Northside Hospital uses staff input to increase efficiency

When Northside Hospital – Cherokee, Canton, Ga., moved to a newly built replacement facility in Canton in 2017, the environmental services department faced enormous challenges that come with transitioning to a much larger facility.

Twelve years in the making, the $264 million, state-of-the-art, seven-story hospital and medical center on a 50-acre complex was built to accommodate the growing health care needs of the region.

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At more than three times the size of the previous facility, the hospital’s cleanable square footage jumped from 125,000 to 450,000 square feet, while room size increased from 200 square feet to 300 or even 450 square feet, depending on the use. In 2018, the number of beds increased from 84 to 126-plus.

“A considerable challenge for [environmental services] workers, the transition meant acclimating to a much larger facility while maintaining rigorous standards for patient service, quality and infection control,” says Frank Peacock, CHESP, T-CHEST, environmental services manager.

“In the months leading up to opening, [environmental services] staff were rotated through the new hospital to maintain cleanliness before the move, increase their familiarity with the new space and train on new competencies needed at the location,” Peacock says. “The team’s commitment to service was maintained throughout the process.”

While the successful transition was a point of pride in 2018, the department scored a number of other accomplishments as well, including reducing turnaround times, reducing overtime hours, and steadily increasing Press Ganey and HCAHPS scores, which reflects the staff’s deep commitment to the patient experience.

“The [environmental services] team treats every patient like they are the only patient,” says Peacock, who is a contractor for Aramark, which partners with Northside Hospital. “We strive to be the best in class in environmental services for health care.” Aramark provides management for the environmental services department and maintains a strategic partnership through systems, programs and processes.

For these achievements and others, Northside Hospital has been named the winner of the Association for the Health Care Environment’s (AHE’s) 2019 Environmental Services Department of the Year award in the 1-250 beds category.

Efficiency excellence

In a never-ending goal to achieve the Triple Aim — improving the patient experience, improving the health of populations and reducing the per capita cost of health care — the environmental services team abides by another manifesto.

“We have three-pillar system,” Peacock says. “People, quality and patient satisfaction.”

Realizing those goals means constantly reassessing schedules, staffing and processes to increase efficiency.

To that end, environmental services leaders created a new role last year: an Environmental Services Flex Discharge Team. In the multidisciplinary patient flow committee, members collaborated to analyze data and reassess processes and staff schedules.

The patient flow committee evaluated monthly data trends to assess discharges by time and day, adjusting schedules based on those outcomes. As a result, the team cut turnaround times to under 50 minutes and averaged a response time of 12 minutes.

Made up of managers from departments who have a role in admitting and discharging patients, the patient flow committee conducted a multidisciplinary analysis of the bed demand curve and was able to further optimize patient flow efficiency.

“The reduction of turnaround times is an integral part of patient throughput and decreased wait times,” Peacock says. “Not only has the team provided staffing during the times that they are most needed, but the turnaround times also reduce the productivity loss during shift changes.”

To further optimize efficiency, Northside’s environmental services leaders rely on a data-driven vendor computerized maintenance management system (VCMMS) to help determine staffing levels and schedules. Aramark provides a proprietary scheduling program that provides the service standards and frequency determined by the Northside leadership. “The program uses the square footage, type of room, and number of fixtures to determine the frequency and time needed to service the room,” Peacock says.

Based on VCMMS data, environmental services added just 11 full-time staff members to handle the enormous new space. In addition, the environmental services department was able to reduce overtime hours by 17.54%, cutting costs that can be funneled to patient care.

Such results demonstrate the team’s commitment to realizing or exceeding target goals by relying on technological advances as well as human resources, according to by Marci Butts, CHESP, director of environmental services at UC Health West Chester, Cincinnati, and a judge in the AHE competition.

“By utilizing data-driven decision making, the Northside environmental services team accomplished improvements in turnaround time and experienced a more than 17% reduction in [overtime] hours,” Butts says. “It is very clear that the leadership in this department is highly engaged in the success of [environmental services], their individual team members and the facility as a whole.”

Engagement and retention

Environmental services leaders know that investing in the department’s workforce creates loyal, satisfied employees, keeping turnover low and retention rates high. In one year, retention rates took a big leap, increasing from nearly 40% in 2017 to close to 69% in 2018.

Those metrics tie in closely with Northside’s commitment to training, recruitment and onboarding of staff. A Service Technical Excellence Program (STEP) provides a five-level path to career advancement that includes Certified Health Care Environmental Services Technician and Certified Health Care Environmental Services Professional training.

Each level is recognized within the facility. For example, staff who advance to a Level Two Support Tech receive a badge change, a different color uniform and a pay increase, Peacock says. “The new uniform helps other staff recognize the Level Two techs,” he says.

Environmental services leaders also offer a roster of robust staff engagement activities including catered department meetings, pop-up appreciation events, an environmental services newsletter, and high-, middle- and low-performance coaching with environmental services staff to help keep staff satisfied.

Across the board, Peacock says the environmental services team has earned a facilitywide reputation for proficiency and discipline that keeps techs in demand. “While our top performers may be recruited to other departments, we want to make sure they have a clear pathway for advancement in environmental services through our levels program,” Peacock says.

Patient input critical

The staff also has a stellar reputation with patients, whose satisfaction scores are also trending upward. In 2018, Press Ganey scores increased by more than 11%.

Northside, which relies heavily on patient input to drive strategy, holds biweekly environmental services patient satisfaction meetings in all three campuses, sharing information among departments.

That commitment is reflected in Northside’s HCAHPS scores for cleanliness, which are continually impressive. In 2018, more than 80% of Northside’s patients responded that their room was “always” clean during their stay.

“We started with seven floors, and now we are working on nine,” Peacock says. “This facility is moving up, and the environmental services team will always be a critical part of that expansion. We are here for the long haul.”