Title : Sustainability governance in the health-care sector: Case studies of four public hospitals in Latvian
Abstract:
Climate change puts a twofold burden on the healthcare sector. On the one hand, healthcare must adapt to climate change by transforming the healthcare system to treat climate change-induced diseases and health disorders. On the other hand, it is acknowledged that the healthcare sector is responsible for almost 5% of global emissions, a figure which can even reach 10% in some high-income nations [1] and lags behind other sectors in reducing its carbon footprint [2]. To enhance the governance solutions in the Latvian public hospitals as well as develop recommendations to the public hospitals and the policy-maker, Riga Stradins University launched a Latvian Council of Science financed project “Socially Responsible Green Transition: Enhancing Governance Solutions to Empower Homo Climaticus in the Healthcare Sector” (Nr. Lzp-2023/1-034) in 2024. The goal of the project (study) is to enhance the governance solutions in the healthcare to empower the so-called Homo Climaticus, which is defined here as a rational agent who is aware of the long-term consequences of climate change and therefore acts responsibly in his/her everyday life (Bjorst, 2012). Based on the results of the systematic literature (165 papers), Tripple-bottom Line Concept, Corporate Governance concept as well as requirements of the European Sustainability Reporting Standards (Commission Delegated Regulation (EU) 2023/2772, ESRS), 49 potential measures have been identified for defining sustainability governance measures in the healthcare sector. Above measures were grouped and a new, four-dimensional (environmental, social, governance and economic) utility model was proposed for defining measures in the context of the sustainability linked to a framework for designing the corporate governance of the public hospitals. This study was aimed to assess the corporate governance of four public hospitals in Latvia against the defined measures. 48 semi-structured interviews were conducted. Preliminary findings indicate that all hospitals surveyed have undertaken some measures aimed at promoting sustainability, although the extent and nature of these initiatives vary significantly across cases. Limitations of the study come from the sustainability reporting/management framework within the scope of the ESRS as well as most of the studies have focused on public healthcare settings only. Future research directions may consist of further investigations of the actual outcomes in sustainability corporate governance of healthcare organisations that are based on their developed and adopted business models.
