Healthcare organizations have a significant carbon footprint due to their substantial energy consumption and waste generation. Operating 24h a day using high-power electronic equipment and producing thousands of tons of different types of waste, they account for approximately 4-5% of total greenhouse gas emissions. Despite the demand for healthcare organisations to reduce their negative environmental impact and develop effective green practices, policy makers and practitioners still lack a holistic view of how to proceed. This paper aims to investigate the impact of Green Organizational Practices (GOPs) on Climate Change Mitigation Performance (CCMP) within publicly owned hospitals, particularly in the English NHS, which has pledged to achieve net-zero emissions by 2040. On the one hand, the results point out that, when considered individually, the practice that seems to play the most decisive role in improving environmental performance is green energy procurement. Therefore, hospitals with limited resources could prioritise the purchase of energy from certified renewable sources to get a higher CCMP. On the other hand, the findings also highlight how the impact of individual GOPs on CCMP can depend on the presence or absence of other practices. Specifically, when a healthcare organisation engages in green energy procurement and this is aligned with an environmentally-oriented strategy for the management of estates and facilities, the practices of having an energy manager and a waste manager combine interchangeably. Conversely, when the environmental strategy does not play a major role, this can be offset by the presence of both management roles, i.e., energy and waste manager. Regarding implications for practice, the coordination and strategic alignment of different green practices are of paramount importance. Hospital managers should prioritise the integration of these practices by identifying and leveraging their synergies and interactions. As far as policy making is concerned, the findings suggest that environmental regulations and sector standards should be designed to take into account the integrated nature of green practices, allowing individual hospitals the flexibility to adapt and shape their climate change initiatives.
