Improving EVS departmental efficiencies

EVS leaders should engage their teams in assessing the pros and cons of their tools and equipment.

Image courtesy of Geisinger

In hospitals across the country, environmental services (EVS) departments are experiencing increased demands for service from internal customers within their health care organizations. EVS leaders are tasked with operationalizing these demands with current or even lower staffing levels while striving to increase their cleanliness scores.

With more demands and less resources to perform, staff tend to lose productivity if they are not engaged and committed to identifying solutions on how to accomplish their tasks.

Creating efficiencies

As health care organizations move to larger private rooms containing more medical equipment, EVS departments are expected to clean more physical space with costlier and more technical pieces of equipment than they had before. In addition, they are asked to do it faster to increase patient flow and satisfaction.

An EVS leader needs to understand how efficient their department is today to establish a clear direction of where they plan to create more efficiencies in the future. Identifying key performance indicators (KPIs) with baseline data will guide them to the indicators they should start focusing on to gain those efficiencies. No matter what KPIs they decide to focus on, it all starts with their greatest resource — their people.

Having a team at all levels engaged in the decision-making process is just as important as the cleaning and disinfecting services they provide. Some examples of KPIs in an EVS department may include productive hours worked, open positions, budget variance percent or value, and discharge and transfer bed cleaning times. In addition to KPIs, EVS leaders also may want key volume metrics to aid in justifying their KPI levels, such as emergency department visits, surgical cases, patient days, discharges and outpatient visits.

Without engaged individuals, an EVS leader does not have a team, especially an efficient one. Staffing challenges are experienced in all specialties. EVS leaders can turn those challenges around by developing their current frontline staff through training and education opportunities, such as Certified Healthcare Environmental Service Technician (CHEST) or Certified Surgical Cleaning Technician (CSCT) programs through the Association for the Health Care Environment (AHE).

Providing an EVS team with an opportunity to learn and grow as professionals will enhance the engagement of the team, and innovative ideas on how to be a more efficient team will come. EVS leaders also can encourage their EVS leadership team on obtaining their Certified Healthcare Environmental Services Professional (CHESP) certification through AHE.

Focusing on people

Leaders should focus on their people and develop them not by continually providing them with the answers but letting them find the answers through collaboration and trial and error. They should be engaged in the process and unafraid to step in when they see their team needing assistance.

Internal training and education on why certain tasks are performed is extremely important for staff development and engagement. EVS leaders need to encourage their staff to ask the “why” questions, and EVS leaders need to be prepared to answer them clearly and with excitement. Staff must also understand their KPIs and how they can impact them.

Other staffing challenges may include looking into other nontraditional EVS candidate pools. EVS leaders may want to consider looking at organizations seeking employment opportunities, such as veterans, workers with disabilities, stay-at-home moms and dads, high school students, retirees and others. EVS leaders also should consider advertising their training opportunities to entice less experienced candidates to join a great organization that is willing to invest in them.

Developing partnerships with other support service and clinical departments within the organization to collaborate on best practices and service demand reviews is critical for understanding the demand and reasoning for it, whether it be increased volumes, regulatory changes or something else.

Whether EVS leaders collaborate with their infection prevention and control teams or their nursing teams, they need to have clinical support for their EVS department to be recognized as a valuable member of the organization. Collaboration with clinical leaders opens one another’s eyes to how some clinical processes can create inefficiencies or nonvalue-added waste for EVS or other support service departments. Having an engaged multidisciplinary team collaborating and partnering on operational challenges helps reduce the shifting of nonvalue-added waste from one area of responsibility to another.

Collaboration also can be successful outside of the organization. Networking with outside professionals can be beneficial in identifying opportunities to become more efficient or to provide a source of validation of an EVS team’s challenges or efficiencies. Outside professionals that EVS leaders connect with may be from other health care organizations or manufacturers and distributors.

Daily assignments vary from hospital to hospital and can make or break a team, so they must be realistic and fairly distributed among the staff. EVS leaders should develop their assignments based on critical need and reality of time to accomplish the assignments.

EVS leaders tend to identify assignments based on “this is how we always have done it” and very rarely review the space and volume increases affecting their team’s ability to service the areas for a clean environment. Assignments should be reviewed quarterly or semiannually to ensure that space and volume adjustments are made to the assignments.

If EVS leaders create assignments that are unmanageable for the staff, they will lose engagement and productivity. EVS leaders must get staff engaged with the review and provide them an opportunity to participate in the design and decision-making process of their assignments. Who better to know what it takes to complete an assignment than the staff member who is responsible for it?

EVS leaders need to build trust with their staff so staff members feel comfortable providing input that will make their assignments fairer and more realistic. Trust also will produce other opportunities for efficiency by the staff within the EVS department.

Technology and tools

There are many technologies on the market to help EVS leaders design and manage their assignments. However, they need to ensure that any technology they utilize adds value and does not become an anchor to operations.

Technology is only as good as the information inputted and maintained. Resources can become overwhelming as the EVS leader’s facility or number of facilities grows and changes. EVS leaders also should have a full understanding of daily upkeep of the technology to ensure its value.

Identifying the right tools and equipment for assignments is another area to engage employees. EVS leaders should gather a small group of staff members from all levels of their team together to discuss the pros and cons of their tools and equipment. They may find that the team has some great, innovative ideas.

Partnering with manufacturers and distributors in conjunction with staff to review products and equipment can lead to additional ideas for efficiency. If a health care facility has limited storage space and the EVS leader is looking for ways to reduce hours, they may want to review the use of reusable versus disposable wipes or mops. EVS leaders may have an opportunity to reduce labor by eliminating processes needed to have an adequate supply readily available.

Having the right cleaning and disinfectant chemicals also will impact EVS operations. Leaders need to ask themselves and their teams some questions when reviewing these items. Can the department reduce the number of cleaners and disinfectants to reduce errors in product use? Is there a better-functioning product that may cost more upfront, yet reduce hours and labor expense?

EVS leaders need to have an open mind when reviewing products. They shouldn’t dismiss an opportunity because it is more expensive. They should do their homework on identifying the best possible solution to positively impact KPIs.

Compliance verification is important in developing an environment of high-quality cleanliness. Utilizing survey tools to manage cleaning and disinfecting compliance can bring to light other cleaning opportunities. Being able to visualize trends in items and locations missed while cleaning and disinfecting will help to justify additional training and education for those processes. The data also will be useful to quality and infection prevention teams as well as regulatory agencies.

EVS leaders shouldn’t spend time engaging their staff, training them and allowing them the opportunity to develop their assignments, and then never following up on how they are performing and completing all their assignments daily. If EVS leaders don’t follow up and hold their staff accountable, including their managers, they will not have a successful and efficient team and department.

Finally, communication is always a top concern for both EVS leadership and frontline employees. There are many different types of communication technology and processes utilized today, from pagers to two-way radios to mobile devices (see sidebar, page 44). Finding the best fit for a team without loading additional tools on their carts or uniforms goes a long way. EVS leaders should focus on technology that will reduce noise within the facility yet be clear and concise in delivering effective communication.

Moving parts

There are many moving parts within a hospital EVS department. Understanding the key performance indicators and volume metrics to provide the highest quality service is a large undertaking.

Collaborating with other health care professionals inside and outside the organization and utilizing all levels of the EVS team in the decision-making processes will not only make the department more efficient but will develop a successful and efficient team. 

Eric M. Nowak, MBA, T-CHEST, T-CSCT, is senior director of sustainability and environmental services at Geisinger, Danville, Pa. He can be reached at emnowak@geisinger.edu.