Development of the 3-I framework for green transformation in clinical laboratories

Abstract Background Healthcare laboratories play a critical role in patient care but contribute substantially to environmental impact due to high consumption of energy, water, and chemicals, as well as the generation of biomedical waste. Despite increasing global attention to sustainable healthcare, laboratory sustainability initiatives remain fragmented and inconsistently implemented. Aim The study aimed to develop and present the “3-I” framework, a multilevel model designed to guide sustainable transformation in laboratory medicine. Methods A systematic mixed-methods approach was applied, integrating literature synthesis with practice-based observations derived from the authors’ professional experience. The framework was designed to connect international policy directives, institutional governance mechanisms, and individual behavioral drivers within a unified structure. Results Preliminary evaluation suggests that the framework is practical, scalable, and adaptable, providing structured guidance for sustainability assessment, planning, and policy adoption in diverse laboratory settings. Key barriers—including financial constraints, safety considerations, resistance to change, and uncertainty regarding eco-friendly products—were incorporated into the framework design. The model may support improvements in regulatory compliance, operational efficiency, environmental sustainability, and institutional reputation. Conclusion The 3-I framework provides an evidence-informed model for advancing green transformation and sustainability in clinical laboratories. Recommendation Further implementation studies are recommended to evaluate the framework’s effectiveness across diverse laboratory contexts.