Three low-cost ways to improve environmental services

The Agency for Healthcare Research and Quality released a technical brief last month titled "Environmental Cleaning for the Prevention of Healthcare-Associated Infections." The report, based on research from ECRI Institute–Penn Medicine Evidence-based Practice Center (EPC), is intended to help health care leaders make well-informed decisions when selecting and implementing environmental services practices.

The report, which is thorough and informative, reviews the major methods used to clean and disinfect patient rooms and the tools used to monitor the effectiveness of those methods. Anyone who needs to know the difference between using microbiologic monitoring and fluorescent markers and other technical how-tos would benefit from a read-through.

However, while the report gives great insight into which tools are being used by environmental services departments, it's important not to neglect the role of the people who are in charge of putting these tools into practice.

The report's authors note that key experts interviewed during the research process emphasized that the most effective environmental services departments not only pay attention to what is being used, but how it's being used as well. Which means an expensive monitoring system or the latest disinfection technology means little if it's not being used correctly. That's where staff come into play.

Here are three simple ways key experts who contributed to the report say environmental services departments can improve their effectiveness through staff-based methods:

1. Everyone must comply. One of the study's experts noted that if a hospital uses a bleach agent that must be diluted and the hospital also has "20 environmental services personnel, you have 20 ways to dilute bleach." But when trying to assess the effectiveness of a program, uniform compliance is a must.

In a recent feature on improving environmental services operations, Bill Grimwood, an expert in cleaning-cost analysis, says environmental services managers need to design training programs that include a combination of classroom teaching, workshop-style learning, online training and on-site training. The training also should be customized to site-specific needs to ensure that each employee receives the proper level of training according to best practices.

2. Speak the language. When it comes to patient-facing language barriers, hospitals are stepping up to accommodate patients who do not speak English as a first language, a move that can boost patient safety and satisfaction.

One of the experts interviewed notes that environmental services leaders should take the same steps when dealing with front-line staff. "While many environmental services staff may not speak English as their primary language, training materials and protocols rarely are available in other languages," the expert noted.

Translating printed materials and having a second training in another language for those who need it may cost a little more up front, but if it keeps the department on the same page and aids in reducing health care-associated infections (HAI), it could be worth it in the long run.

3. From the top down. It's Environmental Services Week, which means environmental services professionals around the world are being acknowledged and celebrated for their important work. But according to the experts interviewed in the report, a week of appreciation is not enough.

As noted in the report, "Almost every key informant indicated that staff are often underappreciated despite playing a critical role in the infection prevention community."On the flip side, hospitals that got it right were described as having leaders that "embraced and emphasized environmental cleaning's importance, resulting in better compliance with best practices."

Experts recommended elevating the title of front-line staff to "environmental cleaning technicians" or another similar title that reflects the technical complexity of their responsibilities. Also, sharing HAI rates with staff help to reaffirm their role in patient outcomes.

If you or any other leaders need more convincing of the critical role environmental services plays in quality and patient outcomes, check out the recent Environmental Services Department of the Year winners.