Q&A with Care Logistics experts on prepping Transport & EVS for a surge in capacity

Contributions by:

Alex Bohn, Lead Transformation Engineer - BSIE, LEAN Six Sigma Black Belt

Karen Purcell, Solutions Engineer - LSSGB, MBA, MSIT


 As the COVID-19 crisis continues to expand, you've probably reviewed many websites and data to try and determine what you can do to help prepare your hospital for anticipated capacity constraints that you could see in the upcoming weeks.  Having a plan for all of your departments is key.  As we've been researching over the past several weeks, one particular area that we haven't seen as much discussion around is EVS and transport, specifically regarding the cycle time for cleaning rooms of COVID-19 patients.  More designated rooms requiring special cleans could impact patients that are waiting for rooms that are boarding in the ED and other areas of the hospital.  In order to provide you with more information on this topic, we asked several Care Logistics client transformation experts for their thoughts on this topic to help you better prepare for the coming weeks.

 

There's a lot of talk about capacity and throughput, but you don't see a lot about EVS and Transport.  Can you talk about some critical components of EVS and Transport that hospitals can focus on now?

Two major opportunity areas for Environmental Services are effective cleaning and disinfection of spaces to cut down on the spread of the virus, as well as efficient cleaning of high-priority rooms to take another patient.  EVS staff are critical in maintaining the cleanliness of the facility while reducing the chances of spreading an infection that may be living on surfaces. Refer to the COVID-19 EVS Protocol published on the UW Medicine COVID-19 Resource Site.  In addition, timely room turnaround can mean a patient is able to get an ICU or other critical bed as quickly as possible, in addition to decompressing the ED. An EVS Dispatcher should be working with Bed Placement to identify these beds and ensure that EVS is able to clean the room efficiently and effectively. Every hour counts in severe COVID-19 cases, so bed availability for these patients is immensely critical.

Regarding Transport, the most critical component to focus on is the importance of physical distancing as it applies to patient movement around the hospital. Transporters are coming into contact with, and moving patients, all over the facility. The key is to be aware of not only their personal contact with patients, but even how they are positioning patients in testing and procedural areas. We recommend adjusting policies around how patients are positioned and moved in diagnostic departments (testing, procedural, therapy, etc) so that patients are adhering to the CDC recommended 6-foot distance guideline and providing education to staff on this topic.  You should also make sure that Transporters have access to necessary PPE and are educated the same as clinical unit staff as well as being held to the same standards of hand-washing and COVID-19 prevention protocols.

What are some things that you can do right now to prepare your EVS and transport teams for higher capacity?

There are several things that you can do now to prepare for higher capacity, a few examples are:

·      Review EVS & Transport staffing times to ensure that they align with forecasted admission and discharge peak hours

·      Increase cleanings of public/high traffic areas such as elevators, waiting rooms, break rooms, etc.

·      Provide training on the cleaning of temporary facilities such as tents and flexed units

·      Proactively order supplies and equipment for increased cleaning demand

What can hospital teams do to optimize the use of existing machines or cleaning procedures?

They can review the process and policy of how cleans requiring specialized cleaning equipment are prioritized. Consider implementing a temporary procedure wherein cleans requiring this equipment are manually reviewed and prioritized, to ensure that the use of the machine aligns with the needs of patients waiting for rooms.  Another important point is to consider if these machines have disposable equipment (filters, covers, etc.) that may need to be ordered in bulk and if there are any parts that are prone to break, which could be better stocked.