Sustainable Healthcare Management Practices and Hospital Performance: Exploring the Role of Green Operations and Digital Innovation

The health care sector is responsible for generating 4–5% of the world's GHGs and hospitals are expected to enhance the quality and efficiency of services offered, and, above all, decrease their significant environmental impacts. There are two areas on which a way forward can be provided: green operations that includes energy and water efficiency, waste reduction and green procurement, and digital innovation including applicability of the Internet of Things for monitoring and analytics and electronic health records, telemedicine. But much of the research on these changes has focused on them individually and few studies have connected them to hospital performance. This paper introduces an integrated model concept that explores the relationship between sustainable healthcare management practices, green hospital operations as a relevant concept of sustainable management, and digital innovation, and how these strategies affect hospital performance. Based on the natural resource-based view, dynamic capabilities theory and the triple bottom line, and integrating concepts from the healthcare, operations management and information systems literature, seven propositions are developed. To boost not only green operations but also digital innovations, sustainable management practices are proposed. The proposals for both capabilities are based on improving performance at the environmental, operational–financial, and quality-of-care levels, while also aiming to mitigate management practices. The use of digital innovation is proposed as another enabling technology of the processes of greening, as well as to improve their impacts on performance. The paper offers construct definitions, a measurement instrument adapted from existing scales, and a partial least-squares structural equation modelling analysis plan to allow for empirical testing. This framework provides a model that can be tested, and also serves as a blueprint for hospital managers and policymakers for a green and digital integration.