is secured by integrating the proposed guidelines with the adoption of ISO 50001 energy management systems to achieve the United Nations’ sustainable development goal – SDG 7 “affordable and clean energy”.
Research limitations/implications
This study is limited to the initiatives/experiences of the hospitals studied in the Middle East and North Africa region.
Originality/value
This study’s findings, conclusions, recommendations and proposed guidelines enrich the body of knowledge. This will allow industry key stakeholders, hospitals and health-care facilities managers to overcome challenges of implementing energy management. In addition, adopting the proposed guidelines will improve energy efficiency and help hospitals in green initiatives as they seek to demonstrate their support for United Nations’ sustainable development goals.
... To overcome these issues, healthcare organisation have started introducing environmental management into their strategic objectives. Considering the significance of sustainable development in healthcare industry, there is a lacks of clarity on what constitutes a sustainable firm and is experiencing a research shortage in this area (Rodriguez et al., 2020). Currently, several studies in healthcare are trying to lower carbon footprints as a successful sustainable practice, but they are failing to recognise the underpinning link between humanity's interactions with the environment for the good of the ecosystem (Gurevich, 2020). ...
Purpose
Environmental sustainability (ES) is an increasing tendency in the healthcare industry as it seeks to enhance the environmental friendliness and reduces waste in operations to save money. The objective of research article is to identify the factors that contribute to improving the performance of ES in hospitals. Understanding the factors that contribute to the improvement of healthcare services may be helpful for practitioners, who need to address and implement an effective framework to enable an environment-friendly practice in hospitals.
Design/methodology/approach
The current study utilised the technique called total interpretive structural modelling (TISM) to identify the factors and understand the interconnection between the identified factors. A literature review revealed 12 factors, which were then refined with the input of hospital experts. Based on a questionnaire survey, a planned interview is conducted in chosen Indian hospitals. The matrix impact cross multiplication applied to classification (MICMAC) study employs dependency and driving power to identify the hierarchical relationship between the detected factors.
Findings
Green building initiatives, water consumption, resource usage, and renewable energy were identified as key factors in the study. Other factors such as staff behaviour, procurement of goods and management of hazardous substance would be influenced by these fundamental components. With the implementation of green initiatives in the hospital, ES is primarily used to reduce the excessive use of scarce resources.
Practical implications
The ES programme begins at the hospital grounds, with awareness and specific training provided to all personnel, including doctors, nurses, and managers at all levels. The training programme is intended to raise awareness; sessions are divided into targeted groups; a new organisational structure is created; and a consultant agent is hired to commence ES.
Originality/value
Existing literature has focussed mostly on ES factors such as carbon emissions, water conservation, and effective waste disposal, while ignoring organisational viewpoints and their interrelationships. As a result, the current study used TISM to show the relationship between various organisational and environmental perspective components in order to comprehend the reasoning behind improving performance.
... The importance of healthcare as a key determinant in quality of life is being recognized not only by individuals or industries but also by societies or nations. Thus, building a comprehensive healthcare system may not just give great benefits to the individuals' physical or mental health and quality of life, but also bring driving force to the harmonious, stable and orderly development of economy and society (Rodriguez et al., 2020). However, with the continuous increase of elderly population, the situation is not that optimistic. ...
The purpose of this study is to explore ways to apply information technologies such as big data, Internet of things (IoT), mobile internet, and so on to the healthcare industry. By analyzing the impact path of such high-techs on healthcare, it intends to propose an application system for the sustainable development of so called “smart healthcare”. It identifies the influencing factors of smart healthcare from three different perspectives: society, economy and environment. It then constructs an indicator system containing 14 factors, and comprehensively analyzes the importance and dependence of the factors by using Fuzzy Decision-making Trial and Evaluation Laboratory (DEMATEL) and Interpretative Structural Modeling Method (ISM) based on a multi-level hierarchy model. Using the theoretical framework of scientific research methods, this paper reveals the hierarchical path of the sustainable development of the whole intelligent healthcare which starts from the social level, combines the social and economic levels to achieve the balanced development of benefits, and finally brings the benefits to the environmental level. Based on this finding, this paper develops a sustainable application system for intelligent medicine in three levels: government, enterprise and user. The development of the sustainable application system for smart healthcare can provide theoretical guidance for model application evaluation.
... Research has already been conducted concerning the current status of sustainability and its evolution from the past to the present and into the future. For example, Rodriguez, Svensson, and Wood [10] identify multiple evolutionary directions for assessing organizational sustainability efforts and prioritizations over time in the healthcare sector. However, issues regarding the appropriate hospital configuration and necessary changes to business models for future challenges, remain unresolved [11]. ...
The private healthcare sector was chosen because of the fundamental importance of quality in this sector, the widespread understanding that sustainable development is part of hospital quality standards, and the compelling need for the supply chain components to work together in order to add value to the business models of private healthcare services. This study uses a qualitative methodology, striving to add value to and shed light on the relationship between private hospital communication modes and their stakeholders’ needs and their stakeholders’ expectations of business models in the marketplace and society. This research lists a range of actions and services for assessing the priorities of private hospital communication modes in business models with respect to stakeholder needs and expectations. Furthermore, the study links stakeholder needs and the expectations of business models in private hospitals, with respect to private hospital communication modes with stakeholders, and vice versa. It also provides directions for managers in the healthcare industry to determine the appropriate actions and services for addressing stakeholders’ needs and stakeholders’ expectations of business models in private hospitals considering sustainable development. This research contributes to framing the future direction of sustainable development in business models of the healthcare industry. The paper outlines the assessment of communication modes in relation to economic, social, and environmental performance in the context of sustainable development.
... Various institutional entities are usually equipped with better computational resources and reliable and higher throughput networks [28]. As a result, this allows us to train larger models with larger amounts of training steps [135]. This way we can share more model information. ...
This paper provides a comprehensive study of Federated Learning (FL) with an emphasis on enabling software and hardware platforms, protocols, real-life applications and use-cases. FL can be applicable to multiple domains but applying it to different industries has its own set of obstacles. FL is known as collaborative learning, where algorithm(s) get trained across multiple devices or servers with decentralized data samples without having to exchange the actual data. This approach is radically different from other more established techniques such as getting the data samples uploaded to servers or having data in some form of distributed infrastructure. FL on the other hand generates more robust models without sharing data, leading to privacy-preserved solutions with higher security and access privileges to data. This paper starts by providing an overview of FL. Then, it gives an overview of technical details that pertain to FL enabling technologies, protocols, and applications. Compared to other survey papers in the field, our objective is to provide a more thorough summary of the most relevant protocols, platforms, and real-life use-cases of FL to enable data scientists to build better privacy-preserving solutions for industries in critical need of FL. We also provide an overview of key challenges presented in the recent literature and provide a summary of related research work. Moreover, we explore both the challenges and advantages of FL and present detailed service use-cases to illustrate how different architectures and protocols that use FL can fit together to deliver desired results.
... One expectation that societies in the developed world have of organizations is that they need to exhibit the behaviors that the society deems as being sustainable for the society moving forward (Eriksson and Svensson, 2016;Rodriguez et al., 2020). ...
Purpose
This study aims to assess the determinants of corporate direction in sustainable development through time in a B2B setting.
Design/methodology/approach
This study has been conducted in one industry, and overcoming contextual bias as a judgmental sampling was used to select the organizations studied in a Business to Business (B2B) setting.
Findings
The determinants of sustainable development in this study indicate the existence of different corporate directions in a B2B setting taken through time in the healthcare organizations studied. The determinants found are change in organizational leadership, financial assets of the organization, religious orientation of the organization, organizational connection to the healthcare system, internal values of the organization and top-staff orientation in the organization.
Research limitations/implications
The empirical findings reported in a B2B setting have disclosed key determinants of corporate direction in sustainable development.
Practical implications
The determinants provide managerial guidance to assess the corporate direction in a B2B setting taken in the continuing development of sustainable practices in these organizations.
Originality/value
This study contributes to a multidimensional framework of determinants in a B2B setting to assess the corporate direction taken in sustainable development through time in a B2B setting. The organizational gap between past and present sustainable development provides guidance to assess the corporate direction in B2B taken by an organization into the future.
... The vacuum in institutional healthcare guidelines A perusal of existing global literature highlights the lack of guidelines that aid in sustainable healthcare delivery (Rodriguez et al., 2020) (Leslie et al., 2020). Further the existing guidelines do not overcome the critical translational barriers in terms of access to and security of data, and performance evaluation which are necessary to address the fundamental shift from individual to institutional healthcare delivery (Ben-Israel et al., 2020). ...
This study explores the implementation of sustainability measures within German hospitals, emphasizing their critical role in mitigating environmental impacts and promoting public health. The healthcare sector significantly contributes to global greenhouse gas emissions, necessitating urgent reforms in energy use, waste management, construction, transportation, and food systems. Key findings highlight the potential for hospitals to enhance energy efficiency, adopt renewable energy sources, and reduce waste through innovative technologies and sustainable practices. Initiatives such as green hospital designs, climate-conscious food systems, and sustainable procurement strategies are central to reducing the ecological footprint. Despite these opportunities, barriers such as workforce shortages, insufficient funding, and technical complexity hinder progress. Addressing these challenges through leadership commitment, resource allocation, and staff engagement is essential for aligning the healthcare sector with national and international sustainability goals. By prioritizing sustainability, hospitals can achieve long-term economic benefits, improve patient outcomes, and foster a healthier, more resilient society.
In recent years, novel technologies in smart healthcare systems have opened significant opportunities for diagnosis and treatment across various medical fields. Federated Learning (FL), a decentralized machine learning approach, trains shared models using local data from devices like wearables and hospital systems without transferring sensitive information, offering a promising solution to privacy challenges in areas such as cancer prediction, COVID-19 detection, drug discovery, and medical image processing. This literature survey reviews FL architectures (e.g., FedHealth, PerFit), applications, and recent advancements, demonstrating their impact on healthcare through enhanced predictive models for patient care. Key findings include improved accuracy in wearable-based diagnostics and secure multi-institutional collaboration, though limitations persist. We also highlight open challenges, such as security risks, communication costs, and data heterogeneity, which require further research attention.
Abstract
Purpose
Healthcare organizations are rethinking their practices in response to the framework provided by the sustainable development goals (SDGs). The purpose of this paper is to explore whether, how and why sustainable development practices have been implemented in the healthcare sector.
Design/methodology/approach
The study is based on a systematic literature review, carried out using Scopus and Web of Science databases. The papers were analyzed according to the five activity-based theoretical framework categories: purpose, subject, community, object and practices.
Findings
Results reveal a lack of research regarding the integration of sustainable development and SDGs into managerial systems or functions. Moreover, they identify key areas of interest within sustainable development and healthcare practices, offering guidance for future research and strategies to better align healthcare with the SDGs.
Originality/value
To the best of the authors’ knowledge, this is the first paper that aims to summarize the scientific literature on this topic through the lens of the activity-based theoretical framework, allowing for an analysis of the literature that investigates how sustainable development practices shape organizational life.
Background:
Digital health technologies (DHTs) are promoted as means to reduce the environmental impact of healthcare systems. However, a growing literature is shedding light on the highly polluting nature of the digital industry and how it exacerbates health inequalities. Thus, the environmental footprint of DHTs should be considered when assessing their overall value to healthcare systems. The objectives of this article are to: (1) explore stakeholders’ perspectives on integrating the environmental impacts of DHTs in assessment and procurement practices; (2) identify the factors enabling or constraining the operationalisation of such a change; and (3) encourage a constructive dialogue on how environmental issues fit within healthcare systems’ push for more DHTs.
Methods:
Semi-structured interviews were conducted with 29 stakeholders involved in DHTs in a large Canadian academic healthcare centre. Data were collected and analysed through a mixed deductive-inductive process using a framework derived from diffusion of innovations theories.
Results:
The integration of the environmental impact of DHTs in assessment and procurement is contingent upon key micro-meso-macrosystemic factors that either enable or constrain changes in practices and processes. Innovation (micro) factors include stakeholders’ recognition of the environmental issue and the extent to which it is feasible for them to address the environmental impact of DHTs. Organisational (meso) factors include the organisation's culture, leadership, policies, and practices, as well as the expertise and professional skillsets available. Finally, external (macro) factors include political and regulatory (e.g., national strategy, laws, standards, norms), economic (e.g., business models, public procurement), and professional and scientific factors (e.g., evidence, methodologies, clinical guidelines).
Conclusion:
Considering the environmental impact of DHTs depends on micro-meso-macrosystemic factors involving a variety of stakeholders and levels of governance, sometimes with divergent or even antagonistic objectives and expectations. It highlights the importance of better understanding the complexity inherent in the environmental shift in healthcare.
The Environmental Protection Agency classifies healthcare as one of the leading energy-consuming industries. Extensive energy is needed around the clock in healthcare institutions for lighting, ventilation, and operating medical equipment. However, there is a growing concern over the sustainability of energy utilization by healthcare institutions worldwide. This narrative review thus seeks to examine energy efficiency and utilization in healthcare institutions and energy management and conservation techniques and make recommendations for future optimal usage. The paper notes that healthcare institutions use different quantities of energy from diverse sources, including hydropower, biomass, solar energy, and wind power. However, energy consumption varies from one institution to another, with the number of beds and intensity of healthcare operations, with an average of 0.27 MWh m⁻². Moreover, this review also identified various techniques and measures to enhance energy efficiency, such as the variant refrigerant flow technology and the combination of renewable energy sources with diesel generators to reduce the cost of electricity. Overall, healthcare institutions need energy management systems such as automated energy monitoring technologies, to check the systems' efficiency. The same techniques can also help Middle Eastern healthcare institutions with efficient energy utilization. Ultimately, the literature review aims to introduce an approach that focuses on reducing site-level consumption of energy while increasing the quality of the energy used and hence, helping reduce energy costs while conserving the environment.
Determining the priorities for sustainable development involves critical problems identifying, the conditions creating necessary for successfully solving such problems, and identifying a set of methods and tools to ensure that these conditions are met. The existing quantitative approaches to the priorities definition do not consider the problems of resource provision of scientific priorities. The developed expert system makes it possible to use effectively multilevel information-logical structures for the systematic analysis of scientific priorities according to many criteria. It allows ensuring the transition from research goals to methods of achieving these goals, the choice of specific means and the development of the necessary research methodology.
Sosyal sorumluluk ve çevreyi esas alan sürdürülebilirlik kavramı son yıllarda önemli hale gelmiştir. Bu anlamda kurumların sürdürülebilirliğinin ölçümü önem kazanmış, sürdürülebilirliği ölçmeye yönelik performans tabanlı teknikler ortaya çıkmıştır. Bu performans ölçümlerinden biri de Sürdürülebilirlik Balans Skor Kart (SBSK) yaklaşımıdır. Bu çalışmanın amacı, Sürdürülebilirlik Balans Skor Kart (SBm SK)’ın beş boyutlu formunu bir sağlık kurumu olan Diş Hekimliği Fakültesi’nde uygulamaktır. Bu amaca yönelik olarak, kuruma ait beş boyutlu SBSK strateji haritası oluşturulmuştur. Boyutlar; “sürdürülebilirlik”, “finansal”, “müşteri (hasta)”, “iç süreçler”, “öğrenme ve gelişme” boyutlarıdır. Ardından her bir boyutun performansını ölçmede kullanılacak stratejik amaç ve değerlendirme ölçütleri belirlenmiştir. Daha sonra, boyutların performansı belirlenen stratejik amaç ve değerlendirme ölçütleri kapsamında incelenmiş ve açıklanmaya çalışılmıştır. Boyutların incelenmesi sırasında gerekli verilerin elde edilmesinde hem nitel hem de nicel veri toplama tekniklerinden faydalanılmıştır. Nitel verilerin elde edilmesinde mülakat çalışması yapılmıştır. Nicel verilerin elde edilmesinde ise, anket çalışması yapılmış ayrıca kurumun 2017-2018 yıllarına ait bilanço, gelir tablosu ve faaliyet raporlarından yararlanılmıştır. Araştırma sonucunda kurumun, sürdürülebilirlik boyutunda kısmen başarılı olduğu, finansal boyutta pozitif değerlere sahip olduğu ve gelişim gösterdiği, müşteri boyutunda ve iç süreçler boyutlarında genel olarak başarılı olduğu, öğrenme ve gelişme boyutunda ise çalışanlar kapsamında başarısız olduğu tespit edilmiştir. Toplamda ise, belirlenen 17 stratejik amaçtan 6’sında başarısız olduğu sonucuna ulaşılmıştır.
The objective of the present study was to identify the environmental sustainability indicators in the hospitals of Bihar, India and assess the performance of hospitals on these indicators. We adapted the sustainability index from Smercenik and Anderson (2011) and evaluated the environmental performance of hospitals on six dimensions: Sustainable Management, Managing Hospital Pollution, Environmental Communication, Resource Conservation, Energy Conservation, and Patient Room Sustainability. The sample consisted of 234 medical practitioners and administrative staffs employed in 76 private and government hospitals located in Bihar. The data were analyzed using SPSS 24. Descriptive statistics and bar graphs were used to examine the degree of implementation of environmental sustainability practices. The results revealed a below average level of implementation of sustainability practices in the sampled hospitals. The highest level of implementation was found for ‘resource conservation’ followed by ‘managing hospital pollution’, ‘patient room sustainability’, and ‘energy conservation’. The least implemented practices were ‘sustainable management’ followed by ‘environmental communication’ and ‘water recycling’. This study by investigating the status and nature of implementation of eco-friendly practices in a resource constrained state of India contributes to the scant knowledge base on the state of environmental sustainability from developing cities of the world. It provides important insights on current trends in the healthcare industry and paints a picture of environmental sustainability in hospitals.
Recent research and practice have shown that business model innovation can be one way to create and capture new value and drive production and consumption toward sustainability. However, business model tools typically do not create a space to consider how sustainability concerns may be integrated into the innovation process. To address this gap, this article describes a tool that can help companies identify new opportunities to create and capture value through sustainability by analyzing value captured and uncaptured for key stakeholders across the product life cycle. The Sustainable Value Analysis Tool is shown to help companies recognize value uncaptured and turn it into opportunities; it facilitates sustainability-focused business model innovation by identifying value uncaptured—and hence, opportunities for innovation—associated with environmental and social sustainability in production, use, and disposal.
Healthcare facilities throughout Europe are constantly changing to support efforts to provide efficient healthcare services with decreasing resources. Recent changes include larger and more specialist hospitals to achieve economies of scale. This approach has yet to be proven to sustainably respond to the demands, and efficiently satisfy the users’ needs. The evidence that supports larger healthcare facilities as more cost effective is limited and contradictory as wider sustainability issues need to be given greater consideration. This information paper presents the findings of a comprehensive literature review that addresses aspects that can lead to sustainable small healthcare facilities. It also establishes sustainable-related factors, including economics and energy efficiency, which could be employed to evaluate the viability of healthcare facilities. A typical small-scale facility provides a case study that contextualises these factors, captures their interdependencies, and explores the viability and sustainability of small hospitals. The findings from the work suggest that small facilities can be viable and more comprehensive research that provides a balanced view of economies of scale is required to support future healthcare design policies, where large and more specialised hospitals may no longer be environmentally, technologically, socially and economically sustainable.
Objective:
To develop a framework for evaluating and monitoring a primary health care service, integrating hospital and community services.
Method:
A targeted literature review of primary health service evaluation frameworks was performed to inform the development of the framework specifically for remote communities. Key principles underlying primary health care evaluation were determined and sentinel indicators developed to operationalise the evaluation framework. This framework was then validated with key stakeholders.
Results:
The framework includes Donabedian's three seminal domains of structure, process and outcomes to determine health service performance. These in turn are dependent on sustainability, quality of patient care and the determinants of health to provide a comprehensive health service evaluation framework. The principles underpinning primary health service evaluation were pertinent to health services in remote contexts. Sentinel indicators were developed to fit the demographic characteristics and health needs of the population. Consultation with key stakeholders confirmed that the evaluation framework was applicable.
Conclusion:
Data collected routinely by health services can be used to operationalise the proposed health service evaluation framework. Use of an evaluation framework which links policy and health service performance to health outcomes will assist health services to improve performance as part of a continuous quality improvement cycle.
Consumers increasingly turn to online health communities for health information and social support. Yet, the type of value consumers derive from online health communities is not well understood. This study examines social support as the mechanism through which consumers co-create and experience different types of value. Cutrona and Russell’s typology of social support and Holbrook’s consumer value typology are applied to posts and threads obtained from two online communities for people with Parkinson’s Disease and ALS. Results demonstrate that online health communities give consumers the opportunity to create and experience forms of consumer value that would not otherwise be available in a traditional health delivery system. The results lend support to a re-conceptualisation of medical practice and health delivery for consumers with chronic conditions
This article explores how corporate governance processes and structures are being used in large Australian companies to develop, lead and implement corporate responsibility strategies. It presents an empirical analysis of the governance of sustainability in fifty large listed companies based on each company’s disclosures in annual and sustainability reports. We find that significant progress is being made by large listed Australian companies towards integrating sustainability into core business operations. There is evidence of leadership structures being put in place to ensure that board and senior management are involved in sustainability strategy development and are then incentivised to monitor and ensure implementation of that strategy through financial rewards. There is evidence of a willingness to engage and communicate clearly the results of these strategies to interested stakeholders. Overall, there appears to be a developing acceptance amongst large corporations that efforts towards improved corporate sustainability are not only expected but are of value to the business. We suggest that this is evidence of a managerial shift away from an orthodox shareholder primacy understanding of the corporation towards a more enlightened shareholder value approach, often encompassing a stakeholder-orientated view of business strategy. However, strong underlying tensions remain due to the insistent market emphasis on shareholder value.
Purpose of the paper and literature addressedThe purpose of this paper is to examine how one of the most cited theories in sociology, structuration theory, might help inform our understanding of time in business networks. Structuration theory deals with the creation and maintenance of ideas and structures as well as with change and continuity processes. It defines a social system as any set of practices, patterns of interaction and social relationships that are relatively enduring.Research methodThis is a conceptual paper.Main contributionThis paper outlines improved theoretical and methodological bases in industrial marketing research, which specifically takes into consideration time. This new understanding draws upon Giddens structuration theory, and more recent critiques of his work.
This Special Issue of Industrial Marketing Management brings together a range of articles by authors who have undertaken the difficult task of researching time and process in business networks. Understanding interaction processes within a business relationship and network perspective requires the elaboration of time, the central construct by which humans grasp and comprehend change. As an introduction to the articles we present the concept of human time and delineate accordingly three methodological approaches available for the study of network processes. We also introduce the authors' contributions to the special issue that broadly divide into two groups: those that deal with methodological issues concerning the study of processes in business networks and those that consider the role of time and timing for studying business processes.
Given the significant, sustained growth in services experienced worldwide, Arizona State University’s Center for Services Leadership embarked on an 18-month effort to identify and articulate a set of global, interdisciplinary research priorities focused on the science of service. Diverse participation from academics in a variety of disciplines working in institutions around the world—in collaboration with business executives who lead organizations ranging from small startups to Global 1000 companies—formed the basis for development of the priorities. The process led to the identification of the following 10 overarching research priorities:
• Fostering service infusion and growth
• Improving well-being through transformative service
• Creating and maintaining a service culture
• Stimulating service innovation
• Enhancing service design
• Optimizing service networks and value chains
• Effectively branding and selling services
• Enhancing the service experience through cocreation
• Measuring and optimizing the value of service
• Leveraging technology to advance service
For each priority, several important and more specific topic areas for service research emerged from the process. The intent is that the priorities will spur service research by shedding light on the areas of greatest value and potential return to academia, business, and government. Through academic, business, and government collaboration, we can enhance our understanding of service and create new knowledge to help tackle the most important opportunities and challenges we face today.
The concept of sustainable development was placed on the international agenda with the release of the report Our Common Future by the World Commission on Environment and Development in 1987. Although considerable attention has since been devoted to the idea of sustainable development itself, the broader conceptual framework of the idea—whereby the Commission tried to integrate environmental policies and development strategies in order to create the foundation for a global partnership—has been neglected in much of the literature. The purpose of the present article is to offer an interpretation of Our Common Future, where the concept of sustainable development is linked to the broader framework of normative preconditions and empirical assumptions. The structure of the argument is to demonstrate that the relationship between sustainable development and economic growth has been over-emphasized, and that other vital aspects of the normative framework have been neglected. Social justice (both within and between generations), human istic solidarity, a concern for the world's poor, and respect for the ecolog ical limits to global development, constitute other aspects of sustainable development; aspects which are indeed relevant for the growing disparity between North and South.
This paper discusses internal dynamics of the firm that contribute to the failure of knowledge conditions, using the Enron scandal as a case study. Ability of the board to effectively monitor conduct at operational levels includes various dynamics: senior management being isolated from those at operational levels; individuals pursuing subgoals that are contrary to overall corporate goals; information flow along a narrow linear channel that effectively forecloses adverse information from getting to senior management; a corporate culture of intimidation, discouraging open expressions of doubt or skepticism, resulting in reluctance to challenge senior officials, and pushing the limits of ethics and the law.
Elements of information blockage in the corporation include: the "law of diminishing control"; deliberate concealment of information by officers; motivation to report to the boss what one perceives the boss wants to hear; theory of "bounded rationality" that explains surprising role of irrationality in decisionmaking – unconscious emotions and motivations. Discussion of behavioralist studies of cognitive dissonance, belief perseverance, confirmatory bias, entity effect, motivated reasoning, group cohesion or "groupthink," and the false consensus effect. Problem of overoptimism – tendency of many people to overrate their own abilities, contributions and talents – and tendency toward puffery and dismissal of risks in formulating disclosures and press releases.
Imposing liability on directors for failure of oversight is extremely difficult to sustain in a court of law. Directors are likely to face much greater demands of accountability in the wake of Enron. Solutions to enhance flow of information include programs to encourage employees to expose wrongdoing without fear of retribution; devising of communication system that enables important information to move upward to the proper decisionmaker without getting distorted; restructuring of audit committees, providing adequate training for new directors, expanding the number of independent directors on the board. In the wake of Enron, corporations may simply have no choice but to meet increased demands by workers, shareholders, customers and the government for greater accountability.
Appendix to paper discusses the history of the corporation, moral dilemmas of the shareholder-centric model, and whether important social goods sometimes trump the notion of profit-maximization.
Purpose – The authors perform a large-scale literature review and use conceptual theory building to introduce the concept of sustainability to the field of supply chain management and demonstrate the relationships among environmental, social, and economic performance within a supply chain management context. Design/methodology/approach – Conceptual theory building is used to develop a framework and propositions representing a middle theory of sustainable supply chain management (SSCM). Findings – The authors introduce the concept of sustainability – the integration of environmental, social, and economic criteria that allow an organization to achieve long-term economic viability – to the logistics literature, and position sustainability within the broader rubric of SSCM. They then present a framework of SSCM and develop research propositions based on resource dependence theory, transaction cost economics, population ecology, and the resource-based view of the firm. The authors conclude by discussing managerial implications and future research directions, including the further development and testing of the framework's propositions. Originality/value – This paper provides a comprehensive review of the sustainability literature, introduces sustainability to the field of supply chain management, and expands the conceptualization of sustainability beyond the triple bottom line to consider key supporting facets which are posited to be requisites to implementing SSCM practices. The use of conceptual theory building to develop theoretically based propositions moves the concept of sustainability from a relatively a-theoretical treatment toward new theory in supply chain management.
This article deals with the temporality in business networks. Marketing as networks approach stresses interaction processes and interdependence among actors noting that business markets are mainly socially constructed. The approach has increased our understanding of business marketing but further attention for theory development and empirical validation is needed. Theoretical foundations of the approach are conceptually analysed here, taking time and timing into particular consideration. A model of event net-works is developed as an approach to understand temporality in busi-ness networks. The event network perspective is exemplified using practical cases. It is argued that extensions of network theory, methods and models can be approached using connected events as a base.
This paper argues that widely accepted understanding of the respective responsibilities of business and government in the post war industrialized world can be traced back to a tacit social contract that emerged following the second world war. The effect of this contract was to assign responsibility for generating wealth to business and responsibility for ensuring the equitable sharing of wealth to governments. Without question, this arrangement has resulted in substantial improvements in the quality of life in the industrialized world in the intervening period. I argue that with advance of economic globalization and the growing power and influence of multi national corporations, this division of responsibilities is not longer viable or defensible. What is needed, fifty years after the United Nations Declaration of Human Rights, is a new social contract that shares responsibilities for human rights and related ethical responsibilities in a manner more in keeping with the vision captured by the post war Declaration. I conclude by suggesting some reasons for thinking that a new social contract may be emerging.
Purpose:
To frame the sustainable development in private hospitals, based on descriptive determinants of orientation and organization from the past to the present.
Design/methodology/approach:
Based on an inductive approach, judgmental sampling was used to target relevant health care organizations. Informants were assessed according to their knowledge of their organizations' sustainability initiatives.
Findings:
Report the main determinants of orientation and organization revealed in relation to the hospitals' past and present sustainability initiatives, providing a foundation for describing their sustainable development.
Research limitations/implications:
Reveals a selection of descriptive determinants of sustainable development in private hospitals, all of which offers a basis for assessing whether the evolution of organizational sustainability initiatives is major, minor or non-existent.
Managerial implications:
The sustainability orientation has changed from value-based initiatives to business-based ones. It has also resulted in the orientation changing from environmental initiatives to social ones, as well as a change from reactive initiatives to proactive ones.
Originality/value:
Contributes to framing sustainable development through descriptive determinants in private healthcare organizations. It also divides these determinants into two categories, namely the orientation and organization of sustainability initiatives.
The authors review the concepts of social responsibility and business ethics as well as some of the reasons why their adoption by marketing practitioners has been somewhat limited. An approach is developed to integrate these concepts into the strategic marketing planning process.
The interaction between marketing actions with a social dimension and marketing actions with an economic orientation is at the heart of this study. The authors introduce institutional theory as the theoretical lens used to inform this research. Results from an experiment in a retail context show that there is a minimum acceptable level of marketing actions with a social dimension, below which the effectiveness of a firm's economic-oriented actions is hindered significantly.
Purpose
The purpose of this paper is to examine the logic and differentiators of organizational positioning and planning of sustainability initiatives between private and public organizations in the healthcare industry. Sustainability initiatives refer to organizations’ economic, social and environmental actions.
Design/methodology/approach
This study is based on an inductive approach judgmental sampling and in-depth interviews of executives at private and public hospitals in Spain have been used. Data were collected from the directors of communication at private hospitals, and from the executive in charge of corporate social responsibility in public hospitals. An empirical discourse analysis is used.
Findings
The positioning and planning of sustainability initiatives differs between private and public hospitals. The former consider sustainability as an option that is required mainly for social reasons, a bottom-up positioning and planning. It emerges merely spontaneously within the organization, while the sustainability initiatives in public hospitals are compulsory. They are imposed by the healthcare system within which the public hospital, operates and constitutes a top-down positioning and planning that is structured to accomplish set sustainability goals.
Research limitations/implications
A limitation of this study is that it is undertaken exclusively in Spanish organizations from one industry. This study differs from previous ones in terms of exploring the positioning and planning of the sustainability initiatives, which focus on the organizational logic of such sustainability initiatives. There are both common denominators and differentiators between private and public hospitals.
Practical implications
The logic of determining the positioning and planning of the sustainability initiatives is mainly about satisfying organizational needs and societal demands. Nowadays, organizations tend to engage in sustainability initiatives, so it is essential to understand the logic of how organizations position and plan such efforts.
Originality/value
This study investigates the path that follows sustainability initiatives in public and private organizations. It reports mainly differentiators between private and public organizations. It also contributes to explaining the organizational reasoning as to why companies make decisions about sustainability initiatives, an issue which has not been addressed sufficiently in existing theory studies.
This study investigates challenges of implementing green public procurement (GPP) in Australian public healthcare sector. Through an extensive literature review it develops a framework of GPP implementation that incorporates five challenge-categories and sixteen challenges. The problem is structured as an analytic hierarchy process (AHP) based multi-criteria decision-making model. The AHP-based structured interviews are conducted with the health-procurement executives to collect data and information. The results of the analysis reveal that the key challenge-categories of green health procurement are related to government, NGO and public issues, and organisational green issues. The most critical challenges found are lack of legislation on green procurement, senior management support for green, government incentives for green purchase, and lack of financial support. Some of the least important challenges identified are green preferences in purchasing, understanding of green policy, availability of green product supplier, and collaboration with supplier. The most critical challenges are mainly strategic, whereas, the least important challenges are operational in nature. An insight into the criticality of the challenges and a clear understanding of their decision-making domains could assist public health institutions devising strategies and policies on green procurement.
Purpose
The purpose of this paper is to frame the development and directions of business sustainability efforts.
Design/methodology/approach
A qualitative study was undertaken with respect to a convenience sample of reputable companies in Norway, which have implemented significant business sustainability efforts within their organisations, their business networks, the marketplace and in the society, beyond the level of mere compliance.
Findings
Different directions are associated with the development of corporate efforts in connection with business sustainability. Business sustainability efforts are not static, but dynamic and based upon continuous flexibility to changes and adaptations over time.
Research Limitations/implications
The current study highlights the need for further research into the development and directions of corporate efforts in connection with business sustainability in the marketplace and society. A key suggestion for further research is to further explore the existence of other directions.
Practical Implications
The directions reported, provide a framework to assess the development or the status of companies’ business sustainability efforts in the marketplace and society. Corporate efforts in connection with business sustainability develop over time as experiences are gained and personal impressions move the identified directions forward.
Originality/value
This study contributes to seven interconnected directions of corporate efforts in connection with business sustainability that are both relevant and potentially fruitful to both scholars and practitioners.
Sustainable development refers to an economic, environmental and social development that meets the needs of the present and does not prevent future generations from fulfilling their needs. In this context, businesses play an important role. However, progress towards sustainable development has been slow, indicating the need for more concrete guidance that will allow businesses to act strategically and successfully in a sustainable way. This theoretical paper connects three distinct, but complementary, dimensions of strategic management as viewed from the perspective of sustainability in order to encourage the integration of sustainability issues into corporate activities and strategies. These three dimensions are: strategy process, strategy content and strategy context. Sixteen propositions related to these dimensions have been developed to explore the contributions of corporate sustainability management to the creation of value for businesses, society and nature. This theoretical discussion contributes to existing research in that it reveals relationships between strategic management and sustainable development and provides an agenda for further empirical research.
Corporate social responsibility (CSR) expresses a fundamental morality in the way a company behaves toward society. It follows ethical behavior toward stakeholders and recognizes the spirit of the legal and regulatory environment. The idea of CSR gained momentum in the late 1950s and 1960s with the expansion of large conglomerate corporations and became a popular subject in the 1980s with R. Edward Freeman’s Strategic Management: A Stakeholder Approach and the many key works of Archie B. Carroll, Peter F. Drucker, and others. In the wake of the financial crisis of 2008–2010, CSR has again become a focus for evaluating corporate behavior. First published in 1953, Howard R. Bowen’s Social Responsibilities of the Businessman was the first comprehensive discussion of business ethics and social responsibility. It created a foundation by which business executives and academics could consider the subjects as part of strategic planning and managerial decision–making. Though written in another era, it is regularly and increasingly cited because of its relevance to the current ethical issues of business operations in the United States. Many experts believe it to be the seminal book on corporate social responsibility. This new edition of the book includes an introduction by Jean–Pascal Gond, Professor of Corporate Social Responsibility at Cass Business School, City University of London, and a foreword by Peter Geoffrey Bowen, Daniels College of Business, University of Denver, who is Howard R. Bowen’s eldest son. © 2013 by the Estate of Howard R. Bowen and 1953 by the Federal Council of the Churches of Christ in America.
Purpose
This paper aims to describe and discuss a balance model of theoretical business sustainability, to leverage the inferior side, so as to enhance performance.
Design/methodology/approach
A conceptual description and discussion are provided, along with an empirical depiction.
Findings
The empirical illustration presents one organization that embodies the goals of theoretical business sustainability in the marketplace and society.
Research limitations/implications
Further research is needed to enhance our understanding of the phenomenon and performance of business sustainability in supply chains.
Practical implications
Findings highlight that there is no justification for practitioners to strive consistently for anything other than theoretical business sustainability, and stakeholders need to push organizations in that direction.
Originality/value
The paper contributes to our understanding of what should be done and why business sustainability performance should be improved in supply chains.
The strategic leadership of ethical behavior in business can no longer be ignored. Executives must accept the fact that the moral impact of their leadership presence and behaviors will rarely, if ever, be neutral. In the leadership capacity, executives have great power to shift the ethics mindfulness of organizational members in positive as well as negative directions. Rather than being left to chance, this power to serve as ethics leaders must be used to establish a social context within which positive self-regulation of ethical behavior becomes a clear and compelling organizational norm and in which people act ethically as a matter of routine. This article frames the responsibility for strategic leadership of ethical behavior on three premises: (1) It must be done - a stakeholder analysis of the total costs of ethical failures confirms the urgency for ethics change; (2) It can be done - exemplars show that a compelling majority of an organization's membership can be influenced to make ethical choices; (3) It is sustainable-integrity programs help build and confirm corporate cultures in which principled actions and ethics norms predominate.
Research on time in organizations spans disciplines and introduces a wide range of concepts. Here we set out to find an underlying structure to clarify the current state of temporal research. Our examination yields three categories of variables: conceptions of time, mapping activities to time, and actors relating to time. We elaborate intricacies within each category, interrelationships among categories, and assumptions made in each category about the others. We then use the framework to compare existing studies and generate propositions to develop the notion of temporal fit.
The authors review the concepts of social responsibility and business ethics as well as some of the reasons why their adoption by marketing practitioners has been somewhat limited. An approach is developed to integrate these concepts into the strategic marketing planning process.
Supported by a qualitative study of triple bottom line (TBL) firms—those that simultaneously prioritize economic, social, and environmental objectives—we investigated the market logic and practices of TBL firms to better understand how they fulfill their mission and achieve their goals. We explored if and how TBL firms may differ in their approach to stakeholders and the management of their resources, including dynamic capabilities. We employed a research design that emphasizes the iterative comparison of narrative data within themselves and with scholarly literature [i.e., resource-based view (RBV)] to develop new theoretical insights. Because the RBV is commonly used to theorize how firms achieve competitive advantage, we explored whether TBL firms achieve competitive advantage differently from what RBV theory would predict. Our data suggest that how a firm defines value has a significant influence on the capabilities it creates and how it treats its resources. We find that TBL firms redefine value to not only focus on the end product or service but also to include the systemic cost of delivering goods. As a result, TBL firms differ from prevailing scholarly thought in RBV. They strive to have resources that are sustainable and therefore imitable, commonly found, and substitutable. Moreover, they are not only transparent in their processes but also collaborate with others in the value chain and in their sector. In doing so, they deliberately create new markets from which other firms can benefit. Rather than focusing on competitive advantage, they focus on collaborative advantage.
Purpose
– The purpose of this paper is to describe: corporate reasons for, and organizational challenges of sustainable business models; and the evolution of economic effects, social boundaries and environmental actions in sustainable business practices.
Design/methodology/approach
– This study is based on insights gained from eight Norwegian companies in different industries. Purposeful sampling was employed to ensure that the companies had sustainable business models beyond the level of mere compliance, of sustainable business practices in the marketplace and society. A deductive approach to data collection ensured that the companies had sufficient understanding to relate their sustainable business practices to interviewers. The interviews were subsequently transcribed and analyzed systematically by the research team.
Findings
– The empirical findings indicate evolutionary changes as companies move on a continuum from superficial to embedded sustainable business models and the application of sustainable business practices. The planning, implementation and evaluation of sustainable business models evolves over time within companies and their supply chains, as well as in the marketplace and society.
Research limitations/implications
– A limitation of this study is that it is exclusively undertaken in Norwegian companies, although the companies are from different industries with different characteristics. Future research is clearly necessary and will be conducted in other countries in similar industries, so as to explore the empirical findings from this study in other contexts. In addition, the interfaces between environmental actions, economic effects and social boundaries need to be investigated further.
Originality/value
– The study contributes to a growing body of knowledge on corporate reasons for and organizational challenges of sustainable business models, as well as environmental, social and economic aspects of sustainable business practices.
Purpose
– The aim of this paper is to provide a snapshot of the existing research and suggest potential opportunities for academic inquiry related to the concept of sustainable supply chain management.
Design/methodology/approach
– The researchers review the extant literature at the intersection of “sustainability” and “supply chain management”. This literature is subsequently categorized with the aid of a classification matrix derived from the literature in order to review the current state of thought development across three distinct disciplines (logistics/supply chain management, operations/production management and social/environmental management). The analysis suggests future research opportunities in this area.
Findings
– The findings indicate that the existing literature is primarily focused on individual sustainability and supply chain dimensions rather than taking a more integrated approach. In addition, the findings suggest both the emergence of a group of themes within an individual dimension, such as green logistics within the environmental dimension as well as a set of themes that are consistent across dimensions. The analysis establishes several areas of opportunity for future inquiry.
Originality/value
– The paper contributes to our knowledge on sustainability as it relates to supply chain management by using the triple bottom line approach and supply chain management elements that had been previously established in literature as a means to classify extant literature in this space and identify specific research opportunities in a systematic manner.
Purpose
– The paper seeks to demonstrate how local entities, such as cities and counties, can use environmentally preferable purchasing plans as a tool in developing the local green economy. First, the authors focus specifically on either the rise of economic development programs through buy‐local efforts, or the focus on environmental sustainability through green procurement programs. Second, the authors discuss how locally driven, environmentally preferable purchasing could be used as a strategy to marry these goals together and utilize procurement as a tool to achieve green local economic development.
Design/methodology/approach
– This research used qualitative methods to examine both procurement for economic development through the use of buy local campaigns, in addition to environmentally preferable procurement policies that have been used to bolster environmental quality in communities.
Findings
– Green local economic development can be achieved by melding together procurement programs previously singularly focused on either economic development aims, or environmental preservation. It is found that procurement can be used as a viable tool in fostering both economic and environmental goals, and as a key policy and planning tool for sub‐national governments in the pursuit of a green economy.
Originality/value
– Given the increased attention of achieving sustainable development in communities, this paper seeks to re‐envision procurement as one crucial tool for municipalities and regional governments that seek to bolster green jobs in their communities. The paper seeks to develop a new framework for public procurement through this investigation.
This article is written in the context of current British interest in management training and development, in which an emphasis on “competency” is viewed critically, as technically oriented, with little attention paid to ethics and moral values. It is suggested that a concern for ethics in management development can be expressed in terms of four requisite management “attributes” or “qualities”: theoretical knowledge and understanding; affective qualities; personal and interpersonal skills; and self-knowledge. Following Kohlberg's work on moral development, the cultivation of these attributes is viewed as a life-span process involving three broadly defined forms of management development practice, each appropriate to different circumstances and stages in a learner's career. It is concluded that the conventional teaching of theory, learning from experience and counselling/mentoring, are equally important in the contribution which management development can make to the resolution of ethical dilemmas in business practice.
The lack of consideration of process dimensions of time in business marketing and management literature in general and in B2B case-based research in particular is in sharp contrast to the importance of time in our society. Marketing scholars need a stronger involvement of time to enrich case study research. This paper offers a structure and a set of questions on critical elements of time and presents a review of the debate on and treatment of time in management and (case-based) marketing science. Based on case-based articles in Industrial Marketing Management and the Journal of Business and Industrial Marketing (2004–2006), a content analysis of seven process dimensions is presented that reveals a limited presence of time aspects. Our findings indicate that case studies can benefit from an explicit incorporation of time and its different dimensions. While often only steps or stages are described and references to the flow of time are made, richer case studies also include the dimensions of duration, timing, frequency, pace and order. That way business marketing researchers will be able to deepen their case observations thereby increasing their learning.
This article defines corporate social performance (CSP) and reformulates the CSP model to build a coherent, integrative framework for business and society research. Principles of social responsibility are framed at the institutional, organizational, and individual levels; processes of social responsiveness are shown to be environmental assessment, stakeholder management, and issues management; and outcomes of CSP are posed as social impacts, programs, and policies. Rethinking CSP in this manner points to vital research questions that have not yet been addressed.
Interaction is central to the relationship framework in business markets. Yet there is some theoretical imprecision with regard to the way interaction works in time. Clarification of this nexus further develops the interaction concept and provides theoretical support for the dynamic view of business relationships being developed by the industrial marketing and purchasing (IMP) group. The role of time as a backdrop for interaction is elaborated in conjunction with the cognitive ability of humans to arrive at an understanding of interfirm interaction. This elaboration extends the concept of horizontal relationship time (i.e., past, present, future), illustrates constraints on interfirm interaction, and analytically distinguishes between interaction as exchange versus adaptation while also displaying the importance of the actor in business relationships. In addition, theoretical grounds are provided for dismissing business relationship life cycle theories. Finally, the cognitive nature of time and relationships provides a means for theory development and management implications free from cultural and normative overtones.
Purpose
The purpose of this paper is to show how macro‐social marketing and social engineering can be integrated and to illustrate their use by governments as part of a positive social engineering intervention with examples from the Canadian anti‐smoking campaign.
Design/methodology/approach
This is a conceptual paper that uses the case of the Canadian anti‐smoking campaign to show that macro‐social marketing, as part of a wider systems approach, is a positive social engineering intervention.
Findings
The use of macro‐social marketing by governments is most effective when it is coupled with other interventions such as regulations, legislation, taxation, community mobilization, research, funding and education. When a government takes a systems approach to societal change, such as with the Canadian anti‐smoking campaign, this is positive use of social engineering.
Research limitations/implications
The social marketer can understand their role within the system and appreciate that they are potentially part of precipitating circumstances that make society susceptible to change. Social marketers further have a role in creating societal motivation to change, as well as promoting social flexibility, creating desirable images of change, attitudinal change and developing individual's skills, which contribute to macro‐level change.
Practical implications
Social marketers need to understand the structural and environmental factors contributing to the problem behavior and focus on the implementers and controllers of society‐wide strategic interventions.
Social implications
Eliminating all factors which enable problem behaviors creates an environmental context where it is easy for consumers to change behavior and maintain that change.
Originality/value
The value of this paper is in extending the literature on macro‐social marketing by governments and identifying the broader strategy they may be undertaking using positive social engineering. It is also in showing how marketers may use this information.
This groundbreaking text focuses on the application of sustainability and sustainable development theories to public administration practice. It's designed to guide planning, resource management, and outcomes measurement for future and current non-profit and public managers.
The book introduces sustainable development and related theories; ties these theories to public administration practice; and elaborates on applications to specific PA specializations including energy management, transportation, water, waste management, urban development, wildlife conservation, and higher education. It also includes a chapter specifically geared to outcome measurement of sustainability goals in public and non-profit agencies.
Currently, many businesses are implementing a proactive, strategic tool known as an environmental management system (EMS) to gain a competitive advantage. Companies can no longer simply use compliance plans to deal with environmental concerns; consumer demands for greener products and services, and operational efficiencies require long term strategic and sustainable approaches for environmental management. An EMS includes documentation of: commitment and policy; planning; implementation; measurement and evaluation; and review and improvement. Establishment and maintenance of an EMS can be costly and time consuming, therefore implementation should be carefully structured to assure success. This paper identifies human resource (HR) factors such as top management support, environmental training, employee empowerment, teamwork, and rewards systems as key elements of the implementation process of an EMS. Furthermore, the interaction of these factors is examined in terms of the five categories of an EMS mentioned above. Finally, a conceptual model of the EMS-HR factors is proposed to assist in proper facilitation of the environmental management program.
In this article I describe and compare ct number of alternative generic strategies for the analysis of process data, looking at the consequences of these strategies for emerging theories. I evaluate the strengths and weaknesses of the strategies in terms of their capacity to generate theory that is accurate, parsimonious, general, and useful and suggest that method and theory are inextricably intertwined, that multiple strategies are often advisable, and that no analysis strategy will produce theory without an uncodifiable creative leap, however small. Finally, I argue that there is room in the organizational research literature for more openness within the academic community toward a variety of forms of coupling between theory and data.
This paper contrasts the normative foundations of the stakeholder and shareholder theories of the firm. It demonstrates how the shareholder theory of the firm appears to have at least as much normative support as stakeholder theory and suggests that a way forward may be for a variant of pure shareholder theory to emerge.
In this paper we propose the notion of temporal structuring as a way of understanding and studying time as an enacted phe-nomenon within organizations. We suggest that through their everyday action, actors produce and reproduce a variety of tem-poral structures which in turn shape the temporal rhythm and form of their ongoing practices. A focus on temporal structur-ing, combined with a practice perspective, allows us to bridge the subjective-objective dichotomy that underlies much of the existing research on time in organizations. After developing the notion of temporal structuring, we illustrate its use in the con-text of a prior empirical study. We conclude by outlining some implications of temporal structuring for organizational research on time.
Although time has been included in theory and theory building as a boundary condition, this paper argues that time can and should play a more important role because it can change the ontological description and meaning of a theoretical construct and of the relationships between constructs. We suggest that theorists explicitly incorporate multiple aspects of temporality into the “what, how, and why” building blocks of their theories. First, we describe six important time dimensions that we propose are especially relevant to theory building about people, groups, and organizations: the past, future, and present and the subjective experience of time; time aggregations; duration of steady states and rates of change; incremental versus discontinuous change; frequency, rhythms, and cycles; and spirals and intensity. Second, we put forward a series of time-related questions that can serve as a guide or template for improving theory building through the incorporation of temporality into the what, how, and why of theories. Third, we propose how temporality can be incorporated into theorizing, viewed from a process standpoint. Lastly, we demonstrate how the explicit incorporation of time into theoretical analyses may not only lead to better theorizing and theories but also shed light on ongoing debates in the organizational literature.
The stock market crash of 1987 had a profound effect on corporate Australia and the Australian community in general. The fall-out revealed that some of our most respected business figures had not been as ethical, or even as lawful, as we would have hoped. This impropriety produced in Australia an awakening to business ethics. Whilst many companies endeavoured to introduce ethical practices into their corporations, they perceived ethics as a way of minimising damage to the corporation and in some cases as a means of competitive advantage. What was lost was the reason that one should embark on business ethics; and that is to make the society and corporate Australia a more ethical place in which to exist.This paper proposes a model based on 2 factors: commitment and partnerships, as a means of enabling corporate Australia to refocus attention on the main purpose of being inherently ethical in all that we do. This ethical model requires a commitment to partnerships with all stakeholders both internal and external in an attempt to enhance the level of ethical business practices that are contemplated and pursued within corporate Australia. Whilst the research agenda and the information collected is Australian-based, it is hoped that the ideas contained within this paper will have a wider appeal to corporations in similar cultural settings.