Fuzzy TOPSIS Model for Assessment of Environmental Sustainability: A Case Study with Patient Judgements

Health care organisations have broadened their commitment to corporate social responsibility, since, as well as providing health care to patients, their activities negatively affect world pollution. This is a result of the products and technologies they use, the resources they consume, the waste they produce, and the buildings they occupy and operate. This, in turn, affects the health of the community. For this reason, a growing number of health care organisations have become involved in improvements to environmental sustainability, in order to promote public health. These improvements need to be controlled by a system whose effects can be assessed within a process of continuous improvement. This research, therefore, sets out a model constructed by extension to a fuzzy environment of the technique for order preference by similarity to ideal situation (TOPSIS), to assess the environmental responsibility of health care organizations. The weights were obtained from judgements given by both an expert in environmental matters, and a group of patients, and the judgements of both types of stakeholder were combined. The model has been applied in a Spanish public hospital over a period of five years. The closeness coefficients obtained with the judgements from the patient group are on average 6.59% higher than those obtained from the expert, and so it can be said that patients are less demanding on environmental matters. The similarity of the models was assessed, by comparing the model that combines both sets of judgements with the model constructed from the judgements of the expert and the model built from the judgements of the patient groups. The similarity is seen to be high, but it is greater in the case of the ranking obtained from the patient judgements. The results in all cases suggest a low risk of a serious environmental problem in the hospital. Nonetheless, it also implies that there are opportunities for continuous improvement. The use of a model with judgements from a patient group was intended to take into account the increasingly important need to include the judgements and opinions of different stakeholders in decision and assessment processes in the hospital environment.