To ensure that the right chemicals are being used the right way, Hicks advocates for management to train their staff to act not as sanitation workers, but as infection prevention specialists.

“Educate staff so that they’re not just mopping floors and cleaning toilets, but they understand the whys of what they’re doing,” he says. “Explain how disease is transmitted, and train them in the right way to do the cleaning process.”

As an example of this, Attman says that Acme Paper and Supply now regularly trains hospital employees on how to use its products.

“How do you clean transport carts or public waiting areas? How do you use microfiber systems instead of mops and buckets? Reducing HAIs and increasing HCAHPS scores” — that is, feedback from Hospital Consumer Assessment of Healthcare Providers and Systems patient satisfaction surveys — “is so critical to our partners that they appreciate someone taking this expertise on and helping them, especially since, over time, this information will be more public,” similar to how restaurants now post scores from their local public health departments, says Attman.

To follow up on those protocols, cleaning staff should measure surfaces with ATP (adenosine triphosphate) meters.

“ATP is present in all living things,” says Thompson. “As a manager, I’d randomly select an area for testing, swab to detect the level of organic material present on a surface before the cleaning technician comes in, then swab again afterward. If you start with a reading of 2,000 ATP, then clean and sanitize and get down to 100, you’ve reduced the soil load on that surface, and if you’ve removed soil, then you’ve reduced risk.”

What’s more, ATP swabs are one of the few ways that end users can provide proof that their departments are doing its share to reduce HAIs, since other results can be harder to detect directly.

“You can say you’re doing everything properly,” says Attman, “but if you’re not checking, you don’t really know.”

W. Eric Martin is a freelancer in Apex, North Carolina.