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August 2014 Lets Talk Shop

EVS Departments Address HAI Prevention

New healthcare legislation provides both challenges and opportunities.

July 31, 2014
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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, metropolitan hospital.

When the hospital’s operations director informed him that the hospital’s HAI numbers were too high, he also made it clear that he expected Tom to do something about it.

Understanding The Impact

In April 2014, federal officials released a preliminary analysis of potentially affected hospitals.

That list identified some 761 hospitals nationwide 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 October 2014, hospitals not in compliance with reporting requirements would lose 1 percent of every Medicare payment for a year.

While the above study notes all HAI causes, infection control departments recognize the impact that effective or deficient EVS practices can have on their spread.

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 coordinators and EVS management from select hospitals to create a process for measuring compliance directly related to housekeeping.

This process is then mandated with regular 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 mandating all the specifics of testing.

They are more interested in the methods and the consistency of their application.

For example, some may require ATP testing (swab testing for bacteria), though the specific brand used for the testing is up to the individual hospital.

Or they may require fluorescent gel testing 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 a monthly basis and report the findings to a centralized management team at the state level.

Meeting The Challenge

So what should our friend Tom be doing? 

  • First, he should ensure that his department’s cleaning processes are actually disinfecting surfaces effectively. This means using chemicals that are effective cleaners and bacteria killers.
  • Staff should be trained to use chemicals 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 maintenance of high touch point surfaces.

That will serve as proof that EVS is doing everything it can to minimize HAIs and mitigate the risk to his hospital.

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