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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 single‑case study design, the research draws on semi-structured 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 patient-safety-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.

Strategic management assists organizations in formulating, implementing, and evaluating decisions to set objectives. Energy management should consider top management commitment, risk management, corporate social responsibility, and knowledge and awareness of energy strategies as criteria for implementation. The research aimed to evaluate the four criteria in terms of energy management strategy implementation. A quantitative, non-experimental research design was followed using a structured questionnaire. The most important criterion identified is top management commitment. The results indicate a strong positive correlation between top management commitment and energy management strategies and the importance of risk management. Corporate Social Responsibility and limited knowledge and awareness showed a lower correlation but also contributed to the implementation of energy management strategies. It showed that a lack of knowledge and awareness influences the implementation; organizations can do internal awareness campaigns and appoint a dedicated energy team that can assist management in educating and communicating energy strategies. Further findings included that energy management strategies are essential to the overall business strategy of organizations and that organizations can increase their public reputation by positively contributing to corporate social responsibility and top management commitment. Management needs to lead from the front and provide training, resources and leadership in energy practices. It is recommended that organizations set energy plans, have a dedicated energy team and increase their internal awareness and communication.