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Real ES Staffing Standards – Hospital House Keeping

Environmental services staffAdequately staffing a Healthcare Environmental Services department is one of the most unique challenges for any EVS operation.  While regulatory agencies provide some guidance to match Nurse staffing levels with patient acuity needs, EVS Departments lack regulatory guidance for staffing level needs for the vital services they provide.

There are benchmarking organizations that can provide productivity standards based upon their internal data gathering; however, the challenge lies with management in determining which “compare” group is appropriate, or what “normalization” efforts they need to perform, to ensure a comparison of apples to apples.

  • At best this could, with enough engagement from the department manager, provide a high level analysis of staffing levels recommended. Unfortunately, there would be no specifics in regards to labor standards within patient centered cleaning, floor care, square footage associated activity.
  • At worst the EVS manager will not perform the required normalization activity accurately, causing the high level recommended staffing model to be truly inaccurate in providing an environment acceptable for patient care.

Outsource organizations have staffing standards that provide detailed expectations of the facility they are working for or hope to be working for.  From this standpoint, it seems reasonable that this staffing analysis would be appropriate for most facilities.  However, many organizations have a predisposition towards profitability and a need to be less costly than competitors or self-operated EVS departments.   The nature of the outsourced business is to drive as lean as possible.  Their goal can often lead to staffing standards that are not focused on what the hospital and infection prevention professionals would recommend for quality and safe outcomes

International Housekeeping organizations also have identified staffing standards for their members, but these are not necessarily specific to healthcare and include other types of facility cleaning such as offices, hotels, etc…

In 2015, AHE established a Task Force to look at EVS staffing standards and methodologies used to create productivity which allows for both efficiency and effectiveness, with Patient Safety as a guiding core principal.  One of AHE’s most frequent inquiries from members is  how to staff their individual departments correctly and what measurements for productivity should be used.  The task force spent significant time understanding the substantial size and scope of the question at hand and the almost limitless variations of possible solutions.

The final determination by the task force is that that staffing Environments Services in Healthcare is not measured by one core metric such as Square Footage but rather, it is a combination of various workload inputs that drives specific staffing needs.

Three core areas necessary to determine EVS staffing requirements are:

  • Patient Volume Activity
  • Square Footage
  • Individual Hospital Lock-in positions due to need.

The combination of these three categories would provide a balanced outcome in regards to staffing needs.

The AHE Staffing Task force created a member survey sheet centered on time studies required to clean various areas of their facility.  Specifically, identifying the size (Square Footage) of the area being cleaned, and the time required to clean that space using identified standard practices.  This data was collected over the course of two years, from across the country, and analyzed to ascertain how time spent cleaning might, or might not, correlate to size of the area.

Through regression analysis, it was identified that cleaning of some areas of a hospital are:

  • Directly correlated with square footage
  • Dot directly related to square footage at all (i.e. Patient volume driven)
  • Linearly Related – meaning measurement requires a modifier and formula constant to correctly identify staffing needs.

All of the analysis, data, and comprehensive review of the surveys returned from AHE members to the Staffing Task Force was then compiled into a publication and is being made available to EVS departments.  Utilizing this tool, , the department can begin to evaluate their own staffing and either validate where they currently stand, or identify what staffing adjustments may need to be made based upon a comparison with the AHE standards provided in the book.

This vision of this work was aimed at providing staffing standards which would allow for both efficient staffing outcomes and quality results as identified by AHE members. It should be used as a tool to help the manager identify staffing requirements unique to each individual facility. It is expected that each departments results will be somewhat varied as each facility is unique.

This is a tool to help you identify how to develop staffing for each individual facility. It is not a one stop quick fix to staffing questions.  Each facility manager should conduct additional research into square footage for their facility to ensure that the category of space is accurate and that time studies are run for the hospital to see they are within reasonable agreement of the standards identified in the publication.

Soriant Solutions Environmental Services Professionals serve within the AHE organization and were instrumental in the development of the staffing work.   These same professionals participated significantly in the analysis, authorship and outcomes of the AHE staffing work.

The book is available will be available for purchase fall of 2017.  You can order the book on the AHE website 

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