The 3-Legged Stool: People, Process and Technology–Part 1

The 3-Legged Stool: People, Process and Technology--Part 1

After being in the business of providing a safe, clean and disinfected environment in hospitals for the past 33 years, I have come to the conclusion that the best cleaning/disinfection program involves three basic elements: 1. People; 2. Process; and 3. Technology. In this 3 part blog, my goal is to whet your appetite for all three elements.  Hopefully, when you have read all three parts you will feel as passionate as I do about saving lives through better, more thorough cleaning.

Let’s start with the most crucial element of this three-legged stool: People (Process and Technology comprise the other 2 legs). The BEST Process and Technology will ultimately fail if the person expected to deliver them struggles with low self-esteem, poor training, too little time for the task, low pay and poor management.

The person on the front-line of the battle could be called “Housekeeper”, “Cleaning Tech”, “Matron” or numerous other titles that do little to convey their essential role of preventing or controlling the spread of infections in healthcare institutions around the world. The time has come to turn cleaning professionals into CERTIFIED Hygiene Specialists™.

Infection prevention and control will only become a reality when the CERTIFIED Hygiene Specialist™ is properly regarded, educated, equipped and compensated. Until then, the system will remain broken, or at the very least, in need of improvement.  Simple cleaning and disinfection of the environmental surfaces may be one of our key defenses in the future battle against multi-drug resistant organisms or pandemic. With MDROs proliferating on common touch-points for 56 days or longer, the role of the cleaning professionals cannot be left to untrained people who come from some of the most disadvantaged areas of our society.

We cannot wait until the pandemic is upon us to raise up a legion of CERTIFIED Hygiene Specialists; there simply won’t be enough time. On the other hand, there are over 750 hospitals in the U.S. who stand to lose millions of CMS (government) reimbursement due to their higher than average hospital-acquired infection rate. Many of those HAIs in those hospitals who will suffer financial loss are multi-drug resistant organisms in need of CERTIFIED Hygiene Specialists.  The time to train and certify Hygiene Specialists is NOW!

The CERTIFIED Hygiene Specialist ™ must be:

  • Well trained (a national/international accredited training program)
  • Equipped with the best in class tools to clean, sanitize and disinfect
  • Allotted time to do the necessary tasks
  • Provided the tools to enable scientific measurement of training, chemicals and processes
  • Educated about the prevention and transmission of disease

The CERTIFIED Hygiene Specialist needs partners in providing a safe, clean and disinfected environment in which patients can recuperate.  The cleaning staff is in the patient’s room 15 minutes out of a 24-hour period.  Who maintains the environmental hygiene of the room the other 23 hours and 45 minutes out of the day? 

Infection prevention doesn’t rely solely on the cleaning professional or Hygiene Specialist at your facility.  Infection prevention must be a partnership and joint effort between the cleaning staff, patient, nursing staff, doctors and anyone else who enters the patient’s room. 

For example, the environment can be maintained throughout the day by using disinfectant wipes to clean common touch-points, removing spills immediately, removing waste (both general and red-bag) routinely, posting isolation signs and verbally reminding others to wash their hands.

Because nurses enter patient rooms most frequently, asking them to assist in this process will help in reducing surface-mediated transmission of disease.

Without a doubt, PEOPLE are the most important element in infection prevention.  Without their full engagement, the stool cannot stand.

In Part 2 we will look at the Process of cleaning and disinfecting the patient’s room.


About Darrel Hicks

J. Darrel Hicks, B.A., is the author of Wiley Publishing's "Infection Prevention For Dummies", and is nationally recognized as one of the top experts in infection control. Darrel Hicks is also the Past President of the IEHA and is an active member in AHE where he holds the designation of CHESP. View all posts by Darrel Hicks

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