How sustainable is our oncological care?

Environmental sustainability in healthcare: A qualitative study of the perspectives of nursing, medical and public health students in Kazakhstan

Research and field experience have identified a global gap in postdisaster rebuilding of healthcare systems due to the current primary focus on returning devastated community infrastructures to predisaster conditions. Disasters, natural or man-made, present an opportunity for communities to rebuild, restructure, and redefine their predisaster states, creating more resilient and sustainable healthcare systems. A model for sustainable postdisaster healthcare rebuilding was developed by bridging identified gaps in the literature on the processes of developing healthcare systems postdisaster and utilizing evidence from the literature on postdisaster community reconstruction. The proposed model-the Sustainable Healthcare Redevelopment Model-is designed to guide communities through the process of recovery, and identifies four stages for rebuilding healthcare systems: (1) response, (2) recovery, (3) redevelopment, and (4) sustainable development. Implementing sustainable healthcare redevelopment involves a bottom-up approach, where community stakeholders have the ability to influence policy decisions. Relationships within internal government agencies and with public-private partnerships are necessary for successful recovery. The Sustainable Healthcare Redevelopment Model can serve as a guideline for delivery of healthcare services following disaster or conflict and use of crisis as a window of opportunity to improve the healthcare delivery system and incorporate resilience into the healthcare infrastructure.

Purpose “Sustainability” in a health-care context is defined by the sustainable development goals (SDGs) adopted by the United Nations in 2015, and in particular the third SDG. Accordingly, this research summarizes seminal studies and draw on it to identify the waves of challenges affecting this sector. This study aims to contribute to the discourse on sustainability in health-care organizations (HCOs) by exploring the role of performance monitoring systems (PMS), such as the balanced scorecard (BSC). Design/methodology/approach To explore this issue further, the authors illustrate the transformation model of the HCOs, from inputs to outcomes. The authors rely on the systems and organizational analysis/behavior theories. They use a qualitative case study approach (the American University of Beirut Medical Center in Lebanon – AUBMC) to delve into the intricacies of PMS implementation in an HCO. Findings The authors’ findings underline the role of PMS in operationalizing sustainability within HCOs. By adopting a PMS, HCOs can facilitate the integration of environmental, social and economic factors into decision-making processes. HCOs can enhance their performance and create long-term value. Research limitations/implications Despite the important findings, this paper is not enough to “generalize” and “replicate” the results. However, this paper is able to highlight a road map for HCO’s managers. Furthermore, it does not take into account the impact of artificial intelligence on the design, implementation and analysis of the results produced by such a PMS. Practical implications This paper highlights the importance of strong leadership and a well-defined approach for HCOs to achieve sustainability. It highlights that sustainability is no longer just about reputation; sustainability can enhance organizational performance across various aspects. Leaders need to integrate sustainability into the organization’s mission, vision and values. Thus, implementing a PMS like the BSC is crucial. On the other hand, a focus on sustainability can attract and retain top talent who are increasingly concerned about environmental and social responsibility. Furthermore, sustainability efforts should consider patient needs. And finally, sustainability can drive innovation through developing new services, partnerships and technologies that reduce environmental impact and improve financial performance. Social implications This study highlights how adopting a sustainable approach in HCOs aligns with and supports achieving the UN-SDGs related to health care (SDG 3: Ensure healthy lives and promote well-being for all at all ages). The findings conclude on the HCO’s sustainability efforts to: improve access to quality care (by providing more efficient operations and resource allocation, potentially allowing HCOs to treat more patients and improve access to quality care − SDG 3.1, 3.8); encourage investments in preventative care programs and public health initiatives (by contributing to a healthier population and reducing treatment burdens − SDG 3.3, 3.4); support environmental responsibility (by reducing energy consumption and waste disposal in HCOs can lessen their environmental footprint and contribute to a healthier planet − SDG 3.9); focus on the employee well-being (by creating a more positive work environment with better air quality and potentially stress-reducing practices, potentially improving employee well-being − SDG 3.9); and innovate for better health care (sustainability can drive innovation in areas such as telemedicine, renewable energy sources for powering HCOs and developing environmentally friendly medical equipment − SDG 3.b). Originality/value This research contributes to the emerging field of sustainability in health care by providing empirical evidence of the role of PMS in achieving sustainability goals. The case study offers practical insights for HCOs seeking to improve their sustainability performance and highlights the potential of a PMS as a strategic management tool.

With increasing healthcare service utilization and the introduction of costly therapies, healthcare organizations are pressured to deliver cost-effective services within constrained budgets. Rising costs and the need for efficient healthcare delivery are major concerns for governments, insurers, and health plans. It aims to understand the impact of these intangible assets on creating value and organizational resilience in healthcare, informing better practices and strategies for VBHC implementation. An applied research approach using the Work Breakdown Structure (WBS) methodology was adopted. The research was divided into seven interconnected Work Packages (WPs), each designed to investigate different aspects of the integration between VBHC and intangible assets, with a focus on enhancing organizational resilience through innovative health processes. Key methodologies included literature reviews and qualitative analyses, employing Open Innovation and Design Thinking. The study revealed a dynamic interplay between VBHC, organizational resilience, and intangible assets. It showed that managerial effectiveness is influenced by direct patient outcomes and elements like intellectual capital and organizational reputation. Data integration from various Work Packages provided new insights into how intangible assets underpin VBHC strategies, proposing novel management approaches. Findings highlight the essential role of intangible assets in enhancing service delivery and fostering sustainable healthcare practices. The study highlights a significant oversight in the integration of intangible assets within healthcare organizations, despite their crucial role in optimizing VBHC. It supports literature emphasizing the importance of intellectual capital and organizational culture in enhancing healthcare management efficiency and resilience. A paradigm shift in VBHC to include these assets is needed for building a more adaptable and sustainable healthcare system. This integration can lead to better clinical outcomes, patient satisfaction, and overall healthcare efficiency, aligning more closely with VBHC goals. Recognizing and effectively managing intangible assets are paramount for the successful implementation of VBHC and enhanced organizational resilience. Strategic integration of these assets into healthcare management practices can significantly improve patient outcomes and create a more sustainable, patient-centered, and resilient healthcare system. Future studies should develop methodologies for robust measurement and integration of these assets to fully realize the potential of VBHC.

Planetary health and nursing: Embedding values into standards, behaviours, and education.

Measures of Sustainability in Healthcare

To explore the perspectives of Kazakhstani healthcare professionals on environmental sustainability in healthcare. An exploratory qualitative design. Four focus group discussions (FGDs) on environmental sustainability in healthcare were conducted among healthcare professionals (nurses, physicians, midwives and physical therapists) from June to August 2023 in three cities of Kazakhstan. Each FGD consisted of at least 6 to 11 participants and lasted between 60 and 90 minutes. The collected data were analysed using the thematic analysis. A total of 137 initial codes were identified and further organized into 22 sub-themes based on similarities in codes and meanings, and then 5 significant themes were identified. The five main themes are 'Environmental Sustainability Practices in Healthcare', 'Purposes of Environmental Sustainability in Healthcare', 'Impact of Environmental Sustainability in Healthcare in Patients', 'Challenges in Implementing Environmental Sustainability in Healthcare' and 'The Role of Healthcare Leadership in Improving Environmental Sustainability in Healthcare'. The findings highlighted the perceptions and practices of healthcare professionals on environmental sustainability's purposes in healthcare, its impacts on patients and its implementation challenges. The study also underscored the critical role of strong and active leadership in ensuring a sustainable implementation of green policies in healthcare facilities and achieving successful results of environmentally conscious healthcare practices. The findings provide invaluable information that can be used by policymakers and healthcare organization leaders to create a sustainable healthcare system. Implementing environmental sustainability practices in healthcare should be widespread, intentional, and sustainable, entailing strong leadership and unwavering personal and organizational commitment. No patient or public contribution. We adhered to relevant EQUATOR guidelines, specifically the Consolidated Criteria for Reporting Qualitative Research.

Despite having prevented public health center (PHC) dysfunction in response to COVID-19 during the first wave, public health nurses (PHNs) who play a central role in preventing COVID-19 and supporting community people were unable to share practical knowledge with other PHNs immediately. This report aims to introduce the development of novel sustainable public health care systems with regard to COVID-19 in Japan: task sharing, securing staff, and task shifting. A descriptive study. The Japan Ministry of Health, Labour, and Welfare enlisted good practices regarding resource allocation and developing full readiness for sustainable public health care systems in September 2020. Public health center developed systems for office support, infection control, hospital coordination, and outsourced inventory control. To reduce the workload of PHNs, a support team of three to four office workers developed a response manual for residents and a format for telephone consultations regarding COVID-19. Developing an infection control team and web-based system for hospital coordination decreased the workload of PHCs in each community to prepare for the pandemic. Public health center should consider managing limited human resources and focus on providing specialized care for COVID-19 patients. Task sharing, securing staff, and task shifting are crucial strategies for developing sustainable public health care systems.

Professional standards and the Codes of Ethics from the International Council of Nurses and American Nurses Association are frameworks driving professional practice and are linked to positive patient and nursing outcomes. To describe qualitative themes extracted from narrative responses on how nurses' personal values influence nursing care and converge with quantitative results assessing personal values, professional values, and the practice environment, a key component of nurse satisfaction and subsequent care quality. A convenience sample of nurses across 19 sites within a large nonprofit healthcare system was surveyed. Quantitative measures included the Short Schwartz's Value Survey for personal values, the Nurses Professional Values Scale-3 for professional values, and the Practice Environment Scale of the Nursing Work Index, assessing practice settings. Concurrently, nurses were asked, "How do your values influence the care you provide?" Responses were examined using a descriptive qualitative method for thematic analysis. The sample included qualitative (n = 408) and quantitative (n = 671) responses. Six qualitative themes emerged: patient-centered care, professionalism/integrity of practice, advocacy, dissonance, golden rule/ethics of reciprocity (religiosity), and perseverance. Themes converged with the mean personal values of achievement, self-direction, universalism, benevolence, tradition, and conformity, and diverged with hedonism, security, and stimulation. All professional values factor means and work environment subscale means converged. Findings highlight convergence and divergence between qualitative and quantitative responses from nurses, offering new insights into the themes of dissonance, perseverance, and religiosity. The findings present valuable opportunities to enhance recruitment and retention strategies.

Sustainable healthcare systems are developed to priorities healthcare services involving difficult decision-making processes. Besides, wearables, internet of things (IoT), and cloud computing (CC) concepts are involved in the design of sustainable healthcare systems. In this study, a new Multi-objective Chaotic Butterfly Optimization with Deep Neural Network (MOCBOA-DNN) is presented for sustainable healthcare management systems. The goal of the MOCBOA-DNN technique aims to cluster the healthcare IoT devices and diagnose the disease using the collected healthcare data. The MOCBOA technique is derived to perform clustering process and also to tune the hyperparameters of the DNN model. Primarily, the clustering of IoT healthcare devices takes place using a fitness function to select an optimal set of cluster heads (CHs) and organize clusters. Followed by, the collected healthcare data are sent to the cloud server for further processing. Furthermore, the DNN model is used to investigate the healthcare data and thereby determine the presence of disease or not. In order to ensure the betterment of the MOCBOA-DNN technique, an extensive simulation analysis take place. The experimental results portrayed the supremacy of the MOCBOA-DNN technique over the other existing techniques interms of diverse evaluation parameters.

Background: Healthcare organizations incorporate products and services at economical prices to deliver healthcare services of good quality. All the operations performed in the organizations aimed to achieve a higher level of environmental sustainability governed by the Sustainable Developmental Goals of 2030. Aims: This study aims to develop a sustainable healthcare model using Analytical Hierarchy Process (AHP). Methods: First and foremost, the authors have identified the factors associated with the sustainable healthcare system through a literature review. Based on these factors, a questionnaire was developed and administered to 25 healthcare organizations from December 2020 to March 2021. An Analytical Hierarchy Process is utilized to rank the factors, and a conceptual model is developed. The Felix Hospitals substantiate this model. The authors have also applied sensitivity analysis to validate the results achieved via AHP. Results: The AHP model demonstrates the focus is on the environment first, followed by the economic and social dimensions sustainably. The validated model was also substantiated by the hospital (Felix) results and sensitivity analysis. Conclusion: It can be concluded that hospital sustainability highly depends on the environment in the first stage and economic and social sustainability in the second and third stages. The same result was achieved through AHP. Keywords: analytical hierarchy process, hospital, sustainable healthcare.

Background: Healthcare organizations incorporate products and services at economical prices to deliver healthcare services of good quality. All the operations performed in the organizations aimed to achieve a higher level of environmental sustainability governed by the Sustainable Developmental Goals of 2030. Aims: This study aims to develop a sustainable healthcare model using Analytical Hierarchy Process (AHP). Methods: First and foremost, the authors have identified the factors associated with the sustainable healthcare system through a literature review. Based on these factors, a questionnaire was developed and administered to 25 healthcare organizations from December 2020 to March 2021. An Analytical Hierarchy Process is utilized to rank the factors, and a conceptual model is developed. The Felix Hospitals substantiate this model. The authors have also applied sensitivity analysis to validate the results achieved via AHP. Results: The AHP model demonstrates the focus is on the environment first, followed by the economic and social dimensions sustainably. The validated model was also substantiated by the hospital (Felix) results and sensitivity analysis. Conclusion: It can be concluded that hospital sustainability highly depends on the environment in the first stage and economic and social sustainability in the second and third stages. The same result was achieved through AHP. Keywords: analytical hierarchy process, hospital, sustainable healthcare.

In a world increasingly vulnerable to environmental and health crises, sustainable healthcare systems are crucial. This study focuses on the resilience and sustainability of healthcare services in Saudi Arabia’s Eastern Province, assessing their readiness to endure and adapt amidst disaster scenarios. Conducted through a cross-sectional survey involving 522 hospital employees, the research provides an in-depth analysis of various sustainability-related aspects of healthcare preparedness. This includes examining both structural and non-structural safety elements, standard operating procedures, staff training in disaster response, data security, and sustainable management of resources during emergencies. The results reveal a noteworthy commitment to sustainable disaster preparedness: 53.7% of hospitals, predominantly governed by the Ministry of Health, have implemented comprehensive disaster recovery plans. Furthermore, the study found a strong representation of female participants (54.2%) in these hospitals. A significant 64.1% of respondents confirmed the existence of disaster recovery plans in their workplaces, and an even higher percentage, 70.6%, reported receiving specific training in disaster response. These findings underscore the proactive efforts of Eastern Province hospitals in fostering a sustainable and resilient healthcare framework, demonstrating an approach that prioritizes preparedness beyond immediate crisis response. This proactive stance is pivotal in ensuring the continuity of healthcare services amidst the ever-evolving nature of global disasters.

This study explores if the value priorities and their impact on future managers' attitudes towards environmental responsibilities vary with gender. While relevant prior studies mostly focus on gender‐based variations of individuals' personal values in developed economies, we concentrate on both personal values and pro‐environmental attitudes in an emerging economy. This study is built on MBA students (a proxy for future managers) in India since India is characterized as a male‐dominated society and a producer of larger number of MBA graduates. Overall, our results show that personal values and attitude towards environmental responsibilities do not vary significantly with gender. Only two values (among the 21 values) and one value type (out of 10 values) get significantly higher ranking from females compared with males. Further, although ‘universalism’ and ‘benevolence’ are found to have a statistically significant impact on respondents' attitude towards environmental responsibility, the latter is invariant to the respondents' gender. Our findings may indicate India's transformation from a male‐dominated society towards a more gender‐balanced society. These findings can be used to operationalize a pro‐environmental recruitment policy and to formulate strategies to improve female participation in MBA cohorts of business schools.

GI multisociety strategic plan on environmental sustainability.