let’s talk shop EVS Departments Address By: Lance Witschen HAI Prevention New healthcare legislation provides both challenges and opportunities. U Under the Affordable Care Act that went into effect in the U.S. in 2010, Medicare will no longer cover costs for certain hospital-acquired infections, or HAIs. In other words, hospitals will “foot” the bill on the care required to return patients to a healthy, non-infected status when infections occur in a hospital due to preventable causes. In addition, hospitals are now expected to report their HAI numbers on a regular basis. Hospitals not viewed in compliance with acceptable standards can receive hefty fines. This legislation puts the cleaning industry on the front lines, as was made clear recently to Tom, director of EVS in a large, metropoli-tan hospital. When the hospital’s operations director informed him that the hospital’s HAI num-bers were too high, he also made it clear that he expected Tom to do something about it. ognize the impact that effective or deficient EVS practices can have on their spread. a monthly basis and report the findings to a centralized management team at the state level. States Respond In addition, while the federal government is leading the way with healthcare reform, states are now getting into the act as well. Some state health boards are creating teams that include infection control co-ordinators and EVS management from Meeting The Challenge So what should our friend Tom be doing? ● First, he should ensure that his depart-ment’s cleaning processes are actually disinfecting surfaces effectively. This means using chemicals that are effec-tive cleaners and bacteria killers. ● Staff should be trained to use chemi-cals according to the manufacturer’s guidelines. A disinfectant with a five minute dwell time is totally ineffective if the cleaning staff leaves it on for only two minutes. ● Finally, he should establish a process for consistent monitoring. If his state requires specific timeframes and types, he will use those. Otherwise, he needs to implement a consistent system that can report results on a regular basis. In following these processes, Tom will have the documentation needed to display his staff’s efficacy as it relates to mainte-nance of high touch point surfaces. That will serve as proof that EVS is doing everything it can to minimize HAIs and miti-gate the risk to his hospital. Hospitals not viewed in compliance with acceptable standards can receive hefty fines. select hospitals to create a process for measuring compliance directly related to housekeeping. This process is then mandated with regu-lar reporting at the state level. By doing so, state health boards will be able to easily identify problem areas and correct them as needed. These states are not necessarily mandat-ing all the specifics of testing. They are more interested in the methods and the consistency of their application. For example, some may require ATP test-ing (swab testing for bacteria), though the specific brand used for the testing is up to the individual hospital. Or they may require fluorescent gel test-ing for effective cleaning of areas, again, without mandating a specific brand. Based on the CDC’s High Touch Points, each hospital is then expected to conduct a random sampling of those touch points on Understanding The Impact In April 2014, federal officials released a pre-liminary analysis of potentially affected hos-pitals. That list identified some 761 hospitals na-tionwide that were at risk for penalties. According to Kaiser Health News, these penalties would total approximately $330 million over a one year period. A study conducted in 2012 revealed that one out of every eight patients suffered a potentially avoidable complication during a hospital stay. The study also pointed out that as of Oc-tober 2014, hospitals not in compliance with reporting requirements would lose 1 per-cent of every Medicare payment for a year. While the above study notes all HAI causes, infection control departments rec-Lance Witschen, president of 1ClassConsulting, uses his years of experience to provide solu-tions for a variety of clients. Scout Management Solutions, which he recently co-founded, allows clients one-stop shopping for programs address-ing profesionalism and recognition of the clean-ing industry. Witschen is the author of Behind the Broom along with Judy Gillies, The SurgeGroup. com, and Kevin Keeler, KeelerConsulting.net. Visit www.BehindTheBroom.com for information. www.CMMOnline.com 13
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