Ethical Leadership and Sustainable Performance in Healthcare: The Role of Green HRM and Employee Environmental Behavior in Pakistan

Healthcare institutions are under increasing pressure to improve sustainability performance due to severe resource and regulatory constraints. While EL has been linked with pro-environmental attitudes, there is little empirical data on how EL translates into measurable sustainability outcomes in healthcare settings. Drawing on Social Learning Theory and Organizational Support Theory, this study examines the relationships among EL, GHRM, OCBE, PGOS, and sustainable performance in Pakistani hospitals. The cross-sectional method was applied, and 376 healthcare professionals were sampled from hospitals in Punjab, Pakistan, including both public and private hospitals. PLS-SEM was used to test the hypothesized associations. The findings show that SP is directly and indirectly associated with EL in terms of GHRM and OCBE. GHRM provides leadership values that shape employees’ discretionary environmental behaviors that support sustainability objectives. These results provide avenues between leadership and sustainability and can provide useful guidance to healthcare administrators who encourage sustainable business practices.