According to the CDC, about 1 in 25 hospital patients has at least one healthcare acquired infection (HAI) on any given day . However, studies suggest that when infection prevention (IP) and environmental services professionals work collaboratively, rates of infection transmission, process redundancies and costs are reduced and facility outcomes and patient satisfaction are improved . Thus, there is a large opportunity for healthcare facilities to drive positive change through regular collaboration between infection prevention, environmental services, and other key pathogens. . 

What’s holding back collaboration? 

It’s only natural that the joining of forces between two groups would present a few challenges. To bridge the gap, infection preventionist and environmental services must first remember that at the end of the day, they share the same mission: to maintain a clean and safe environment to prevent HAIs. Acknowledging that both groups have equal responsibility to turn that mission into a reality is vital for collaboration. According to a poll conducted in 2008 by The American Society for Healthcare Environmental Services (ASHES), which is now known at the Association for the Healthcare Environment (AHE), a personal membership group of the American Hospital Association, only 38.5 percent of infection prevention professionals view the environmental services role with high value. Similarly, the poll reveals that only 52.6 percent of environmental services professionals view the infection prevention role with high value . When both departments recognize the importance of one another, a strong relationship can form, which ultimately leads to positive change for the healthcare facility. 

A strong working relationship between infection prevention and environmental services largely impacts a healthcare facility’s ability to implement and maintain proper training and education. According to the Clean Spaces, Healthy Patients survey conducted by The Association for Professionals in Infection Control and Epidemiology (APIC) and the Association for the Healthcare Environment (AHE) in 2011, 51 percent of infection prevention and environmental services professionals find it difficult to locate useful resources about proper cleaning and disinfection . 

Additionally, high room turnover demands make it challenging to build a strong collaborative relationship between infection prevention and environmental services. Due to the critical nature of collaboration to reduce Healthcare Associated Infections, patient safety must take priority over facility pressures to rapidly clean patient care areas and rooms. For best practices related to environmental cleaning, environmental services technicians and infection preventionists should adhere to the evidence based practices in the Centers for Disease Control and Prevention (CDC) Guidelines for Disinfection and Sterilization in Health Care Settings and the Association for the Healthcare Environment (AHE) Practice Guidance for Environmental Cleaning. 

Achieving a collaborative solution

Healthcare facilities that have a strong working relationship between infection prevention and environmental services professionals will see sustainable and transferable results that drive sustainable positive change and improve clinical outcomes. Healthcare facilities can achieve a collaborative solution by bringing to life a shared mission, creating two-way communication and developing accessible and up-to-date educational resources and training programs. The demand for consumer transparency is greater today than ever, and public reporting requirements that impact both environmental services professionals and infection preventionists. Patient satisfaction is also partially measured by the Centers for Medicare and Medicaid Services (CMS) with questions specific to the cleanliness of the healthcare environment during the patient’s inpatient stay. 

Before infection prevention and environmental services can effectively work together, they must recognize a shared mission. Facility leadership must empower environmental services and make sure there is an open dialogue between the two groups. A successful tactic utilized by facilities that have achieved collaboration is to have infection prevention professionals regularly attend environmental services departmental meetings and vice versa. This provides regular interaction as well as a forum for environmental services professionals to speak up about particular issues, pain-points and successes they are seeing in the field each and every day. Additionally, it gives infection prevention an opportunity to express their appreciation towards environmental services and for the team to see firsthand how their work contributes to the shared mission of maintaining a clean and safe environment to prevent HAIs.  

To further ensure effective communication between infection prevention and environmental services, infection prevention must develop thorough educational resources and training programs with the help of environmental services. Environmental services leadership must be consulted in this process to ensure that what is being created works for everyone involved, and most importantly, provides the necessary tools for both infection prevention and environmental services to perform at their highest level.  Once educational resources and training programs have been developed, the next step is for infection prevention and environmental services to work together to constantly keep resources and programs updated. That way, facilities can take control of and mitigate issues that typically result from turnover of environmental services staff. With up-to-date resources at the ready, staff will feel empowered and prepared to do their job at the best of their ability. 

The use of evidence-based methodologies, such as the Agency for Healthcare Research and Quality TeamSTEPPS program, can assist both infection preventionists and environmental services professionals with enhancing cross-functional collaboration, and also breaking down communication barriers that prevent accomplishing zero Healthcare Associated Infections. TeamSTEPPS provides higher quality, safer patient care by: 1) producing highly effective teams that optimize the use of information, people, and resources to achieve the best clinical outcomes for the patients, 2) increasing team awareness and clarifying team roles and responsibilities, 3) resolving conflicts and improving information sharing, and 4) eliminating key barriers to quality and safety. 

The responsibilities of infection prevention are those of every single healthcare provider, even if they do not provide true clinical care. The environmental services technician is responsible for the cleanliness of the clinical care environment. Through acknowledging a shared mission between infection prevention and environmental services, creating open dialogue between the two groups, and developing up-to-date educational resources and training programs, a strong partnership between infection prevention and environmental services can be established, leading to increased efficiencies around processes, reduced costs, and most importantly, improved and sustainable patient outcomes. 

J. Hudson Garrett Jr., PhD, MSN, MPH, FNP-BC, CSRN, CHESP, PLNC, FACDONA, VA-BC is the vice president of clinical affairs for PDI, Inc. Email: Hudson.garrett@pdihc.com