Incorporating sustainability in small health-care facilities: an integrated model.

Purpose It is challenging for small health-care facilities to implement changes when human and financial resources are limited for day-to-day operations. This paper aims to propose an integrated model for small- and medium-sized health-care facilities to integrate sustainability in their day-to-day operations, which have been derived from the leadership and change theories. Design/methodology/approach Drawing on previous research on leadership and change theories, the paper first critically reviewed the approaches to implementing changes and how applicable they are in the context of small- and medium-sized health-care facilities. Next, it proposes an integrated model with an execution plan. Findings The first part of the paper discusses how either the planned approach or emergent approach for change may fail in facilitating the implementation of sustainable initiatives, as incorporating sustainability into operations require both leadership of change and open learning systems. The second part outlines the four-phase combined approach, which includes phases of "exploration", "planning", "action" and "integration", and discusses how change readiness is ensured through such approach. Practical implications The authors propose an integrated model as a framework for integrating sustainability into the operations of small health-care facilities. The clearest possible steps at various phases are proposed. Potential barriers and risks are highlighted and the coping strategies proposed to maximise the chance of successfully transforming organisations. Originality/value Applying the "how to" ideas based on the integrated model for change management will help leaders of health-care facilities gradually integrate sustainability into their day-to-day operations.