Program on the Environment

Despite their primary mission to improve human and population health, hospitals currently account for 4.4% of annual global greenhouse gas emissions, nearly double that of the aviation industry. This discrepancy underscores the need to understand how to effectively integrate sustainability into hospital management and organizational structures. This study identifies the managerial and organizational factors most impactful for sustainability integration in hospitals. During an internship as a Sustainability Reporting Intern at Harborview Medical Center, semi-structured interviews were conducted with department leads, an anonymous survey was distributed to general staff, and findings were supplemented with a literature review on sustainable business management practices. Results indicate that cross-departmental collaboration and visibility, widespread participation in a non-financial reporting framework, and top-management involvement in sustainability initiatives are the most influential factors for effective sustainability integration. These findings suggest a broad framework for effective sustainability integration within hospitals and other firms. Effective implementation requires internal education programs, transparent reporting mechanisms that demonstrate cost savings and environmental impact, and strategic engagement of leadership at all levels. While grassroots motivation and peer collaboration are powerful drivers of change, institutional transformation ultimately requires top management commitment and accountability. Organizations that prioritize making sustainability visible, collaborative, and embedded in everyday workflows can bridge the gap between stated commitment and operational reality, creating lasting organizational change.