Environmental Performance Measurement in Hospitals: A Bibliometric Review of Literature (1987–2017)

  • Andreia Pasqualini BlassEmail author
  • Sergio E. Gouvea da Costa
  • Edson Pinheiro de Lima
  • Ubiratã Tortato
  • Lilian Adriana Borges
Part of the World Sustainability Series book series (WSUSE)


The publication of the Brundtland Report in 1987 has placed the term ‘sustainability’ as a paramount research topic in several disciplines. 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 and processes. Hospitals deal with a significant amount of hazardous and non-hazardous materials and generate polluting outputs. Moreover, in developing countries such as Brazil, healthcare operations involve high costs for provided services, limited productive resources and lack of public expenditure. Frameworks that directly address the measurement of environmental performance are regarded as crucial to address these demands. This study involves a bibliometric review of literature on the topic ‘hospital environmental performance measurement’ during the period 1987–2017, i.e., since the publication of the Brundtland Report. A certain prevalence of studies placed in high-income countries 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.


Environmental performance Measurement Hospital Framework 


  1. Ananth AP, Prashanthini V, Visvanathan C (2010) Healthcare waste management in Asia. Waste Manag 30(1):154–161CrossRefGoogle Scholar
  2. Berhanu N, Abrha H, Ejigu Y, Woldemichael K (2016) Knowledge, experiences and training needs of health professionals about disaster preparedness and response in southwest Ethiopia: a cross sectional study. Ethiop J Health Sci 26(5):415–426CrossRefGoogle Scholar
  3. Blass AP, da Costa SEG, de Lima EP, Borges LA (2017) Measuring environmental performance in hospitals: a practical approach. J Clean Prod 142:279–289CrossRefGoogle Scholar
  4. Brundtland Commission (1987) Our common future: report of the World Commission on Environment and Development. UN Documents Gathering Body of Global AgreementsGoogle Scholar
  5. Duić N, Urbaniec K, Huisingh D (2015) Components and structures of the pillars of sustainability. J Clean Prod 88:1–12CrossRefGoogle Scholar
  6. Feng SC, Joung CB (2011) A measurement infrastructure for sustainable manufacturing. Int J Sustain Manuf 2(2–3):204–221CrossRefGoogle Scholar
  7. GGHHA (2015) Global green and healthy hospitals agenda. Available at Last accessed 1 Oct 2015
  8. Kangasniemi M, Kallio H, Pietilä AM (2014) Towards environmentally responsible nursing: a critical interpretive synthesis. J Adv Nurs 70(7):1465–1478CrossRefGoogle Scholar
  9. Kleindorfer PR, Singhal K, Van Wassenhove LN (2005) Sustainable operations management. Prod Oper Manag 14(4):482–492CrossRefGoogle Scholar
  10. Laing D, Kean WF (2011) The Greening of healthcare: fabrics used in health care facilities. College Publishing 6(4):45–64Google Scholar
  11. Lega F, Prenestini A, Spurgeon P (2013) Is management essential to improving the performance and sustainability of health care systems and organizations? A systematic review and a roadmap for future studies. Value in Health 16(1), Supplement, S46–S51Google Scholar
  12. Machado CML, Scavarda A, Zhao F, Kipperd LM (2015) A proposal of an energy saving technology framework for the hospital. Chem Eng Trans 45:241–246Google Scholar
  13. McGain F, Naylor C (2014) Environmental sustainability in hospitals—a systematic review and research agenda. J Health Serv Res Policy 19(4):245–252CrossRefGoogle Scholar
  14. McNatt Z, Linnander E, Endeshaw A, Tatek D, Conteh D, Bradley EH (2015) A national system for monitoring the performance of hospitals in Ethiopia. WHO Indic 93:10Google Scholar
  15. McNaught C, Lam P (2010) Using Wordle as a supplementary research tool. Qual Rep 15(3):630Google Scholar
  16. Phillips PS, Holley K, Bates MP, Freestone NP (2002) Corby waste not: an appraisal of the UK’s largest holistic waste minimisation project. Resour Conserv Recycl 36(1):1–31CrossRefGoogle Scholar
  17. Pinzone M, Guerci M, Lettieri E, Redman T (2016) Progressing in the change journey towards sustainability in healthcare: the role of ‘Green’ HRM. J Clean Prod 122:201–211CrossRefGoogle Scholar
  18. Porter ME (2010) What is value in health care? N Engl J Med 363(26):2477–2481CrossRefGoogle Scholar
  19. Ryan-Fogarty Y, O’Regan B, Moles R (2016) Greening healthcare: systematic implementation of environmental programmes in a university teaching hospital. J Clean Prod 126:248–259CrossRefGoogle Scholar
  20. Sadatsafavi H, Walewski J, Taborn M (2015) Patient experience with hospital care-comparison of a sample of green hospitals and non-green hospitals. J Green Build 10(1):169–185CrossRefGoogle Scholar
  21. Townend B (1996) The implications of sustainable development and the zero option for health care waste. In: Proceedings of 7th ISWA international congress, pp II74–II81Google Scholar
  22. Woolridge A, Morrissey A, Phillips PS (2005) The development of strategic and tactical tools, using systems analysis, for waste management in large complex organisations: a case study in UK healthcare waste. Resour Conserv Recycl 44(2):115–137CrossRefGoogle Scholar
  23. Yang Y, Zhang S, Xiao Y (2017) Optimal design of distributed energy resource systems based on two-stage stochastic programming. Appl Therm Eng 110:1358–1370CrossRefGoogle Scholar
  24. Yataganbaba A, Ozkahraman B, Kurtbas I (2017) Worldwide trends on encapsulation of phase change materials: a bibliometric analysis (1990–2015). Appl Energy 185:720–731CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Andreia Pasqualini Blass
    • 1
    Email author
  • Sergio E. Gouvea da Costa
    • 2
    • 3
  • Edson Pinheiro de Lima
    • 2
    • 3
  • Ubiratã Tortato
    • 4
  • Lilian Adriana Borges
    • 5
  1. 1.Operations Management DivisionUNIDAVIRio do SulBrazil
  2. 2.Industrial and Systems EngineeringPontifical Catholic University of Parana (PUCPR)CuritibaBrazil
  3. 3.Industrial and Systems EngineeringFederal University of Technology - Parana (UTFPR)Pato BrancoBrazil
  4. 4.Business SchoolPontifical Catholic University of Parana (PUCPR)CuritibaBrazil
  5. 5.UNIDAVIRio do SulBrazil

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