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Using Human Factors Approach to Discover New Strategies to Improve Environmental Cleaning within the Hospital Setting

Hospital room cleaning equipment

The contamination of the health care environment plays a significant role in the transmission of high-consequence pathogens in health care settings. Adequate environmental cleaning and disinfection is a vital component to prevent these transmissions. Yet there is limited research and investment in the training, practices and risk-reduction strategies for environmental service workers, who perform environmental cleaning and disinfection. Studies have shown that in research settings the burden of microbiologic environmental contamination can be greatly reduced with appropriate cleaning and disinfection. However, the characteristics of health care work systems in which environmental service associates perform their job vary widely, and gaps in implementing recommended practices have been associated with outbreaks. New methodologies are needed to understand the practices and risks of environmental cleaning and disinfection and to develop a sustainable program of highly reliable cleaning.

Our Goals

Our overall goal is to improve environmental cleaning in hospitals. More specifically, we have been using human factors approaches and methods to identify the work system factors that are associated with optimal cleaning of the hospital environment. Based on this in-depth analysis and using a participatory ergonomics approach (that includes active participation by environmental service associates, supervisors and nurses in intervention design), we are developing a scalable, multifaceted and novel intervention package to improve patient room cleanliness. We will then perform a quasi-experimental study to assess the impact of the multifaceted novel intervention package in academic and community hospital settings.

Related News and Journal Articles

"Researchers Explore Ways to Improve Patient Room Cleaning" (Health Facilities Management, February 16, 2017)

Rock, C., Cosgrove, S., Keller, S., Enos-Graves, H., Andonian, J., Maragakis, L., . . . Xie, A. (2016). Using a Human Factors Engineering Approach to Improve Patient Room Cleaning and Disinfection. Infection Control & Hospital Epidemiology, 37(12), 1502-1506. doi:10.1017/ice.2016.219

Research Team Members: Clare Rock, Anping Xie, Ayse P Gurses, Sara Cosgrove, Peter Pronovost, Patience Osei, Verna Scheeler, Sara Keller, Jennifer Andonian,  Elaine Nowakowski, Yea-Jen Hsu
Funding Agency: CDC Epicenters
Dates: 9/30/2015 – 9/29/2018