OM in the News: Infection Rates and the Outsourcing of Hospital Cleaning

The Vancouver Sun (May 7,2012) has just reported another outbreak of  infection rates at Canadian hospitals. The article states that  health authorities have been warned for 10 years or more that the outsourcing of hospital cleaners – key personnel in any infection prevention and control program – was a misguided attempt to save money and would put patients at risk.   In  2004,  incidents at Surrey Memorial Hospital concluded that infection prevention had completely broken down. An auditor-general’s 2007 review found that the ministry of health had failed to implement systems for the prevention and control of infection.

Things heated up in 2009 when Vancouver  released reports from its Centre for Disease Control (CDC) on a persistent and lethal  infection  out-break at Nanaimo Regional General Hospital, the third in four years.   The CDC found that: “There were insufficient numbers of cleaning staff to meet the basic daily needs of the facility and they were not adequately trained in appropriate cleaning procedures for a health care facility. They were not able to meet the increased demand for environmental cleaning that is required to control an outbreak.”

Best practices in infection prevention programs highlight the vital role of hospital cleaning: adequate staffing and training, proper equipment and supplies, and real communication and cooperation among hospital personnel at all levels.   None of these factors are included in the government-ordered cleaning audits (which were confined to visual inspections only) that report hospitals passing with flying colors even while infection outbreaks were raging.

Scotland banned the outsourcing of hospital housekeeping in 2008 and brought cleaning back in house. The result? Infection cases have dropped dramatically. Reviews of Ontario’s devastating 2003 SARS outbreak named hospital cleanliness as a critical component in preventing and containing infections, and hospital cleaners’ involvement essential.

Discussion questions:

1. Why are janitorial services successfully outsourced in most organizations, but not here?

2. What OM tools are available to address this quality issue?