The Path towards Healthcare Sustainability: The Role of Organisational Commitment

Translating Planetary Health Principles Into Sustainable Primary Care Services

Global anthropogenic environmental degradations such as climate change are increasingly recognized as critical public health issues, on which human beings should urgently act in order to preserve sustainable conditions of living on Earth. "Planetary Health" is a breakthrough concept and emerging research field based on the recognition of the interdependent relationships between living organisms-both human and non-human-and their ecosystems. In that regards, there have been numerous calls by healthcare professionals for a greater recognition and adoption of Planetary Health perspective. At the same time, current Western healthcare systems are facing their limits when it comes to providing affordable, equitable and sustainable healthcare services. Furthermore, while hospital-centrism remains the dominant model of Western health systems, primary care and public health continue to be largely undervalued by policy makers. While healthcare services will have to adapt to the sanitary impacts of environmental degradations, they should also ambition to accompany and accelerate the societal transformations required to re-inscribe the functioning of human societies within planetary boundaries. The entire health system requires profound transformations to achieve this, with obviously a key role for public health. But we argue that the first line of care represented by primary care might also have an important role to play, with its holistic, interdisciplinary, and longitudinal approach to patients, strongly grounded in their living environments and communities. This will require however to redefine the roles, activities and organization of primary care actors to better integrate socio-environmental determinants of health, strengthen interprofessional collaborations, including non-medical collaborations and more generally develop new, environmentally-centered models of care. Furthermore, a planetary health perspective translated in primary care will require the strengthening of synergies between institutions and actors in the field of health and sustainability.

Innovations and eco-sustainability: exploring the role of organizational environment

Purpose

This paper aims to analyze the contribution of the diffusion of innovation framework to eco-sustainability. It examines the interplay of organizational environment, innovation and innovation adopters’ characteristics on the diffusion of environmental sustainability.

Design/methodology/approach

The data for empirical validation were obtained through an offline survey from the hospitals. The proposed conceptual framework was tested using the hierarchical regression analysis technique.

Findings

The results show that diffusion of innovation characteristics and organizational environment significantly influence the environmental sustainability index. The adopters’ characteristics do not have any direct effect on the environmental sustainability but this effect becomes significant in the presence of a favorable organizational environment.

Practical implications

Focusing on innovations that offer an advantage over the existing processes, are compatible with the existing system, are uncomplicated and simple to implement and can be experimented before full implementation may greatly accelerate the adoption of eco-innovations in hospitals. Fostering an organizational environment where employees are encouraged and rewarded for contributing to sustainable innovations can play a substantial role in the implementation of environmental sustainability innovations.

Originality/value

This study is an original contribution as it advances the limited understanding of the predictors and moderators of environmental sustainability in hospitals.

Public-private partnership in health care organizations. How to cope with complexity issues: a comparative case-study between Italy and the US

Purpose

Health-care systems around the globe share several pressing challenges – including increasing costs and patient outcomes. Innovative arrangements, such as public–private partnerships (PPP) can be adopted to help address these challenges. Although the promise of PPPs is great, so are its peril if the arrangements are not managed and regulated adequately through the contracting process. Yet, PPP arrangements can introduce their own unique set of problems. This paper aims to analyze how PPPs contracting accounts for three major problems identified reviewing the: performance measurement and audit; determination of compensation and risk management–related issues.

Design/methodology/approach

The authors used a case study approach to analyze contracting among health-care PPPs in two countries: Italy and the USA. With a structured review performed on Scopus database using a keywords Boolean research, the authors identified three recurring major issues to investigate in two selected cases, one per country. For each major issue, the authors defined several sub-issues retrieved from a widely used institutional framework. In each sub-issue, a documental analysis on all published information related to the signed contract has been performed identifying the approaches used by the two organizations.

Findings

The authors find that PPP contracting in the USA case seems to be oriented more toward managing institutional change as well as more flexibility in the deductibility and compensation determination for organizations and providers, suggesting this organization is more oriented to change in general. The authors find that PPP contracting in Italy more clearly delineate the allocation of risk between organizations that engage in PPPs, suggesting a more practical approach.

Practical implications

PPP is complex. Contracting helps manage the complexity of these arrangements. This case study approach to PPP contracting highlights the variation in contracting approaches across two different countries. Policymakers and health-care managers need to ensure that PPP contracting clearly delineates auditing and performance measurement, compensation and risk management.

Originality/value

The authors’ analysis sheds light on the different approaches to arranging health-care PPPs in two different country settings. More research should be done to connect these different approaches to important outcomes, such as patient and organizational finances, as well as expanding the scope of countries adopting PPP in health care.

Determinants of diffusion of environmental sustainability innovations in hospitals of Bihar state in India

Purpose

This paper aims to examine the effect of the characteristics of innovation and change adopters on the rate of adoption of environmental sustainability innovations in hospitals of Bihar state in India.

Design/methodology/approach

Data were collected from hospital administration, managers, doctors, nurses and staff working at various levels in both public and private hospitals of Bihar. Research model was tested using regression analysis with the help of statistical package for social sciences 24.

Findings

Innovation characteristics of relative advantage, simplicity, trialability and compatibility were found to significantly predict the adoption of eco-innovations while innovativeness and environmental opinion leadership failed to demonstrate any significant impact on sustainability adoption in hospitals.

Originality/value

This study provides important information to the change agents on how to diffuse green innovations in the unsustainable and inefficient areas and make them more sustainable. With no systematic investigation of sustainability innovations being done in the health-care sector in India, this study on eco-innovations in a resource-constrained state of India provides a fresh perspective and practical insights on the state of sustainability innovations in health care.

The Social Dimensions of Corporate Sustainability: An Integrative Framework Including COVID-19 Insights

Corporate sustainability is considered a fundamental paradigm and solution in creating a prosperous future for organizations. However, social sustainability issues and pandemic problems from COVID-19 have affected corporations and interrupted plans for sustainable development. To date, corporate sustainability frameworks have taken a relatively narrow view of this paradigm. This study highlights serious challenges to corporate sustainability while providing a framework in an attempt to enable more sustainable business practices. To fill the gap in the literature, we have developed a framework to organize and prioritize important sustainability indicators. The first phase of the study involves the classification of 45 sub-criteria of corporate sustainability under nine main categories by using a literature review and novel Fuzzy Delphi method. The resulting categories are Corporate Governance, Product Responsibility, Transparency and Communication, Economic, Environmental, Social, Natural Environment and Climate Vulnerability, Energy Consumption along with Energy Saving, and includes Pandemic COVID-19 as a new aspect of social sustainability. Next, we applied the Fuzzy Analytical Hierarchical Process (FAHP) to help determine the weights and prioritizing the criteria and sub-criteria. The results revealed that the Pandemic, along with the Natural Environment and Climate Vulnerability, ranked higher among the main criteria category. Whereas, emergency response planning, social distances, modification of working hours, and just-in-time delivery are the most influencing sub-attributes among the 45 sub-barriers of different categories. Contributions of this study include new insights regarding corporate sustainability criteria and subcriteria, application of novel methods, and integrated framework for dimensions of corporate sustainability. This study is among the first of its kind to consider the COVID-19 pandemic as an essential category and social sustainability attribute of corporate sustainable business practices. Outcomes of this study can help assist scholars, corporations, and decision-makers in understanding sustainable development initiatives while simultaneously improving social sustainability practices.

Predicting Nurses Burnout through Quality of Work Life and Psychological Empowerment: A Study Towards Sustainable Healthcare Services in Malaysia

The nursing profession is a much-demanded profession that requires the individual capacity to work under intense physical and emotional dynamics in the workplace. Work related factors cause burnout and need attention from scholars and professionals to reduce the effects of the burnout among nursing staff. This study aimed to examine the meditational role of psychological empowerment and work-life quality on the burnout experiences of nursing staff in Malaysia. This study investigated a sample of 432 nursing staff from 10 registered hospitals in the Selangor area that have been listed on the Malaysian Health Tourism Council (MHTC) website. The responses collected via a self-reported questionnaire, and the data was analyzed using partial least square regression structural equation modelling (PLS-SEM). The findings statistically support the argument that the provision of quality of work-life (adequate and fair compensation, constitution in the work organization, safe and healthy working conditions, social integration in the work organization, social relevance of work-life, and work and life span) could promote psychological empowerment among nurses. Psychological empowerment statistically resulted in reducing the burnout effects by mediating the effect of work-life quality (QWL) on burnout. This study contributes to the literature that QWL factors need to be studied separately, and its affects on psychological empowerment, and how psychological empowerment permits curtails the effects of the burnout among nursing staff providing the services to health tourists. This study also provided important implications for the management staff of the nursing industry to initiate the management of burnout with the provision of psychological employment. The present study contributed to the current literature of burnout management through the psychological empowerment provided by the factors of the quality of work life.

Bibliometric Review of the Knowledge Base on Healthcare Management for Sustainability, 1994–2018

In response to the United Nations’ (UN) Sustainable Development Goals (SDGs), health care organizations throughout the world have adopted management initiatives designed to increase their sustainability. This review of research used bibliometric methods to analyze a dataset comprised of 477 documents extracted from the Scopus database. The review sought to document research on sustainable healthcare management (SHM) that has accumulated over the past 25 years. Results indicated that the intellectual structure of this body of knowledge is comprised of three schools of thought: (1) sustainable change in health care services, (2) innovations in managing health care operations, and (3) prioritizing and allocating resources for sustainability. The review also highlighted the recent topical focus of research in this literature. Key topics were linked to organization and management of health care services, quality of patient care, and sustainability of health care delivery.

Uganda public health fellowship program's contribution to building a resilient and sustainable public health system in Uganda

Background: Low-income countries with relatively weak-health systems are highly vulnerable to public health threats. Effective public health system with a workforce to investigate outbreaks can reduce disease impact on livelihoods and economic development. Building effective public health partnerships is critical for sustainability of such a system. Uganda has made significant progress in responding to emergencies during the past quarter century, but its public health workforce is still inadequate in number and competency.

Objectives: To reinforce implementation of priority public health programs in Uganda and cultivate core capacities for compliance with International Health Regulations.

Methods: To develop a competent workforce to manage epidemics and improve disease surveillance, Uganda Ministry of Health (MoH) established an advanced-level Field Epidemiology Training Program, called Public Health Fellowship Program (PHFP); closely modelled after the US CDC’s Epidemic Intelligence Service. PHFP is a 2-year, full-time, non-degree granting program targeting mid-career public health professionals. Fellows spend 85% of their field time in MoH placements learning through service delivery and gaining competencies in major domains.

Results: During 2015–2018, PHFP enrolled 41 fellows, and graduated 30. Fellows were placed in 19 priority areas at MoH and completed 235 projects (91 outbreaks, 12 refugee assessments, 50 surveillance, and 60 epidemiologic studies, 3 cost analysis and 18 quality improvement); made 194 conference presentations; prepared 63 manuscripts for peer-reviewed publications (27 published as of December 2018); produced MoH bulletins, and developed three case studies. Projects have resulted in public health interventions with improvements in surveillance systems and disease control.

Conclusion: During the 4 years of existence, PHFP has contributed greatly to improving real-time disease surveillance and outbreak response core capacities. Enhanced focus on evidence-based targeted approaches has increased effectiveness in outbreak response and control, and integration of PHFP within MoH has contributed to building a resilient and sustainable health system in Uganda.

Analysis of the Factors Affecting Sustainable Electronic Supply Chains in Healthcare Centers

To improve their long-term performance, organizations must maintain their business operations and practices over time. They can do so by engaging in sustainable practices aimed at meeting the interests of the enterprise, and of its suppliers, employees, and customers in the long run. Not surprisingly, the implementation of sustainability practices has expanded in the healthcare industry. Information technology (IT) is a way to promote quality, security, and efficiency in healthcare. IT brings vital information, and so important support to the care point for decision-making. It also allows the assessment of everyday quality turn into as a measured reality. In the present study, the factors affecting the sustainability of electronic supply chains in healthcare centers were identified using library methods and a keyword review of the literature. Then, the relationships between these factors were analyzed using an interpretive- structural modeling approach. The results reveal that infrastructure management and technology management should be considered the most important factors affecting the sustainability of electronic supply chains in healthcare centers.

Organizational commitment, psychometric qualities and invariance of the Meyer and Allen Questionnaire for Portuguese Nurses1

Objective:

to evaluate the psychometric qualities of the Portuguese version of the Organizational Commitment Questionnaire for the nursing context, through confirmatory analysis and invariance, aiming to evaluate the reliability, internal consistency, construct validity and external validity of the instrument.

Method:

confirmatory factor analysis of the Portuguese version of the questionnaire was carried out with a sample of 850 nurses, in hospital context. The analysis was complemented using specification search. Goodness of fit was evaluated through different indices. Reliability, internal consistency and construct validity were estimated. The invariance of the model was evaluated in two subsamples of the same sample, in order to confirm the external validity of the factorial solution.

Results:

the refined model demonstrated good overall fit (χ²/df=6.37; CFI=0.91; GFI=0.92; RMSEA=0.08; MECVI=0.62). The factorial structure was stable (λ:Δχ²(14)=18.31; p=0;193; Intercepts: Δχ²(14)=22.29; p=0.073; Covariance: Δχ²(3)=6.01; p=0.111; Residuals: Δχ²(15)=22.44; p=0.097).

Conclusion:

the simplified model of the questionnaire demonstrated adequate goodness of fit, representing a stable factorial solution. The instrument was fit to monitor and evaluate the organizational commitment of Portuguese nurses.