Sustainability Accounting and Reporting: Searching for a Viable Framework in Public Healthcare Organizations

Context. Public healthcare organizations (PHOs) have recently been involved in measures to promote sustainability and bear witness to their work. Hence, accounting has become a handy tool for reporting and informing stakeholders. Aims. From a theoretical perspective, the paper focuses on the analysis of sustainability factors in public healthcare organizations. Considering the current gap in the literature on the application of sustainability measures in the health sector, the paper aims to offer an advancement in this field and to put forward a proposal for the construction of a possible sustainability reporting model capable of reporting on the public value created. In particular, it investigates how sustainability practices can influence the accounting aspects and are declined through actions aimed at balancing different levels ranging from governance to social and environmental factors. Methodology. The paper consists of two parts, one on a theoretical basis and the other on an empirical basis. The theoretical basis includes a literature review for constructing a framework related to sustainability advancement in healthcare. The second part is devoted to a case study of building a sustainability report in a public hospital. Results. A sustainability report, with its stakeholder-centred approach and materiality analysis, can help to understand the needs and improve communication with patients, their families, employees, society and institutions. This is even more accurate for the hospitals that integrate research and teaching into the assistance activity and, consequently, must also interface with the needs of prominent stakeholders such as universities. Sustainability reporting also allows for better management of environmental, social, and governance risks, granting a deeper understanding of the impact of its internal processes and strategies and creating a corporate culture intended as a “real” emancipatory change in thinking and performing activities.