By Natalie Bruce

When we talk about innovation we tend to think of state of the art technology or breakthrough ideas that result in revolutionary changes in the way we do our business.  Often this occurs as a result of strategic planning, relentless research and discipline. However, this is not always the case. In the face of the pandemic many in health care including Environmental Service Departments (EVS) were forced to address countless challenges in the absence of additional resources, and without compromising best practice and patient safety.

EVS departments are vital in the prevention of healthcare-associated infections and communicable diseases, including COVID-19. During the first wave of the COVID-19 pandemic supply chain disruption was one of the greatest threats for EVS to effectively complete their necessary work. Simply being able to access disinfectants was very difficult and in some cases impossible. Jenn Worboy, the EVS Manager at Peterborough Health Centre, Ontario, recalls at the beginning they were not able to access any hospital disinfectants from their supplier. “We needed to be very creative”, says Jenn. “One of the large national office supply stores ended up supplying us with disinfectant, so we were one of the lucky ones; we never had to go without”.  Thinking outside the box to obtain disinfectant was the norm in the first wave. Some EVS departments recycled disinfectant containers, refilled them with available product, and sourced replacement wipes to ensure disinfectants were readily available for use by frontline staff. Some needed to quickly redistribute product to meet equipment manufactures’ instructions for use (MFUs). Radiology equipment and hemodialysis machines, for example, have very specific MFU requirements, and simply using any disinfectant would not only jeopardize the integrity of the equipment but negate the warranty of such important and expensive medical equipment. At one hospital, an expedited review of all disinfectants was conducted, supply was monitored very closely, and products were sorted and redistributed. Not only were they able to successfully follow MFUs and best practice, but they found opportunities for efficiencies that they may not have otherwise.

Staffing shortages on top of the already increased workload continues to be an immense challenge for EVS. The very basic pandemic necessities of increased isolation rooms and increased use of alcohol-based hand rub have resulted in exponential workload for EVS. Chris Fougere, the EVS Supervisor at Lakeridge Health in Ontario, states “It has been very challenging and we are running as lean as possible without sacrificing excellent service, but the team is fatigued. The silver lining through all of this is the great teamwork and collaboration despite the added workload on the team. Some days what is accomplished is just short of a miracle.” With the staffing shortage, EVS leadership teams need to increase training and hiring. Fougere also reports the continuous recruitment and training to ensure he has the “people power” has been one of the greatest challenges. Some facilities have reviewed their training programs, and have implemented standard work and other strategies to expedite onboarding of new EVS staff without sacrificing the quality of training, while at the same time ensuring staff are feeling comfortable on the frontline.

Despite the staffing shortages experienced throughout the country, EVS teams are making an unanticipated impact on the care of those suffering from COVID-19. Worboy explains, “We (EVS) are in patients’ rooms for a minimum of 15 minutes every day and many patients look forward to our arrival.” Isolation can be a very lonely experience, and the EVS team can make a positive change in the patient’s hospital experience.

As the pandemic rages on and the world continues to struggle with COVID-19, our EVS teams across the country continue to find creative solutions to solve the many challenges in maintaining environmental hygiene best practice and ensuring patient safety. Their ongoing perseverance to improve process and innovate is a fine example that will help us get through the pandemic. Their ability to redefine EVS process during stressful circumstances is an example of how innovation can result from perseverance, dedication and creative thinking, without the need for high-tech or expensive solutions.

Natalie Bruce RN MScN CIC is an Infection Control Consultant in Ottawa, Ontario.   This article is reprinted with permission of Infection Prevention and Control Canada.