Research Problem Description
As the number and capabilities of healthcare facilities continue to grow, so does the risk of negative environmental impacts from their operations. Thus, addressing relevant concerns from a managerial practice perspective is a priority, which is simultaneously ISO compliant. Currently, there is not enough research on the practical application of green SCM approaches in the healthcare industry. While many hospitals around the world are actively moving from SCM to GSCM to reduce waste and negative environmental impact, more research is needed in this area. Moreover, the strategies used by managers to transform supply chains require additional investigation in a healthcare setting. Many hospitals are currently choosing the GSCM practice to meet international requirements 4001-2015 and ISO 9001-2015. Since the implementation of these principles is at an early stage, it is necessary to consider which strategies have already been applied and what results have been achieved. Consideration of these aspects will make it possible to assess the effectiveness of adopting international standards and the difficulties that healthcare facilities may encounter.
Particular attention should be paid to international standards and the extent to which they help promote environmental management practices in hospitals. Many healthcare facilities around the world are unable to effectively optimise their supply chains. The cause of this problem is reliance on the outdated principles of total quality management and little knowledge about optimization techniques. These factors hinder the construction of green supply chains that could meet modern standards. In this regard, the basis of this study is the operations of two hospitals in Australia and Turkey. The results of the assessment further allow identifying to what extent the supply chain management practices in the two healthcare facilities comply with ISO standards. Additionally, it is possible to define procedures that can be applied to implement the relevant strategies.
This study aims to compare the two healthcare systems in Australia and Turkey and the supply chain management systems that the two states employ. Hence, there is a need to look at historical data, such as statistics, government reports, legislation, research papers, and reviews that focus on this topic. The goal is to find data that would help understand how green practices following the ISO standards can be implemented in the healthcare supply chains. Based on the data the needs to be collected, this study is a collection of the history of the two systems.
The literature review design addresses the needs of this study because it allows collecting descriptive data that will allow the researchers to define the characteristics of the supply chains of the two healthcare systems. In addition, the researchers aim to collect historical data on this topic because the application of green SCM practices has not been a matter of concern for a long time. However, in recent years this topic has become more important, and both researchers and policymakers have dedicated efforts towards studying the potential ways of improving the SCM of the healthcare facilities. Hence, this study will help understand how the SCM systems of Australia and Turkey developed and how GSCM has become a topic of discussion in recent years.
During this study, the researchers will collect both quantitative and qualitative data by analysing papers that use descriptive design and studies that employ statistical data analysis methods. A literature review will help identify existing practices that both states are using to implement GSC and meet international standards. Hence, this study was conducted using the desk research methodology where literature on the topic was collected and analysed, focusing primarily on the history of the healthcare systems’ SCM practices in both states. The obtained empirical data was based on the analysis of both qualitative and quantitative information. To achieve this goal, both descriptive and explanatory research was used. The choice of mixed methods research is justified by the need to produce high-quality research that addresses the risks and benefits, as well as differences and similarities in the experiences of the two states. Thus, a combination of qualitative and quantitative research is necessary to deal with such a complex task.
For quantitative analysis, we used annual financial reports, financial documentation, documentation on the ISO standards and GSCM practices, and non-¬confidential documentation. In particular, the focus was on collecting information directly related to the costs associated with the implementation of the GSC. Further analysis and comparison of the data revealed any changes in the financial performance of the two systems before and after the practice. Techniques such as interviews, observations, and focus groups were used to collect qualitative data. This strategy allows the collection of more in-depth information about the studied phenomenon for a detailed answer to the research questions posed. The received answers were later analyzed using NVivo software, which allowed identifying the topics presented in the answers and determining the concepts that are associated with the participants with the implementation of GSC. In summary, the approach to examining the hypothesis of this study is the comparison of the histories of the two SCM systems, the Australian and Turkish.
Results of the Study
The purpose of this research was to evaluate the relationship between green SCM application, ISO 9001-2015 and ISO 14001-2015 compliance, and overall performance. The topic of green supply chain management is still somewhat new to hospitals, though it has been applied extensively in other industries. However, there have been efforts to implement it in some nations, particularly Turkey and Australia. They served as excellent examples from which implications for best practices in applying the principles of green SCM can be drawn. Moreover, the two countries are sufficiently different in their approaches that a comparison between the two is warranted, with Australia setting out requirements with which hospitals have to comply and Turkey applying a more laissez-faire approach. To that end, this study selected two different hospitals in the two nations and evaluated their success in applying green SCM.
Overall, both facilities discussed in this study have been able to improve their environmental performance substantially following their application of green SCM principles. The Royal Melbourne Hospital implemented environmental education for its employees and increased its usage of recycling practices and material separation, ultimately reducing its clinical waste production by nearly half. Meanwhile, though the Derindere Hospital applied several similar practices to those of its counterparts, it also focused on reducing paper usage and had to rely more on incineration and landfilling. Both hospitals’ management agreed that, by becoming more sustainable, they could serve higher numbers of patients more efficiently. As such, the measures taken by both facilities coincide substantially and generate similar results, which indicates that the approach is effective overall.
Derindere Hospital is private, while the Royal Melbourne Hospital is public, and this distinction manifests itself in several different ways. One of these is the motivation for their choice to implement green SCM practices. Derindere Hospital’s reason for adopting them was the sensitivity of the environmental question in Turkey. As such, in doing so, it aimed to improve its reputation in the community and win the trust of its visitors. On the other hand, the reasoning of the Royal Melbourne Hospital’s management was less direct, and it adopted green SCM to improve the environmental performance of the facility. While the goal is valid, achieving it does not necessarily provide any tangible benefits for the hospital. Instead, Victoria’s government provides negative reinforcement by requiring non-compliant organizations to review their standards. In the long term, this approach may not be sustainable, as, instead of genuine improvements, hospitals may be motivated to only comply with the statistics without regard for side effects.
Ultimately, the study found substantial differences between the application of the practice in the two nations. In the absence of government regulation, Derindere Hospital relied heavily on ISO 9001-2015 and 14001-2015 standards, using them to inform its operations. On the other hand, the management of Royal Melbourne Hospital was largely unaware of the guidelines, instead relying on government-mandated requirements and trusting them to incorporate all of the components necessary for success. As such, its compliance with ISO standards was difficult to evaluate objectively without further research into the matter. With that said, since the guidelines are substantially broad, the assumption can be made that the Victoria government’s green strategy was designed with them in mind. As such, so long as the government designs its green strategies responsibly, both the centralized approach and the decentralized one used in Turkey should be viable.
With that said, the challenges involved in implementing green SCM should be taken into consideration before attempting to replicate the measures. Interview participants from the Royal Melbourne Hospital noted how they could not find providers that could help them deal with specific types of waste, such as Styrofoam. Considering Australia’s overall high level of technological advancement and the government’s promotion of green practices, it is likely challenging to find such recyclers in other parts of the world, as well. The Turkish participants agreed that a nation’s level of technological sophistication would affect the success of green measures strongly, as well. Another problem identified in both nations was the need for continuous education of staff to comply with the latest green standards as they evolve continuously. Until a conclusive set of guidelines can be established, this issue is unlikely to be resolved.
Cost is the last matter that needs to be discussed, as it is the reason cited most often for why businesses do not implement green SCM practices. The implementation of new, more complicated waste management practices is typically expected to result in additional expenses that are not necessarily offset by tangible benefits. However, the participants from the Royal Melbourne Hospital make the opposite claim, stating that their costs were lowered as a result of the green SCM application. The stated reason for this change was that, through more mindful waste management practices, the amounts of it that were produced dropped substantially, requiring smaller utilization efforts. On the other hand, while Derindere Hospital also partially experienced the same phenomenon, its costs increased instead. The stated reason was that it was still in an early stage of an environmentally-friendly transition, and the expenses were expected to go down later on. With that said, it should be noted that the financial performance of both hospitals was worse in 2019, when they started implementing green SCM, than in 2018.
Implications of the Research
The study has found that overall, green SCM is viable for hospitals, effectively reducing their waste production and the associated costs. There are also incentives for private hospitals to adopt it, such as improved reputation and patient trust. Moreover, it confirms that ISO 9001-2015 and ISO 14001-2015 compliance can effectively enable a hospital to follow environmentally friendly practices. With that said, implementing green SCM is associated with increased costs in the short term as the facility adapts to the new standards. Moreover, the long-term implications of the constantly-evolving environmental science and the adaptations it requires can incur additional expenses. Lastly, the technological capabilities of the hospital’s region need to be considered, as they can inform the degree to which it can be environmentally friendly. After considering the short-term viability of the move and the overall potential for savings, hospitals should have substantial reason to consider adapting their practices.
Limitations of the Research
The most significant limitation of this research lies in the fact that it has only analysed two hospitals. As such, the possibility that they are not representative of the overall hospital industry is substantial. Moreover, Derindere Hospital is private while the Royal Melbourne Hospital is public, which means that the two’s objectives and incentive structures are entirely different. As such, a direct comparison between the two may not necessarily be valid, as it will likely be complicated by a variety of confounding factors. Lastly, as mentioned in Chapter 6, the individuals the researcher interviewed did not have access to all of the information regarding strategy and financial performance. As such, some of the statements they made may be inaccurate or misleading, though the possibility of this happening is low. Overall, a more extensive investigation is required to determine whether the results of this study are accurate.
Future Research Directions
Future research will need to determine whether the results of the study are valid and applicable across the broader hospital industry. It will need to evaluate more public and private facilities that apply green SCM principles for performance changes. An experimental-design study that would oversee the implementation of the approach at a hospital would be of particular interest, as, throughout the process, it would be able to determine specific issues and improvement opportunities. Additional investigations into the green SCM standards that are applied worldwide and their compliance with ISO 9001-2015 and ISO 14001-2015 are also warranted. Research into efficient continued medical worker education regarding changing environmental guidelines can help address the problem identified in this research. Lastly, a consolidation of environmental friendliness research that improves the overall understanding of best practices in the field would be beneficial.
Though green SCM and its application to hospitals have not been studied excessively, there appears to be substantial potential for their implementation and usage. While medical facilities do not have many opportunities to affect their upstream supply chains, they can optimize their operations and minimize their waste production. Moreover, there are incentives for both public and private hospitals to do so, such as reduced costs in the long term. With that said, this study demonstrates that green SCM adoption is a process that cannot be effectively performed in an isolated facility. The environment in which it operates needs to be suitable for the purpose, which implies the existence and availability of diverse waste recycling facilities, among other factors. As long as supporting factors exist for the transition, most hospitals will likely make the choice to transition to green practices due to the benefits the practices create.