environmental hygiene
By J. Darrel Hicks, BA, MESRE, CHESP
Technology No Match
for an Educated and
Engaged EVS Staff
My
wife and I spent three nights in a very up-scale
vacation club hotel in Orlando, Fla recently; along
with those fantastic accommodations we had to endure the
two-and-a-half-hour sales pitch from the sales team. I’m sure
you have probably done something similar, so I won’t go into
detail about the experience.
The salesman asked us a rhetorical question, “What is the
most expensive room in a hotel?” My wife took the words
out of my mouth, “Penthouse suite.”
“No, it’s an empty room,” replied the salesman. From there,
he expounded on how we could capitalize on the need of
hotels and resorts to “sell” those empty rooms.
Let me ask you, what is the greatest cost to your environ-
mental services (EVS) department? Is your highest cost labor?
Expenses? Contracted services?
I would like to make a case that it is none of these. Instead,
the greatest cost to your department and to providing a safe,
clean and disinfected environment for patient care is this:
Uneducated and unengaged cleaning professionals.
What is the cost of not providing a safe, clean environment?
It could be millions of dollars and a loss of confidence by the
community a hospital serves. A court awarded $13.5 million
to the family of a patient who died of flesh-eating bacteria
that she contracted during chemotherapy treatment. In a
separate case, a patient was awarded $2.58 million because he
contracted methicillin-resistant Staphylococcus aureus (MRSA)
in a hospital. Although cleaning and hygiene issues may not
always be the subject of dramatic litigation, there is little doubt
that poorly cleaned facilities are contributing factors to serious
disease transmission.
In the business of providing healthcare to more than 35
million inpatients and performing 51 million-plus procedures
annually, 1 it is critically important that everyone – from hospital
executives down to front-line workers – understands and
embraces patient and employee safety. If a culture of safety
is not at the heart of the organization, the health of patients,
employees and the organization’s bottom line can all be
adversely affected.
Additionally, long-term care facilities continue to send many
of their residents to hospital emergency departments and most
of them end up becoming inpatients. In those long-term care
facilities, “…between 1 million and 3 million residents get a
healthcare-associated infection and up to 380,000 succumb
to those infections.”
Beyond patient and employee safety, there is also the
financial risk to hospitals from loss of Centers for Medicare
and Medicaid (CMS) and insurance reimbursement. A
healthcare-acquired infection (HAI) could potentially add 19
42
days to the average 4.8 day length of stay, 2 and possibly, at the
expense of the hospital.
When hospitals want to compete in their market, leaders
often look to the latest 128-slice, 3D CT scanner, a DaVinci robot
to perform surgeries, recruit the best surgeon, or begin a new
service line with the best ROI. While these capital expenditures
and improvements might attract publicity for a fleeting moment,
the board of directors needs to consider a different, low cost
option that provides the best chance to improve patient
satisfaction, reduce HAIs and improve the bottom line: the
Environmental Services Department.
When it comes to keeping pathogenic organisms at a safe level
on environmental surfaces, the least educated and lowest paid
people in the hospital must eliminate those dangerous bacteria.
“This is the level in the hospital hierarchy where you have the
least investment, the least status and the least respect,” says
Jan Patterson, MD, past-president of the Society for Healthcare
Epidemiology of America (SHEA).
That’s because hospitals have consistently held a low regard for
the EVS department. Too often, housekeepers or environmental
service workers are thought to be expendable (anyone knows
how to clean a toilet and mop a floor, right?) and difficult to
educate because English may not be their first language. The
thought is, “What if I educate and train them and they leave?”
But, worse than that, what if you don’t educate and train them
and they stay?
Could the lack of educating and certifying your staff be costing
your facility between $1 million and $3 million in extended stays
associated with unsanitary patient-care environments? Has the
safety of patients and staff been compromised to the point of
loss of life? Shouldn’t you consider educating and certifying
your EVS workers?
When it comes to technology as it relates “cleaning robots” or
room disinfection systems, in a recent study researchers concluded
that although UV disinfection was found to significantly lower
bacteria counts, it provided the greatest benefit by supplementing
the least efficient cleaning solutions, disinfectants, and cleaning
professionals. The researchers and I believe, an educated and
engaged EVS staff who are properly trained in proper cleaning
protocols is the best defense against hospital pathogens.
In an increasingly more inclusive and employee-friendly
healthcare industry, employee engagement has been catapulted
to the forefront for many in the C-suite. Employees are surveyed
more often to gauge their satisfaction with management, senior
leadership, supplies, pay, and a host of other items deemed
important by administration.
EVS worker engagement isn’t the problem; it’s a symptom
of poor leadership. If a department or organization’s leadership
is complacent about creating a great place to work, then why
should they have the expectation that their employees will be
anything but complacent about their day-to-day responsibilities?
How much does this complacency cost your organization? Ac-
cording to Gallup, disengaged employees have 37 percent higher
absenteeism, 18 percent lower productivity and 15 percent lower
profitability. When that translates into dollars, you’re looking at the
cost of 34 percent of a disengaged employee’s annual salary,
april 2020 • www.healthcarehygienemagazine.com