Knowing Your ES staffKnowing Your ES staffHow often does the facility IP

meet with the Environmental Services (ES) management?◦Yearly◦Quarterly◦Monthly◦Weekly◦Daily◦More than daily?

What formalized rounding What formalized rounding processes does the facility processes does the facility IP participate?IP participate?

ES RoundsEnvironment of Care RoundsEmergency Preparedness RoundingConstruction (Including the design

phase)◦ Internal construction (Daily)◦External

Weekly RoundingWeekly Rounding

All patient Care UnitsAll OR areasDecontamination areasSterile stores areasHospital waste areasKitchenOutside the facility, roof, tunnels,

parking lot, green space areas, local vicinity

Non-Patient Area Non-Patient Area RoundingRoundingEngineering areasBoilers, water heaters, chillers,

cooling towers, air handlersWater softeners, water quality,

water reserves, compressed air, O2

Planned maintenance schedules: Who, What, When, Where, How, Why?

Patient Rooms / Equipment / Patient Rooms / Equipment / Patient areasPatient areasWhat exact products are used to

clean and disinfect?How are the products used?Are they used alone or in

combination? Cleaning vs. disinfection?Are they mixed or ready to use

products?

Patient Rooms / Equipment / Patient Rooms / Equipment / Patient areasPatient areas

If mixed, ◦How and where are they mixed?◦What ratios to optimum

concentrations?When are the products being

used after mixing? When are they tossed?

Contributing VariablesContributing VariablesWhat are the wet times?How long does it take the

product to dry on the surface in winter, in summer?

How does the internal humidity and air exchanges affect wet times?

How and when are processes adjusted to accommodate?

NursingNursing Staff Education Staff EducationWhat is the training frequency for

available products?What is the training / retraining for use

of new products?What is the training for how and when

to use each product?Who on the nursing staff is responsible

for cleaning what?Is there a mechanism for reporting

deficiencies in the cleaning process?Where is it documented what roles is

responsible for cleaning of what items?

ES Staff EducationES Staff EducationWhat is the training program for ES

employees?How often is retraining conducted? What are the differences for each

process and product?Is there a mechanism for reporting

deficiencies in the process? Where is it documented whose role

is responsible for cleaning of what items?

Evaluation of processesEvaluation of processesWhat is the mechanism for reporting

deficiencies in the cleaning process?How is quality control checked? How

often? By whom? Daily Feedback?What are the expectations, standards,

benchmarks, matrix…?How are they evaluated and reported

upward, downward and laterally?What is ES’s management role and

expectations for reporting to the IP?

Evaluation of processesEvaluation of processesWhat changes are needed?What implementation processes

and strategies will be used?How will implementation be

evaluated for success? How will implementation be

sustained?

Take home messageTake home messageMake rounds daily…Go everywhere!Know the processes…Know when

they are not working.Know the people…They want what

you want and need your help.Ask questions…People like to share

their expertise.Ask the hard questions…The best

solutions come from answering the hard questions.

Ask many, many, many questions!