Environmental Services is Being 'Trashed' as Hospitals Cut Costs, Raise HCAHP Scores


A developer of infection prevention systems today said he fears environmental services (ES) is being overlooked as Americas hospitals simultaneously scramble to cut costs and raise levels of patient satisfaction incorporating the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and scores.
One year from today on Nov. 1, 2012 Americas hospitals will be learning the exact amount of their bonus payment as their Centers for Medicare and Medicaid Services (CMS) reward for quality based on their HCAHP scores, says George Clarke, CEO of Chicago-based UMF Corporation, which develops infection prevention systems for the healthcare, hospitality and pharmaceutical markets. That leaves little time for hospitals to get their housekeeping in order when it comes to recognizing the role of ES in the hospital operating equation.
Clarke adds,  My fear is that on two fronts hospital management is underestimating the critical role of ES staff in patient care: first, regarding their influence on patient satisfaction and second, as the first line of defense in the battle against healthcare-associated infections (HAIs), he said.

Clarke said he bases his fears on a recent UMF ad-hoc survey of ES managers across the U.S. which indicates that many hospitals are taking steps to reduce the number of full-time ES staff in efforts to cut costs as healthcare expenses escalate.
ES managers polled indicated that their departments were, on average, short by five to nine full-time people, Clarke said. This is happening in spite of hospital expansions, expanded services, increased patient admissions and shorter lengths of stay, which create more room turnover. We heard from one ES director who told us that because of severe cuts in staff, its less about hygiene and more about merely emptying the trash.
In fact, Clarke said, trash and dash was the term and trend often described by ES managers in conversations regarding increased demands on their departments at the recent conference of the Association for the Healthcare Environment (AHE) held in September.
A trash-and-dash mentality means that an ES housekeeper is responsible for so many rooms each day that they literally only have time to empty the trash, he said.  Fewer rooms will be hygienic and safe.  It remains to be seen if this situation leads to an increase in hospital-associated infections and deaths. Every year nearly 2 million healthcare-associated infections (HAIs) claim almost 100,000 lives."

Clarke said when it comes to improved HCAHPS scores and bonus payments from CMS, hospitals need to recognize the contributions of ES staff in helping to create the best patient experience. ES personnel are involved with most aspects of a hospitals operations, touching everything from cleanliness and sanitation to family interaction and patient communication all of which have value in the HCAHPS patient survey. Oftentimes, patients have more interaction with housekeepers than they do with doctors and nurses.
Clarke noted that, of the 27 HCAHPS patient survey questions, more than 25 percent are linked to communications and cleanliness. Now is not the time to be reducing ES staff, he said. 
UMF Corporation develops of high performance fibers and textiles including the PerfectCLEAN® Infection Prevention System.


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Mona Shah, MPH, CIC, FAPIC, Construction infection preventionist  (Photo courtesy of Mona Shah)
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