Magazine article Health Facilities Management

Children's Medical Center Dallas: Environmental Services Department Improves Patient Care with Infection-Prevention Initiatives

Magazine article Health Facilities Management

Children's Medical Center Dallas: Environmental Services Department Improves Patient Care with Infection-Prevention Initiatives

Article excerpt

In the war on germs, hand hygiene is one of the greatest weapons in any hospital's arsenal. And with a hand-hygiene compliance rate of 91 percent, it's apparent that the environmental services (ES) department at Children's Medical Center Dallas is armed with highly effective tools for preventing health care-associated infections (HAIs). One method, according to ES Director Randall Manno, CHESP, T-CHEST, T-CSCT, is something of a secret weapon.

"Hand hygiene is monitored through our 'secret shopper program,'" says Manno, who supervises 200 employees in the hospital's ES department. "We have dedicated personnel who watch hospital staff going in and out of certain rooms, monitoring the hand-washing process."

ES staff are trained in the AIDET [Acknowledge, Introduce, Duration, Explanation, Thanks] protocol, in which they enter patient rooms, tell them they are disinfecting their hands and repeat the process before leaving the room--again in front of the patients. While not every room cleaning in the 490-bed hospital can be monitored, Manno's team conducts nine audits a month and then crunches the numbers to determine the hand-hygiene rate. Results are discussed at departmental meetings without identifying employees. And hand hygiene is a goal tied to every staff member's performance evaluation, including Manno's.

"Our hand-hygiene program is successful because it requires the same level of participation from our technicians as any of our clinical providers and, in some cases, more," Manno says.

The protocol not only reinforces the routine for team members, but also is a big factor in bolstering patient satisfaction and HCAHPS scores, both of which are on the upswing. Currently, patient satisfaction is at 68 percent--an 8 percent increase since 2015. HCAHPS scores increased from an average of 69.6 in 2015 to a year-to-date average of 72.8 in 2018. The national average is 72.2; the Texas state average is 72.3.

Such results helped Children's Medical Center Dallas to earn the Association for the Health Care Environment's (AHE's) 2018 ES Department of the Year Award in the 250-499 bed category. This award recognizes outstanding ES performance in a number of critical performance categories.

People power

Manno says the success of the ES department hinges on its team, the daily focus on the hospital's core mission and the hospital's commitment to its employees. Manno, who has worked in health care for more than 20 years, joined Children's Medical Center Dallas three years ago and began implementing the philosophy that has brought him success over the years.

"We hold staff accountable, but we treat them with respect, and we make sure they have what they need to succeed at their jobs. They are not just a number," Manno says.

In 2017, ES team members received an across-the-board pay increase to $14.70 an hour. While Manno considers the pay rate a major accomplishment, he says that money is just part of the equation. Continuing education, training for all team members--including supervisors--daily communication, having the tools and technology necessary to succeed and treating staff with respect are all factors that lead to happier employees.

And having happier staff leads to better retention rates. Doug Rothermel, a consultant with Rothermel Consulting Services LLC in Florida and who served as one of the judges in the AHE contest, was impressed with the turnover rate in the ES department at Children's Medical Center Dallas, which continues to improve every year.

"The turnover rate in the ES department improved from 38.4 percent in 2015 to 25.8 percent in 2016 to 18. …

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