Abstract
This study investigates how a major South African private hospital group adopts and scales multiple
renewable energy sources (MRES) within a mission-critical healthcare environment characterised by
chronic grid instability. Using a qualitative singlecase study design, the research draws on semistructured
interviews with senior executives and technical managers, complemented by documentary
analysis, to explore the barriers, enablers and governance mechanisms underpinning MRES adoption.
The results reveal that financial and economic constraints, regulatory fragmentation, legacy
infrastructure, and supply chain limitations constitute multidimensional barriers. In contrast,
economic viability, executive leadership, risk-managed implementation, and energy-security
imperatives serve as decisive enablers. The study demonstrates that effective adoption arises not from
technology choices alone, but from an integrated organisational approach that combines diversified
energy portfolios, phased implementation strategies, contractual procurement, and structured
sustainability governance. The proposed Integrated MRES Adoption Framework synthesises these
dimensions, offering a holistic model for energy transition in high-risk medical settings. The study
concludes that hospitals can meaningfully advance renewable energy penetration when technical
diversification is embedded within robust governance, financial feasibility assessments, and patientsafety-
aligned risk management. Limitations include a single-case scope and senior-level perspectives;
future research should compare public and private systems, evaluate long-term performance, and
deepen inquiry into staff-level change processes.