Cleanliness in the Hospital- Does it Really Matter
Why trash cans matter
Patient Satisfaction Survey data often frustrates physicians. Common complaints include whether patients really know what they need, and whether this data should be so important as a quality marker of care provided by the team and the physicians on that team. It isn’t uncommon to specifically hear complaints about the portion of the surveys dedicated to “room cleanliness.”
What lies below the surface are tensions for physicians that I completely understand.
Our decisions are so complex (physiology, pressors, antibiotics), how could something so simple really be important?
Do patients even appreciate all the training it takes to make these complicated medical decisions?
In an era of constant ICU bed shortages, when we need a room for a patient, we need it fast. We’ll do our best to clean it and empty the trash, but minutes matter and we know it.
·We work hard, long hours, often at personal sacrifice.
We have to rely on the team; we can’t be expected to clean the room.
There are other things to spend our money on, then incentives for environmental services. More nurses, scribes, advanced practice providers, etc.
Even if I acknowledge how important room cleanliness is, I don’t like it to be how the quality of my care is judged, because I’m not the one responsible for room cleanliness.
But, I also understand these complaints from the patient’s perspective. I’ve been in the ICU as a patient a lot. My family commits to a 24/7 presence when I am admitted. When I get home from the hospital, I hear my mother complain about room cleanliness a lot.
Why does the hospital buy furniture that can’t be cleaned? (fabric instead of leather or pleather?)
Why don’t people see that there is garbage around or under chairs? Are they so non-observant they just can’t see it? Or do they just not care?
If they don’t care about something that even I can see, something even I can pick up, then what else don’t they care about?
If they can’t empty the trash, how do I know they wash their hands? Clean your port? Wash the feces off your skin after the magnesium citrate they ordered causes diarrhea?
Is that why you get port infections? They just don’t recognize how important cleanliness is?
If they don’t notice the trash in the room, do they notice the several drug intolerances you have? Because that is fine print kind of stuff, and the trash isn’t….
At the end of the day, everyone knows that trash is dirty. Everyone can see it. And if the “smart people”—the health system--doesn’t fix it, they undervalue the patient’s families (who sit in all those chairs by their loved ones beds or out in the waiting room), and risk sending the message that they don’t want the family there. Even worse yet, and they send the message that they might not care about the really important things the patient needs.
And that is a reflection on quality of care.
