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A. P. Blass et al.
tries was found. Nevertheless, a growing focus on the specific context of developing
countries was also identified. The content analysis revealed that the proposal and testing of frameworks for the measurement of environmental performance in hospitals
is still an unsolved issue.
Keywords Environmental performance · Measurement · Hospital · Framework
1 Introduction
Organizations in developed and developing countries have been urged to rationalize the way resources are used and how they affect sustainability (Kleindorfer et al.
2005; McNatt et al. 2015). The relationship between the healthcare sector and the
environment is twofold. Environmental deterioration tends to generate health problems, which require treatment by healthcare providers whilst the waste generated by
the sector, pollution and use of natural resources to provide these services should be
minimized to achieve sustainability.
In the healthcare sector, hospitals have faced considerable demands: tougher legislation and ongoing pressures for cost reduction and improved quality, which have
forced them to re-examine the performance of their operations. According to McGain
and Naylor (2014), the measurement of the environmental impact caused by hospitals
is still troublesome. Moreover, it requires an effort across borders and policy changes.
Lega et al. (2013) emphasize the findings of Porter (2010), i.e., the improvement of
value in healthcare is paramount. Concerns related to cost reduction are meaningless
if quality is to be worsened.
Feng and Joung (2011) conducted a comprehensive review of literature, seeking
an appropriate model to measure sustainability in manufacturing operations. On one
hand, the authors observed a growing concern about external stakeholder perception.
On the other hand, a lack of internal efforts in gathering information for decisionmaking or innovation was noteworthy.
Despite the current focus on frameworks related to measuring environmental
performance in the healthcare sector, outcomes have been regarded as unsatisfactory
(Phillips et al. 2002). The amount of waste generated from healthcare operations has
gradually increased (Woolridge et al. 2005).
In developing countries, healthcare operations involve high costs of provided
services, limited productive resources and lack of public expenditure. Ananth et al.
(2010) argue that measuring performance is necessary to acknowledge improvement.
Conceptual and methodological frameworks are regarded as necessary to forge sustainability thinking (Dui´ c et al. 2015).
Considering this context, especially in developing countries, this study includes
a bibliometric review on the topic over the past 30 years. The period includes the
year of publication of the Brundtland Report (1987) up until 2017. Bibliometric
A. P. Blass et al.
tries was found. Nevertheless, a growing focus on the specific context of developing
countries was also identified. The content analysis revealed that the proposal and testing of frameworks for the measurement of environmental performance in hospitals
is still an unsolved issue.
Keywords Environmental performance · Measurement · Hospital · Framework
1 Introduction
Organizations in developed and developing countries have been urged to rationalize the way resources are used and how they affect sustainability (Kleindorfer et al.
2005; McNatt et al. 2015). The relationship between the healthcare sector and the
environment is twofold. Environmental deterioration tends to generate health problems, which require treatment by healthcare providers whilst the waste generated by
the sector, pollution and use of natural resources to provide these services should be
minimized to achieve sustainability.
In the healthcare sector, hospitals have faced considerable demands: tougher legislation and ongoing pressures for cost reduction and improved quality, which have
forced them to re-examine the performance of their operations. According to McGain
and Naylor (2014), the measurement of the environmental impact caused by hospitals
is still troublesome. Moreover, it requires an effort across borders and policy changes.
Lega et al. (2013) emphasize the findings of Porter (2010), i.e., the improvement of
value in healthcare is paramount. Concerns related to cost reduction are meaningless
if quality is to be worsened.
Feng and Joung (2011) conducted a comprehensive review of literature, seeking
an appropriate model to measure sustainability in manufacturing operations. On one
hand, the authors observed a growing concern about external stakeholder perception.
On the other hand, a lack of internal efforts in gathering information for decisionmaking or innovation was noteworthy.
Despite the current focus on frameworks related to measuring environmental
performance in the healthcare sector, outcomes have been regarded as unsatisfactory
(Phillips et al. 2002). The amount of waste generated from healthcare operations has
gradually increased (Woolridge et al. 2005).
In developing countries, healthcare operations involve high costs of provided
services, limited productive resources and lack of public expenditure. Ananth et al.
(2010) argue that measuring performance is necessary to acknowledge improvement.
Conceptual and methodological frameworks are regarded as necessary to forge sustainability thinking (Dui´ c et al. 2015).
Considering this context, especially in developing countries, this study includes
a bibliometric review on the topic over the past 30 years. The period includes the
year of publication of the Brundtland Report (1987) up until 2017. Bibliometric