For any healthcare administrator to discount quality results – with documented evidence – and revert to justification based on square footage borders on the unconscionable and very possibly unethical.  To ignore your results and measures and revert to staffing levels and budget levels based only on square feet of floor surface will certainly have a detrimental effect on overall patient health, outcomes, and survival.  Just as proper staffing and proper processes in place by nursing saves lives, proper staffing and proper processes used by Environmental Services saves lives.  Environmental Services should be viewed by everyone in healthcare as an investment in patients and quality outcomes, not an expense to the bottom line.

Our profession is so immensely diverse because of the level of talent and professionalism our members bring to the table. Many years ago, various housekeeping departments were just that–housekeeping–but due to the evolution of health care environmental services managers, we have become multifaceted department managers with responsibilities encompassing a wider array of functions.

With the increased complexity of the job, such as emerging pathogens and potential worldwide outbreaks like avian bird flu, there is demand for professionals who are both experienced and have Certified Healthcare Environmental Services Professional (CHESP) certifications in health care systems throughout the world. We all need to be ready to step up and take the extra challenge on, view it as an opportunity and allow it to shape us as professionals.

Another impacting grand approach is to ensure you have an active succession-planning program in place for your future environmental champions. This profession has provided a lifelong career to many individuals and provides a clean, safe, healthy and healing environment to the patients we serve every day.

As part of the proposed changes to healthcare, reimbursement for hospital care and post-acute care will be bundled; patient readmission’s will be at a lower rate in some cases; hospital reimbursement and performance will be directly linked; and physician self-referral will be more closely regulated. Out of those four important items, environmental services has a direct impact on two—readmission rates and performance-based reimbursements. A sufficiently staffed environmental services department plays a major role in minimizing patient readmission’s. The proliferation of microorganisms affecting our communities and the patient population demands a properly cleaned and disinfected care environment. It is my belief that investing in the environmental services department and assuring proper funding, staffing, training, and consistent cleaning procedures and protocols will have a positive impact on lowering the infection rates, lowering the rate of “never” events like patient falls and improving patient satisfaction rates. Each of these examples provides a direct link between our departments and performance-based reimbursements.

So what does this all mean to the environmental services department? This is an opportunity to position the department as the front-line quality assurance and infection control team able to facilitate cost containment for the health care facility and ensure a proper setting for care delivery throughout the continuum of care. Speak up and make sure your senior leaders know the value you and the departmental staff bring to the health care facility. Make the business case for what you do and the big-picture impact on finances, patient readmission and performance-based reimbursement.

There are thousands of health care facilities in the United States. I imagine there are mock surveys and actual surveys everyday somewhere. And during each one, many regulations and requirements are checked for compliance. An increasing focus is being paid to regulated medical waste or RMW.

Most health care facility professionals understand the need to be familiar with the regulatory complexities of managing waste. In Environmental Services we deal with a lot of waste, including RMW.

There are many regulations and standards, including the Joint Commission’s Leadership (LD), Environment of Care (EC) and Emergency Management (EM) standards, as well as the federal Department of Transportation, Environmental Protection Agency and many state and local rules and regulations.

Quite a few of the standards related to regulated medical waste can be found in these standards:

• LD.04.01.01
• EC.01.01.01 (EP 5)
• EC.02.02.01 (EP 11, 12)
• EC.04.01.01 (EP.01, 8, 15)
• EM.02.02.05 (EP 4)

An organization can be fined thousands of dollars per day per violation by local, state and federal authorities if it is found noncompliant with waste regulations. Many of these fines vary by state. It is very important to be familiar and understand your own state’s current and emerging regulations to avoid these costly fines and remain a compliant leader within the health care industry and their community

The major difference between cleaning a medical facility and any other building is the focus on the un-seen enemy, bacteria. Environmental Service’s job is to not only provide good visible results, but to reduce the number of surface bacteria to a safe level in order to control cross infection. This is an extremely important responsibility because it keeps harmful bacteria from infecting the person next door or across the hall. Persons whose bodies are recuperating from surgery, injury or a primary infection are in a weakened condition and therefore, cannot put p their normal fight against harmful bacteria. A secondary infection in these cases can cause very serious illness.

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