EVS Optimization Project Playbook a DIY (do it yourself) Project

1. EVS Optimization Project Playbook a DIY (do it yourself) Project For details or more info please contact: Sue Barnes, RN, CIC, FAPIC Independent Clinical Consultant sueabarnes@gmail.com Playbook sponsored by

2. EVS Optimization Project – Overview • Step by Step DIY (do it yourself) Project Guidelines • Identify a Project Coordinator • Engage a Sponsor(s) • Engage Master CHEST trainer or TCHEST certified EVS Professional • Confirm local executive champion • Prepare for project • Create a Dropbox location or other online repository for project materials • Recruit work group members • Schedule weekly meetings with work group members • Complete a self assessment/baseline for EVS in project department (template provided) • Develop a project plan (template provided) Playbook Contents

3. Step by Step DIY (do it yourself) Project Guidelines continued • Hold weekly meetings (template agenda provided) • Project Components – select one or all – templates attached • Plan Kickoff Event • Policy review compared to AHE standards with gap analysis • Identify super trainers and shadow training schedule • EVS recognition program • EVS report to Infection Control Committee • Daily cleaning checklist • Standard cleaning cart stock list • Cleaning accountability guide CHEST certification review and course • Project evaluation, product evaluation(s), exit conference, plan for sustaining gains Playbook Contents continued

4. Overview

5. Project conceived by San Francisco APIC chapter board of directors in 2016. Project Purpose: To support reliable design (standardization of evidence based practices) for environmental cleaning and disinfection in healthcare facilities to reduce the risk of HAI (healthcare associated infection). Rationale: Many challenges face EVS departments including frequent staff turnover and staffing shortages, English as a second language, Environment plays a proven role in healthcare associated infection (HAI) transmission with associated cost and patient suffering Environment plays a proven role in patient satisfaction scores. Methods: SF APIC Chapter set out to design and test an easy to follow plan for improvement of outcomes for the EVS department in any hospital. This playbook is a vehicle to support replication of the project by APIC chapters and/or individual hospitals or hospital systems. Outcomes: To be measured by methods such as staff survey, HCAHPS, fluorescent marker, ATP, visual assessment. Estimated Project Timeline: 90 days SF APIC Chapter EVS Project Overview

6. Project Sponsor Manufacturer of disposable microfiber mops and cloths https://www.contecclean.com/products • Funded Project Manager 8 hours/month, • Provided disposable microfiber mops and cloths to one department in one project hospital for 90 days, • Provided training on microfiber products, and guidance throughout the project.

7. 10 Step 90 DayDIY (do it yourself) Project Guidelines

8. Step 1: Identify a Project Coordinator • One individual could do it – or two could partner to share the job • Must be organized with good people skills • Examples: EVS manager, nurse manager or director, IP professional, project manager

9. Step 2: Engage a Sponsor(s) • The sponsor can provide a number of resources to support and improve the project including providing products designed to improve environmental cleaning for a trial during the project (e.g. disposable microfiber) • The sponsor may also be willing to pay the fee for an EVS member to attend a TCHEST course which would enable her/him to return and teach all EVS staff. • The following companies are interested in serving in this role: • Clorox: Josh Wolf josh.wolf@Clorox.com • Contec: Kevin Venezia kvenezia@contec.com • Cintas: Aaron Jett jetta@cintas.com

10. Step 3: Engage a Master CHEST trainer or TCHEST certified EVS Professional • A certified EVS professional is critical for advising regarding training content and guidance which are key components of this project; and for providing content review for the CHEST course, as well as information regarding where the next TCHEST course will be provided. • An EVS department manager or staff member should be sent to the next available TCHEST training course, to enable her/him to return and transfer the teaching to all EVS department staff members. • If you do not have a certified EVS professional on your team, please contact Aaron Jett for recommendation(s): jetta@cintas.com

11. Step 4:Confirm Local Executive Champion • The local executive champion can influence, motivate and use her/his power to overcome any barriers encountered in the project. • Examples include members of the C-suite such as CEO, COO, or another executive such as the Director of Facilities Services, etc.

12. Step 5: Prepare for Project • Create a free online location such as Dropbox to post project materials so that they are easily available to project member (https://www.dropbox.com) • Develop project charter – template here (double click icon to open): • Post resources from AHE, APIC, others in online location for easy access by project members – examples here: Resources • Recruit project members – consider including not only EVS professionals, but representatives from Nursing and Infection Prevention departments, as well as one or representatives from the sponsor(s). • Schedule weekly meetings with work group members. Template meeting agenda here: (double click icon to open)

13. Step 6: Self Assessment by EVS Manager • Self assessment questions here • (double click on icon to open) • Consider loading questions into online survey tool such as Survey Monkey (free) https://www.surveymonkey.com/

14. Step 7: Develop a project plan and timeline Project plan template provided here (double click on ion to open)

15. Step 8: Schedule and Hold Weekly Meetings Template meeting agenda (double click on ion to open): Topics to cover during weekly meetings: • Policy review compared to AHE standards with gap analysis • Identify super trainers and shadow training schedule • EVS recognition program • EVS report to Infection Control Committee • Daily cleaning checklist • Standard cleaning cart stock list • Cleaning accountability guide • CHEST certification review and course

16. Step 9: Project Components (Implementation Details Follow for Each Component) Plan Kickoff Event Plan Product Trial(s) EVS Policy Review, Gap Analysis and Plan Identify and Prepare Super Trainers Shadow Training Program by Super Trainers Develop/Enhance EVS Recognition Program Develop/Enhance EVS Cleaning Assessment Program Develop EVS Report to ICC Develop Daily Cleaning Checklist Develop Standard EVS Cleaning Cart Stock List Develop Cleaning Accountability Guide CHEST Course content review and plan for staff TCHEST training and certification Provide Project Updates

17. Project Component A: Plan Kickoff Event Template Kickoff Event Agenda (double click icon to open): Tasks involved in planning a successful Kick Off Event: • Confirm speakers • Provide speakers with template slides to customize, available here: template slides • Find venue/room • Coordinate projector and lap top for presentations • Send invitations • Lunch order (by sponsor if you have one) • Plan for department visit after Kick Off meeting

18. Example: Contec Disposable Microfiber Trial Project Component B: Plan Product Trial(s) • Estimate volume of product needed for 90 day trial: • Zone 8 – 10 rooms (4 mops per room / 3 for room, 1 per bathroom) = 40 per day • Zone 6 – 9 rooms (4 mops per room / 3 for room, 1 per bathroom) = 36 per day • Hallways – provided extra cases for these areas. • 76 mops required per day x 90 days = 6840 mops needed. • 34 cases or 8160 total mops sent • 3- Quick Turns Mops • 3- Metal Frames • Case of converters • Case of backer plate  • Use Quick Turn Mop for hallways /larger areas - holds 32 ounces of solution making it more convenient, easier, and faster. • Use blue absorbent pads for the Close Quarter Tool used with the doodle-bug holder to clean the elevators. • Make sure to put the TRIAL PRODUCTS in an area where you can control the release of the mops daily to the EVS staff in the project department.

19. Project Component C: EVS Policy Review and Gap Analysis/Plan • CHEST certified member of project team or other EVS expert to compare EVS policies to AHE/CHEST standards and identify any gaps/opportunity areas. AHE standards here: http://www.ahe.org/Education/publications_home.shtml • Limit policy review to only those related to Shadow Program see Shadow Program Checklist here (double click on icon to open) • Prepare a plan for editing policies if needed, and for communicating revisions/new policies to EVS staff.

20. Project Component D: Identify and Prepare Super-Trainers for Shadow Program AHE TCHEST certified EVS staff member or other EVS expert to review Shadow Training checklist (next slide) with Super Trainers to prepare them for training the other EVS staff in the project department.

21. Double click on icon to open shadow training checklist Project Component E: Shadow Training Program Once briefed by a CHEST certified or otherwise expert EVS team member, Super Trainers will begin shadow training program by completing a checklist with each EVS professional in the designated project department.

22. EVS Manager to recognize staff member of the Quarter with: Double click on icon to open documents: Certificate of Appreciation presented during staff meeting, Poster EVS Professional of the Month posted widely, Email message to individual, HR and Administration. Project Component F: Enhance/Develop EVS Staff Recognition Program

23. Project Component G: Enhance/Develop Cleaning Quality Assessment Program Assessing the quality of cleaning is an important component of any effective EVS Program. Tools commonly used include: • ATP checks – How to guide here: • Fluorescent marker checks How to guide here: • HCAHPS scores – more info here: http://www.mghpcs.org/eed_portal/Documents/PatExp/What_is_HCAHPS.pdf

24. Project Component H: Develop Infection Control Committee report for EVS Double click on icon to open document

25. Project Component I: Develop Daily EVS Cleaning Checklist Double click on icon to open document

26. Project Component J: Develop Standard Cleaning Cart Stock List Double click on icon to open document

27. Project Component K: Develop Cleaning Accountability Guide Double click on icon to open two different templates

28. Project Component L: CHEST Course Content Review by TCHEST Certified EVS A certified EVS professional (TCHEST) can provide an interactive engaging review of the entire 3 day CHEST course content to your EVS staff.

29. Project Component L continued: Plan for TCHEST training and certification of at least one EVS staff member Investing in sending one EVS professional from your department to a TCHEST course, will enable that person to return and provide the training to your entire EVS department.

30. Project Component M: Provide Project Updates Provide project status reports on a regular basis (e.g. monthly) to the executive champion and any committees and groups as indicated including Infection Control Committee. Template status report here (double click on icon to open):

31. An assessment of agreed upon metrics should be used to evaluate the success of the EVS Optimization project such as: • HCAHPS score EVS [Hospital Consumer Assessment of Healthcare Providers and Systems] • Fluorescent marker scores • Turn time occupied patient rooms • EVS, IP, Nursing evaluation survey • Evaluation questions template • here (double click icon to open): Step 10: Project Evaluation – Survey and Metrics

32. Any product tested during the project should be evaluated using an evaluation tool often available from the company. • A determination of whether or not to continue using the product after the project should be made and communicated. Step 10 continued: Product Evaluation

33. Step 10 continued: Exit Conference Post project lunch or virtual meeting should be planned after project completion in order to: • Review progress, and remaining opportunities for improvement, and results of post project survey • Create a plan for sustaining gains Template exit conference agenda: (double click on icon to open)

34. If the project was successful, consideration should be given to widely sharing it throughout IP and EVS communities via multiple platforms: APIC chapters, articles, webinars, and presentations. Sharing and Spreading the Project

35. When you Admit a Mechanic to a Hospital