Corporate sustainability practices in accredited Brazilian hospitals: a degree-of-maturity assessment of the environmental dimension

Nascimento, Glauce; Araujo, Claudia Affonso Silva; Alves, Luciana Albuquerque

doi:10.1016/j.rausp.2016.10.001

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Sustainability • Rev. Adm. (São Paulo) 52 (1) • Jan-Mar 2017 • https://doi.org/10.1016/j.rausp.2016.10.001 copy

Corporate sustainability practices in accredited Brazilian hospitals: a degree-of-maturity assessment of the environmental dimension

Práticas de sustentabilidade corporativa em hospitais brasileiros acreditados: verificação do grau de maturidade quanto à dimensão ambiental

Prácticas de sostenibilidad corporativa en hospitales brasileños acreditados: evaluación del nivel de madurez en la dimensión ambiental

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The main objective of this paper is to assess the degree of maturity of Brazilian accredited hospitals in relation to sustainable practices, specifically the environmental dimension. Therefore, a questionnaire was constructed, shaped by the literature review and the evaluation method of the Corporate Sustainability Index of BM and FBovespa (n.d.)BM&FBovespa. (n.d.). Índice de Sustentabilidade Empresarial: metodologia – critérios e pesos 2011/2012. Retrieved from http://isebvmf.com.br/arquivos/files/Dimensoes.pdf.
http://isebvmf.com.br/arquivos/files/Dim... . Furthermore, the relationship between three corporate sustainability tools (the certification of the International Organization for Standardization [ISO] 14001, published sustainability reports, and the existence of an area dedicated to corporate sustainability) and the maturity of hospitals in relation to sustainability practices were assessed. The results show that, of the 38 hospitals that participated in the survey (43% of subjects studied), 58% obtained a maturity rating of very high or high rating, according to the established criteria. In addition, some research variables showed statistically significant differences among the hospitals that have ISO 14001 certification, those that publish sustainability reports, and those that have an area dedicated to sustainability. Consequently, hospitals should take action to include much more sustainability actions in their strategies, such as how to establish a participatory dialog with stakeholders, in order to improve and raise the level of maturity of hospitals.

Keywords
Sustainability; Environmental sustainability; Accredited hospitals; Maturity level

Dimension	Criterion	Indicator	Weight
General	Commitment	Basic commitment	15
	Commitment	Voluntary commitments	15
	Alignment	Consistency of commitments	25
	Alignment	Policy of engagement with stakeholders	25
	Transparency	Remuneration	40
	Transparency	Reports	40
	Fighting corruption	Fighting corruption	20
Environmental	Political	Commitment, scope and dissemination	5
	Management	Environmental responsibility	55
		Planning
		Management and monitoring
		Management systems
		Communication with stakeholders
		Global commitment: biodiversity
	Performance	Consumption of environmental resources – inputs	25
		Emissions and waste
		Critical emissions and waste
	Legal compliance	Permanent preservation area	15
		Legal reserve
		Environmental liabilities
		Administrative requirements
		Administrative procedures
		Judicial procedures

Dimension	Variable	Item weight	Dimension weight	Maximum score	Total score
General	1. Insertion in the strategy	14.28	100	71.4	500
	2. Measurement of risks and impacts	23.81		119.05
	3. Variable remuneration	23.81		119.05
	4. Impact monitoring	38.1		190.5
Environmental	5. Systematic communication to stakeholders	15.79	100	78.95	500
	6. Communication independent of demand	15.79		78.95
	7. Educational programs	2.63		13.15
	8. Efficiency and effectiveness	15.79		78.95
	9. Independence from financial results	2.63		13.15
	10. Beginning at waste management	7.895		39.475
	11. Security of executors	7.895		39.475
	12. Reuse of hospital items	7.895		39.475
	13. Energy efficiency programs	7.895		39.475
	14. Water management programs	7.895		39.475
	15. Sustainable procurement	7.895		39.475

ISO 14001 certification	U	Z	p-value
1. Insertion in strategy	16	-2.601	0.009^ Differences statistically significant at 5%.
2. Measurement of risks and impacts	22.5	-2.224	0.026^ Differences statistically significant at 5%.
3. Variable remuneration	22.5	-2.31	0.021^ Differences statistically significant at 5%.
4. Impact monitoring	37	-1.543	0.123
5. Systematic communication to stakeholders	34.5	-1.652	0.099^* * Differences statistically significant at 10%.
6. Communication independent of demand	56	-0.586	0.558
7. Educational programs	34	-1.688	0.091^* * Differences statistically significant at 10%.
8. Efficiency and effectiveness	35	-1.651	0.099^* * Differences statistically significant at 10%.
9. Independence from financial results	64.5	-0.18	0.857
10. Beginning waste management	45.5	-1.178	0.239
11. Security of executors	54	-0.686	0.493
12. Reuse of hospital items	59.5	-0.418	0.676
13. Energy efficiency programs	50	-0.933	0.351
14. Water management programs	19	-2.43	0.015^ Differences statistically significant at 5%.
15. Sustainable procurement	50	-0.886	0.376

Publication of reports	U	Z	p-value
1. Insertion in strategy	84	-0.97	0.332
2. Measurement of risks and impacts	100	-0.329	0.742
3. Variable remuneration	93	-0.623	0.533
4. Impact monitoring	98.5	-0.394	0.694
5. Systematic communication to stakeholders	92.5	-0.625	0.532
6. Communication independent of demand	42.5	-2.55	0.011^ Differences statistically significant at 5%.
7. Educational programs	55	-2.103	0.035^ Differences statistically significant at 5%.
8. Efficiency and effectiveness	100	-0.337	0.736
9. Independence from financial results	73	-1.448	0.148
10. Beginning waste management	55.5	-2.197	0.028^ Differences statistically significant at 5%.
11. Security of executors	94	-0.562	0.574
12. Reuse of hospital items	85.5	-0.896	0.37
13. Energy efficiency programs	87.5	-0.862	0.389
14. Water management programs	56.5	-2.042	0.041^ Differences statistically significant at 5%.
15. Sustainable procurement	107	-0.058	0.953

Sustainability area	U	Z	p-value
1. Insertion in strategy	31	-2.339	0.019^ Differences statistically significant at 5%.
2. Measurement of risks and impacts	33.5	-2.174	0.03^ Differences statistically significant at 5%.
3. Variable remuneration	41.5	-1.89	0.059^* * Differences statistically significant at 10%.
4. Impact monitoring	46.5	-1.627	0.104
5. Systematic communication to stakeholders	32.5	-2.238	0.025^ Differences statistically significant at 5%.
6. Communication independent of demand	60.5	-0.975	0.33
7. Educational programs	34	-2.186	0.029^ Differences statistically significant at 5%.
8. Efficiency and effectiveness	47.5	-1.59	0.112
9. Independence from financial results	82	-0.023	0.981
10. Beginning waste management	53	-1.402	0.161
11. Security of executors	69.5	-0.578	0.563
12. Reuse of hospital items	75	-0.335	0.738
13. Energy efficiency programs	63.5	-0.894	0.371
14. Water management programs	41	-1.869	0.062^* * Differences statistically significant at 10%.
15. Sustainable procurement	64	-0.827	0.408

Variable	ISO 14001	Report	Sustainability area
1. Insertion in strategy	^ Differences statistically significant at 5%.		^ Differences statistically significant at 5%.
2. Measurement of risks and impacts	^ Differences statistically significant at 5%.		^ Differences statistically significant at 5%.
3. Variable remuneration	^ Differences statistically significant at 5%.		^* * Differences statistically significant at 10%.
4. Impact monitoring
5. Systematic communication to stakeholders	^* * Differences statistically significant at 10%.		^ Differences statistically significant at 5%.
6. Communication independent of demand		^ Differences statistically significant at 5%.
7. Educational programs	^* * Differences statistically significant at 10%.	^ Differences statistically significant at 5%.	^ Differences statistically significant at 5%.
8. Efficiency and effectiveness	^* * Differences statistically significant at 10%.
9. Independence from financial results
10. Beginning waste management		^ Differences statistically significant at 5%.
11. Security of executors
12. Reuse of hospital items
13. Energy efficiency programs
14. Water management programs	^ Differences statistically significant at 5%.	^ Differences statistically significant at 5%.	^* * Differences statistically significant at 10%.
15. Sustainable procurement

Departamento de Administração da Faculdade de Economia, Administração e Contabilidade da Universidade de São Paulo Avenida Professor Luciano Gualberto, 908, sala F184, 05508-900 São Paulo / SP Brasil, Tel./Fax 55 11 3818-4002 - São Paulo - SP - Brazil
E-mail: rausp@usp.br

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[1] * Corresponding author at: Rua Pascoal Lemme, 355, CEP 21941-918 Rio de Janeiro, RJ, Brazil. E-mail:luciana.alves@coppead.ufrj.br (L.A. Alves).