Leadership, Organizational Culture, and ESG Performance in Hospitals: A Decadal Review and Research Agenda

Abstract

ESG (Environmental, Social, and Governance) issues are becoming increasingly crucial in healthcare management, particularly in rapidly developing urban regions like Mumbai. Hospitals are now expected to provide high-quality care while demonstrating responsibility toward the environment, promoting social fairness, and ensuring transparent governance. This paper offers a ten-year review of leadership, organizational culture, and ESG performance in hospitals, combining global data with insights from India. It systematically examines existing literature and features stakeholder interviews to show how transformational leadership and a supportive culture foster ESG adoption, leading to better patient outcomes and sustainability. The results suggest that Indian hospitals are beginning to implement ESG frameworks, but adoption varies and is heavily shaped by leadership vision and cultural factors. The paper proposes a framework connecting leadership styles, cultural traits, and ESG metrics, along with recommendations for future research. It contributes meaningfully to both theory and practice by demonstrating how leadership and culture act as strategic tools to integrate ESG into healthcare.