In Part I, I made the case for why “The Ugly Cubicle Curtain” is always hanging around hospitals. In part II, I would like to suggest what you can do to turn that ugly curtain into a beautiful swan, just like in Hans Christian Anderson’s story of the “Ugly Duckling”.
So, how does one transition from “ugly” to something that would be very acceptable?
Step 1: Determine who the cubicle curtain stakeholders are; make sure your Infection Control folks are on the invitee list of stakeholders. At your first meeting, ask the group questions like:
• If you are sending your cubicle (privacy) curtains out for laundering or cleaning of some sort, how much are you paying for that service?
• What is the size of your curtains (length x width)? Break down the cost per square foot.
• If an outside vendor is doing them, what is the expectation for turn-around time 1 day, 2 days, etc.)?
• Do you have enough spare curtains so the shelf is never bare?
• Who pays for the cleaning of the curtains-Housekeeping or nursing?
• Do you change curtains after every H1N1, airborne, droplet and contact isolation? Or, just C-diff?
• Are you aware of the availability of disposable cubicle curtains?
• Is your IC department dictating the frequency of changing curtains?
• Whose budget is charged for spare cubicle curtains?
• From start to finish, how much labor is expended by Housekeeping in changing a cubicle curtain (15 minutes, 30 minutes, more)?
• If you are laundering cubicle curtains in-house, do you have an idea of cost per sq. ft.? This would include utilities (electricity, water, gas, sewer) and chemicals PLUS labor.
Step 2: The stakeholders need to break up into work groups. They will have homework assignments to answer or get background on the following questions. For example,
1. Group 1-Break the facility into areas and have the group do their own survey of the areas where the “cubicle curtain system” breaks down. Carry a camera and take photos of the good, the bad and the ugly. Make a Power Point presentation of the findings to present at the next meeting.
2. Group 2-work on a curtain changing policy that addresses the frequency of cleaning, whether they can be laundered in-house or if a outside contractor needs to give a bid.
3. Group 3-work with an outside vendor (or two) that will pick up, launder and return cubicle curtains to a central area for distribution. The group will write the bid specifications addressing appearance, whether the clean curtains will be folded or placed on hangers, the turn-around time, etc. Have the group bring the cost proposal(s) back to committee for consideration.
4. Group 4-If the curtains are laundered in-house, what is the true cost? Include Housekeeping’s labor from the time they receive a phone call and then to take down curtains, hang up a clean curtain, take the soiled curtain to a central holding area. Figure the time necessary to pickup the curtain from a central holding area to take it to the laundry area. Figure the time to load the washer, transfer to the dryer, unload the dryer and fold the clean curtains. You will need your Plant Operations manager to address the cost of utilities (water, gas, electricity, sewer treatment, etc.) A good rule of thumb is, look at residential cost for these utilities if the curtains were laundered at home. You will want to compare this cost to the outside-contractor’s bid.
5. Group 5-Should there be a “standard” cubicle curtain for the whole house? If so, what is the cost estimate of changing the whole house from what you currently have to a standard curtain? If so, the group may want to bring their recommendations for color, fabric and pattern back to committee.
6. Group 6-Whose budget gets charged if the group decides to have a “standard” cubicle curtain? Who buys the spare curtains? As a rule of thumb, you will need 30% more for shelf-stock for exchange purposes so be sure to add additional dollars. Whose budget is charged for the spare curtains?
7. Group 7-Have somebody make a “storyboard” of the life cycle of a cubicle curtain. It might be a humorous look at cubicle curtains that too many people take for granted.
8. Have somebody investigate alternative systems; whether it be disposables or another system that allows curtains to be changed without a ladder and makes the curtains look uniform in appearance.
If committee’s decision is to move ahead (See Step 5) with a comprehensive program for the eradication of “the ugly cubicle curtain”, you can purchase new cubicle curtains or simply have your existing curtains re-worked.
This may be a new revelation, but it is impossible to have a uniform look unless you adopt a two-piece cubicle curtain. To get a uniform appearance, keep workers off ladders, and to make the exchange of curtains as frequently as necessary, there are two elements that need to be met:
Same fabric, same sized panel-The fabric color and pattern should be the same and panel size should be the same throughout the facility. When a curtain has to be changed, a worker shouldn’t have to think about the room, department or division. Ideally, there would be only ONE fabric, ONE pattern, and ONE curtain size for the whole facility. If the panels are all the same width and length, one only needs to think about how many panels they need to provide for the patient’s privacy.
The mesh has to be made separate from the fabric-If the ceiling height varies from one room to the next, from one department to the next and from one nursing division to the next, the mesh has to be made separate from the fabric. The mesh remains in place with each curtain change; only the fabric panel is exchanged. The mesh is one piece for the entire length of the cubicle track. The mesh has to be a minimum of 18” long in order to meet Life Safety Code (this is to allow the fire sprinkler to work effectively) but can be longer. The width of the mesh will be determined by the height of the finished curtain from the floor. The snaps (where the fabric panel is snapped to the mesh) should be 72” off the floor.
There are two ways of getting a standard curtain as described above:
If you already have the same curtain fabric color and pattern in your facility, the committee can recommend that the current curtains are re-made into a two-piece curtain. Or, if you want to keep the fabric the same on a nursing division because it is unique to that decor, you can have those curtains remade. The existing mesh has to be cut off the curtain and thrown away. New mesh is made with grommets at the top to hook on the current hooks and snaps are installed at the bottom of the mesh. See notes above regarding the width and length of the mesh being tailored to each room’s ceiling height. The fabric then has to be cut and re-sewn into finished 66” long x 66” wide panels with snaps at the top. At this height, any worker taller than 5’5” can exchange a cubicle curtain without needing to climb a ladder or step stool (improving worker safety and eliminating Worker’s Comp claims caused by workers on ladders). The panels should overlap by one snap where they butt up against each other. This overlap insures that the patient’s privacy is maintained.
The committee can recommend the purchase of new curtains already made in the two-piece system. There may be more than two companies who make a two-piece system, but I will tell you about the two that I am aware of. Phoenix Textile offers the Simply 66 curtains program. You can check out this company and curtain at: http://www.phoenixtextile.com/c-3079-simply-66.aspx. The mesh that remains in the room is made from antimicrobial material to allay the concerns of Infection Control practioners. The fabric 66”x66” fabric panels are made in a variety of textures, patterns and price ranges. The second company is ICP Medical in St. Louis, Missouri. ICP offers the Rapid Refresh (or “R2”) disposable cubicle curtain. This would be ideal for facilities that utilize an outside company for laundering their curtains or for areas that have a high volume of curtain exchanges due to infection control concerns (i.e., the Emergency Department, intensive care units, or dedicated isolation rooms). You can check out ICP Medical’s curtain that does not utilize standard mesh at the top at http://www.icp-med.com/. The elements of the R2 system are disposable curtains that are made from recycled material and are able to be recycled and a quick change of the curtain that does not need ladders or step stools. They have a financial tool that will help the committee determine the return on investment. In some cases, the ROI of the Rapid Refresh could be In closing, the ugly cubicle curtain doesn’t need to hang around any longer. He needs to be transformed for the better. It will require a committee that is willing to work on the transformation; but first they need to see the ugly curtain through the eyes of your patients, visitors and staff.
Once the problems are identified, you are equipped with a roadmap to get you from where you are to where you need to be. Kick Murphy out of your house!