Achieving cleanliness in hospitals
October 1st 2004

Monitoring cleaning within hospitals is essential if there is to be improvements.

Geoff Jones FCMI, FCMC, MBICSc, managing director, Business Performance explains how software can aid this...

In any hospital, the continuous monitoring of cleanliness is not an option – it is a vital element in operational control.As Florence Nightingale famously said ‘the first duty of a hospital is not to make the patient worse’.Nobody at senior levels doubts this of course, and many words of good management speak are devoted to extolling the high targets expected of the cleaning service. Quite right too – the path to maintaining quality at the highest level must start at the top.The problem is that, in most cases, not enough effort is made at this level to ensure that quality standards stay at their maximum.

Quality objectives cannot be left as a set of nebulous ideals; they must be translated into a series of specific targets in all departments. Also, all staff in each department must be as aware of these standards as their manager – and they must be motivated to identify and correct any lapses. In an ideal world, this would be all that is necessary to achieve continuous improvement.However, in the less perfect world we all live in, quality monitoring is the essential means by which we get a regular and accurate measure of the real standards found in all areas at all times.

The first step in creating an objective quality assessment format is to define – in each department – the key items and their relative importance. For example, when developing a checking system for guest rooms in a large hotel chain, the managers agreed that 5 items in a guest room that will always get a complaint if they are sub-standard are the bed, television, toilet, shower and supplies.These were therefore given a higher rating than say, the high dusting which, if unsatisfactory,would not normally ever be complained about. In a hospital, the same principle applies.

The checklists can be created as printed sheets, which can be used by all levels of manager for a series of random checks throughout the week.

The results collated and reviewed at regular management meetings.

The vital component in ensuring the checks continue permanently is that the senior manager must receive the report each week – and preferably chair the quality meeting to review it. If he or she isn’t bothered, the system will soon drop out.

An easier, faster and more accurate method to maintain the system in place is to use a quality monitoring software programme such as CheckMate.

This uses a desktop PC to hold the main details of the different departments, public areas, rooms and so on and the inspection details for each. Each week a random selection can be downloaded into a handheld computer that is easily and unobtrusively used out in the areas to assess the quality.The data transfers back in seconds and the reports are immediately available.

Whichever way inspections are done, the important thing is to find the truth, report the truth, and act on the information to improve the whole operation.What we are talking about here is an operational management system, run on a routine, daily basis.

This should not be confused with the PEAT inspections where mixed groups of management, patient representatives, cleaning and non cleaning professionals carry out irregular hospital inspections.Valuable though these are as a back-up, they cannot take the place of a professional operational management system as the primary measure of performance.

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