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Title: Development of sustainability in the public sector. Actors and factors influencing the speed of implementation in healtcare.
Authors: Vluggen, RHC
Issue Date: 1-Jun-2014
Publisher: Open Universiteit Nederland
Abstract: Problem statement The need for sustainable development has stimulated many organizations in the public sector to include environmental and social aspects into their strategic agenda. Many studies have investigated the drivers and barriers to sustainable practices in organizations. However, the vast majority of these studies are concerned with organizations in the private sector. There is a limited body of research on drivers and barriers of sustainability initiatives in the public sector. Most commonly, this research is performed on leading public organizations, reporting on successful implementation of sustainability. However, despite the urge for sustainable initiatives, many public organizations still struggle with the implementation of sustainability. Therefore, more research is needed amongst public sector organizations that lag behind in developing sustainable initiatives. Management in public agencies is faced with procedural, legal and political constraints. In addition, many internal and external stakeholders have an impact on the success of sustainable initiatives. These multiple stakeholders are likely to pursue conflicting goals. A study to the development of sustainability in the public sector should therefor include an investigation of factors (drivers and barriers) and actors (multiple stakeholders). This study is aimed at answering the following problem statement: What actors and factors influence the speed of implementation of sustainability in the public sector? Research method A qualitative research design was selected for this exploratory study that investigates the relationships between actors and their impact on sustainable initiatives. The case study included four organizations within the public sector, more specific, within the healthcare sector. These organizations are specialized in mental care and care for disabled people. In each organization semi-structured interviews were conducted with three types of actors: institutional top management, budget owners and procurement professionals. A review of the extant literature resulted in four main categories of factors: management support, information/communication, organization, and external pressure. The theoretical expectations about the impact of actors and factors are derived from the stakeholder theory. Results The most important actor appeared to be the institutional top management. This actor has very high salience and is able to have a major influence on the implementation process of sustainability. In all organizations top management is able to make a topic strategic and important. Budget owners have a certain power within their own business unit and are able to create positive or negative incentives on any subject. Budget owners have an advisory role to the institutional top management and in relation to the procurement professionals they are the leading party. The procurement professionals have to follow the top management and budget owners and only accomplish an advisory role and have little influence on the implementation process of sustainability. Top management and budget owners are the main actors, impacting the (un)successful implementation of sustainability. Particular top management support is a main driver for the implementation of sustainability in the leading organizations. Top management is in the position to set the right incentives and make sustainability a part of the strategic agenda. In a way the top management must show their involvement and support on the subject to make it real and alive. The intention of wanting to be sustainable does not end with management support but it is an important precondition. The support of budget owners is needed to create successful initiatives in the business units. Budget owners are major influencers within a business unit. In the lagging organizations, top management does not prioritize sustainability and budget owners are not very interested in the development of sustainability. They are main influencers in the inability to develop sustainability. Top management is a substantial influencer of budget owners and both are substantial influencers of procurement professionals. The procurement professionals are advisors for budget owners and top management. They are able to use their knowledge on sustainability to influence all actors in an organization. This influence is bigger in the leading organizations and very marginal in the lagging organizations. Knowledge on sustainability is important and procurement professionals are the designated party to adopt this knowledge. Procurement professionals are in the position to give good advice and share their knowledge with all organizational parties. Sometimes external pressure was needed to make top management and budget owners (more) aware of sustainability. Leading organizations show active management support and open and transparent communication of information as well as attention for education of all staff. In the lagging organizations there is no active support of management and people are not motivated to start initiatives. Information and communication only reach a select part of the organization and education of employees on sustainability is not addressed. As far as organizational conditions concern, the development of a sustainable policy with clear objectives stimulate the implementation of successful initiatives. The leading organizations even developed the policy with stakeholders and keep adjusting the policy in corporation with stakeholders. In addition, they give extra attention to sustainability by generating a specific department or working with designated people as ambassadors. These initiatives have a positive effect on the implementation of sustainability in the progressive organizations. The less progressive organizations were not able to develop the policy together with their stakeholders. Increasingly, external stakeholders are pressuring healthcare organizations to create sustainable initiatives. However progressive organizations developed sustainability with an internal drive and in this way were ahead of external demands. This resulted in the opportunity to generate favorable perceptions and believes with their external stakeholders. Our study expands the body of knowledge by finding organizations are influenced by internal drivers rather than external drivers. Our study confirms the importance of management support and adds the importance of employees developing sustainable initiatives. An organization can set all the right parameters but when employees do not participate, development is unlikely to occur. In addition it is notable that an explicit representative body for sustainability is very appreciated and an addition in the existing factors. We also found an addition on the theoretical context in the development of a vision on sustainability before setting a policy and goals. A vision gives the reason why an organization wants to develop sustainability, which is an important tool in creating awareness by employees. Also we found that the sharing of knowledge on sustainability is a driver for the development of sustainability. Recommendations for practice The lagging organizations need to consider creating a more incentive environment for the development of sustainability. Develop sustainability because you want to and make sure the whole organization supports the development. Also t is recommended to generate a structural budget for initiatives so they get a fair chance in growing to be successful. Make education a part of the structural educational agenda and support people in sharing their knowledge. Extra support and attention for initiatives is a driver and can be organized by facilitating a department or ambassadors on sustainability. The results of the study illustrate the limited role of the procurement managers. Organizations could make an effort to develop their procurement function in order to empower it so it can be a more driving and motivating actor, instead of merely performing an advisory role. Recommendations for further research The knowledge of the development of sustainability within the healthcare sector is very limited and the results and conclusions of our study are a beginning in exploring the status of sustainability within the sector. A major limitation of this study is the number of healthcare organizations involved and the number of respondents interviewed within these organizations. The study was limited to the perspective of institutional top management, budget owners and procurement professionals. The limitation of these actors does not exclude other actors and factors with a relationship to the implementation of sustainability. A promising line of research would be to include more stakeholders and their impact on sustainable initiatives. Research could also be focused on the interrelationships and interests of various internal and external stakeholders. Regarding the external validity it should be noted that this study is performed in four selected healthcare organizations, with only a selected group of respondents. The external validity of the study research could be questioned. More research could be conducted amongst healthcare organizations that lag behind in developing sustainable initiatives. It would be useful to replicate this study to a larger number of healthcare organizations in order to establish relationships between actors and factors influencing the process of implementing sustainability.
Appears in Collections:MSc Management Science

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