Sustainability in Hospitals: Identifying Boosting Elements Through the Triple Bottom Line Framework

Abstract

Growing populations and resource-intensive production have intensified environmental, social, and economic pressures, compelling healthcare institutions to embed sustainability within their operations. Hospitals, among the most resource-demanding organizations, are increasingly challenged to deliver quality care while maintaining ecological responsibility. This study explores how Indian teaching hospitals can adopt sustainable management practices. A qualitative design was employed, combining document analysis with semi-structured interviews of administrators, clinicians, and facility managers. Using the Triple Bottom Line (TBL) framework, sustainability factors were examined across environmental, social, and economic dimensions. Thirty key elements were distilled into five core drivers: circular economy, sustainable infrastructure, organizational knowledge, structured management systems, and technological innovation. These drivers provide a framework to reduce environmental impact, enhance workforce well-being, and secure long-term financial viability. Theoretically, the study integrates fragmented insights on hospital sustainability, while practically it delivers context-specific strategies that support administrators in aligning hospital operations with India’s National Health Policy (2017) and the United Nations Sustainable Development Goals (SDGs). The findings suggest that adopting these drivers systemically can transform hospitals into sustainable institutions that offer equitable, environmentally conscious, and economically resilient healthcare. Future research should expand the framework to diverse healthcare contexts in India, strengthening sustainability as a core principle of healthcare management.