University of Vermont Medical Center lets collaboration lead the way

FRONT ROW, FROM LEFT: Jennifer Bergeron, CHESP, supervisor; Cristal VeStrand, CHESP, CMIP, manager of operations; and Michelle Bruner, office coor WINNERdinator. MIDDLE ROW, FROM LEFT: Penny Thompson, CHESP, CMIP, training and development coordinator; Terri Goodemote, CHESP, assistant manager; Danielle Poole, supervisor; Caitlin Hurley, CHESP, supervisor; and Marva Jarrett-Dallas, supervisor. BACK ROW, FROM LEFT: George Gattullo, director of facilities management; Jerrad Mesec, supervisor; David Lumsden, supervisor; Chris Bouchard, supervisor; and Myla Weiss, talent acquisition coordinator.

Image by Ryan Mercer

While the environmental services (EVS) department at the University of Vermont Medical Center (UVMMC), Burlington Vt., has made major strides in 2019 on everything from patient satisfaction to infection control, EVS leaders are quick to point out they could not have done it alone.

1 to 249-bed winner

Cohen Children's Medical Center — Northwell Health

“Our success comes from the relationships we have built with other departments such as infection prevention, health and safety, nursing and many other stakeholders that we provide service to,” says Cristal VeStrand, CHESP, CMIP, manager of operations at the 526-bed tertiary care facility University of Vermont Medical Center • Burlington, Vt. Collaboration leads to major strides in department’s performance serving Vermont and northern New York. “We rely on the expertise each department offers in guiding us as we establish standards, practices and policies.”

Along with the daily benefits of working with other departments, multidepartment collaboration was especially vital during the design and construction of the Miller Building — a 180,000-square-foot, 128 private bed inpatient facility that opened at UVMMC in June 2019.

Icarus Somerville performing daily tasks on an inpatient unit

Image by Ryan Mercer

The EVS department was involved in the construction planning and opening of the building that welcomed patient input to create an inviting, comfortable environment. EVS staff worked with patient placement, nursing and many other departments to successfully transfer all patients from other units into the new facility in one day.

“Our staff, leads and supervisors were behind the scenes cleaning rooms for the patients who were transferred to the new building from other units,” VeStrand says. “The move went smoothly without any issues due to the collaboration between all departments involved.”

In another act of commitment to patients, the EVS department adjusted employees’ start times to better accommodate patients and their families in the new building.

Such teamwork and dedication regularly translates into impressive metrics across the board.

Miss Thiam cleaning in the emergency department

Image by Ryan Mercer

From the previous year, the department’s Press Ganey patient satisfaction top box score of 66.1% reflects an increase of 3.4% in 2019, while the HCAHPS cleanliness of hospital environment score of 72% reflects a 3.75% increase from 2018, placing UVMMC in the 36th percentile ranking.

For these accomplishments and many others, the EVS department at the University of Vermont Medical Center was selected as the 2020 Environmental Services Department of the Year Award recipient in the 500-plus bed category. The award, from the Association for the Health Care Environment (AHE), recognizes outstanding EVS performance in critical areas.

Teaming up for IP

One of the EVS team’s most critical partnerships is with infection prevention (IP), which is a driving factor in the department’s success. The IP staff gives regular feedback on EVS daily operations and interprets data that allows EVS staff to be proactive in identifying and preventing infection risks to patients.

Both departments are continually seeking new ways to improve cleaning and efficiency. In 2018, EVS and IP began collaborating on an initiative to completely clean all inpatient units with bleach for one full week every five weeks.

Chanikan Malairattana making a bed in the newly constructed Miller Building

Image by Ryan Mercer

The team dynamic is yielding impressive results. The facility’s C. diff standardized infection ratio is 39% for the time between January 2019 and March 2020. “This is significantly lower than the national experience,” VeStrand says.

One of the AHE judges, Tom Mattice, CHESP, CMIP, T-CHEST, director of EVS at Montefiore Nyack Hospital, Nyack, N.Y., says he was impressed by the facility’s C. diff scores and praised the facility’s aggressive cleaning and disinfection schedule for inpatient rooms.

He was also impressed with the facility’s rounding program, in which EVS leads and supervisors shadow five employees every week.

“This practice shows the department’s commitment to quality, consistency and continuity,” Mattice says. “It’s good for the front-line staff to know how important their work is and also to have more team members watching and learning cleaning practices.”

Lead housekeeper Deanna Coolbeth completing a quality assurance tool with Junko Yano

Image by Ryan Mercer

Staying on top of technology to improve processes and efficiencies is core to the department’s success. In 2019, the EVS department adopted electronic health record software from Epic Systems, Verona, Wis., for bed tracking, and uses it in conjunction with Epic’s Rover app to create a seamless patient discharge process.

“Through the program, employees are sorted into zones and sectors based upon their assignment and are automatically assigned rooms in the area they are servicing,” VeStrand says. “This creates quick room response times, allows leaders to spend more time on the floor and eliminates the need to manually assign rooms.”

A green pathway

In his assessment of the EVS department, Mattice also singled out UVMMC’s commitment to sustainability initiatives, which continues to earn recognition throughout the industry.

Madeleine Makembo moving a bed

Image by Ryan Mercer

Each year since 2009, UVMMC has earned top green honors from Practice Greenhealth, a national health care sustainability organization.

Metrics illustrate the facility’s continued progress. In 2019, UVMMC increased its recycling rate by 9.5% and diverted 18.6 tons of waste through donations — a 34% increase from 2018.

Another example: When the Miller Building opened in 2019, 100% of construction and demolition debris was recycled, keeping in line with UVMMC’s “Recycling & Zero Waste Program.”

In 2019, the EVS department expanded its “Kick the Can” campaign to reduce the amount of waste containers and standardize signage to increase recycling. “This supports our organizational sustainability goals of reducing waste by reducing the number of plastic liners used,” VeStrand says.

Staff satisfaction

While patients are the first priority of the hospital, it is important that the staff caring for patients feel appreciated as well.

Ion Cius using a rideon-floor machine

Image by Ryan Mercer

That is the goal of the department leaders who strive to attract and keep a quality workforce. To that end, the department offers comprehensive onboarding, ongoing training and education and a succession plan that provides staff with a clear path for career advancement, which is critical to staff retention. The EVS department has 221 full-time employees.

“This succession plan benefits our employees by using specific training modules to support advancement within the department,” VeStrand says. “This ensures all employees have constant open communication about advancement and a clear path to their goals.”

The department offers on-site English as a second language classes supporting the diverse department that represents 25 languages and 31 countries. Staff are offered incentives such as computer classes, an on-site EVS recruiter and various department recognition awards for quality indicators.

Alex Komeyan collecting linen on an inpatient unit

Image by Ryan Mercer

Mattice says he was especially impressed with the EVS department’s rate of internal promotion within the facility in 2019, including nine employees who transferred to other departments.

“This shows they are doing a good job in recruiting and onboarding people,” Mattice says. “But it also shows the importance of giving staff the chance to really go after their dreams. That really has a great impact on the entire organization.”

That, in turn, is directly tied to the facility’s core commitment to patient, family and staff satisfaction. “The correlation between our patient satisfaction and cleanliness score is even greater evidence of the importance of the work our department does every day,” VeStrand says. “That really tells the story.”