Environmental management strategies

Oct 13, 2025 by wbrum.org 92 views

The Influence of Institutional Pressure and Environmental Management Strategies on Hospital Performance through the Implementation of Environmental Management Accounting with Green Innovation as a Moderating Variable: Case Studies in Hospitals in North Sumatra

Introduction

In recent years, the healthcare industry has faced increasing pressure to adopt sustainable practices and reduce its environmental impact. Hospitals, as major consumers of resources and generators of waste, are at the forefront of this movement. Environmental management accounting (EMA) has emerged as a key tool for hospitals to measure and manage their environmental performance. However, the implementation of EMA is often hindered by institutional pressure and environmental management strategies. This study aims to investigate the effect of institutional pressure and environmental management strategies on hospital performance through the application of EMA, with green innovation as a moderating variable.

Background

The healthcare industry is one of the largest consumers of resources and generators of waste. Hospitals, in particular, are significant contributors to environmental degradation, with high energy consumption, water usage, and waste generation. In response to these challenges, hospitals are increasingly adopting sustainable practices and reducing their environmental impact. Environmental management accounting (EMA) has emerged as a key tool for hospitals to measure and manage their environmental performance. EMA involves the systematic collection, analysis, and reporting of environmental data to inform decision-making and improve environmental performance.

Methodology

This study employed a case study approach, focusing on hospitals in North Sumatra, Indonesia. A total of 129 respondents were involved in the study, consisting of one representative from the Ministry of Finance and a representative of the hospital's internal audit unit. The study used a mixed-methods approach, combining both qualitative and quantitative data collection and analysis methods.

Results

The results of this study showed that institutional pressure and environmental management strategies had a positive impact on the application of EMA and hospital performance. Institutional pressure was found to have an indirect influence on hospital performance through the application of EMA, while environmental management strategies did not show significant indirect effects through the application of EMA. Furthermore, green innovation did not succeed in strengthening the relationship between the application of EMA and hospital performance. Although green innovations directly affected hospital performance, they were unable to increase the effect of the application of EMA.

Discussion

The findings of this study highlight the importance of institutional pressure and environmental management strategies in promoting the adoption of EMA and improving hospital performance. Institutional pressure, both from the government and the community, encourages hospitals to innovate in environmental management. The strategies taken need to be adjusted to the conditions and needs of the hospital and the surrounding environment in order to provide optimal results.

Green innovation, although it does not strengthen the relationship between EMA and performance, is still important to consider. Hospitals need to develop effective measurement and evaluation systems to assess the impact of innovations applied. In addition, involving all stakeholders in the change process is a crucial step so that resistance can be minimized.

Conclusion

Overall, this research highlights the importance of the application of EMA supported by institutional pressure and effective environmental management strategies. With measurable and planned green innovations, hospitals can achieve better and more sustainable performance. For this reason, a strong commitment is needed from all parties involved so that changes can be received and implemented properly.

Recommendations

Based on the findings of this study, the following recommendations are made:

Institutional pressure: Hospitals should be encouraged to adopt EMA through institutional pressure from the government and the community.
Environmental management strategies: Hospitals should develop effective environmental management strategies that are tailored to their specific needs and conditions.
Green innovation: Hospitals should develop effective measurement and evaluation systems to assess the impact of green innovations applied.
Stakeholder involvement: Hospitals should involve all stakeholders in the change process to minimize resistance to change.

Limitations

This study has several limitations that should be acknowledged. Firstly, the study was conducted in a specific context (hospitals in North Sumatra, Indonesia) and may not be generalizable to other contexts. Secondly, the study relied on a small sample size, which may limit the reliability of the findings. Finally, the study did not control for other factors that may influence the adoption of EMA and hospital performance.

Future Research Directions

This study provides a foundation for future research in the area of EMA and hospital performance. Future studies should aim to:

Generalize the findings: Future studies should aim to generalize the findings of this study to other contexts and populations.
Investigate other factors: Future studies should investigate other factors that may influence the adoption of EMA and hospital performance, such as organizational culture and leadership.
Develop more effective measurement and evaluation systems: Future studies should aim to develop more effective measurement and evaluation systems to assess the impact of EMA and green innovations.

Conclusion

In conclusion, this study highlights the importance of institutional pressure and environmental management strategies in promoting the adoption of EMA and improving hospital performance. With measurable and planned green innovations, hospitals can achieve better and more sustainable performance. For this reason, a strong commitment is needed from all parties involved so that changes can be received and implemented properly.
Frequently Asked Questions (FAQs) about the Influence of Institutional Pressure and Environmental Management Strategies on Hospital Performance

Q: What is the main focus of this study?

A: The main focus of this study is to investigate the effect of institutional pressure and environmental management strategies on hospital performance through the application of environmental management accounting (EMA), with green innovation as a moderating variable.

Q: What is environmental management accounting (EMA)?

A: EMA is a systematic approach to measuring and managing environmental performance. It involves the collection, analysis, and reporting of environmental data to inform decision-making and improve environmental performance.

Q: What is the significance of institutional pressure in promoting the adoption of EMA?

A: Institutional pressure, both from the government and the community, encourages hospitals to innovate in environmental management. This pressure can lead to the adoption of EMA and improvement in hospital performance.

Q: What is the role of environmental management strategies in promoting the adoption of EMA?

A: Environmental management strategies are essential in promoting the adoption of EMA. These strategies need to be tailored to the specific needs and conditions of the hospital and the surrounding environment to provide optimal results.

Q: What is the impact of green innovation on hospital performance?

A: Green innovation has a direct impact on hospital performance, but it does not strengthen the relationship between EMA and performance. However, green innovation is still important to consider, as it can lead to improved environmental performance and sustainability.

Q: What are the challenges faced by hospitals in implementing EMA and green innovation?

A: One of the main challenges faced by hospitals is resistance to change. Green innovation often requires changes in existing work procedures, which can be met with resistance from staff or other stakeholders.

Q: What are the recommendations for hospitals to improve their environmental performance?

A: Based on the findings of this study, the following recommendations are made:

Institutional pressure: Hospitals should be encouraged to adopt EMA through institutional pressure from the government and the community.
Environmental management strategies: Hospitals should develop effective environmental management strategies that are tailored to their specific needs and conditions.
Green innovation: Hospitals should develop effective measurement and evaluation systems to assess the impact of green innovations applied.
Stakeholder involvement: Hospitals should involve all stakeholders in the change process to minimize resistance to change.

Q: What are the limitations of this study?

A: This study has several limitations that should be acknowledged. Firstly, the study was conducted in a specific context (hospitals in North Sumatra, Indonesia) and may not be generalizable to other contexts. Secondly, the study relied on a small sample size, which may limit the reliability of the findings. Finally, the study did not control for other factors that may influence the adoption of EMA and hospital performance.

Q: What are the future research directions in this area?

A: Future studies should aim to:

Generalize the findings: Future studies should aim to generalize the findings of this study to other contexts and populations.
Investigate other factors: Future studies should investigate other factors that may influence the adoption of EMA and hospital performance, such as organizational culture and leadership.
Develop more effective measurement and evaluation systems: Future studies should aim to develop more effective measurement and evaluation systems to assess the impact of EMA and green innovations.

Q: What are the implications of this study for policymakers and healthcare organizations?

A: The findings of this study have implications for policymakers and healthcare organizations. They should encourage hospitals to adopt EMA and green innovation to improve their environmental performance and sustainability. Additionally, they should provide support and resources for hospitals to develop effective environmental management strategies and measurement and evaluation systems.