Bright lights at the end the hospital corridor. The concept of life and death.

Healthy Facilities Institute University (HFI-U) is advising environmental services departments to adopt systems focused on improving service to patients and preventing healthcare acquired infections, which cost the United States billions of dollars each year.

Dr. W. Edwards Deming taught that every system must have a goal, and a clear goal of healthcare is to provide optimal care of patients profitably.

Environmental services departments are a vital, sometimes neglected component of this system as they are responsible for cleaning and disinfecting throughout a healthcare facility, and notably in patient areas which sometimes carry the greatest threat to transmitting healthcare acquired infections. 

A key aspect of improving systems is the use of Deming’s “Plan-Do-Study-Act” cycle, which the United States Department of Veterans Affairs’ Quality Enhancement Research Initiative describes as a vital component to improving quality, patient-centric care and reducing HAIs.

“The ‘Plan-Do-Study-Act’ cycle ... is probably the most useful single framework I have encountered in 20 years of my own work on quality improvement,” says Donald M. Berwick, MD, in The Improvement Guide, a manual used to enhance organization performance. “It can guide teams, support reflection, and provide an outline for oversight and review.”

The Improvement Guide also provides three key questions to ask as a model for improvement:

1. "What are we trying to accomplish?"

2. "How will we know that a change is an improvement?"

3. "What change can we make that will result in improvement?"

“Also, ask the question: ‘When should a healthcare EVS department operate at a higher cost?,'” says Allen Rathey, principal of HFI-U. “The answer is ‘When doing so enables the system aim, improves quality, and reduces HAIs.'"

This requires spending more money on environmental services functions if they help improve quality, patient outcomes and reduce HAIs.