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When two tribes go to war: EVS to the rescue!

A while back we discussed the two tribes that inhabit the healthcare world—the finders and the fixers. During that discussion, I advised the development of a more robust participation on the part of the finders, so the fixers can focus on the fixing, as opposed to having to go out and find stuff to fix (during safety rounds, etc.) This week I’d like to focus on a very important group in the finder tribe: the environmental services staff (EVS).

Generally speaking, at least in my experience, once they have completed a cleaning task, the EVS folks are charged with performing a visual inspection of the area that has been cleaned. Sort of like reviewing the answers to a test before you turn in the test paper—dotting the “I’s” and crossing the “t’s” as it were. So the thought I had (though it may be as much question as thought…here’s where you folks come into the picture) is to find out whether your EVS folks are checking for what might loosely be termed “maintenance issues” when they go about their cleaning rounds. I guess my overarching thought on this is that when (or maybe if…I’ll let you be the judge of that) a room is ready for occupancy (which I suppose kind of limits this to rooms cleaned after patient discharge), the room should be as “ready” as possible. This includes making sure that the place is not only clean, but the various and sundry component systems are also in good working order: TV works, lights work, toilet flushes, faucet doesn’t leak, ceiling tiles are clean and present, cubicle curtains are all hooked up, etc. It seems to me that it would be a pretty fair customer satisfier not to have to worry about whether stuff works, but that may just be me (I know I would like that…). So, what do you folks think?

Finders and fixers: Can we get them to say something if they see something?

One of things that continuously comes up on my pondering list is how to enlist the eyes, ears, noses, and fingers of frontline staff in the pursuit of the early identification of risks in the physical environment. Unless one of the facilities maintenance folks happens to be in the right place at the right time, in all likelihood, an aberrant condition is going to manifest itself to somebody working out at the point of care/point of service. And my firm belief is that the organizations that manage environmental risks most effectively (including the “risks” associated with unannounced regulatory survey visits) are the organizations that have most effectively harnessed these hundreds, if not thousands, of agents in the field 24/7.

So, my latest take on this is that we can subdivide the totality of every (and, really, any) organization into two main constituencies—finders and fixers. The key is to get the finders mobilized, so the fixers (who, truth be told, in most organizers are currently finder-fixers) can focus on actually repairing/replacing stuff. I’m at a loss to explain why this can be such a difficult undertaking, so I’ll ask you, dear reader: What do you think? Or if you’ve found a way to really mobilize the “finders” in your organization, how did you make it happen? Did you have to guilt them into it, did you establish a “bounty” system for reporting conditions, etc.? I am firmly convinced that if we can enlist these folks in the identification of hazards, we can really move towards a process for ensuring constant readiness.