Recycling and Environmental Sustainability in the New Zealand Healthcare Setting: A Practice-led Case Study Research-Project
The current economic and environmental climate presents challenges and opportunities for the healthcare sector. Healthcare provision inadvertently results in significant environmental harm. The volume of waste produced by healthcare providers is often large and costly to dispose of. This thesis presents my experience of establishing and leading a recycling and environmental sustainability research project in the New Zealand (NZ) healthcare setting. It is presented as a practice-led case study undertaken to change practice primarily targeting the NZ healthcare sector. It incorporates both quantitative and qualitative data. As such it represents the first of its kind in NZ to explore the impact of a recycling and environmental sustainability programme in the healthcare setting. Two sites were chosen as case study sites - both sites being different in size and function - involved in the delivery of inpatient and outpatient services; further enhancing the originality of the study. This study is interwoven with the development, delivery, and evaluation of the recycling project and environmental sustainability programme. The theoretical constructs of sustainability, leadership, and change management frame the research project and provide the lens through which to view the project. This professional doctorate reflects the tension of undertaking my normal role and adding the complexity of research. As such it is impossible to separate the two aspects. I became the ‘actor-director’ holding the tension of the practice-research nexus. Findings show recycling is an essential component of an environmental sustainability programme. Leadership is shown by providing a recycling solution and by managing the changing behaviour among the end-users, from the status quo to pro-environmental behaviour. This study reveals important benefits in terms of costs avoided and decreasing environmental harm. This study found that using a patient indicator of activity is reliable in the NZ healthcare context. This measure is found to be the most beneficial, especially for facility managers, as it allows for more accurate waste management planning. Survey results show ethical and emotive reasons drive pro-environmental behaviours. Respondents believe healthcare organisations need to prioritise recycling. Respondents also assert that the uptake of the project and the programme is greater when there is departmental leadership support and when led by a dedicated sustainability officer. When considering sustainable healthcare waste management and adopting the theoretical lens of complexity leadership theory, the findings suggest adopting a multi-level system-wide approach to recycling in healthcare whilst situating recycling within the context of a wider environmental sustainability programme. This thesis finds organisational change is required for successful behaviour change results, leadership is needed to ensure effective design and implementation of the change programme, and sustainability programmes require a strategic approach. A new conceptual model is presented with practical implications, thereby allowing regional and national replication. This research project could be replicated in other settings within and outside the healthcare context. Extended research is needed to establish benchmarks for tracking sustainability performance and to support workplace training and education programmes in sustainability management.