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Organizations have increasingly been compelled to engage in ecological businesses in recent decades, necessitating identifying environmental practices contributing to enhanced sustainability. One of the main reasons for doing this research is to see how far down the path to green transformational leadership (GTFL) in Green Human Resource Management (GHRM) practices in the healthcare industry in Pakistan. Additionally, this research aims to analyze how this change affects the long-term success of businesses in sustainable performance (SP).

To identify factors related to the study variables, the research utilized master journals, as well as the Web of Science and Scopus databases. The ISM-DEMATEL (Interpretive Structural Modeling - Decision Making Trial and Evaluation Laboratory) technique was employed to establish a hierarchical model. This model facilitated the identification of cause-and-effect relationships among factors, which were further elucidated using the DEMATEL interrelationship diagram.

The analysis of the results indicates that Green Training (F4), Green Job Analysis (F1), Intellectual Stimulation (F10), and Green Product Innovation (F9) are the primary factors that have a significant impact on achieving Environmental Policies and Regulations (F13), and Subjective Environment Norms (F14) of SP factors.

The study is implemented in the healthcare industry of Pakistan, with a focus on practical and managerial aspects. It encourages managers to develop and adapt their human resources policies and environmental strategies. Implementing safety health standards is crucial to mitigate the detrimental effects on the environment. The research was carried out during the period of the pandemic. The scope of this study was restricted to the healthcare industry in Pakistan.

In order to improve SP, this study presents a unique strategy combining sustainability into decision-making procedures with the function of GTFL in GHRM. Implementing safety health standards is crucial to mitigate the detrimental effects on the environment.

As a result, the current study attempted to investigate the impact of green human resource (GHR) practices on long-term performance, and the path has been explained through organizational identification, which is supported by social identity theory.

To achieve the present study's primary goal, data were obtained from manufacturing businesses and analyzed using partial least square (Smart PLS) on the data of 284 Pakistani small and medium-sized enterprises (SMEs) registered with the small and medium-sized enterprises development authority (SMEDA).

As a result, the findings show that organizational identification explains the indirect relationship between sustainable performance and green human resource management (GHRM).

To limit the limited negative effect on the environment and society, the findings provide several suggestions for the government authorities and policymakers to adopt green practices and policies.

Green practices are essential for a company to limit its negative environmental effect. Environmental critical problems among shareholders put pressure on the firm to implement GHR practices and organizational identification with long-term success.