UM Emergency Department Deep-Cleaning Final Report Improving Communication, Coordination, and Deep-Clean Tracking Between Departments

IOE 481 Project Team 4 Jessica Cernak Michael Shay Emily Snitchler David Walborn

Background Infection Control and Epidemiology (ICE) is leading an initiative to deep clean 100% of Emergency Department rooms every 24 hours ~40-50% of rooms deep-cleaned currently UMHS currently uses two systems MiChart tracks patients TeleTracking tracks room cleans

Goals & Objectives Goal Provide a solution to allow Environmental Services to deep-clean Emergency Department rooms every 24 hours Objectives Improve communication between the ED and EVS Develop tracking method to monitor deep-cleans in real-time

Methodologies Observations and Interviews Literature Search 40 hours of observations 15 interviews Literature Search 3 articles Survey Data 17 housekeepers 47 nurses Data Analysis Hospital Occupancy Data TeleTracking Data

Conclusions Variation in Deep-Clean Understanding Variation in Reporting and Cleaning Practices Discontinuous Communication Flow Missed Opportunities for Deep-Cleaning Minimal Cross-Team Collaboration

Variation in Deep-Clean Understanding 1 High Dust 2 Damp Wipe 3 Clean Sink 4 Remove Trash & Linens 5 Restock Supplies 6 Dust Mop 7 Wet Mop 8 Walls & Ceilings EVS Training EVS Housekeepers ED Staff

Variation in Reporting and Cleaning Practices Sample Size n = 7631 room cleans; Date Range: 6/1/16 – 11/17/16

Variation in Reporting and Cleaning Practices Failing to Logout Batching Sample Size n = 7631 room cleans; Date Range: 6/1/16 – 11/17/16

Variation in Reporting and Cleaning Practices Variation in Cleaning Procedures A past IOE 481 project support this Sample Size n = 7631 room cleans; Date Range: 6/1/16 – 11/17/16

Discontinuous Communication Flow A past Ioe 481 report supports this

Missed Opportunities for Deep-Cleans Cleaning Opportunities ADD SAMPLE SIZE AND DATES OF COLLECTION, mention why this is important and where the data is coming from Sample Size n = 17971 patient visits; Date Range: 7/1/16 – 9/30/16

Minimal Collaboration Observations Housekeepers primarily operate independently Housekeepers are geographically divided Surveys 21% of commenting nurses advocated for increased teamwork 55% of commenting housekeepers advocated for increased teamwork Literature Search Nursing Management Article cites lack of collaboration between nurses and housekeepers as main source of process disruption Nursing Management Article supports this

Recommendations Nursing Management Article supports this Retrain EVS Housekeepers and include ED Nurse Techs. Identify EVS Housekeeper Leadership. Re-examine staffing levels at a later date. Implement Tracking and Communication Methods. Nursing Management Article supports this

Recommendations: Impact: Retrain EVS Housekeepers and include ED Nurse Techs. Identify EVS Housekeeper Leadership. Re-examine staffing levels at a later date. Implement Tracking and Communication Methods. Variation in Deep-Clean Understanding Variation in Reporting and Cleaning Practices Discontinuous Communication Flow Missed Opportunities for Deep-Cleaning Minimal Collaboration

Communication Methods Walkie Talkies Cost-Effective No Lag Time Promote Collaboration Two-Way Communication No Written Record High Noise Paging System Written Record Pre-Existing Housekeepers Rated 6.5/10 for Efficiency Lag Time One-Way Communication

Tracking Methods Ipods Written Record Two-Way Communication TeleTracking and Epic - Friendly Tracking & Communication Tool High Risk of Theft Resource Intensive Misuse by Workers Paper Cost-Effective Drive Improvement Accessible to Both Departments Data Entry

Expected Impact Initiate Culture Change Fosters open forums for communication Develop a Performance Baseline Tracking method will give EVS more reflective data regarding deep-cleans Permits focus on improvement and troubleshooting Pave the Way for Future Improvement Allows future projects to have more concrete data to work from Establishes foundation for projects to build off of

Questions?