Integrating Sustainability Practices and Governance Capabilities in South Africa’s Private Healthcare System for Improved Performance

This article examines how sustainability is understood and enacted within South Africa’s private healthcare sector, focusing on which practices matter most and how they are integrated into organisational routines. Using an interpretivist design and abductive reflexive thematic analysis, the study sampled seventeen professionals from across the three major hospital groups to ensure sample heterogeneity. The analysis revealed that sustainability is shaped by the interaction of leadership commitment, coordinated governance, resource optimisation, and integrated performance feedback. These dynamics were synthesised into the Sustainability Integration and Performance Model (SIPM), illustrating how sustainability functions as a coherent organisational capability rather than a set of isolated initiatives. The findings provide insights into navigating institutional ambiguity and support the transferability of these results to comparable resource-intensive healthcare settings.