Author: John Weir

With over 27 years in Healthcare Environmental Services (ES), I lead with a belief that attitude drives outcomes. As a Regional Director at MultiCare Health System, I oversee multi-site ES operations with a focus on people-first leadership, infection control, and operational excellence. I champion a Positive Mental Attitude (PMA) not as a slogan, but as a leadership principle. I believe positivity is contagious, and as a leader, I set the tone. Through consistent, uplifting communication, I create environments where ES teams feel empowered to be helpful, proactive, and proud of their impact. For me, development is a choice, and I invest in training, huddles, and coaching that energize teams, helping them thrive in their current roles and grow toward what’s next. My approach to high standards isn't theoretical, it's practical. Just like we notice when a hotel room is clean and fresh, patients and families immediately sense a space that’s been cared for. Through standardized protocols, team accountability, and a shared mission, I help create clean, safe, and healing environments that directly enhance patient experience and staff well-being. It's a privilege to lead teams that play such a vital role in the patient journey, and to help elevate the perception and performance of ES professionals across our system.

disinfectant

Factors that influence the choice of disinfection procedure for Environmental Surfaces:

-Nature of item to be disinfected

-Number of organisms present

-Innate resistance of organisms

-Amount of organic soil present

-Type & concentration of germicide contact

-Specific indications & directions for use.

Consider efficacy, spectrum, versatility, ease of use, safety profile and cost.

It is cheaper and more effective to prevent environmental & health damage than to attempt to manage or cure it. Prevention requires examining the entire life cycle of products. It encourages the exploration of safer alternatives and the development of cleaner workplaces.

ProblemComplexity

It doesn’t take much skill to spot a problem. The majority of us in Environmental Services can see the obstacles in front of us, yet only a select few see the opportunities. We need to understand the need to stop focusing on problems and look for opportunities to improve our operations.

I have learned to be analytical and persistent in dealing with problems. Defining the issue and seeking out other peoples’ opinions. Many times, I have not understood a situation at first, then while trying to explain my problem to another colleague, some ideas come to mind. Through this process I have come to understand a few simple truths:

Problems are a matter of perspective. Through many difficulties others will often give up. A confident manager will show team members and stakeholders how easy it is to prevail when they try.

Obstacles, setbacks and failures are simply parts of our daily operation. You can’t avoid them, but don’t give in to them either. Focus on possibilities rather than liabilities and push the limits of what you can do. Take what you have and find a way to make it work.

Problems either stop us or stretch us. When it comes to approaching problems, you really have only four choices: flee them, fight them, forget them or face them. Which do you usually do?

Here are a few suggestions to help you become a leader focused on solutions:

Refuse to give up. No problem can withstand sustained troubleshooting. Work with your key team members on the issues and don’t wait until you are too tired or distracted to start.

Rethink your strategy. Albert Einstein once said, “The significant problems we face cannot be solved at the same level of thinking we were at when we created them.” Think outside the box, break a few rules. Redefine the problem.

Repeat. If at first you don’t succeed, keep at it. Remember your goal is to cultivate a solution oriented attitude within your department.

Star Trek

I don’t remember when I first started watching Star Trek, but I loved it from day one and have watched every episode, read the books, built the plastic models of the Enterprise NC-1701, the shuttle craft, the Klingon bird of pray and hung them from my bedroom ceiling. I also had a phaser, and learned all about it and most everything else from my Star Fleet Operations Manuel.

So yesterday Kim and I went to see the latest in the long running history of Star Trek. This movie is the eleventh film based on the original and has the main characters from the television series. The movies follows James T Kirk and Spock before they unite aboard the USS Enterprise. They have to combat Nero, a Romulan from the future who threatens the United Federation of Plants. I don’t want to spoil it for you if you have not seen it but the interesting twist they use to free the movie from the whole series constraints is very well thought out, even if Harry Potter was told it can’t be done.

This movie absolutely rocks, from the beginning scene to the very end. It draws you right into the original classic, but in a fresh and fun way. This is not at all like the earlier Star Trek movies, with old story lines, rather it is brand new and very creative.

The Enterprise is the basic same shape, but gone are the two weapons that always failed right away. Instead they have an array of weaponry that are really cool. The characters are so believable as younger versions of our heroes,  but so different and fresh then the past. Those familiar lines like… “I’m givin it all she’s got captain” take you right back in time to the orginal series.

This movie is full of action, laughs, suspense. It is a win no matter how you look at it. And finally we have the beginning timeline that has been missing up to this point.

You will love this movie. I suggest you go out and see it right away. If you are a fan of the original Star Trek you will probably want to see it again. I know I do and this is the first movie in a long time, one of the few, that I felt like I would enjoy it just as much the second time around.

Jelly Belly Shop


ICE STORM TESTS KY HOSPITALS’ METTLE

by John Commins, HealthLeaders Media, March 11, 2009

If you weren’t living in Kentucky in the last week of January, the ice storm that crippled the Bluegrass State wasn’t much more than a lead item on CNN – something regrettable that happened to somebody else. You watched the coverage. You felt bad for them, but you probably forgot about it when CNN moves to the sports segment. After all, there is nothing more local than weather.

The news that wasn’t reported, however, was the widespread closure of rural hospitals, and hospitals running out of supplies and food, and leaving desperate, freezing patients to fend for themselves. That wasn’t reported because it didn’t happen. And that didn’t happen because of the remarkable efforts by some of those small, isolated community hospitals in the path of the storm.

Methodist Hospital, a 205-licensed bed community hospital in Henderson, on the Ohio River about 15 miles south of Evansville, Indiana, not only kept the lights on when a lot of the region was in the dark, but seved as a shelter for townspeople who’d lost power, needed a warm place to sleep and a hot meal, and had nowhere else to turn. The hospital lost land-line and most of its cellular telephone services and the icy roads cluttered with downed tree limbs limited access, but Methodist continued to provide care because of dedicated employees, a solid emergency management plan, and the help of suppliers.

Don Nauser, director of materials management at Methodist, says the hospital was ready when the storm hit due to disaster preparedness training that several dozen employees at the hospital had taken at the Emergency Management Institute in Anniston, Al. The hospital set up its command center that spelled out each operational task and the personnel assigned to that task.

“One of the things they teach you at Anniston is the first 72 hours you are on your own,” Nauser says. “The National Guard didn’t show up with MREs and cots until the Monday or Tuesday of the next week. They were affected as much as anybody.”

In the initial hours after the storm hit, when electric power for much of the area was cut by falling tree limbs and temperatures plunged, “everybody knew the place to go was the hospital because everyday assumed the hospital would have power,” he ways.

The biggest obstacles for Methodist were the ones they didn’t foresee. For example, when the land line went down, the local cellular telephone service that almost everyone at Methodist used also experienced weather-related problems and was all but inoperable. Nauser says they had to rely heavily on his personal cell phone, which was based in southeastern Missouri.

“Don’t assume that one vendor, in terms of cellular service, is going to be reliable,” Nauser says. “I would recommend having a backup. Ours here was completely off line.” He said his cellular service was one of the few links that Methodist had to a smaller, remote sister critical-access hospital in Morganfield, 30 miles away. Methodist also relied on sporadic Internet service, so employees could update the hospital on their availability, and the hospital could update employees about heir staffing needs.

Methodist was also able to use the Internet, satellite phones (“they work a lot better when there isn’t ice on the antenna,” Nauser says), and cellular phones to communicate with vendors who kept the hospital well-stocked, despite the nearly impassible roads. The main supply point in Paducah, KY had been hit hard by the ice storm. So, Methodist’s vendors which include U.S. Foods, Cardinal Health, and Premier Inc., went north of the storm’s wake and routed supplies through Indianapolis. “We did not miss a deliver,” he says. “It may have meant bringing trucks in at 10 at night or later, but the basic supplies that you need was almost uninterrupted.”
There was a huge – and unanticipated – demand for oxygen canisters for home-bound patients nearby. Methodist found itself cast into the role of chief oxygen supplier for the area after local durable medical equipment suppliers and retail pharmacies that normally sell oxygen told their patients they’d either run out of oxygen or couldn’t get the product to patients.

“They were telling people ‘go to the hospital because we can’t take care of you’,” Nauser says. “Every other problem paled in comparison to the demand for home oxygen. Smaller hospitals, know where your DME is coming from.” The ice storm and its fallout prompted Methodist to reconsider whether it will expand its role as oxygen supplier for the area in the future.

As they struggled during the week-long emergency to provide care and shelter, Methodist officials didn’t have much time to reflect on their reaction to the weather disaster. “You get to the point where you’re running on adrenaline,” Nauser says. But during that frenetic week, no patients were denied care or shelter and services continued in an orderly way. “When it was over I wandered back to the apartment and started to reflect that this worked smoothly,” Nauser says. “It wasn’t perfect. We learned lessons for the next time. But our level of preparedness helped prevent a whole lot of problems. It was as close to business as usual as we could get under the circumstances.”

I hope there is some relief in the activity at your institution now that we have made it through another heavy viral season. Not that there really is a slow season in health care anymore, just a less busy one. So, welcome to the less busy season, when there is time to think and plan.

Environmental services departments are pivotal in the “flow” process, but it must be balanced with proper infection control practices. The challenge is timely, thorough communication—getting and giving good information.

Let’s imagine the emergency room waiting area is filled to capacity and census is at 99 percent. The health care institution has a patient throughput initiative and, hopefully, all of you have been involved in this initiative.

Here is the scenario:

The emergency room has just informed Patient A that he will be admitted. Bed management then scurries to see where the patient can be placed. For purposes of this scenario, we will assume Patient A is a cardiac patient and will need to be admitted into the cardiac intensive care unit, which is currently full. This means the patient shuffle will now occur.

This pending admittance is happening after 7 p.m., when staffing is at a lower level. The most stable patient, Patient S in the cardiac intensive care unit, will move to the step-down unit. But Patient O, who is currently in the step-down unit, needs to be relocated since there is now no need for monitoring this patient, but he is still not ready for discharge. We will now have to move multiple patients to get emergency room Patient A into a necessary room, but the only data that will be looked at is the time it takes to get Patient A to his room, although this is not the only process that is occurring.

The race is on to get Patient A into an intensive care unit room within a certain time frame. Patient S, who is in an intensive care unit room, has to move to the step-down unit room occupied by Patient C. Patient C is stable enough to move to Patient H’s room, which was discharged earlier in the day during the shift change.

This means either there was a lack of communication or miscommunication both from human beings and/or from the “fail-safe” electronic system to notify the incoming environmental services shift of the discharge. The room now resides in “neitherland”; hopefully, it will be discovered and cleaning completed within the required amount of time of the patient flow initiative. If not, we just encountered our first “dam” in the flow.

The current status for environmental services is one critical patient in the emergency room, two patients needing relocating, four rooms counting the ER exam room needing to be cleaned, with the emergency room waiting area overflowing and the health care institution on the verge of going into divert. Contact time to properly disinfect surfaces is 10 minutes, and two of the three rooms are in the same cleaning zone of one person. Patient C needs to go into Patient H’s room, which is the empty discharge room that is lost in the communication process. Patient A, who will move when Patient O moves, can go into Patient S’s room. What does all this mean for the hospital’s environmental services department?

Well if you played along with my little word game, the answer is “chaos”! Most hospitals spend from November to April in this type of scenario. Though the patient flow initiative may not have been accomplished, patients are treated in a timely, effective and safe manner with positive outcomes.

Now, when things are calmer, evaluate your turnaround times, your communication methods and your systems and start to develop process improvement initiatives. Use this time to document, evaluate your data and present this information to your administrator with improvement suggestions. This will assist you and your staff to develop, acquire or change initiatives that will lessen the burden next viral season.

On the road to excellence!

Tina L. Cermignano, CHESP
Operations Manager
Children’s Hospital of Philadelphia
Philadelphia

This article first appeared in the June 2008 issue of HFM Magazine.

Following the ‘Six Aims’
By Tina L. Cermignano, CHESP

There has been a lot of media attention about the Institute of Medicine’s (IOM) report “To Err is Human,” especially over outbreaks of community-based Methicillin-resistant Staphylococcus aureus (MRSA). However, we should concentrate on the second report from the IOM, “Crossing the Quality Chasm,” which provides a road map for quality.

In this report, the IOM describes “Six Aims” to ensure health care quality. The Six Aims are identified as: safe, timely, effective, efficient, equitable and patient-centered health care. So what does this mean for ASHES members?

There is no other service in the health care environment that more intimately and consistently touches patients than environmental services. The patient comes in constant contact with our products, from the textiles that they wear and sleep on to the furniture, fixtures and various pieces of equipment they touch on a daily basis.

Taking this into consideration, our base of operations must be in complete balance with the Six Aims. A health care institution may employ the best in clinical care and purchase the finest technology available, yet little of it will matter if the institution is not properly cleaned and disinfected where appropriate. At its very core, environmental services’ reason for being is patient-centered. If we do not perform our roles in a safe, effective, efficient, equitable and timely manner we compromise the quality and health of our patients.

Environmental services staff and the roles they play are often the forgotten heroes in the quest for quality. As the rest of the institution works to achieve and improve upon the Six Aims, our services are often viewed as a way to improve timeliness and the core purpose is defeated. It is our job and obligation to make sure that everyone in the institution and within the industry is aware of how vital our services are to the safety and the healing environment of the patient.

There is no substitute for a clean environment that is free from potentially harmful organisms. The quality initiatives of environmental, waste, linen and transport services cannot be minimized or overlooked as insignificant in the quest for quality improvement.

What can you do? Get involved! In the IOM report, quality is defined as, “The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.” Professional knowledge is not limited to our profession. Be knowledgeable about other professions and their roles in quality as well. Be knowledgeable about what is going on in your institution. Make sure when the rest of your institution is working on the Six Aims, that you and your staff are involved and that you have allies in the infection control, safety and quality departments so you are included in the discussions and decisions when initiatives are being developed.

It is common for improvement initiatives that seem simple in the planning phase to turn into a problem for another department further down the continuum of care. This is not done intentionally; it usually occurs from lack of awareness about the rest of the cycle. Do not let this happen to you. Keep your eyes and ears open to what improvements are being discussed in your institution and play an active role.

Quality should be a topic when you meet with your boss, your peers across the institution and your staff. They tend to know more than we do at times, because they are on the units every day.

What steps have you taken in order to be consistent with professional knowledge? Let’s talk about it.

On the road to excellence!

Tina L. Cermignano, CHESP
Operations Manager
Children’s Hospital of Philadelphia
Philadelphia

A new study has concluded the U.S. hospitals are beginning to embrace Lean and Six Sigma business management strategies to cut costs and boost productivity, despite there currently being little evidence as of yet that these strategies are effective. Lean management focuses on removing waste from companies and processes, while delivering added value to customers. Six Sigma, meanwhile, is to reduce variations in processes, products and services.

The study, from the American Society for Quality, included 77 hospitals. Researchers concluded that 53 percent of hospitals reported some level of Lean deployment, while 42 percent reported some level of Six Sigma deployment. Not surprisingly, given the gradual evolution of these practices in hospitals, only 4 percent reported “full deployment” of Lean, and only 8 percent full deployment of Six Sigma.

Where hospitals had not deployed either method, reasons included a need for more resources (59 percent), lack of information (41 percent) and lack of leadership buy-in (30 percent). Another 11 percent of hospitals surveyed weren’t familiar with either strategy.

Get more information on the survey:

– read this Healthcare Finance News Article Here

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quote-hcahps

Chasing the numbers

I spent a good part of the day writing performance evaluations. I find it somewhat refreshing to think about a staff member and write wonderful words that reflect their performance during the last year. Of course not every word is, glowing, but for the most part all my staff are good, hard workers and each one has positive qualities that work together for the department, and the hospitals good.

A good portion of the rest of the day was spent chasing numbers. You know, the NRC Picker, or Press Ganey satisfaction survey results that go along with the HCAHPS survey results. I find I’m more and more often aligning strategies, scripting, and work teams to push these numbers up. It can become an obsession… the daily logging into Press Ganey, running the queries, reading the reports.

Hurray! +.5 % on the mean score for courtesy, oh sad, -.6 on cleanliness, but wait, the emergency room waiting area jumped up 7%. Lets go clean the furniture again, did we make enough patient room rounds today? It is not enough to manage by walking around (MBWA), we need to fill out some quality assurance checks and speak to a dozen patients as well, hold staff huddles, post the numbers, give more praise and recognition, re-train on high dusting, pass out more putty knives to scrape those corners, look into 55 gallon drums of floor finish, as we go through gallon jugs too fast and so on, so forth.

I find it rather exciting to push the numbers. Of course it is not smoke and mirrors. Behind those gains are many staff members and other hospital employees working hard, doing things right, taking care of the patients, guests and each other. That is why I am in this business, but we measure, measure and measure again to make sure we keep on doing those right things.

Chasing the numbers? Yes, it can seem that way. And those are moving targets, what with the hospitals we compete with doing everything they can to improve just as we are. I might achieve an increase in my cleanliness mean score but if other hospitals also increase, and higher than I do my percentile will go down. So we compete against ourselves, and against other hospitals. Makes it all just a little more complicated.

What is MRSA?

Methicillin-resistant Staphylococcus aureus (MRSA) is a type of bacteria that causes serious infections that are resistant to many of the strongest antibiotics, including methicillin and other more commonly used antibiotics (including penicillin and amoxicillin). (1)

MRSA occurs most frequently among patients who undergo invasive medical procedures or who have weakened immune systems and are being treated in hospitals and healthcare facilities. (2) These healthcare-associated infections (HAIs) include surgical wound infections, urinary tract infections, bloodstream infections and pneumonia. (3) People who have been hospitalized or had surgery within the past year or who are receiving treatments like dialysis are at increased risk for infections with MRSA. (4)

MRSA infections have risen sharply in recent years. In 1972, MRSA accounted for only two percent of all Staphylococcus aureus HAIs reported to the Centers for Disease Control and Prevention (CDC) in the U.S. (5) Recent data show that MRSA now accounts for 50 to 70 percent of Staphylococcus aureus infections. (6)

Staphylococcus aureus (“staph”) organisms are common bacteria that can live on the skin and are one of the most common causes of skin infections in the U.S. (7) The bacteria also live harmlessly in the nasal passages of roughly 30 percent of the U.S. population. These people are sometimes called “staph carriers” or persons who are “colonized” with staph organisms. Staph organisms can cause infection when they enter the skin through a cut or sore. Infection can also occur when the bacteria move inside the body through a catheter or breathing tube. The infection can be minor and local (for example, a pimple) or more serious. (8)

Though MRSA is generally associated with healthcare institutions, it can also occur in persons who have had no contact with a healthcare facility. These types of MRSA infections are classified as community-acquired MRSA (CA-MRSA) and are presenting to hospital emergency departments and outpatient clinics in increasing numbers. In addition, patients with CA-MRSA who are admitted to a healthcare facility can be the source for organisms that can be spread to other hospitalized patients, and such spread has been well documented. Many such infections have also occurred among athletes who share equipment or personal items (such as towels or razors) and among children in daycare facilities who are in very close contact with one another throughout the day. (9) By some estimates, more than half of all skin infections now treated in emergency rooms are caused by MRSA. (10)

How does someone contract MRSA?
MRSA is most often contracted while a patient is in the hospital. Transmission of MRSA organisms can occur from skin-to-skin contact with someone who has MRSA on their skin, by hands of healthcare personnel who pick up organisms on their hands from a colonized patient and then care for another patient without washing their hands between the tasks, by contact with items such as computer keyboards or surfaces such as bedrails that have the
organisms on them, and through insertion of devices such as catheters or breathing tubes that bypass the body’s natural defenses.

The risk for the spread of CA-MRSA is highest where people with poor hygiene are associating in close quarters such as prisons, homeless shelters, locker rooms and daycare centers.

How do we clean rooms used by MRSA infected patients?
Using a EPA registered disinfectant with a MRSA rating clean thoroughly using friction, all surfaces in the patient room, paying particular attention to high touch  surfaces. Be sure to follow contact precautions in addition to universal precautions, and wash hands thoroughly, when you finish cleaning.

References:

1 www.nlm.nih.gov/medlineplus/print/ency/article/007261.htm
2 https://www.cdc.gov/ncidod/dhqp/ar_MRSA_spotlight_2006.html
3 https://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca_public.html
4https://www.nlm.nih.gov/medlineplus/print/ency/article/007261.htm
5 www.cdc.gov/od/oc/media/pressrel/r061019.htm
6 Siegel JD, Rhineheart E, Jackson M, Linda C; Healthcare Infection Control Practices Advisory Committee.
“Management of Multidrug-Resistant Organisms in Healthcare Settings, 2006.” Available at
https://www.cdc.gov/ncidod/dhqp/pdf/ar/mdroGuideline2006.pdf.
7 https://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca_public.html
8 https://www.nlm.nih.gov/medlineplus/print/ency/article/007261.htm
9 https://www.nlm.nih.gov/medlineplus/print/ency/article/007261.htm
10 Moran GJ, Krishnadasan A, Gorwitz RJ, Fosheim GE, McDougal LK, Carey RB, Talan DA; Emergency ID Net Study Group. (2006). Methicillin-Resistant S. aureus Infections among Patients in the Emergency Department, New England Journal of Medicine, 355,666-674.

Suggestions for Infection control procedures for free-standing imaging centers and hospital radiology departments

The cleanliness of free-standing imaging centers and hospital radiology departments is crucial for reducing the spread of MRSA and other acquired infections. The following are 11 simple procedures to implement that can prevent the spread of these infections.

1. Have a written infectious control policy to include MRI cleaning procedures as well as the cleaning schedule and have it posted throughout the center.

2. Implement a mandatory hand washing / hand sanitizing procedure between patient exams for technologists and any others who come into contact with patients.

3. Clean the MRI tables, inside the bore of the magnet and any other items that come into contact with a patient. Infection control experts recommend this be done between each patient.

4. Clean all pads and positioners with an approved disinfectant. Infection control experts recommend cleaning after each patient.

5. Periodically inspect the pads with a magnifying glass, particularly at the seams, to identify fraying or tearing. If present, the pads should be replaced.

6. Regularly check all padding material with an ultraviolet (black) light and make sure that any biological material detected on the pads can be removed.

7. Replace damaged or contaminated pads with new pads incorporating permanent antimicrobial agents.

8. Use pillows with a waterproof covering that is designed to be surface wiped. Replace pillows when their barrier is compromised.

9. Promptly remove body fluids, and then surface disinfect all contaminated areas.

10. If a patient has an open wound or any history of MRSA/other infection:

a. Gloves and gowns should be worn by all staff coming in contact with the patient. These barriers must be removed before touching other areas not coming in contact with the patient, i.e. door knobs, scanner console, computer terminals, etc.

b. The table and all the pads should be completely cleaned with disinfectant before the next patient is scanned, if it is not already being performed between every patient. For patients with any known infectious process add 10-15 minutes onto the scheduled scan time to assure there is enough time to thoroughly clean the room and all the pads.

11. All furniture should be periodically cleaned. Ideal surfaces are those that are waterproof and wipeable. Infection control experts recommend this be done between each patient.

By now, everyone should know that patient satisfaction data is no longer public. The Centers for Medicare & Medicaid Services (CMS) developed the Hospital Consumer Assessment of Healthcare Providers and Systems or HCAHPS for short, to increase accountability and transparency of healthcare delivery practices. It is the first public, and nationwide standardized survey that provides direct comparisons of hospital services.

Survey results are posted on the web at www.hospitalcompare.hhs.gov along with other clinical measures to give patients a fairly complete view of the quality any given hospital is providing. One idea behind this is that consumers will “shop around” for their healthcare, something like one would shop around for a restaurant or a new car.

At my, like most hospitals we use in addition to HCAHPS, another survey tool that measures many more aspects of patient care and performance. A drawback to HCAHPS is that it measures only the basic elements of patients care, excluding a lot of factors important to patients in their overall experience.

For my area of responsibility HCAHPS includes only one question: “During this stay, how often were your room and restroom kept clean?” -Never, Sometimes, Usually or Always. This can be misleading because it does not measure the level of cleanliness, only the frequency. If the housekeeper makes several visits to your room does that mean “Usually” or “Always”. If the housekeeper makes several visits to tidy or straighten up but does not clean would that influence the response”.

Regardless of the answer to that we take definite and clear steps to improve our scores and raise the patient awareness that we are cleaning, and we want their room and restroom to always be clean, really clean. Our staff are trained with scripting and hospitality programs that include greeting the patient and letting them know what we will be doing in their room. We use leave behind cards when the patient is asleep or away for a test letting them know their room was cleaned and a phone extension to call if they would like any further service.

I have no doubt that HCAHPS, in the present form or revised will remain. I work hard to help my staff be successful at delivering a quality service to our patients and guests worthy of the “Always” score. We will continue to do so regardless of this survey though. Our greatest satisfaction comes from the patient who really feels their room is very clean and safe for them.

  1. Never mix chemicals.
  2. Always wear gloves.
  3. Always wear protective eye wear or glasses when pouring chemicals or working overhead.
  4. Always wash your hands after chemical use and before eating.
  5. If a potentially harmful chemical comes in contact with your skin or eyes, flush with water immediately and call your supervisor.
  6. If n doubt about proper use, always ask your lead, supervisor or manager.
  7. Chemicals should always be dispensed in the safest manner possible from a flip top cap. The only exceptions are glass cleaners and deodorizers, which can be dispensed by trigger sprayers.
  8. Any chemical on a cleaning cart or in a storage closet must be labeled with the correct name of the contents in the bottle, the specific hazard warnings, and the target organs affected by exposure to the chemical. In other words, a pre-printed label. Don’t just write the name on a bottle.
  9. For any question concerning makeup or compounds, please refer to the MSDS or your hazard communication manual.

The most important staff related task we have in Environmental Services is training. Almost every challenge or difficulty we face can be reduced or eliminated with great training. I’m going to list steps that will help you conduct successful training. This is not meant to be a perfect or complete list, just use this as your starting point and customize it for your needs.

ACTION STEPS:

1. Organize the Approach for Training

a. Decide the amount of skill you expect the trainee to acquire and by what dates.
b. Prepare a schedule to follow

1. Have the employee ready for training.
2. Decide what area will be used for training.
3. Decide items to be covered in each training session.

2. Organize the Work

a. Decide how the area to be covered will be separated into segments that can be learned.
b. Arrange for the proper supplies.
c. Be sure the necessary equipment is available and in good condition.

3. Orient the Employee

a. Put the person at ease.  Make them feel comfortable with you.
b. Explain the task to be learned and find out how much the employee knows about it.
c. Stress the importance of the task, the reason it must be done, and the results of doing it well.  The employee must become interested in learning the work.
d. Explain and show the employee each step of the task, one step at a time.  Don’t go too fast, look for understanding.
e. Stress each step clearly, completely, and with patience to make sure the employee understands.

4. Hands on Training

a. Have the employee attempt the task, and correct any errors while he or she does the task.
b. Have the employee do the task again, and explain each step as the employee does the tasks.
c. Repeat the procedure until you are certain that the task is being done properly and the employee fully understands.

5. Follow Up

a. Allow the employee to perform the task on their own.  Be sure they know that they should contact their supervisor if assistance is needed.
b. Check on the employee frequently until they are thoroughly comfortable in the performance of their duties.  Always encourage the employee to ask questions.

6. Evaluation Employee Performance

a. What are the areas of poor performance?
b. Should they be retrained?
c. If retraining is required, when should it be started, and how long should it last?
d. Is the schedule being met?  If not, why?

Any Questions?

Cleaning is Fundamental

We know that our primary purpose is cleaning. We train our staff to recognize dirt and soil in so many forms and to remove it. We educate, coach and celebrate our successes. We also know that good strategies for combating infection and cross contamination include things such as hand washing and personal protective equipment. In fact recent studies point more often to poor hand washing practices then the environment as the primary cause of hospital acquired infections.

We in Environmental Services understand the importance of hand washing as well as the importance of a clean environment. No matter how well hospital employees adhere to hand washing policies we simply cannot keep pathogens out. Without a top quality training program focused on cleaning and disinfecting the environment, infections will continue to be a problem; germs must be killed wherever they exist within the hospital environment.

I teach my staff to focus on cleaning. Our primary purpose is cleaning, and we never stop and say good enough. We clean and disinfect so that our surfaces not only look clean, they are free of contamination also. I work closely with our infection control department to track results and the partnership has helped to develop best practices that have proven very successful.

When you think about your role in healthcare, remember that without a healthy environment, patients will get sicker, and ultimately, go somewhere else for their healthcare. Support you facility with excellent cleaning, a team relationship with your infection control department as well as your staff. And don’t ever lose focus on cleaning for success.