Maintaining the Built Environment

1. Maintaining the Built Environment Real World Issues, Needs and Challenges for Facilities Management in Healthcare J. Darrel Hicks, BA, R.E.H., C.H.E.S.P. Director of Environmental Services, St. Luke’s Hospital, Chesterfield, Missouri

2. Objectives of Session • To provide each participant with practical tools and ideas. • To share best practices • To improve understanding of the role of the EVS Department • Connect the Dots

3. Focusing on Principles: Environmental Services • Bottom Line Results • Commitment to Excellence • Patient Satisfaction • Employee Satisfaction • Physician Satisfaction • Recognize and Reward Success • Connecting the Dots

4. Bottom Line Results of Operational Excellence in Facilities Management • Good Housekeeping-Clean is Not Enough • Infection Prevention and Control • Financial Return on Investment (ROI) • Good Stewards of the Environment-Waste Management

5. Housekeeping- Why Clean is NOT Enough • Company’s Coming! • From the Basement to a Business Partner • Stop the Stinkin’ Thinkin’ • Cleaning for Health, Not Just Appearance • Infection Prevention and Control • Green Cleaning • Edge on Competition

6. Infection Prevention and Control • “The Channel 5 News Crew is here!” http://www.ksdk.com/news/cover_story/cover_article.aspx?storyid=111962 • http://www.ksdk.com/video/player.aspx?aid=45049&bw= • Public Reporting-Who Wants to Know Your Hospital’s Rate of HCAI? • http://www.consumersunion.org/pub/core_health_care/004118.html • http://www.dhss.mo.gov/HAI/index.html

7. Baby Boomers Like Sir Michael Edward “Mick” Jagger, born July 26, 1943, soon to be eligible for Medicare. Savvy consumers will know how your hospital ranks in several categories. Give them the BEST experience possible.

8. Holding the Line on Contamination • The Role of the Physical Environment in the Hospital of the 21st Century • Environmental surface cleaning-it’s everybody's job • SARS • NOROVIRUS • MRSA, VRE, C-diff • Avian Flu • Emerging Diseases-the Coming Pandemic

9. Financial Return on Investment (ROI) • Life-cycle Cost-Preserving Capital $-ieha.org • Reduced Claims • Reduced legal expenses • Reduced absenteeism • Reduced turnover • Improved clinical outcomes-decreased HAI’s • Reduced length of stay

10. Good Stewards of the Environment-Waste Management • In order to be a good steward of the environment (earth, air, water), you need to manage the various waste streams in a hospital. • “First, do no harm.”-H2E (Hospitals for Healthy Environment) www.h2e-online-org • OSHA e-tool Website http://www.osha.gov/SLTC/etools/hospital/mainpage.html

11. Stewardship of the Environment • List of wastes generated by hospitals: • Food and cooking grease • Pharmaceutical • Hazardous chemicals (LQG v. SQG) • Sewer (Chemicals, heavy metals, blood, OPIM) • Air-ETO, Lab, Pharmacy • Underground fuel storage tanks • Biological and medical waste • Sharps • Recycling-Cardboard, office paper, xylene, alcohol, etc. • Electronic waste • Fines $$$-EPA, DOT, OSHA, State Regulatory Agencies • Legal/Financial/Public opinion (remember Channel 5 News Crew?) • Green Guide for Health Care http://www.gghc.org, ieha.org • LEED Certification http://www.usgbc.org/DisplayPage.aspx?CategoryID=19

12. Commitment to Excellence-There are Three Books You Must Have • “Good to Great”, Jim Collins • Good to Great and the Social Sectors, a Monograph to Accompany Good to Great, Jim Collins • “If Disney Ran Your Hospital-9 ½ Things You Would Do Differently”, Fred Lee • “Hardwiring Excellence”, Quint Studer

13. Patient Satisfaction • 3-Legged Stool-Food, Nursing Service, CLEAN! • “If we don’t do something special for our guests, they won’t remember us. It they don’t remember us, why would they come back to our hospital?”-Fred Lee • “If Disney ran your hospital, you would make courtesy more important than efficiency. By making courtesy more important than efficiency, you would be putting corporate values in line with what patients have indicated as the key drivers of their satisfaction and loyalty.” –Fred Lee

14. Employee Satisfaction “Employees need to believe that their organization has the right purpose. They want to know that their job is worthwhile. They want to make a difference. The best ways to help staff understand the importance of their actions and behaviors are to always connect back to purpose, communicate at all levels, and recognize behaviors you want to be repeated,”-Quint Studer

15. Physician Satisfaction “Satisfied physicians are as important to a great hospital as satisfied employees and satisfied patients. Leaders play a critical role in ensuring the five main physician satisfiers are hardwired: • Quality • Efficiency • Input • Appreciation • Telling the truth Quint Studer, “Hardwiring Excellence”

16. Recognize and Reward Success • The power of employee Thank You notes • It doesn’t have to be “above and beyond” behavior, just consistent. • Rewarded behavior gets repeated, which further reinforces consistency. • Physicians need reward and recognition, too

17. Connecting the Dots • What does that term mean to you? • Let me do it for you… • Purpose of the Environmental Services Department • The worthwhile work of the EVS Department • Making a difference in healthcare • Bottom-line results • Questions and Answers

18. Bibliography • Caution-Clean is not Enough!; Steven Rowell; Abundance Publishing, 2004; pgs. 27, 148, 149 • Ibid; pgs. 148, 149 • Protecting the Built Environment-Cleaning for Health; Michael A. Berry; Tricomm 21st Press; 1993; pgs. 23-25 • If Disney Ran Your Hospital-9 ½ Things You Would Do Differently; Fred Lee; Second River Healthcare Press; 2004; pgs. 10, 11, 24 • Ibid; pgs 29, 34, 35 51 • The Role of the Physical Environment in the Hospital of the 21st Century: A Once-in-a-Lifetime Opportunity; Roger Ulrich, Xiaobo Quan, Craig Zimring, Anjali Joseph, Ruchi Choudhary; 2004, pages 4 ff • Good to Great; Jim Collins, Harper Business; 2001; pgs. 90, 91, 95, 96 • Good to Great and the Social Sectors; A Monograph to Accompany Good to Great; Jim Collins; 2005, pgs. 3, 11, 15, 1719, 27 • Hardwiring Excellence; Quint Studer; Fire Starter Publishing, 2003; pgs. 19, 81, 94, 104, 122, 123, 144, 224-225, 240-244, 247-252