CLEAN BY DESIGN: HOW TO CLEAN UP YOUR HEALTH CARE FACILITY AND KEEP IT THAT WAY

By Bohdan Kolomijez

A practical how-to guide on setting up an EVS program for a medical facility. Many of the policies can also apply to commercial, industrial, and office settings. It contains amazing feats, secrets, charts, and tables to help the reader make significant improvements in their programs. These are supported by real-life stories and examples that show readers what to do and more importantly what not to do. The book's policies will help provide an operations manual that even the most cynical of insurance companies will like. What is wrong with saving money on liability insurance premiums?

• Language: English
• Publisher: Fulton Books, Inc.
• Release date: Jun 8, 2023
• ISBN: 9798887310701

Book preview

Table of Contents

Title

Copyright

Acknowledgments/Dedication

Why This Book?

Policy No. 1: Know Thyself

Policy No. 2: This Job Is as Big as It Is!

Policy No. 3: Approach the Job with Respect!

Policy No. 4: Know your Expectations

Policy No. 5: Know Your Facility

And now a word about our occupants!

And now a word about architects.

Policy No. 6: Know Your Tools

Policy No. 7: Know Your Infection Control and Prevention

Policy No. 8: Know Your Team

Policy No. 9: Know and Grow Your Systems!

A. The Quality Assurance Program

A1. Standards

A2. Inspections

A3. Audits

A4. Process and Procedural Reviews

A5. Rounding

A6. Work Sampling

A7. Key Metrics

A8. Performance Improvement

B—specifications, our second of six major systems.

B1. Watch Your Language!

B2. Service Definitions

Defining and Describing our Workload and Scope of Activities

B3. Terminology Samples, Task Definitions, and Procedures

Cleaning the Procedure Room

Cleaning the Patient Room

C. Manpower Allocations, the Third of our Six Operating Systems

C1. Using Square Footage

C2. The Time-Task Inventory

C3. Use of Standard Production Rates

C4. Unitization

C5. Using Equipment Design Specifications

C6. Project, Periodic or Non-Routine Cleaning Tasks

D. Human Resources Management, our Fourth Operating System

D1. Sample Daily Zone Assignment

D2. Sample Position Control Worksheet

E. Customer Relations, our Fifth Operating System

F. Continuous Quality Improvement, our Sixth Operating System

Policy No. 10: Know Your Customers!

Policy No. 11: Know Your Marketing!

Policy No. 12: Know Your Communications!

Policy No. 13: Know Your Budget!

Policy No. 14: Know Your Disruption Factor

Policy No. 15: Know Your Textiles, Laundry, Linen

Policy No. 16: Know Your Environment

Policy No. 17: Know How to Wrap It Up!

Policy No. 18: Know Your Resources!

Bibliography

Appendix

About the Author

Clean by Design

How to Clean Up Your

Health Care Facility

and Keep It That Way

Bohdan Kolomijez

Copyright © 2023 Bohdan Kolomijez

All rights reserved

First Edition

Fulton Books

Meadville, PA

Published by Fulton Books 2023

Warning/Disclaimer

The purpose of this book is to educate and inform. The author and/or publisher do not guarantee that anyone following these techniques, suggestions, tips, ideas, or strategies will have stress-free workdays. The author and/or publisher shall have neither liability nor responsibility to anyone with respect to any loss or damage caused, or alleged to be caused, directly or indirectly by the information contained in this book.

ISBN 979-8-88731-069-5 (paperback)

ISBN 979-8-88731-070-1 (digital)

Printed in the United States of America

Acknowledgments/Dedication

I feel more fortunate than most. There have been many super people who have helped me grow as a leader and as a person. It has been my honor and privilege to have worked with people of such good character, dedication, and knowledge. So this one’s for you, guys! I know that as long as many of you are still out there, doing your magic, the world is in good hands. I dedicate this book to you!

When you finish reading this book, you will know much more about how to

evaluate a facility for its ailments, attitudes, and expectations;

identify and confirm the work of the Environmental Services Department;

design and organize manageable, sustainable workloads;

recognize that creating a culture and evolving the department are dynamic, not static processes;

build a cohesive, energized team;

compile and provide status reports that would impress VPs, CEOs, and even board members; and

turn your customers into raving fans!

There are several things that I would like to see come out of this book. One thing for sure is that I would like us all to agree and recognize that having a clean hospital or any clean facility is a really good thing. It’s good for morale, good for the psyche, good for the customers, and good for the bottom line too! The cleanliness of our health care facilities, or any facility for that matter, goes a long way toward instilling confidence in those who work there, those who visit, and especially those who will be medically treated there. Since this latter group and their insurance companies will be footing the bill, I would like them to feel very, very confident in our collective abilities to deliver.

Much has been written and studies have been concluded about the sensitive relationship between a great-looking facility and customer as well as staff satisfaction. Yet much of this great research is being ignored to the detriment of the customer and profits. I don’t want this book sitting on a shelf collecting dust. What I do want is to help interested readers learn how to make a difference.

Why This Book?

I think the better question is Why not?

As always, I am interested in attracting new talent to this field.

There are newer ways of managing this team and their work and a recognition of older techniques that still work nicely.

Many organizations are totally missing the marketing potential that exists in their environmental services departments.

As lessons can be learned from experience, I think it important to use real-life situations to demonstrate various points. I am glad to share examples to show the value to cleaning things up. You may want to brace yourself for some horror stories—some of which would make Freddie Krueger cringe!

To help keep our perspective, I will gladly tell you about some resounding successes. There are ways in which many good-hearted, talented, and competent people exerted extraordinary efforts to make things better.

And it has been a long time since anyone in our profession has written a good recent spellbinding treatise on successfully managing the EVS function in a health care setting. So I will do my best to provide excellent methods and practices you can use today and tomorrow.

Many of the medical facilities my employer and I walked into were in pretty decent shape. Our reason for being there was to help them prepare for or follow up on a facility expansion or renovation. They needed help in reevaluating and adjusting their EVS staffing. A few were mismanaged and needed new direction. And I gotta tell ya, there were a couple of places that were downright nasty. Personally, I am weary of decision makers who are of the opinion that anybody can do this job. My employers and I have had to go into places to fix the messes that Mr./Mrs. Anybody or Any Company screwed up.

I am weary of going into movie theaters where there is so much debris and popcorn on the floor you can’t even tell what color the carpet is. And you better check your seat before sitting down. I am weary of walking into bathrooms in public facilities that are so nasty they bring on the urge to puke. And if you see such conditions in a health care facility, don’t just walk out—run! It’s amazing such low standards exist despite a number of published articles and studies that have clearly identified the sensitive relationship between consumer confidence and great looking facilities.

In Tom Peters’s book titled The Pursuit of Wow! he recognized the impacts and the importance of such mundane things as bathrooms! If these are clean, modern, and well-designed, the public gets a good impression about the facility and the organization. And conversely, if these are unkempt, nasty, dirty, sloppy, and rusty, the public gets the kind of impression that drives them away, keeps them away, and makes the organization the butt of jokes! (Couldn’t resist the pun!)

Quoting from Tom’s book, Incidentally, what’s good for the goose is good for the gander. Employee restrooms vary as much as customer pit stops. Some are clean and inviting. Many are foul and repellent. Some have showers and locker. Most don’t.

Continuing with Tom’s quotes, Yes, I’m actually suggesting that you vault rest rooms to the top of your next business strategy session. They’re a dead giveaway about how much you actually care about your oft-proclaimed ‘most important assets’—your customers and your workforce. Tom even includes some pictures of bathrooms (pages 134 through 137 in his book) referencing the good, the great, and the ugly.

Don’t just take my word for it And you don’t have to take Tom’s word for it either. If you have ever driven the stretch of Interstate 75 between Detroit and Miami, you will have discovered that we do not need to worry about dirty bombs or bacteriological warfare from a foreign enemy! What’s growing in some of these nasty bathrooms can do us in just as handily! Even some of the most desperate people have turned around and walked out, myself included!

Want to make a difference America will notice? Clean up these disgusting public bathrooms!

I am a strong advocate of clean facilities because I know what an impact this can have on customer confidence and business finances. These two concepts are inseparable! If you don’t think this works, just look at the tech giant Apple! If you agree that Apple’s customer confidence is high and their business finances are successful, then I’ve made my point.

The sad part is there are some decision makers who do not believe in this customer/finances relationship. So you and I must do a better job of educating them. What is also sad is that in this duration, in this interim, a tremendous amount of goodwill and revenue will be lost. And as David likes to say, Why lose money?

While I am happy to tell you what my teams did, I encourage you to contemplate what your team can do; I recommend you formulate your own response.

It does not matter to me whether your facility’s housekeeping and laundry services are outsourced or orchestrated on site by an in-house team. The issues and challenges will still be there and will need to be addressed skillfully. Having worked for in-house and contract management situations, I can tell you there are advantages and disadvantages, joys, and heartbreaks to both.

Policy No. 1

Know Thyself

Wherever and whenever the adage originated, Know Thyself was universally adopted and placed at the foundation of knowledge, the cornerstone on which the temples of philosophy should be erected.

The essence of knowledge is self-knowledge, claimed the Greek philosopher Plato.

From Plato’s The Republic, he writes: But in truth justice was, as it seems, something of this sort; however, not with respect to a man’s minding his external business, but with respect to what is within, with respect to what truly concerns him and his own. He doesn’t let each part in him mind other people’s business or the three classes in the soul meddle with each other, but really sets his own house in good order and rules himself.

Centuries before him, the Hindu Upanishads confirmed, Enquiry into the truth of the Self is knowledge.

Leagues away and centuries later, the Persian poet Rumi wondered, Who am I in the midst of all this thought traffic?

The American poet Walt Whitman celebrated his self, a simple, separate person.

Lao Tzu said, Knowing others is wisdom, knowing yourself is Enlightenment.

Let me be perfectly honest with you. I have no idea whether you consider this your dream job or if you are using this job as a stepping stone on your way to CEO. Makes no difference to me whether you work for an outsourced contractor or an in-house team. Just do right by your customers and clients without betraying or compromising your own principles. What is important is this: The more you know and learn about this job, the better will be your performance, your team’s performance, even your boss’s performance! Combine that knowledge with some magnificent human relations skills and you just might be able to write yourself a nice ticket.

Your professional credibility will be built on your knowledge, the quality of your interactions, and your responses to varying situations to say the least. Accentuate the positive! Turn negatives into opportunities!

This is not the time to bluff it, fake it, or pretend to know something you do not. People are not stupid, and they will see right through that kind of effort. Be genuine, considerate, courteous, and thoughtful in this leadership role, and you’ll have plenty of help when you need it.

The Christian version of this sentiment is To thine own self be true!

Regardless of your age, it is in your best interests to bolster your credibility and qualifications, the reason being that you will be working in a health care environment, where many people have a lot of hefty credentials. In their visitation criteria, the Joint Commission likes to see that department heads, committee chairs, and others are qualified by education and/or experience or both. The other leaders you will be interacting with have an excellent working knowledge of how to clean or take care of things in their own specific realms. Of course, we should learn about that and add to it what we know to be appropriate. You get some nice results this way.

What you learn will not put you on the same level as a doctor or a nurse. But it will help you converse intelligently so that problems can be identified and solutions can be evaluated and implemented. So what kind of stuff would you have to learn about?

Try human relations, communications, persuasion, negotiating, hiring, budgeting, building materials, chemistry, purchasing, scheduling, and how to clean a variety of surfaces.

Where do you go to learn? Your local colleges have evolved their hospitality management programs. Their materials concerning institutional housekeeping and other support services are now much better than years ago.

Look to your professional organizations, such as ASHES, the American Society for Health Care Environmental Services. They offer continuing education units as well as professional certification programs. IEHA, the International Executive Housekeepers Association, also has classes and certifications.

Look also to your suppliers, especially the national brands such as S. C. Johnson, Hillyard, and many others. They have video training sessions, on-location training events, and more. There is no reason these days for staff to be uninformed or untrained. All you need to do is ask!

Teach yourself! Then teach your staff! You and they will be rewarded many times over!

Risks

To laugh is to risk appearing the fool.

To weep is to risk appearing sentimental.

To reach out for another is to risk involvement.

To expose feelings is to risk exposing your true self.

To place your ideas and dreams before a crowd is to risk their loss.

To live is to risk dying.

To hope is to risk despair.

To try is to risk failure.

But risks must be taken for the greatest hazard in life is to risk nothing.

The person who risks nothing does nothing, has nothing, and is nothing.

They may avoid suffering and sorrow, but they cannot learn, grow, feel, change, love, or live.

Chained by their certitudes, they are as a slave, forfeiting freedom.

Policy No. 2

This Job Is as Big as It Is!

I can well appreciate that for many people, the process of tidying up and cleaning their own home may present a formidable challenge. Given our busy lifestyles and fully packed calendars, it’s a wonder things get done at all. If you are anything like me, you’ve probably become quite adept at managing the mess or brilliantly camouflaging the clutter!

A long time ago, I read a helpful hint from one of the masters of social etiquette in our local newspaper, that being if company drops in unexpectedly, put up an easel with a canvas on it and simply tell your guests that your spouse or someone else in the family is an artist! Dazzling idea, I thought to myself! I could not find enough easels for my place!

I also happen to be an artist. And in support of the artists I know, they are quite well-organized and for one reason: They like to be able to find things quickly.

Getting back to our project at home, there was even a skilled web writer on AOL who would say to you that your house could be cleaned in ten minutes! Don’t believe it! It takes most of us ten minutes just to find out where to start!

If our at-home project appears somewhat daunting, take a look around your local cityscape. See all those much, much larger skyscrapers, office buildings, government offices, churches, banks, hotels, stores, restaurants, sports bars, airport terminals, medical offices, shopping centers, business establishments, and of course, my favorite, our hospitals!

Makes our little at home project look like a snap-of-the-fingers task!

Respect the job—this job or any job for that matter. It’s not a cakewalk. And it’s not a nightmare. Do yourself a favor. Recognize the job for what it is. Do not underestimate it. Do not undermine it. Do not make light of it. Many people can do this job successfully. Others simply cannot. It’s not in their makeup, their genes, or their capacity to understand it.

Your job is to know what the hell you are doing and to surround yourself with good resources and good people to help you do it—period.

It does not matter if your facility is little or large. It is as big as it is, and it will require you to have some specialized knowledge, a clear vision, and a skillful temperament. By way of this book, I am committed to help you gain in all three of these respects.

My associates and I have worked at cleaning up hospitals whose sheer size was the equivalent of cleaning between three hundred to five hundred homes per day! And those were just some of the smaller to medium-sized facilities! If we take into our view some of our larger, more massive facilities like the Cleveland Clinic, university hospitals, or Cleveland’s MetroHealth, we’ve got some very serious large-scale projects on our hands. The size of a campus like the Cleveland Clinic represents the equivalent of cleaning upward of 9,200 homes each and every day! Friends, this is no small task! How do we know how many people to put in front of this challenge?

As few as possible but as many as needed.

Remember this phrase because we will come back to it often.

When I get to facilities of this larger size, my ordinary little basket of Windex, furniture polish, and all-purpose cleaner just won’t do. Suffice it also to say, our health care facilities are much more than a one-basket, one-person job! So how does it happen?

Glad you asked because that’s what this book is all about.

First of all, we need a plan! That plan has to encompass a skillfully orchestrated combination of

clear expectations;

accurate facility information;

versatile equipment, tools, supplies, and chemicals;

talented people;

systems in synergy;

raving fans for customers;

the essential touch of marketing;

ongoing communications;

a magnificent budget;

state-of-the-art technology; and

some dandy backups in terms of plans and resources!

With such strategic approaches, many of our hospital facilities around the country are made fresh and sanitary every single day. It really is quite an undertaking. In many respects, it represents the best and most intricate efforts of today’s project management concepts, which I recently completed a course of study in.

Over the years, people have asked me What’s the secret? Reread the previous paragraph, and add to that a very healthy dose of communication. That’s what enables and enhances your plans. All these characteristics working in tandem can provide a smooth operation.

We need to be aware of our methodology, our overall goals for how to get all the required activity completed in a timely manner and with the least amount of disruption for our customers. (A bit more about the disruption factor later!)

If all of this sounds too fundamental, that’s because it is. I am sharing with you one of the best lessons learned about this business, which started as friendly advice from Al, my supervisor and mentor in the early days. He would frequently tell me, It’s always back to basics, Don! Back to the fundamentals! The longer I lived, the more I appreciated and realized how true this really is.

On the issues of supervision, Al advised, In God we trust. All others pay cash. This meant Trust but verify! which was one of his other favorite phrases. When the projects were many and the priority was missing, Al reminded me that the road to hell is paved with good intentions. So what I am telling you is prioritize, delegate, and knock ’em out.

Al had a lot in common with Vince Lombardi. Both were driven by fundamentals. And you know what Vince did with the Green Bay Packers! Now visualize that kind of intensity and tenacity in a hospital setting! In both cases, we had winning teams!

In line with this philosophy of staying with the basics, I am approaching this book from three viewpoints. First is that of you, the reader, being a new manager coming into a new position, new facility or into a new assignment. You are welcome to add the lessons and secrets of this book to what you may already know about this business of health care environmental services management. You will find yourself prospering a little more!

Second viewpoint recognizes that you as an existing manager may be at a crossroads in an attempt to transition your team to a higher level of performance. Your dissatisfaction has brought you to this point for a reason. You have become aware that your team is much more capable than they have demonstrated. It may have nothing to do with economics, budgets, or pressures, although we can’t quite escape those. You may simply feel like you need to reignite the team’s passion, maybe even your own! And so you shall, my friend! So you shall!

The third