Enablers for, and barriers to, implementing environmental sustainability initiatives in hospitals in South Africa
Date
2014-01-09
Authors
Dube, Samukeliso
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Abstract
The global threat of climate change is one of the most crucial environmental
issues facing the world in modern times. Every organisation doing business has
a duty to stem this tide, and the health care industry - hospitals in particular - is
no exception. However, in trying to implement environmental sustainability
initiatives, organisations are faced with a number of challenges, and unless
drivers of and barriers to sustainability are identified, there will likely be a
disconnect between the desired outcomes of policies on environmental
sustainability.
This study, set within the hospital industry, sought to identify what hospitals are
doing to curb this environmental scourge, and in the same vein identify various
enablers of and barriers to the implementation of environmental sustainability
initiatives in South Africa.
Following a literature review identifying some of the initiatives implemented in
other industries and hospitals in other countries, and a review of factors that
enable and hinder the implementation of sustainability initiatives, this thesis
undertook qualitative enquiry among the private and public hospitals in the
Gauteng region of South Africa. Use was made of semi-structured interviews,
where a questionnaire was used to guide the researcher’s interview process. A
total of 17 respondents were interviewed covering ten hospitals of which three
were private institutions.
Data collected was analysed using the coding technique and was compared
and contrasted to the literature in a process of explanation building. It was
possible to identify six categories of initiatives being implemented: policy
initiatives, water conservation, energy conservation, green built environment,
behavioural and organisational structure initiatives. It was also possible to elicit
a total of five enablers and six barriers in the study that were all coded into
themes. The five enablers were: compliance to policy (both internal and external
policy); top management support; availability of suitable equipment; an enabling
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human resource strategy and availability of guidance documents. The six
themes that formed barriers were: lack of demand from stakeholders; lack of a
conducive organisational culture; inadequate resources; infrastructural
challenges; unclear policy guidance and technical and information challenges.
Furthermore, in contrast to some of the literature findings only four enablers
were identified as being relevant to the study and these were organisational
support, clear policy; regulatory enablers and traceability. Of the barriers,
knowledge deficiency, lack of staff motivation and lack of funding emerged as
the most inhibiting.
The main recommendation from this study is the need to develop a policy on
environmental sustainability in hospitals that will, through a consultative
process, guide actions of all parties involved in sustainability. This policy should
take into account the findings from this research on enablers and barriers.
Further, more work needs to be done in understanding the initiatives that would
work in a hospital environment, including creating models to measure the
impact of any initiative or even making an investment case before such
implementation. Internal strategies are needed to maintain any momentum
created on sustainability, such as support from top management, a clearly
communicated organisational strategy, staff motivation and, indeed, allocation
of appropriate resources to the environmental sustainability cause.
It is proposed that the government, especially the National Departments of
Health, of Environmental Affairs and of Public Works, should promulgate
enabling legislation and a framework which would encourage the
implementation, monitoring and evaluation of environmental sustainability
initiatives in South Africa.
Description
MBA thesis
Keywords
Environmental sustainability, Hospitals