Back and Forth on Sustainable Development: A Focus on Healthcare Organisations

The sustainability of healthcare systems represents a relevant target of the 2030 Sustainable Development Goals Agenda. Nevertheless, academic research has neglected to study healthcare systems when focusing on the transition toward sustainable healthcare. This study addresses this gap by investigating the implementation of the sustainable development (SD) principle in the Italian healthcare system, in light of international and national institutional discourses on SD. A questionnaire-based survey has been directed to the General Directors (GDs) of government-funded healthcare orgsanisations to investigate their perceptions about the SD principle applied to healthcare, their strategic planning for SD, their implemented projects for sustainability and the intellectual capital factors that influence the latter’s implementation. The study was conducted in two waves: a first survey was administered in 2016, with a second one in 2021. We used content analysis to identify the potential differences emerging over time in GDs’ perceptions in light of the changes in the institutional discourse; we then assessed the differences over time in the perceived contribution of intellectual capital factors to the implementation of sustainability actions. Results show a substantial decrease in strategic planning for sustainability, as well as in the volume of sustainability projects implemented, as organisations were found to be less involved in implementing SD strategies and projects in 2021 than in 2016. Policies at the country level have mainly focused on balancing cost containment with quality targets, leaving the environmental dimension of sustainability and its connection with healthcare with limited guidelines. Regarding intellectual capital factors, organisational culture and technologies are increasingly perceived as enablers of SD; nevertheless, further studies are needed to deepen their effective contribution to sustainable healthcare.