Date of Conferral



Doctor of Business Administration (D.B.A.)




Steve Roussas


During the delivery of healthcare services, hospital employees use enormous amounts of water, energy, and nonbiodegradable carcinogenic plastics. In the U.S., hospital staff generate an average of over 7,000 tons of waste per day at an average cost of $0.28 per pound for the disposal of regulated medical trash, which if efficiently managed or reduced, could result in substantial cost savings. Using the organizational learning and the transaction cost economics theories as the conceptual frameworks, the purpose of this qualitative case study was to explore strategies healthcare leaders used to minimize their waste management operational costs. Data were collected using semistructured interviews with 4 managers at a healthcare system in the Midwestern United States and reviewing financial documents as well as the participants' hospital website. Based on the thematic analysis, 4 primary themes emerged: (a) engaged leadership, (b) incorporate sustainability into the mission, vision, and values of the organization, (c) create an organizational culture of sustainability, and (d) innovation. Because society's health is largely dependent on the environment around them, these findings could assist hospital leaders in the implementation of cost-effective waste management strategies and contribute to positive social change.