Don’t Tell Me How Long It Takes

Important areas to clean in a patient room

I consider myself a very progressive person who stays current with the latest technology and methods for cleaning and disinfecting healthcare facilities.  I learn and share best practices. I communicate with my peers all over the country and I have more than a few years experience in healthcare cleaning.  That said, I am getting more than a little tired of so called “experts” who think they know better how we should run our business.

It is my firm conviction that the EVS profession has allowed itself to be corralled, hobbled, hoodwinked, and kidnapped by so many experts doing time studies specifying cleanable square feet.  It’s time for EVS professionals to take back our profession and present the facts of life to the number crunchers, statisticians, human resources, CFOs and the like by doing their own time studies based on their own individual facilities.  No one knows, or can know, their facility and what it takes – people, time, equipment, and supplies –  to clean and disinfect their facility better than EVS.  The problem is that many EVS directors and managers have not taken the initiative to know what it takes to produce a quality outcome for their facility.  Too many want someone else to give them a formula, a policy, a procedure, practice, numbers, metrics, guidelines or whatever to get the job done then they complain when their Administration brings in an “expert” who tells them they should execute a terminal cleaning of a patient room in 12 minutes!  The experts bring in their BRIM, their ISSA, Premier, or other “studies” and handcuff the EVS department and who suffers?  Patients!  We are here for the patients, to give to them a clean and disinfected, and safe patient care environment.  No one can do it better.  But when EVS professionals abdicate their position and authority to others who many be experts in their field but don’t know EVS from shine-ola, well we asked for it and what else would we expect?

As far as these “benchmarks” are concerned, I have one question for everyone who is being asked to follow those guidelines (as good as they may be for non-healthcare) and others like them:  “What is their definition of ‘cleanable square feet?’  If it’s just the floor surface, I would ask what about the number of square feet of wall space that needs to be dusted down and cleaned?  Ceilings?  What about the square feet of windows that need cleaning?  How many square feet are they allowing for the surfaces of a patient bed – six sides plus the bed frame? A barbaric bed?  An over-the-bed table? Chair surfaces?  Bathtubs and showers?  A toilet?  How many square feet are granted in time allowance to remove and replace a cubicle/privacy curtain? You get the picture.  A cookie cutter “standard” cannot address all of the variables found in a patient room.  But EVS professionals can and should.

Do your own time study; you clean a discharged room and an occupied room.  Then have a similar room cleaned by your “slowest” and “fastest” staff members (be sure you inspect the rooms afterward to ensure completeness).  Take the average and you have then done a very basic time study.  Be sure you do rooms at different times of the day to take into account the energy levels of the staff because as the day progresses their energy level decreases.  Cleaning patient rooms has so many variables its not an assembly line.

The truth is that you must set your own time standards and be prepared to defend them against all comers!

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2 Comments

  1. Hi John,
    The situation is worse than you describe since there are actually no time studies available to the public:

    Healthcare: Zip The AHE says it should take 25-30 minutes to properly clean an occupied patient room and process engineers who looked at that say it’s reasonable
    ISSA: Not validated and not done in real-world conditions. Their 16 minutes per occupied patient room time is a joke and hasn’t been updated since the 90’s
    APPA: Guesswork, not time studies.I know since I crunched the numbers for them.
    I’ve put together a nice little time-study module as part of our software and would be happy to loan use to anyone wanting to do time studies as this situation is horrible.

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