Category: Leadership

For years, infection prevention conversations treated Environmental Services as a support function. A separate department. A cost center. The people who clean after everyone else goes home. That era is ending. The 2026 guidance is explicit: if your EVS team is not staffed, trained, and monitored, that is a leadership failure, not a staff failure.

The guidance documents do not use the word blame. They use the word accountability. The expectation has moved from “did the room look clean” to “can you prove it is clean, and can you show who is responsible when it is not.”

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Years ago, as a Supervisor, at a different medical center, I walked in and found nine callouts. Vacations already approved and sick calls reduced half of my team that same day. On paper it looked impossible.

I didn’t try to fix it myself. I pulled the team together, explained exactly what we were facing, and we worked through it as a group. We agreed on what had to get done that shift, the basics that could not wait, and what could safely hold until the next one, based on who was actually going to be there. It worked. We got through the day, and it still amazes me to this day.

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It’s not always a staffing shortage. We have a leadership development vacuum. If a paycheck is your only retention strategy, you are losing your best people to whoever offers a slightly bigger one.

I’ve hired people straight off the floor who had more leadership in them than some managers I’ve worked with. The instinct in a lot of departments is to look outside for that: post the supervisor job, bring in someone with a title already attached. Meanwhile the person who already knows the building, the staff, and the standard is standing right there, wiping down a room.

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Most advice about holding people accountable quickly moves to progressive guidance. Set the expectation, document the gap, escalate to discipline. The mechanics are not wrong. They are just second, and when a leader reaches for them first they usually do not work.

They don’t work because accountability is not perceived the same way by everyone. The same conversation, using the same words, can be help for one employee and a threat for another. The difference is whether that employee trusts me, and that needs to happen long before I sit down with potential progressive discipline.

If they do not trust me, accountability is not a correction. It is the first step in getting rid of them, and that is how they will hear it no matter how carefully I say it. Once someone believes I am building a case, nothing useful happens after that. They stop listening for what needs to change and start thinking about their defense.

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Most of the data reviewed in healthcare operations meetings is historical. The reports look current because they were just printed, but the outcomes they describe were already determined days, weeks, or months before anyone sat down to discuss them. That is the nature of lagging data, and it is how most organizations are running.

I have sat in those meetings. Everyone is looking at the same numbers, agreeing on the same trends, and calling it management. What it actually is, most of the time, is documentation.

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The financial pressure in healthcare right now is not a temporary condition. Margins are thinner than they have been in years, the scrutiny on every cost center is sharper, and the departments that cannot tell their story in the language of finance are finding themselves on the wrong side of the budget conversation.

The departments that hold their ground are not always the ones with the best outcomes. They are the ones with the best data, and there is a real difference between those two things.

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Most people think the hardship is the thing that happened to them. It is not. The hardship that does the most damage is the one that comes second. The first wave arrives uninvited. You do not choose it. It lands, and you absorb it. As brutal as it is, it has an end. Time helps, support helps, resilience helps, and you get through it. The second wave is different. It does not come from the outside. It comes from inside. It is the story you tell yourself about what happened and why.

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A certified supervisor does not just know more. She sees differently. She asks better questions. She holds a higher standard because she understands why the standard exists. She becomes someone her staff trusts not just because she is their supervisor, but because she has earned it.

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