Prioritisation of barriers in implementing sustainable practices in public healthcare sector: an integrated DEMATEL, ISM and PROMETHEE model

Implementation of sustainable practices in healthcare sector is important due to environmental and social impact of hospital operations. In the present study, the barriers in implementing sustainable practices in the public healthcare sector are prioritised using an integrated DEMATEL-ISM-PROMETHEE approach. The barriers are identified through literature review and discussion with experts from the public healthcare sector in an Indian state. The inter-relationships between the various barriers were identified through the DEMATEL methodology. The driving power and the dependence power among the barriers were obtained using the interpretive structural modelling method. Finally, the prioritisation of the barriers was achieved through the PROMETHEE method. The study shows that lack of support from supply chain members, lack of commitment from top level hospital management and ignorance about government rules and regulations among employees are some of the significant obstacles in adopting sustainable practices in the public healthcare hospitals in the chosen Indian state.