By J. Darrel Hicks

Environmental Services Week, Sept. 8-14, 2019, is a week to join all national and international healthcare environmental services (EVS) professionals to celebrate the outstanding work of these specialists and teams. Every year this week represents a special opportunity to acknowledge the outstanding efforts of your housekeeping team and thank them for a job well done.

Simple cleaning of the environmental surfaces may be one of the key defenses in the future battle against infectious disease. With antibiotic-resistant organisms proliferating on common touchpoints for up to 56 or more days, the study of cleaning and measuring cleanliness is becoming all-important.

“Compliant cleaning and disinfection of environmental surfaces and medical equipment is a critical first line of defense against all pathogens in the healthcare environment, and especially those that are resistant to antibiotics,” says Sarah Bell-West, PhD, senior scientist at Clorox Healthcare.

EVS workers play an essential role in prevention of healthcare-acquired infections (HAIs). Studies have demonstrated significant improvements in cleaning through interventions directed at environmental services workers. For optimal effectiveness, such interventions require that environmental service workers be knowledgeable about the prevention and transmission of disease and well trained with the best practices that keep patients safe.

When it comes to keeping pathogenic organisms at a safe level on environmental surfaces, the least educated and lowest paid people in the hospital must eliminate those dangerous bacteria.

“This is the level in the hospital hierarchy where you have the least investment, the least status and the least respect,” says Jan Patterson, MD, past-president of the Society for Healthcare Epidemiology of America (SHEA).

It’s time to certify Environmental Service Workers
When hospitals want to compete in their market, leaders often look to the latest 128-slice, 3-D CT scanner, a Divinci robot to perform surgeries, recruit the best surgeon, or begin a new service line with the best return on investment (ROI). While these capital expenditures and improvements might attract publicity for a fleeting moment, the board of directors needs to consider a different, low cost option that provides the best chance to improve patient satisfaction, reduce HAIs and improve the bottom line: The Environmental Services Department.

The literature is replete with articles and studies in infection prevention annals extolling the virtues of various environmental hygiene Products, Processes and Programs to reduce HAIs in healthcare. The one missing “P” is the People who work hard, do a dirty (sometimes disgusting) and repetitive job, and make $10 an hour while providing a safe, clean and disinfected environment for patients and staff; the people of the EVS department.

In an article titled, “Clean Sweep: Hospitals Bring Janitors to the Front Lines of Infection Control” (Aug. 15, 2012  Scientific American), Maryn McKenna wrote, “It hasn’t been that long ago the poster bug for nasty bacteria that attack patients in hospitals was MRSA. Because MRSA clings to the skin, the chief strategy for limiting its spread was thorough hand washing. Now, however, the most dangerous bacteria are the ones that survive on inorganic surfaces such as keyboards, bed rails and privacy curtains. To get rid of these germs, hospitals must rely on the staff members who know every nook and cranny in each room, as well as which cleaning products contain which chemical compounds.”

Having been a leader in several different hospital EVS departments over a period of 33 years, I interviewed candidates for front-line positions. When I asked, “Why do you want to work here?” the common reply was, “Because, you pay more than I make now.” The EVS tech job would pay her 25 cents more an hour than she made stuffing hamburgers in bags at Burger King.

This young lady went from working the window at the corner fast food restaurant to cleaning the operating room in two weeks for a quarter more an hour. The comparison of job roles and responsibilities is obviously not close to being similar. It’s time to educate and certify environmental services workers so, in this case, the young lady understands that better, more thorough cleaning and disinfection, saves lives. It’s time to turn that young lady into a Certified Environmental Services Technician (CEST).

Why don’t hospitals value the EVS technician? Too often, housekeepers or environmental service workers are thought to be expendable (anyone knows how to clean a toilet and mop a floor, right?) and difficult to educate because English may not be their first language. The thought is, “What if I educate and certify them and they leave?” But, worse than that, what if you don’t educate and certify them and they stay?

The Learning Objectives for the CEST
• Define Environmental Services #1 job as Infection Prevention
• Equip the frontline cleaning professional with knowledge of infection prevention as it relates to their daily tasks
• Analyze the cleaning professional’s role in patient satisfaction
• Support the cleaning professional with practical “how to” tips for cleaning and disinfection
• Introduce cleaning and disinfection strategies that effectively break the chain of infection (i.e., 7 Steps of Cleaning, daily duty lists, daily checklists, florescent marking of high touch surfaces, employee engagement, etc.)
• Convert the cleaning professional into a Certified Environmental Services Technician

The stakes are too high to allow the rooms of residents or patients to be cleaned by a person who is not a CEST. The CEST must be properly compensated, regarded as a part of the facility’s multi-modal infection prevention program, be well trained in the nuances of cleaning and disinfection, allotted the time to do the necessary tasks, equipped with the “Best in Class” tools to clean and disinfect surfaces and educated about the prevention and transmission of disease.

In closing, an educated and Certified E.S. Tech will be viewed as a knowledgeable professional working amongst other healthcare professionals who are certified or registered in their field. Knowledge leads the environmental services worker to be proud of the profession they have chosen and respected by those they work alongside of.

A closing thought: One well-trained, well-equipped, conscientious Certified Environmental Services Technician, given the proper tools AND an adequate amount of time to clean and disinfect a room patient’s room can PREVENT more infections than a room full of doctors can CURE.

I encourage you to keep the recognition going and celebrate your EVS superstars 365 days a year, this special week is a great excuse to focus on your team and reward them for doing an excellent job!

I am a Certified Environmental Services Technician and I save lives… what’s your super-power?

 

 J. Darrel Hicks, BA, Master REH, CHESP, Certificate of Mastery in Infection Prevention, and a Certified Expert Trainer -- is the owner/principal of Darrel Hicks, LLC. His enterprise specializes in B2B consulting, webinar presentations, seminars and facility consulting services related to cleaning and disinfection. Hicks authored Infection Prevention for Dummies, a 43-page, pocket-size book that deals with the role that proper cleaning and disinfection plays in saving lives.