The unsung heroes of the hospital: Why EVS and Housekeeping are one of your most important assets

The unsung heroes of the hospital: Why EVS and Housekeeping are one of your most important assets

When a patient walks into a hospital, they may notice a couple of things. The first is the inevitable maze that greets them on the way to the front desk or check-in. The second is how clean everything looks. In any business, it is important to have a nice, clean, office. People judge on appearances first, its human nature.


While it is relatively simple to clean a hospital lobby or hallway, things begin to get more complicated once you move into the operating room or into patient rooms. Some ORs have open shelves with manuals on them lining the walls. Almost every OR has several stools that seem like they may have never been cleaned and could never be cleaned. On top of the overwhelming amount of surface area to be cleaned, staff is often charged with turning over the room in 10 minutes or less.


When is the last time you were able to get your kitchen so clean you would perform surgery in it, in just 10 minutes? It takes me 10 minutes to wash a pan sometimes.


Patient rooms are a different animal. There is an additional human component that is challenging to account for. When a new patient comes in, they may have visitors, bring in items, or bring in food. They may use areas in the room that are not common to use. It may seem like it is cleaner than an OR bespeckled or even doused in blood. The lack of visual cues makes cleaning assessments challenging.


Therein lies the primary issue. While a hospital seems clean, looks clean even, it may not be. The margin of difference is where multi-drug resistant organisms thrive and infect patients.


While every facility tries to do its best to clean high-touch surfaces, the execution is challenging. In one early study, it was reported that only 50% of high-touch surfaces were cleaned in the ICU and med/surge units during terminal cleaning. Other studies have suggested that only 25% of high-touch objects in operating rooms were cleaned on a daily basis.


Coupled with the unfortunate reality that some MDROs can survive for days or even weeks on surfaces, it is plain to see that cleaning is paramount in a healthcare setting.


Why do we undervalue these teams when cleaning is so critical?


It is easy enough to suggest that the division of labor favors those with more specialized skill sets. Neurosurgeons make more than someone who works at the front desk. CEOs make more than coal miners. Economic arguments aside, perhaps it is worth considering the housekeeping team in your hospital.


In his groundbreaking work, DRIVE, Daniel Pink outlines new research suggesting that people are motivated by Autonomy, Mastery, and Purpose. Money, he shows often ranks lower on the list when it comes to motivation. In fact, in certain situations, money can be counter productive to performance.


When considering environmental services and housekeeping it is worth taking a closer look into those teams to determine how to make sure they are motivated and loyal. And money will not likely be the primary lever. These teams are truly important to the functionality and safety within a hospital. These teams also have the highest turnover rate.


From a cost perspective, though the “value” of someone who cleans, may be economically low (supply and demand), the relative value to the mission of a hospital is much, much higher. When you clean a patient’s hospital room, not to be hyperbolic, but it could mean life or death for a compromised patient with MRSA sitting on their bed rail. Relative to the bottom line in a hospital, training, retaining, and promoting from the housekeeping and EVS teams is critical as it is of substantial importance to patient safety.


Raising pay for everyone is a go to lever and may not make financial sense. Consider the other levers for these teams. They truly are unsung heroes in the hospital, keeping patients safe behind the scenes. If nothing else, take time to say thank you to the hospital workers cleaning ORs, rooms, and hallways. Their work is monumentally important to a well run and safe hospital.

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