International Journal of Health Policy and Management

International Journal of Health Policy and Management

Employee Green Behavior in Hospitals: A Scoping Review of Definitions and Influencing Factors

Document Type : Scoping Review

Authors
1 College of Nursing, Yonsei University, Seoul, Republic of Korea
2 College of Nursing, Ohio State University, Columbus, OH, USA
3 School of Nursing, University of California, Los Angeles, CA, USA
Abstract
Background
Employee green behavior (EGB) refers to environmentally responsible actions undertaken by employees in the workplace. Although interest in EGB is growing, hospitals represent a uniquely complex environment where clinical demands, operational constraints, and regulatory pressures may shape such behavior in distinct ways. To date, no review has synthesized literature on EGB within hospital settings. This scoping review synthesizes existing research to clarify how EGB has been conceptualized and studied in hospitals, identify factors associated with EGB, and inform future research and sustainability efforts in healthcare organizations.

Methods
This scoping review followed the Joanna Briggs Institute (JBI) methodology and reported per Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines. Seven databases (PubMed, CINAHL, Embase, Web of Science, Scopus, APA PsycINFO, and Emerald) and grey literature were searched from inception to January 31, 2025. Studies examining EGB among hospital employees were included.

Results
Twenty-three studies met the inclusion criteria, with most published after 2021. The majority employed quantitative survey designs and focused on nurses, although some included multidisciplinary staff. Considerable variation was observed in how EGB was defined and measured across studies. Factors reported in relation to EGB were organized into four levels: individual, team, leadership, and organizational. Qualitative findings highlighted barriers such as time constraints, insufficient training, limited knowledge, and lack of leadership support, as well as facilitators including individual motivation, environmental awareness, shared responsibility, and access to sustainability resources and education.

Conclusion
EGB in hospital settings has been defined and examined inconsistently in the existing literature. This review proposes a working definition of EGB as employee actions in the workplace that minimize environmental harm and promote sustainability. The findings indicate that EGB in hospitals is influenced by multiple factors, and effective sustainability efforts in healthcare organizations require coordinated multilevel approaches. Registry Name and Number: The review protocol was registered with the Open Science Framework (osf.io/kd57r).

Keywords

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Articles in Press, Accepted Manuscript
Available Online from 13 July 2026

Supplementary File
(IJHPM does not take responsibility for any information provided in the supplementary files.)

  • Received Date 03 August 2025
  • Revised Date 09 April 2026
  • Accepted Date 12 July 2026
  • First Published Date 13 July 2026
  • Published Date 13 July 2026