Sustainable development and performance measurement in healthcare organizations

The Triple Bottom Line (TBL) has emerged as a leading framework to guide healthcare organizations (HCOs) during the implementation and assessment of sustainable development (SD) strategies. This paper analyzes SD performance measurement practices inside HCOs adopting a TBL perspective. The methodology used is a systematic literature review with discussion of findings based on a comparison of four case studies. The design of SD performance measurement tools tended to be the result of a participatory process in all the case studies analyzed. Adoption of performance measurement enhanced decision making. Among TBL dimensions, the social dimension was defined in different ways by the organizations under study, whereas the environmental dimension had a strong focus on ecoefficiency. However, sustainability strategies seemed to be influenced by the operational context and specificities required by SD implementation. The comparison of case studies allowed us to frame how the process of SD assessment took place, the factors that influenced its implementation, as well as the evaluation’s benefits and limitations. The study is limited due to the scarcity of literature on the topic. Despite the fact that SD performance measurement in HCOs is at an early stage, our study provides some useful insights to guide healthcare practitioners approaching the design and introduction of sustainability assessment tools in their organizations. This paper is the first attempt to frame SD performance measurement practices in HCOs.