A hybrid multi-criteria decision-making approach for hospitals’ sustainability performance evaluation under fuzzy environment

Purpose - Hospital structures serve to protect and improve public health; however, they are recognized as a major source of environmental degradation. Thus, an effective performance evaluation framework is required to improve hospital sustainability. In this context, this study presents a holistic methodology that integrates the sustainability balanced scorecard (SBSC) with fuzzy Delphi method and fuzzy multi-criteria decision-making approaches for evaluating the sustainability performance of hospitals. Design/methodology/approach - Initially, a comprehensive list of relevant sustainability evaluation criteria was considered based on six SBSC-based dimensions, in line with triple-bottom-line sustainability dimensions, and derived from the literature review and experts’ opinions. Then, the weights of perspectives and their respective criteria are computed and ranked utilizing the fuzzy analytic hierarchy process. Subsequently, the hospitals’ sustainable performance values are ranked based on these criteria using the Fuzzy Technique for Order of Preference by Similarity to Ideal Solution. Findings - A numerical application was conducted in six public hospitals to exhibit the proposed model’s applicability. The results of this study revealed that “Patient satisfaction,” “Efficiency,” “Effectiveness,” “Access to care” and “Waste production,” respectively, are the five most important criteria of sustainable performance. Practical implications - The new model will provide decision-makers with management tools that may help them identify the relevant factors for upgrading the level of sustainability in their hospitals and thus improve public health and community well-being. Originality/value - This is the first study that proposes a new hybrid decision-making methodology for evaluating and comparing hospitals’ sustainability performance under a fuzzy environment.