A New Perspective

Have you ever stopped and thought, “What in the world happened in 2020”? Who am I kidding, most of us can’t even go one day without cowering over the thought of life during the pandemic! The good news is, there is a light at the end of the tunnel, and we are slowly regaining normalcy but what about the most impacted demographic, the elderly? How do we fully reopen long-term care facilities while continuing to protect our aging Americans with a non-isolated quality of life? The pandemic exposed the harsh reality of disease transmission in long term care facilities and there are still a host of bacteria looming that existed long before COVID-19. These threats will continue to pose serious harm to the elderly population if we do not change our view of cross contamination and environmental services.

Let’s be honest, while we can never be 100% effective in protecting our elderly from illness, we can better protect by redefining what “Clean” is in long-term care. The general focus for long-term care has historically been that of “Looks clean, smells clean” and while first impressions are the driving force behind most of our decisions in life and shouldn’t be totally negated, we simply cannot make this the cleaning foundation in long-term care.

The cold fact is one-third of COVID-19 deaths in the United States were individuals who lived or worked in nursing homes, 1 in 12 residents of long-term care that contracted  the coronavirus died and moving forward one of the things we can do to prevent a reoccurrence is shifting to a permanent sanitized cleaning approach. We’ve been fighting healthcare associated infections for decades, but the ugly truth is the recent pandemic publicly exposed that long-term care cleaning needs a new perspective closer related to what hospitals have shifted to. Clean does not always mean sanitized and on average over 3 million healthcare associated infections (HAI) are reported in long term care facilities killing nearly 400,000 residents each year.

Another study by Kaiser Health News showed that since 2016, 63% of nursing homes were cited for infection control deficiencies. It also should come as no surprise that, since the start of the pandemic, facility infection prevention deficiencies have dramatically increased. These statistics are pre-COVID so we should not be totally surprised by recent outcomes and while facility cleaning is just one tool in controlling HAIs, it is the first line of defense and one of the controlled services a facility can offer their residents. Administrators should ask themselves “Is my version of clean removing bacteria and how sanitized is my version of clean”?

Take me back to 2019! Well sort of…

As someone who spends a large amount of time working in long-term care facilities across the country, the lack of visitations from loved ones is a somber truth. While it was a hard decision for administrators to restrict visitors within their facilities, it was a needed immediate necessity to stop COVID-19 transmission. But as we begin to move forward into a new normal, there are many amenities and best practices from a pre-COVID-19 long-term care facility toolbox to reimplement or augment.

Most would agree that we, as humans, are social creatures. We thrive on interactions from loved ones and this fact couldn’t be any truer for the elderly. As we approach the final years of life, we do not relinquish the desire to interact with others, in fact, it’s quite the opposite. As we lose the ability to be independent, studies show the elderly not only desire social interaction, but their health depends upon it. The CDC reports that isolation is associated with a 29% increased risk of heart disease, 32% increased risk of stroke, and a 4 times increased risk of death in the elderly.  It is imperative as a part of your care plan to re-cohabitate long term care residents with the outside world, that we create a safe facility.

So how can long term care facilities remedy the isolation caused by COVID-19 yet protect residents? To reiterate, you redefine how you conduct facility cleaning. Visitors are always going to pose a threat for illness. While hand washing will always be critical and perhaps facial masks in long-term care will hang around for a bit longer, we simply can’t accept the pre-COVID-19 HAI statistics as “normal” because we cannot control what comes through the door. A return to normal means encouraging visitations and re-focusing on killing and removal of bacteria continuously.  Its easiest to understand this in the context of your own home.  We do not turn away a house guest simply because they “might” have mud on their shoes. We welcome them in and pick up after them.

Passion Fuels Progress

If we want to truly create a safe new normal in long-term care, teams that are passionate about cleaning are critical. I know what you’re thinking, “Healthcare grade cleaning is great but how do you get it done in the 2021 talent war?”. I get it, staffing someone to clean toilets, and retain them, has become a daunting task as we emerge from the ashes of the pandemic. Pair constant staff shortages and high turnover with the need to properly train team members on healthcare grade cleaning procedures, it creates a stressful problem. But like any problem, there is a solution.

A study by Deloitte showed that 87.7% of American workers are not over excelling in their duties because there is no passion for the work.  The general problem isn’t with the personnel, it’s a lack of education and understanding of the impact they have, the “why” their job is needed. People are passionate because:

  • They enjoy the work
  • They are good at the job

As leaders, when you focus on the number two by inspiring and providing the tools for your team to be great at what they do, your staff begins to enjoy their work and that is where the passion comes from. The first step in pulling the best out of your environmental services team is helping them understand why they are cleaning. Cleaning facilities day in and day out can be one the most mundane jobs on the planet but if EVS staff understands the “why” they clean and how critical they are to resident lives; they can become passionate tenured employees who make an impact.

No looking back

Long term care administration is a challenging job. Your residents have entrusted their lives to your care and when you combine this with managing your business through the scrutiny of COVID-19, there are a lot of variables. The truth is it does not have to be complicated; you just need to change your approach to the game. Hospitals have already experienced this same shift, and while there are efforts to still be defined, there are a lot of resources available to aid you in refining your standard of clean.

Sometimes the best option is to remove the burden of facility cleaning completely from your plate through outsourcing. When you outsource a service, you are entrusting a need to a third-party provider with proven expertise in the field. This typically creates a best in class solution because contracted providers, like Coreworks, are experts at infection prevention.  Compliance with daily sanitation and regulatory procedures becomes the primary goal when supporting a client organization. Our elderly population represents the greatest generation of our time. A generation who values family and has endured dramatic economic changes throughout their lives. 400,000 deaths due to healthcare associated infections is a mind-blowing statistic and while not all the deaths are directly related to facility cleaning, there is no excuse today for not making increased sanitization a top priority. Your residents deserve for this number to go down! How we cleaned long-term care before COVID-19 was not good enough. That was clear before the pandemic and painfully exposed throughout the pandemic. As you discern your own sanitization program, I’ll leave you with a quote I learned long ago that has become fundamental in my own life.  “It’s not what people say, it’s what they do”. If you struggle to personally bridge the gap between promises and reality, don’t be a hero, hire experts to help you.

Redefining Clean in Long Term Care

 By: Derek Harris
Director of Business Development