We ARE Environmental Services

By Patti Costello, Executive Director of the Association for the Health Care Environment

September 29, 2016 | Formats: Article | Content Areas: Administration | Tags: Career Development, Communication, Employee Engagement, Employee life cycle , Environmental hygiene and sanitation, Leadership, Management, Succession Planning


Last year at the EXCHANGE conference, I challenged attendees, AHE members, sponsors and vendors to make a change in the naming convention for healthcare cleaning. AHE believes this change will have a profound impact on the profession. I asked everyone in the room to commit to or continue the commitment to referring to their department as environmental services; and to identify the personnel caring for the healthcare environment as environmental services technicians rather than housekeepers, janitors and custodians.

Since that time, we have launched a pledge campaign on ahe.org providing the professionals an opportunity to formally
pledge their commitment to environmental services versus other titles. We have been asked why more than once. We have heard comments such as, “It’s been this way for years and changing it will just be too hard to do.” The current naming convention using titles such as housekeeping, janitor or custodian are non-descriptive titles when referring to the staff and management teams responsible for maintaining the clinical environment of care. The knowledge base and competencies needed to perform the healthcare duties of any environmental services team member regardless of their being front-line or management are far more complex than those needed in the commercial cleaning and general maintenance industry. For example:

  • Janitors are cleaning professionals who maintain commercial building properties and business offices.
  • Custodians typically maintain educational facilities such as schools, colleges and universities or churches.
  • Housekeepers are domestic workers or employees cleaning in the hospitality arena such as in hotels and resorts.

These are noble professions with their own unique concerns, challenges and significant contributions; but healthcare environmental services professionals care for a highly complex, regulated environment where sick people want and need a care environment conducive to recovery and wellness. That very environment plays a key role in customer/patient satisfaction and quality outcomes throughout a patients’ continuum of care. Simply put, healthcare environmental services contributes to saving lives every day. This is a critical distinction because the requisite knowledge needed to provide a safe, clean clinical environment extends from the emergency room to the surgical suite and everything in between. Leadership and front-line technicians in healthcare environmental services requires knowledge of infection prevention, basic microbiology, evidence-based cleaning and disinfection practice, handling multiple waste streams, floor care, linen handling and distribution, and consistency in performance. Possessing the knowledge and understanding of how and why the environment plays a role in disease transmission can and will impact the overall patient experience. Think about it for just a moment. What are the chances that a custodian, janitor or housekeeper needs to know about clostridium difficile spores or about proper handling of Category A waste?

Don’t get me wrong; our colleagues in the commercial cleaning industry have unique challenges of their own. We are not diminishing the importance of the professionals in that space. What we are saying is, healthcare is vastly different. It’s much more complex, with a lot of movement and interconnectedness where a great deal of coordination is required. The potential for disease transmission must be eliminated, and it requires a much wider knowledge base acquired through ongoing training, education, certification and continuing education. Hundreds of research studies have been conducted over the last eight to ten years just on healthcare cleaning and surface disinfection. The evidence supports the notion that improved cleaning leads to improved patient outcomes and lower infection rates. That level of responsibility and getting to the desired outcomes is more complicated. Healthcare environmental services is part of a care team that needs us to be on top of our
game all day, every day.

We know a large majority of healthcare organizations have already moved from housekeeping to environmental services.
Military contracting is changing from housekeeping to environmental services. Surveyors are being trained to identify technicians as technicians and not housekeepers. There are other organizations in the process of educating their clinical staff as well as patients and families of the impending change and explaining why the change is being made. Then there are others that have pushed back, saying that the length of stay is so short that re-educating the patients and staff doesn’t make sense. We respectfully disagree. As awful as it may sound, just by virtue of perception, the words housekeeper, janitor, custodian are not job descriptors widely associated with needing a wide body of knowledge, technical skills or core competencies.

I ask that you humor me for just a moment. As a young person thinking about your future and investigating a preferred profession, did you say to yourself, “Gee, I want to go to college to be a housekeeping manager in a hospital or resident care facility?” I don’t think so. Most of you backed into the job through internships, summer jobs or transferring from other departments. Others made the transition from hotel management and soon found themselves on the internet looking for help because the roles are vastly different. We know it’s true, because those new to healthcare call AHE all the time asking for help, and we are most happy to oblige.

The healthcare environmental services profession will be recognized as a true profession and not just a calling to serve or because you love working with people. College courses and degreed coursework will be available to students looking for a choice between hospitality and healthcare. So, yes, AHE is building the future of the profession. But we are talking about the present. We are talking about changing perceptions of internal and external customers. We are talking about changing the way even the patients view our work. Yes, perception is reality. Yes, change is hard and requires reeducation. But the game changer in communication is explaining WHY you are making the change.

Why? Because the environment the patient care is being provided in is so vital to their well-being that it’s important enough for us to view it as more than housekeeping. We care enough to care about what others think we are doing versus what we ARE doing. We interact with caregivers, clinicians, and family members. We often spend more time in a patient room than anyone else. The work we do can save lives. The work we do has impact.

So today, we’d like to ask you to help AHE keep moving forward in taking vital steps in shaping professional practice. We ask you to help AHE transform how the broader healthcare teams recognize environmental services professionals and their teams… but more importantly how environmental services view themselves. We are asking YOU to be thought leaders and change agents in moving the profession forward. We are asking you to advocate and represent our profession with passion. Join AHE in an ongoing effort to encourage healthcare environmental services professionals to “take the pledge” to redefine the role of the profession.

Take Action Today!

  • Define the contribution of environmental services teams to the overall quality of care and outcomes.
  • Eliminate the use of titles such as housekeeper, janitor, and custodian in the hopes of better defining the areas of expertise.
  • Become the best advocate for the profession when seated at the table in organizational policy changes or other critical discussions about patient satisfaction, infection prevention and positive outcomes.
  • Advocate for continued education and professional development support to align the job with the requisite competencies needed. You can arm yourself by visiting http://www.ahe.org/ahe/CHEST
  • If being a key member of the care team is important to you, and it should be, we encourage you to take the pledge today! http://www.ahe.org/ahe/lead/We_ARE/WeARE.shtml.

Thank you for the work you do, for inspiring me and for keeping my fire burning for environmental services!