PurposeGreen lean six sigma (GLSS) is a sustainable development approach that leads to improved patient care with improved safety and quality of service to patients. This study aims to identify, study, model and analyze GLSS success factors for the Indian health-care facility.Design/methodology/approachInterpretive structural modeling (ISM) and Impact Matrix Cross-Reference Multiplication Applied to a Classification analyses have been used to understand the hierarchical structure among the GLSS success factors. This enabled the development of dependency relationships between success factors, in particular, which factors support the development of other factors.FindingsSpecifically, this study found that the success factors “commitment of management” and “financial availability” are the most critical to GLSS implementation success, as they support the development of all other success factors. Meanwhile “embedding sustainable measures at each stage of the service”; “the capability and effectiveness of real-time data collection”; and “feedback and corrective actions” most directly support the GLSS implementation in the health-care facility and serve as the final indicators of implementation progress.Research limitations/implicationsThe major implication of this research work lies in suggesting a direction for practitioners to execute the GLSS approach through a systematic understanding of classification and structural relationships among different enablers. This study also facilitates health-care managers to explore different GL wastes in hospitals and challenges to sustainability pursuits in health-care that assist in an organization’s efforts toward sustainable development.Originality/valueThis research work is the first of its kind that deals with the identification and analysis of the prominent factors that foster the inclusive implementation of GLSS within the health-care facility.