Abstract
Hospitals are major contributors to greenhouse gas (GHG) emissions due to their continuous and resource-intensive operations. This study examined how selected Level 3 hospitals in Metro Manila align their environmental management practices with the GHG Protocol principles—completeness, consistency, relevance, accuracy, and transparency—and proposed strategies to improve sustainability and financial performance. Using a qualitative descriptive design, data were gathered from 67 purposively selected managerial staff from 10 public and private hospitals using a validated semi-structured interview guide. Thematic analysis identified gaps in measurement and reporting, limited stakeholder engagement, and inconsistent documentation. Results showed that completeness was the most evident principle, reflecting reliance on consumption data and emission factors, while accuracy was weakest due to the absence of robust quantification tools. Consistency, relevance, and transparency were only partly observed. The findings confirm the need for a Strategic Environmental Management Framework to standardize reporting, enhance stakeholder participation, and integrate cost-effective GHG reduction strategies. This study offers one of the first principle-based assessments of Philippine hospitals, providing practical guidance for managers and policymakers seeking to strengthen both environmental stewardship and financial performance.