EVS considerations in hospital design

Durable materials that are designed to undergo increased rounds of sanitization can make infection prevention easier.

Image courtesy of Essity

Hygiene and infection prevention have always been top priorities for hospitals. However, COVID-19 has significantly changed the perspective of the everyday person who passes through the hospital doors. 

People are now more aware of their own need to follow proper hygiene practices as well as the hygiene practices employed by the health care facility they are visiting. Something that in the past might have been overlooked, such as an empty hand sanitizer dispenser or a dusty railing, is now unacceptable. 

As a result, the critical role environmental services (EVS) professionals play in reducing the spread of health care-associated infections (HAIs) has come into the spotlight even more. 

Today, health care facilities are more closely examining ways to prepare for not just normal operations, but times of crisis like pandemics and natural disasters. The aftermath of an event like COVID-19 is the right time for hospitals to reevaluate their needs and, in particular, the needs of EVS departments. 

Hospitals and health care facilities undergoing renovation or new construction have a unique opportunity to better understand the needs of EVS professionals and help them perform their critical tasks by redesigning in ways that facilitate more effective and efficient cleaning. 

Holistic design

A growing trend in hospital and health care facilities new construction and redesign is implementing a holistic vision. Simply put, holistic design works for the best of patients and staff, considering the mental, physical and emotional well-being of everyone who enters that space. Holistic design goes beyond a simple face-lift, offering a chance to reflect on what has served hospital staff well in the past and where there is room to innovate. It is a chance to become better equipped than ever with fresh perspectives and new, cutting-edge tools and resources to provide a superior level of care. 

One of the most important factors in current holistic designs is the workflow of EVS professionals. While hospitals have always maintained high standards of cleanliness and disinfection as a matter of necessity, particularly in places like emergency rooms and operating rooms, the pandemic put a strain on protocols. Public, high-traffic areas that might have been cleaned once per shift suddenly needed to be cleaned and sanitized every hour. These needs fall on the shoulders of EVS professionals. The pandemic revealed many possible inflexibilities, including high-traffic areas that do not allow for adequate social distancing and waiting rooms without easy-to-access hand sanitizers. 

Optimizing efficiencies to secure a better level of care starts with listening to the concerns of health care EVS professionals and understanding their needs, the layout of a facility and where hygiene products are located. 

For example, studies show that interventions as simple as optimizing skincare dispenser placement increases usage by more than 50% and has a greater impact on usage than increasing the number of dispensers. By placing dispensers in key locations like entrances, patient rooms and nurses stations, the visual cue of seeing a dispenser encourages proper usage. Thus, hand-hygiene stations should be placed in high-traffic areas. When selecting hand-hygiene products, picking an integrated solution that offers a broad range of dispensers, refills and accessories improves efficiency within the different areas of the facility.

The layout and design of a facility also should enable the EVS team to access paper towel, soap and hand-sanitizer refills, and cleaning tools quickly and easily to secure hygiene compliance while maintaining efficiency. Hygiene tools like high-capacity paper towel refills and sealed skincare bottle refills that reduce cross-contamination should be readily available, without being in the way.

Form and function 

The public is more aware than ever of the importance of frequent disinfecting and cleaning in heavily trafficked spaces. It’s become normal for patients to seek out hand sanitizer at the entrance of a building or forgo handshakes. In addition, some health care facilities have implemented health screening protocols before admitting patients and staff into the facility. These necessary steps have had an impact on how people interact in public spaces, as well as on the role of EVS teams in infection prevention. 

When selecting hygiene products in a new construction or redesign, facilities need to balance a desire for beautiful hospital design with tools and equipment that are durable, made to withstand frequent cleaning and are flexible in application. 

For hospitals, cleaning and sanitizing has become more frequent for high-traffic public spaces like waiting rooms. From chairs, tables, floors, walls and dispensers, everything people may touch needs to be cleaned and sanitized frequently, and these items must be carefully selected for aesthetics, functionality and durability to withstand this increase.

For example, a continuous hand-towel system in high-traffic environments should have rounded edges, reducing corners and hard-to-clean areas where bacteria could grow. One-at-a-time dispensing mechanisms and high-quality refills also minimize dust generated when towels are dispensed and users only touch the towel they use, reducing the risk of cross-contamination and minimizing waste.

In addition, with the increased focus on hand hygiene, accessibility to hand-hygiene tools is a must. Therefore, it is important to select hand towel and skincare dispensers that are Americans with Disabilities Act (ADA) compliant. Dispensers that offer high capacity, while still being flush against the wall and protruding no more than 4 inches, make adherence to the ADA regulations easier, allowing for flexibility while supporting hand-hygiene compliance.

Because EVS professionals need to quickly adjust to the needs of a facility, whether it’s increased cleaning rounds of public-facing areas or higher levels of cleaning and sanitizing of locations that need to be converted to accommodate patient care, considering these needs during a new construction or redesign project will help the organization design for improved flexibility and efficiency, and better patient care.

Digital innovation

New technology is crucial to increasing hospital efficiencies and improving patient care, and the EVS profession is no exception to this trend. EVS managers face many challenges, including limited resources, time constraints and increased scrutiny on cleaning and disinfection. EVS leaders should consider new technologies during a redesign that improve productivity, training and compliance of cleaning protocols, helping them achieve their goals and reduce HAIs.

Digital innovation could be as simple as switching out clipboards or posters with digital screens. These are easier to clean and can be changed remotely at the click of a mouse. With the right digital innovations, EVS professionals can establish an environment that is both clean and welcoming so that health care organizations can deliver a heightened patient experience. 

For example, facility management software can aid EVS leaders in managing cleaning routines and maximizing efficiency, while minimizing disruption to patients and staff. These programs provide more visibility and control to EVS managers who can adapt infection control cleaning and disinfection plans in real time to serve the needs of the facility. During a sanitation emergency or a schedule change, the software helps EVS teams adapt and communicate directly. By removing the guesswork, the software gives EVS professionals new power and flexibility, providing rich data and insights to improve processes and create an orderly workflow.

In addition, facility management software integrated with sensors inside hygiene dispensers allows teams to monitor and analyze real-time usage data of hygiene products like bath tissue, paper towels, and hand soap and sanitizer. This visibility helps EVS professionals track dispensers remotely so they can service the health care facility more efficiently. Furthermore, this technology prevents runouts well before they occur, so hygiene products are always available for staff and patients for improved infection prevention.

Digital additions, from display screens to data-driven cleaning software, equip EVS teams with tools to ensure they don’t waste time, energy or resources. It helps them identify crisis areas and prevent common slowdowns and performance issues, as EVS professionals often face challenges like limited resources, time constraints and increased scrutiny regarding sanitation. Considering new technologies could simultaneously save critical time and streamline workflow.

Sustainable considerations

On the surface, sustainability is often defined by allocating resources efficiently and using products with a reduced environmental footprint. Health care facilities are increasingly focusing on products that reduce waste, limit packaging and eliminate the use of batteries. For example, continuous hand-towel system refills can be compressed by 50%, reducing the space needed for storage and shipping. Additionally, some do not use batteries to operate, also contributing to sustainability. 

Sustainability also can mean procuring sustainable products like soaps and sanitizers — ones that reduce the spread of germs while remaining environmentally friendly and safe to use. Some products and materials that enter a hospital environment may contain harmful elements like carcinogens or hazardous waste that require special handling. Sustainability measures like waste reduction and environmentally responsible product procurement have been shown to potentially save hospitals millions of dollars in operating costs. 

The impact of sustainability in health care is transformative. For example, Green Seal, a nonprofit authority on safer, more sustainable products, recently added hand sanitizer to the list of products it tests for carcinogens and other contaminants. Such third-party certifications can be used as good sources of information when making purchasing decisions.

Finally, sustainability considered from a health care standpoint focuses on the health and well-being of the staff. Day in and day out, health care workers fight infection, injury and death. Therefore, sustainability goals should include measures that contribute to staff health and prevent burnout. Sustainable health care facilities often integrate elements of nature into their designs, which improves patient outcomes but also helps boost staff productivity and contributes to their emotional well-being. At the same time, when implementing these designs, infection prevention still needs to be considered by ensuring these features are strategically placed, durable and easy to clean so that the work of EVS is not made more difficult.

An essential role

EVS professionals have always played a crucial part in preventing the spread of infection, and there are ways to make their work more efficient. With a heightened public awareness of hygiene sparked by the pandemic, the role of EVS is more important than ever.  

During redesigns and new construction, hospital leaders should rethink how a facility can better support EVS professionals. Redesigning with EVS professionals in mind helps them become more efficient so the facility can provide a higher level of care. When EVS professionals are properly equipped, HAIs are prevented, and patients and staff members benefit. 

With a holistic facility design that provides access to products and hygiene solutions, EVS professionals are empowered to prevent the spread of HAIs more efficiently. Building with durable materials that are designed to undergo increased rounds of sanitization can make infection prevention easier. 

Implementing updated technology like software that monitors dispenser refill levels gives EVS professionals new insights into a health care facility’s infection prevention needs and frees up EVS professionals to focus on critical hygiene tasks instead of dispenser refill checks. 

Finally, investing in sustainable sanitation tools and beautification can improve patient outcomes and staff well-being, and allow hospitals to save in operating costs while performing infection prevention. There is no better time to ensure the needs of EVS professionals are met than during a redesign or new build.

Interactive hand-hygiene training tool

Clean hands and surfaces save lives in health care. Infection prevention — hand hygiene, as well as surface cleaning and disinfection — is critical. That’s why Tork, an Essity brand, has developed free interactive training tools for health care to address critical hygiene needs of infection prevention, environmental services (EVS) and health care cleaning professionals. 

The award-winning Tork VR Clean Hands Training is available on desktop and mobile and was developed in collaboration with behavioral scientists and world-leading experts in hand hygiene. It invites users into a digital world where they can interact and train on the World Health Organization’s “Five Moments of Hand Hygiene” in a realistic environment with the goal of boosting compliance. 

The free, online interactive tool is designed to make the training process for cleaning health care facilities accessible, engaging and efficient. It is based on the Association for the Health Care Environment’s Practice Guidance for Health Care Environmental Cleaning and aims to ensure that EVS staff fulfill cleaning tasks according to industry standards.

Using their respective training, health care and EVS professionals can learn best practices, helping to contribute to better patient outcomes. 

Thomas Bergin is health care segment director for Tork, an Essity brand.