Environmental Services at Peterson Regional Medical Center, the department whose staff is responsible for cleaning the hospital from top to bottom, seven days per week, is celebrating.
Corey Vann leads this essential department, and he and all his staff are proud that cleanliness of the hospital ranked at the 90th percentile nationally for the third year in a row.
These rankings are drawn from in-patient surveys, completed after patients have been discharged.
Those surveys come from the “Hospital Consumer Assessment of Healthcare Providers and Systems.”
Day to day, the Environmental Services department of PRMC shortens that to “HCAHPS,” said out loud as “H-caps.”
Karissa Henderson, a manager in this department under Director Corey Vann, helped explain how their departmental staff of 30-plus people do all the required and requested cleaning, and track their completed tasks.
This is a standardized survey instrument and data collection method that has been in use since 2006.
On those surveys, the relevant question for this department is, “Was your room clean?” according to Lisa Winters, in the hospital’s marketing office.
She had recent personal experience with this in the aftermath of her hospitalization for a broken ankle, she said.
The survey includes 27 items, 18 of them called “substantive,” that encompass critical aspects of patients’ or their family’s hospital experience.
For example, those items include communication with doctors and nurses, responsiveness of hospital staff, cleanliness, quietness of the hospital environment, pain management and communication about medications, among others.
The survey is available in four formats, by which discharged patients can be contacted – mail only, telephone only, mail with phone follow-up or “Mixed mode,” and Active Interactive Voice Response.
The surveys are sent or presented to patients 18 years or older, and alive at discharge; but not to underage or psychiatric patients or those discharged to nursing homes or skilled nursing facilities, or law enforcement patients (prisoners), or any with a foreign home address; or those who designate “no publicity,” according to the HCAHPS website.
Vann has the goals and action plans for all the parts of the job posted on the wall of the hallway leading to the offices of his department.
Henderson said the number one task on the staff schedules, and a question in the post-hospitalization survey, is, “Was the room cleaned every day?” And following that closely is, “Was it quiet?”
In addition, all staff members interacting with patients are trained on an expected sequence of actions as they work.
A – acknowledge – knock on the door and speak to the patient;
I – introduce yourself;
D – duration, tell the patient the estimated number of minutes the staffer will be in the room;
E – explanation, tell the patient a little about what the staffer will be doing in the room;
T – thank the hospital patient and say something cheerful like, “Have a wonderful day,” so the patient feels more at home in the hospital room.
One of Vann’s goals was to improve HCAHPS “cleanliness” from 86th percentile to 90th percentile or above.
And this is the accomplishment that Vann and his staff are celebrating for the third year in a row.
His plan includes “daily huddles” (staff meetings); training on AIDET; following 7-step cleaning; staff commitment to excellence; and a monthly HCAHPS Audit.
Henderson explained that 7-step cleaning in each empty room as:
• Collecting all trash and linen;
• “High and low” dusting;
• Wiping down all surfaces;
• Cleaning the bathroom;
• Dust-mopping the floor;
• Damp-mopping the floor;
• Inspecting the whole room again.
The sequence is different if the patient is still in the room. Henderson said they will do as many or few of those steps as the patient wants.
It takes the entire staff, split into two shifts, with one starting at 7 a.m., and another at 3 p.m. And depending on the work to be done, sometimes there’s a “mid-shift,” Henderson said.
“Some tasks aren’t daily. Some things aren’t done so often. We do rounds to check those.”
In addition to those daily tasks, she said, when they have extra time, sometimes at night, the cleaning staff will do other cleaning, for instance, cleaning the inside of windows, or the elevators, or the furniture in the public lobbies, or wiping down all the stair rails.
Employee engagement to raise Departmental Tier 3 – 51st to 70th percentile rank –
Improve the employee percentile ranking by the recommended improvement points as measured by Press Ganey (an entity that collects the survey information, Henderson said).
As led by Vann, they try to be consistent on all of the rounding of staff each month. He and managers make sure there’s one document immediately after each.
Be diligent on sending out four thank-you cards a month.
Post updated stoplight report at least monthly and review at staff meetings.
Conduct weekly “staff huddles” (staff meetings) with EVS staff, in addition to daily shift huddles conducted by EVS leadership.
Another goal is to maintain the department’s voluntary turnover (staffers quitting employment and therefore needing replacements) at less than 25 percent.
Vann’s plan is to maintain strategic hiring practices; maintain a healthy work environment, including behavioral expectations and commitment to coworkers.
Continue AIDET training (see above).
Post a “Kudos” board.
Continue the director’s open-door policy and monthly departmental meeting.
He says employee recognition programs need to include:
• Monthly employee recognition based on Press Ganey scores;
• Name an “Employee of the quarter;”
• Inspire others.
Another goal is “Maintaining staffing productivity between 95 and 100 percent of productive full-time employees.”
Their plan includes “Daily labor and overtime management;” and Comprehensive and flexible scheduling.
“Maintain department’s monthly operating expenses to within 1 percent of department’s flexible operating expense budget, on a quarterly basis.”
Henderson said while the PRMC administration has a total budget to cover all departments, each department in the hospital has a specified part of that; and Vann and his managers track their portion of those funds and expenses.
Attend monthly money-management meeting with an accounting staffer; plus the following:
• Review budget weekly in AXIOM, an online budgeting tool;
• Review weekly invoices and approve them in a timely manner;
• Staff continues being good stewards of supplies;
• Flexible scheduling maintained;
• Manage overtime.
Vann put the following employee goals and incentives on a poster shaped like a pyramid. This is what’s listed from the top down –
• World Class Care – today, tomorrow and always;
• Mission - Exceptional compassionate patient-centered care;
• Core competency – elevating health;
• Caring, accountability, learning, leadership, integrity, nurturing, going the extra mile.
“We spend a lot of time talking about going the extra mile,” Henderson said.
Their departmental efforts on all their goals, including this one, are what led to their latest scores and award of “90th percentile or above for the third year in a row.”