Measuring environmental performance in hospitals: a framework and process

Purpose - This paper aims to propose a new framework to define relevant and meaningful indicators for monitoring and assessing environmental performance to improve health-care systems and operations. Design/methodology/approach - A comprehensive literature review followed by field studies conducted with ten hospitals in the southern region of Brazil underlined the scarcity of consistent frameworks applied in practice to measure, monitor and improve environmental performance. A new framework was developed and proposed to address this issue. The proposed framework is operationalized through a process approach and evaluated in terms of feasibility (Can the process be followed?), usability (Is the approach easily followed?) and utility (Are the results useful for managers?). Findings - The paper proposes a framework and a process to evaluate the environmental performance in hospitals. Practical implications - The proposed framework represents meaningful guidance to managers for strategy formalization, goal setting and environmental performance assessment and monitoring. Originality/value - The paper proposes a systematic framework for measuring environmental performance in hospitals drawn from the literature review, current legislation and best practices reported in literature.