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65Hospital Economics And The Business Case For ChangeC o n s i d e r t h e e c o n o m i c s o f a hospital. Revenue streams from patient services, insurance reimbursements and grants are balanced with escalating costs of operations, supplies, staffing and utilities, while striving for efficiency and high-quality care. Lean thinking excels by streamlining patient care and liberating resources, cutting expenses while improving patient flow and staff overburden. Sustainability action is also a powerful ally, mitigating climaterelated risks while unlocking financial gains. These gains may be hidden in utility savings, fines, talent costs, new revenue streams from waste or energy sales, and deferment of future capital expenditure for unnecessary capacity (figure 7). Sustainability may trigger investment in training, supply chain redesign, ecovendors, renewable energy infrastructure, and new measurement systems (e.g. tracking GHG emissions). These upfront costs could be of fset by ef ficiency improvements, fines mitigation, resource conservation, and reduced disposal costs. Some organisations focus on efficiency and quality first, using early gains to fund costlier sustainability investments later. Benefits come to life in real-world applications, as presented in the following stories. Case Examples And StoriesLeader Transformation FirstKaizen is a Japanese philosophy of continuous improvement with a deeper meaning rooted in self-discipline and sacrifice for the greater good. As with any transformation, leader actions set the tone. Grey Dube, a former hospital CEO, shifted his leadership style from crisis- driven to pro -ac tive, humble and empowering. By practicing selfreflection, leading regular gemba walks with his executive team, and personally committing to an A3 improvement plan, Figure 7: Upside Potential from Sustainability Action (Heathcote 2023)專欄文章5 (原文)｜THE EXECUTION GAP