By Kylee Sam
Environmental services professionals play a crucial role in helping to prevent the spread of infections in patients, and to boost their ongoing education and training, the Association for the Healthcare Environment (AHE) of the American Hospital Association (AHA) is introducing a new certification program for these frontline technicians that will enhance their competencies. The Certified Healthcare Environmental Services Technician (CHEST) credential ensures that the cleaning practices in hospitals and other healthcare environments are superior and directly corre-late to help make a positive impact on infection rates, costs, quality of care, patient experience and outcomes.
“As an organization we need to educate the masses around the value of environmental services to the clinical care environment because I think it is overlooked and underappreciated,” says Patti Costello, executive director of the AHE. “The certification by itself is one spoke in a bigger wheel and a bigger strategy of AHA, and in particular AHE, to demonstrate the value of environmental services.”
The program aims to specifically focus on the “Triple Aim” in healthcare with improving the patient experience of care, including quality and satisfaction, improving the health of populations, and reducing the per capita cost of healthcare. The certification program also spotlights effec-tive communication among all personnel, environmental monitoring and quality control, waste removal, laundry and linen handling, multicultural differences and ethical decision-making, according to Costello.
“The curriculum is built on a job analysis, it’s built on sound data, (it’s built on) the content domains that we have identified through an ex-ternal consultant, through interviews and focus groups that these are the areas we focus on,” Costello says. She also notes that the curriculum is based on sound principles and practices, AHE’s practice guidance for healthcare environmental cleaning, and academic research.
The CHEST program curriculum not only teaches frontline healthcare workers what to do in certain situations and how to do it, but also why it is important to do the task a certain way.
“Understanding why is the game-changer,” Costello says. “We’re providing the science behind it, we’re providing the exercises behind it, we’re providing all of the information that folks could possibly handle in the hours that the program takes to go through that are the most criti-cal and most important so that, by default, it will raise the cleaning and disinfection practice.” She adds that AHE believes that having a stand-ardized way of training and becoming certified is essential so that “every facility is using the same kind of training materials to train their staff to take care of, and clean and disinfect the clinical care environment.”
Costello says that infection preventionists, along with directors and managers of environmental services, should team together and invest in their staff in order to drive better outcomes. She adds that positive outcomes include improved retention rates, lower all-around costs and healthcare environmental services staff becoming more engaged and motivated, and ultimately, a cleaner and safer facility.
“Data, no matter where it is and what level, supports the fact that the better educated one, the more information, tools and resources one is provided, the better job they are going to do,” Costello says, “When you do a better job, and you have the resources available, it’s going to drive a better outcome.”
To be eligible for the CHEST program, a healthcare worker must meet one of two tiers of eligibility: The worker must have at least six months of healthcare environmental services cleaning experience in direct patient care, whether it is in acute-care or long-term care, or one year experience in environmental healthcare services without direct patient care, according to Costello.
“The reason for that is there are folks who do healthcare cleaning disinfection that may not necessarily be in acute care or long-term care, but they are still doing the job,” Costello says. “Those that are working in the acute care and direct patient care settings will have more experience with the material, so they would only need six months versus one year.”
In addition to meeting the criteria, an eligible healthcare worker must also be able to read and write English. According to Costello, there are no plans to translate the material into another language as “to continue to elevate the level of respect and recognition for environmental services, particularly the technicians on the frontline. In doing our research, we have not found a credentialing program or certification program that is translated into another language.”
While AHE realizes there will be varying levels of understanding, Costello says the program curriculum is written at a junior high level and above. “The idea here is to also raise the level of understanding of the people taking the curriculum. They will be hearing words and learning words that they may hear on the nursing floor or from other managers, so it is an attempt to continue to raise the bar for them,” Costello says.
The train-the-trainer model is utilized so that healthcare facilities can choose to train one or more staff members through AHE to deliver the CHEST certification program and upon completion, be eligible to train the environmental services staff in their hospitals and other healthcare institutions for a small fee.
According to Costello, the model is based on three different methodologies. AHE has identified environmental services subject matter experts (SMEs) through criteria including experience in healthcare, knowledge in environmental services and experience in education and training. The SMEs train master trainers, who will then train hospital trainers through a three-day, 25-hour AHE CHEST training program. The newly certified trainers are permitted to present the CHEST curriculum to their frontline healthcare staff for $99 per technician. The fee includes one participant guidebook, access to online assessment and proof of certification of the written exam and observational exam are passed at the end.
CHEST trainers must abide by ethical guidelines such as fairness, being unbiased and making sure assessments are conducted with integrity, according to Costello.
“Based on the environment and the turnover, we believe that instead of just managing a program, that we would teach and train the frontline workers directly, we are training trainers to teach in their own facilities because it is more economical,” Costello says.
In addition to being more cost-efficient, the model allows for the CHEST program to be taught when it is convenient for frontline staff workers. It reduces costly on-the-job errors due to gaps in training, improves job satisfaction, which leads to better clinical and financial outcomes. The certification shows that the candidates are qualified, while also positioning hospitals and healthcare organizations with a well-trained and proficient entry-level workforce.
The inaugural AHE 2015 CHEST Train-the-Trainer workshop will debut at EXCHANGE on Sept. 17-19 in Grapevine, Texas, at the Gaylord Texan Hotel and Convention Center. AHE is expecting 45 people, but will limit the program to no more than 50 people. “The larger the group becomes, the more difficult it is to maintain a training environment that is conducive to a highly interactive, high exchange type program,” Costello says.
The training sessions will feature methods and interactivities that are built around the program to help participants engage and absorb the material both individually and within a group setting. Featured exercises include PowerPoint lectures, videos, scenarios, games and poster activities, demonstrations and knowledge checks to reinforce information and to let participants ask questions.
The standard price for a facility employee who works directly for a healthcare organization which delivers direct patient or resident care and is an AHE member attending the CHEST Train-the-Trainer program is $950. The facility employee price for nonmembers is $1,150. The fee for consultants and independent contractors employed on a contract basis for a healthcare organization, and are AHE members, is $2,000. Con-sultants and independent contractors who are nonmembers must pay $2,500.
Pricing for the three-day training session includes one copy of the facilitator guide and accompanying slide deck, breakfast and lunch each day of training, and T-CHEST status that allows the individual to teach the CHEST certification program to eligible environmental services technicians within their facilities.
If a trainer with T-CHEST status leaves their company, a new trainer must complete the train-the-trainer model through AHE in order to administer the certification assessments to frontline healthcare technicians. If a technician has completed the CHEST program and leaves the company, they may take their credential with them.
The CHEST certification is valid for four years from the date of issuance, with the renewal being 20 hours of continuing education roughly translating to five hours per year. The renewal hours can be in the form of an in-service that providers conduct in their facilities, programs such as webinars that AHE offers, or “any activity that’s related specifically to the seven content domains,” according to Costello. The seven content domains include: cleaning and disinfecting, infection prevention, floor care, communications, waste handling, linen handling and worker and patient safety.
“By getting your people certified and putting them through the curriculum, you are demonstrating that you value them as a member of the clinical care team, you value them as part of the team that helps drive better outcomes,” Costello says. “When you do that, by default, you will raise the overall value and perception of the profession, in particular the frontline.”
The first session in Texas has sold out, but there are other opportunities available. Additional training sessions will be held Oct. 13-15 at the Royal Sonesta Harbor Court in Baltimore, and Nov. 3-5 at the VA Long Beach Healthcare System in Long Beach, Calif. For updated information and to register for the program, visit www.ahe.org.
Kylee Sam is a freelance writer.