The adoption of formal environmental management systems (EMS) according to EMAS (Eco-Management and Audit Scheme) represents a voluntary approach that aims to increase corporate environmental performance. Though EMAS can offer several advantages for organizations, registration numbers are falling. In the hospital sector, the dissemination of EMAS is low. The question arises as to what hinders hospitals when planning, implementing, and maintaining such voluntary environmental management initiatives. The results from interviews with environmental managers in EMAS registered hospitals reveal problems such as high initial effort for creation of the required documents, or lacking knowledge and staff awareness. The barriers are presented in a model synthesizing the problems chronologically on the organizational, group, and individual level. The challenges for the adoption of EMAS as a voluntary environmental management approach in hospitals are discussed. This paper contributes by creating an understanding of the barriers organizations might face when implementing an EMS. Thus, measures to actively manage and overcome barriers can be developed by organizations, consultants, reviewers, policy makers, and researchers.
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