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International Accreditation of Healthcare Facilities

ASF Standards · Laboratory · Standard 11

Standard 11 — Sustainable Care

5 criteria · 1 core · 4 standard-level · Version 1.0 · Aligned to ISQua EEA Principle 6, 6th Edition

Environmental conditions for testing accuracy, physical hazard separation, and hazard-class waste segregation are addressed in Standard 5. This standard addresses genuine environmental sustainability — reagent waste, equipment energy use, and cold-chain efficiency.

Criteria in this standard

11.1

Reagent and Chemical Waste Is Genuinely Minimised, Not Accepted as Fixed

Core

The laboratory genuinely reviews reagent and chemical consumption for opportunities to reduce waste — expired stock, over-ordering, unnecessary repeat testing — not treating reagent waste as a fixed, unexamined cost of laboratory operations.

In plain terms: The lab actually looks at where reagents and chemicals get wasted — expired stock, over-ordering — rather than treating this waste as just an unavoidable cost of doing business.

Facility category Crisis Transition Small Standard
Applicability Adapted Full Full Full

Why this matters

Reagent and chemical waste is marked Core because it is genuinely one of the largest, most tangible environmental impact areas for a laboratory — expired stock and over-ordering represent both real financial waste and a real, avoidable environmental cost. A laboratory that has never genuinely examined this is very likely losing real value, not just environmental standing.

What good looks like

  • Consumption is genuinely reviewed for waste reduction.
  • Expired stock is genuinely tracked and its cause investigated.
  • A real instance shows ordering practice genuinely adjusted.

Common failure modes

  • Expired reagents are simply discarded and reordered, with no genuine review of why expiry keeps happening.

Worked example

In practice
A laboratory with a recurring pattern of reagent expiry.
BeforeA particular reagent expired unused on a regular basis, and was simply reordered each time with no genuine investigation of the cause.
ActionA review found order quantities were set well above actual usage; order volume was genuinely adjusted downward.
AfterThe Monitor reviewed expiry tracking data showing a real reduction. Verified.

If you are starting from zero — do this first

  1. Pull expiry/discard records for the past six months and look for a genuine recurring pattern.
The most common mistake: Treating reagent expiry as an unavoidable, unexamined cost rather than a signal worth genuine investigation.

Self-assessment questions

1. Is reagent consumption genuinely reviewed for waste reduction? — A real, documented review.
Evidence: Consumption review
2. Is expired stock genuinely tracked and its cause investigated? — A real, investigated pattern.
Evidence: Expiry tracking log
3. Is there a real, documented instance of ordering genuinely adjusted to reduce waste? — A concrete, real example.
Evidence: Procurement adjustment record

Common reasons for a PARTIAL answer

  • Expiry is tracked for inventory purposes but never actually analysed for root cause.

Implementation plan

When What
Week 1-2 Review expiry/discard records for the past six months.

How the Monitor verifies this

Method What Detail
DOCUMENT Expiry log review Reviews expiry tracking and any resulting procurement adjustment.

Supervisor tips

  • Ask for the actual expiry/discard rate over the past six months, by reagent.

Evidence base

Clinical and Laboratory Standards Institute. Laboratory Design; Approved Guideline. Wayne: CLSI; 2019.

ASF training courses on GMJ Academy →

Foundation courses A-00 to A-03 are live. Criterion-specific modules are being developed and will link here when published.

11.2

Energy-Intensive Equipment Use Is Genuinely Reviewed for Efficiency

Standard

The laboratory genuinely reviews the energy use of freezers, incubators, autoclaves, and other continuously-running equipment for efficiency opportunities — not an unexamined assumption that this equipment’s real energy cost is simply unavoidable and therefore not worth genuine attention.

In plain terms: The lab has actually looked at whether its energy-hungry equipment — freezers, incubators, autoclaves — could run more efficiently, not just assumed nothing can be done.

Facility category Crisis Transition Small Standard
Applicability Adapted Full Full Full

Why this matters

Laboratory equipment running continuously genuinely represents a significant, often overlooked energy cost — but equipment is also where sample integrity concerns can make efficiency measures feel genuinely risky to even consider. Explicit review, with integrity protected throughout, is what separates real opportunity from assumed risk.

What good looks like

  • Equipment energy use has genuinely been reviewed.
  • Consolidation or scheduling options are genuinely considered.
  • A real instance shows an efficiency measure implemented.

Common failure modes

  • Equipment energy use has simply never been examined at all.

Worked example

In practice
A laboratory running two partially-full freezers continuously.
BeforeTwo freezers ran at partial capacity continuously, with no genuine review of whether consolidation was possible without compromising sample integrity.
ActionA genuine review confirmed consolidation into one freezer was safe, and the second was decommissioned.
AfterThe Monitor reviewed the consolidation decision and confirmed sample integrity was genuinely maintained. Verified.

If you are starting from zero — do this first

  1. Review continuously-running equipment for genuine consolidation or efficiency opportunities.
The most common mistake: Assuming any efficiency measure is automatically a safety risk, without ever genuinely reviewing whether that’s actually true.

Self-assessment questions

1. Has equipment energy use been genuinely reviewed? — A real, documented review.
Evidence: Equipment energy review
2. Has consolidation or scheduling been genuinely considered where safe? — A real, considered option.
Evidence: Documented consideration
3. Is there a real instance of an efficiency measure genuinely implemented? — A concrete, real example.
Evidence: Implementation record

Common reasons for a PARTIAL answer

  • A review was discussed informally but never actually documented or acted on.

Implementation plan

When What
Week 1-2 Review continuously-running equipment for genuine efficiency opportunities.

How the Monitor verifies this

Method What Detail
DOCUMENT Equipment review Reviews the documented equipment efficiency review.

Supervisor tips

  • Ask whether equipment consolidation has ever genuinely been considered, not just assumed off the table.

Evidence base

My Green Lab. Freezer Challenge Best Practices Guide. Los Angeles: My Green Lab; 2022.

ASF training courses on GMJ Academy →

Foundation courses A-00 to A-03 are live. Criterion-specific modules are being developed and will link here when published.

11.3

Cold-Chain Continuity Genuinely Balances Sample Integrity and Energy Use

Standard

Cold-chain and refrigeration practice genuinely balances the real, non-negotiable requirement of sample and reagent integrity with genuine attention to energy efficiency — sample integrity is never compromised, but energy use within that safe requirement is genuinely reviewed, not left unexamined on the assumption that any efficiency measure is automatically a safety risk.

In plain terms: Sample integrity always comes first — but within that non-negotiable requirement, the lab has actually looked at whether cold-chain energy use could be more efficient.

Facility category Crisis Transition Small Standard
Applicability Adapted Full Full Full

Why this matters

Cold-chain requirements are genuinely non-negotiable for sample and reagent safety, but this real necessity can become an excuse to never genuinely examine energy use at all. Proactive maintenance and efficient equipment selection achieve both goals simultaneously — safety is never actually a reason to skip genuine efficiency review.

What good looks like

  • Energy use is genuinely reviewed within safe bounds.
  • Equipment is genuinely maintained for efficiency, not just function.
  • A real instance shows an efficiency measure implemented without compromising integrity.

Common failure modes

  • “Sample safety” is used as a blanket reason to never genuinely examine cold-chain energy use at all.

Worked example

In practice
A laboratory with ageing refrigeration units.
BeforeRefrigeration maintenance was purely reactive, addressing failures only after they occurred, with no genuine proactive efficiency maintenance.
ActionA proactive maintenance schedule including seal checks and coil cleaning was introduced, genuinely improving both reliability and efficiency.
AfterThe Monitor reviewed the maintenance schedule and its documented effect. Verified.

If you are starting from zero — do this first

  1. Introduce a proactive, scheduled refrigeration maintenance programme.
The most common mistake: Treating “sample safety requires it” as a reason to never genuinely examine cold-chain energy use.

Self-assessment questions

1. Is cold-chain energy use genuinely reviewed within safe bounds? — A real, documented review.
Evidence: Cold-chain review
2. Is refrigeration equipment genuinely maintained for efficiency? — A real, proactive practice.
Evidence: Maintenance schedule
3. Is there a real instance of an efficiency measure implemented without compromising integrity? — A concrete, real example.
Evidence: Implementation record

Common reasons for a PARTIAL answer

  • Maintenance happens but is purely reactive, with no genuine efficiency component.

Implementation plan

When What
Week 1-2 Introduce proactive, scheduled refrigeration maintenance.

How the Monitor verifies this

Method What Detail
DOCUMENT Maintenance record review Reviews the maintenance schedule and sample integrity records.

Supervisor tips

  • Ask whether maintenance is proactive or purely reactive to failures.

Evidence base

World Health Organization. WHO Guidance for Climate-Resilient and Environmentally Sustainable Health Care Facilities. Geneva: WHO; 2020.

ASF training courses on GMJ Academy →

Foundation courses A-00 to A-03 are live. Criterion-specific modules are being developed and will link here when published.

11.4

Staff Are Genuinely Engaged in Sustainability Practice

Standard

Laboratory staff genuinely understand and participate in the facility’s sustainability practices — not a policy known only to management with no real staff awareness or input into practical, bench-level improvements.

In plain terms: Bench staff actually know what the lab is doing to be more sustainable, and their own practical suggestions genuinely get heard.

Facility category Crisis Transition Small Standard
Applicability Adapted Full Full Full

Why this matters

Bench staff genuinely know the day-to-day workflow best — where reagents actually get wasted, which equipment genuinely runs unnecessarily — in a way management reviewing reports from a distance may not. Genuine engagement draws on this real, practical knowledge rather than treating sustainability as a policy decided elsewhere.

What good looks like

  • Staff can genuinely describe a real practice.
  • Staff input is genuinely sought on bench-level measures.
  • A real instance shows a staff suggestion implemented.

Common failure modes

  • Sustainability is a management-level policy that bench staff have genuinely never been asked about.

Worked example

In practice
A laboratory whose sustainability decisions never reached bench staff.
BeforeSustainability was discussed only in management meetings, with no genuine channel for bench staff to contribute practical suggestions.
ActionA suggestion box and regular team discussion were introduced, surfacing a genuine, practical reagent-sharing idea between two testing stations.
AfterThe Monitor interviewed bench staff who could describe this real, implemented change. Verified.

If you are starting from zero — do this first

  1. Introduce a genuine channel for bench staff to contribute sustainability suggestions.
The most common mistake: Treating sustainability as a management decision with no genuine channel for bench-level input.

Self-assessment questions

1. Can staff describe a genuine sustainability practice? — Real, demonstrated awareness.
Evidence: Staff interview
2. Is staff input genuinely sought on bench-level measures? — Real, two-way engagement.
Evidence: Suggestion record
3. Is there a real instance of a staff suggestion genuinely implemented? — A concrete, real example.
Evidence: Implementation record

Common reasons for a PARTIAL answer

  • A suggestion channel exists but has never actually produced an implemented change.

Implementation plan

When What
Week 1 Introduce a genuine bench-level sustainability input channel.

How the Monitor verifies this

Method What Detail
ASK Staff interview Asks bench staff to describe a specific practice they contributed to.

Supervisor tips

  • Interview bench-level staff directly, not only laboratory management.

Evidence base

My Green Lab. Freezer Challenge Best Practices Guide. Los Angeles: My Green Lab; 2022.

ASF training courses on GMJ Academy →

Foundation courses A-00 to A-03 are live. Criterion-specific modules are being developed and will link here when published.

11.5

Sustainability Commitments Are Genuinely Reviewed, Not Static

Standard

The laboratory’s sustainability goals and practices are genuinely reviewed and updated as circumstances change — not a document written once and never genuinely examined for whether it still reflects actual practice.

In plain terms: The lab’s sustainability goals actually get revisited — not written once and left to go stale.

Facility category Crisis Transition Small Standard
Applicability Adapted Full Full Full

Why this matters

A document written once stops genuinely reflecting current practice as equipment, reagent suppliers, or testing volume change. Real, periodic review is what keeps the commitment meaningful.

What good looks like

  • Goals are genuinely reviewed.
  • A real revision instance exists.
  • Responsibility is genuinely assigned.

Common failure modes

  • A document was written once and never revisited.

Worked example

In practice
A laboratory whose sustainability statement predated an equipment upgrade.
BeforeThe statement made no mention of a freezer consolidation already in effect.
ActionA named person was assigned annual review responsibility.
AfterThe Monitor reviewed the updated, dated document. Verified.

If you are starting from zero — do this first

  1. Assign named review responsibility.
The most common mistake: A document nobody is specifically responsible for revisiting.

Self-assessment questions

1. Are goals genuinely reviewed? — A real, periodic review.
Evidence: Review schedule
2. Is there a real revision instance? — A concrete example.
Evidence: Revision history
3. Is responsibility genuinely assigned? — A real, named accountability.
Evidence: Assigned responsibility documentation

Common reasons for a PARTIAL answer

  • A schedule exists but hasn’t been followed consistently.

Implementation plan

When What
Week 1 Assign review responsibility and conduct the first review.

How the Monitor verifies this

Method What Detail
DOCUMENT Revision history review Reviews the document’s revision history.

Supervisor tips

  • Ask who is specifically responsible for review.

Evidence base

United Nations Environment Programme. Sustainable Healthcare Facilities Guidance. Nairobi: UNEP; 2022.

ASF training courses on GMJ Academy →

Foundation courses A-00 to A-03 are live. Criterion-specific modules are being developed and will link here when published.

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