Towards greener hospitals: The effect of green organisational practices on climate change mitigation performance

Healthcare organisations have a significant carbon footprint due to their substantial energy consumption and waste generation. The existing literature has mostly focused on examining the isolated impact of specific green organisational practices on individual dimensions of environmental performance. Hence, policy makers and practitioners still lack a holistic view of how combinations of green organisational practices can mitigate the impact on climate change of healthcare organisations. Drawing on the practice-based view (PBV) of strategy, the study first examines the extent to which the adoption of imitable, individual green organisational practices impacts on the whole climate change mitigation performance of publicly owned hospitals. Second, it explores possible combinations of green organisational practices that can lead to high levels of climate change mitigation performance. Focusing on the illustrative case of publicly owned acute care hospitals in the English National Health Service and employing a two-stage Data Envelopment Analysis and a fuzzy set Qualitative Comparative Analysis (fsQCA), the analysis shows that the adoption of the practice of green energy procurement can, in isolation, positively lead to high climate change mitigation outcomes. Moreover, high performance levels can be achieved through multiple configurations of green organisational practices. Therefore, the findings suggest that the effectiveness of green organisational practices on climate change mitigation performance of hospitals depends on how practices are combined, rather than on their single effects, and indicate the presence of a complementary as well as a substitution effect between practices.