Regardless of the fact that we are into the second month of 2017, for some the concept of cleaning has not progressed much past Florence Nightingale’s introduction to the concept of hygienic needs during the Crimean war in 1854. For others however, we are looking past the mop and bucket, the cotton versus microfiber cloths, or the difference between disinfectant chemistries. Instead, we are considering change management and implementation science as ways to improve our cleaning and disinfecting practices.
Being someone who actively seeks to learn and develop processes or behaviors to improve our cleaning practices and perhaps more importantly ways that we can elevate the importance of the environmental services department from the CEO downward, I was most excited to read an article from Health Facilities Management about a new three year study that has just begun. I am dismayed of course that I will have to wait three years to learn of the outcomes, but the fact that the study is using human factors engineering as a way to improve and optimize cleaning and disinfection practices is extremely exciting to me!
The study is aimed at using a human factors engineering approach to measure and improve patient room cleaning and disinfection processes. The study will explore work systems, tools and technologies that environmental services staff use as they go about their day. However, the study will go beyond just the methods and process of how the work is done, it will also look at training, education and how environmental staff are valued within the hospitals organization.
After auditing 7 environmental staff clean a total of 70 rooms, the researchers noted that many surfaces were only cleaned about half of the time (or less). They were quick to point out that missing these surfaces was not an issue of the staff being inattentive or careless, but in many cases the missed items were in use during the time they were cleaning the room and/or staff would be asked to vacate the room before they had completed their work.
While it is still in the early days of the study, it’s exciting to see that unlike the focus of many studies where the assumption is that housekeeping staff are simply not doing their jobs, this study is looking at why the job is not getting done and realizing that that there are extenuating circumstances that makes achieving 100% compliance virtually impossible…..at least by today’s methods and by today’s organization standards. The focus on the need to have multidisciplinary collaboration at a unit level is also exciting. If we think of the adage “it takes a village to raise a child” perhaps at the end of the three years we will realize that “it takes everyone on a unit working together” to keep the area clean.
It reminds me of my favorite definition of insanity – doing the same thing over and over and expecting different results. Perhaps through this out-of-the-box approach to investigating the processes, tools or materials used, the training and the collaboration between disciplines working on a unit will finally get us to nirvana…..or at least a place where cleaning and disinfection can happen 100% of the time.