Circular economy (CE) strategies, which emphasize keeping materials and products in a closed loop through reuse and regeneration, have attracted growing attention in healthcare. For medical textiles, this could dramatically reduce healthcare waste and associated environmental impacts, yet barriers make it challenging to transition from traditional linear economies, which rely on single-use materials. While existing research explores medical textile waste, environmental deterioration, and waste management practices in healthcare, there is a gap in understanding the implementation of sustainable practices from an administrative standpoint for non-medical textiles. Understanding why some hospitals implement CE strategies while others remain linear necessitates an examination of the institutional environment in which these decisions happen. Drawing on Institutional Theory, this case study explores how institutional structures and governance, administrative norms, and stakeholder behaviors within hospital systems influence the adoption and implementation of CE strategies for non-medical textile waste. Using Yin’s explanatory case study design, the analysis utilizes secondary data to describe how institutional factors influence organizational behavior. This case study’s findings support several recommendations for policymakers and administrators.
