In an age where budgets bump up against quality, efficiency reigns as king. However, it’s impossible to know the impact of any changes in efficiency without a quality assurance program.

Hospital EVS managers need to consider their inspection rates, their use of ATP meters, quality assurance rounds, patient surveys, etc. Mercy requires its supervisors to perform a specific number of inspections with an ATP meter every month. These inspections use the meter to assess up to 10 high-touch areas to obtain a bioload in surgical rooms, patient rooms and ancillary areas. Supervisors also interview patients in their assigned areas. They assess the patient survey, track hand hygiene and they do fluorescent marking.

“We go into an area prior to it being cleaned, mark high-touch spots, let the housekeeper clean the area, then go back in and use a ultra-violet light to see how well they did,” Green says.

Workloading software also helps quality by accurately assessing what is needed to keep staffing levels correct. These systems allow managers to perform what-if scenarios and determine the impacts of staffing reductions.

“If you need to cut 10 percent of your labor, the system can determine what is actually needed to complete each task,” says Green. “It helps managers know they have the right number of FTEs.”

He adds, “If you bring administrators detailed staffing numbers and frequencies and say this is the FTE count based on ISSA standards, you’ll have a much tighter case for keeping your staff, versus cutting it to the bone and affecting quality.”

A quality assurance program enables EVS managers to present administration with a series of options and details about the downside of each reduction in service, says VanReeth. For instance, if the number of patient-room cleaners is reduced, will administrators accept an increased risk of hospital-acquired infections? If the number of discharge cleaners on the second and third shifts is reduced, will they accept an increase in room turnaround times and a lower number of daily discharges?

“Every type of reduction has an impact, and programs like this would enable managers to include the pros and cons of each one,” he says. “If you can clearly explain what the impact will be, the administration can make an informed decision on which poison pill they want to take.”

In a healthcare setting, viruses and harmful bacteria walk through the doors regularly and the challenge of keeping them at bay does not change. As budgets get slashed in hospitals across the country, environmental services managers must get creative with their cleaning procedures to guarantee standards for clean are not compromised. 

RONNIE GARRETT is a freelance writer based in Fort Atkinson, Wis.

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