Known throughout the facility for its commitment to cleaning and infection control, the environmental services (EVS) team at Cohen Children’s Medical Center – Northwell Health, New Hyde Park, N.Y., has also developed a reputation for qualities that are harder to measure.
One example: When young patients were asked to draw their favorite superheroes, staff members were expecting to see the usual characters: Batman, Superman and Wonder Woman. But a young boy in the hospital’s bone marrow unit saw things differently. He handed over a drawing of an EVS staff member wearing a superhero cape.
The EVS staff member, Trevor Nelson, routinely went out of his way to brighten the boy’s day by talking to him, buying him a video game out of his own pocket, or doing something as simple as bringing him a glass of water or a comic book. Through the eyes of a young boy battling a serious illness, these small gestures were nothing short of heroic.
Such attention and compassion is engrained into the work ethic of every person on the 90-member EVS team, says Vasilios J. Apostolou, CHESP, T-CHEST, T-CSCT, CMIP, VPEI, director of the EVS department at the 300,000-squarefoot facility that is one of the top pediatric hospitals in the New York metropolitan area.
“We teach our EVS staff to drop everything when a patient needs something — even if it’s someone to listen,” Apostolou says. “Every team member goes above and beyond every day. If an EVS team member needs to take 15-20 extra minutes to sit and talk to a child, or to read them a book, we encourage that.”
That dedication to patients is engrained in the work ethic of every staff member in Cohen Children’s EVS department, Apostolou says. Getting the best people in the right positions — and retaining them — while providing avenues for advancement, is critical to the overall success of the department and the hospital as a whole.
That ethic extends to leaders who pass down their training and knowledge to front-line staff. In 2019, the EVS department achieved a long-time goal of having a fully certified supervisory team. Supervisors covering all shifts are Certified Health Care Environmental Services Technicians (CHESTs), which has a positive impact on infection rates, quality of care, and patient experiences and outcomes.
“Supervisors who are certified aid in the growth and development of their staffs by educating them on why certain practices are implemented,” Apostolou says. “Next, we are working on the certification of front-line workers.”
The EVS team’s motto, “The healing process begins with EVS — we do not cut corners, we clean them,” is central to their daily work and is reflected in the hospital’s metrics.
Compared to 2018, the hospital’s HCAHPS scores for environmental cleanliness — respondents who felt the room was always clean during their stay — increased from 72.6 to 81.3 based on Press Ganey survey responses.
For these accomplishments and many others, Cohen Children’s Medical Center has earned the Association for the Health Care Environment’s (AHE’s) 2020 Environmental Services Department of the Year Award in the 1-249 bed category. This award recognizes outstanding EVS performance in a number of critical performance categories.
While the EVS department has always worked closely with the infection prevention (IP) department, a 2019 initiative took that collaboration to a new level. The EVS supervisory team joined with the IP department on a cross-departmental training initiative with the goal of integrating the departments that rely on each other for infection control efficiency.
The training offers staff from both departments the chance to learn the other’s roles and practices in real time, make corrections and suggest changes to processes.
The initiative has expanded the role of EVS in infection prevention. For example, when a health care-associated infection (HAI) is detected, EVS staff are asked to huddle with the IP team for a root cause analysis (RCA) to discuss the case in-depth.
“IP has included the EVS team member for the area in the RCA, empowering them to participate and contribute to the case,” says Melissa A. Belfiore, MS, CIC, infection preventionist at Cohen’s Children Medical Center.
Input from EVS members has even resulted in identifying the need for changes in practice. Also new, IP and EVS teams are doing environment of care rounds to improve infection control processes.
While praising the EVS department in a number of areas, Tom Mattice, CHESP, CMIP, T-CHEST, director of EVS at Montefiore Nyack Hospital, Nyack, N.Y., one of the judges in the AHE competition, was especially impressed with the close collaboration between the two departments.
“Many of their performance enhancements were realized by close collaboration with EVS and IP teams,” Mattice says. “And the creation of an internal rounding tool utilized with patients and families to gauge the patient experience has been well received and has positive results.”
EVS leaders are always looking for new tools and technology to improve infection-control rates. In 2019, they adopted a disposable mop program that prevents cross-contamination and eliminates the need for laundry. Another new tool, ultraviolet (UV) disinfection from PurpleSun Healthcare Technology, Long Island City, N.Y., uses UV light to kill germs and has been shown to reduce HAIs. EVS staff are trained to use the equipment along with manual cleaning.
“The UV device was also used for terminal cleans on designated COVID-19 units following discharge,” says Marianne Pavia, MS, MT (ASCP), CIC, FAPIC, director of infection prevention at Cohen Children’s Medical Center. “And we placed two UV disinfection devices in the hospital lobby so staff and visitors can disinfect their cellphones and tablets when entering or exiting the facility.”
In terms of adenosine triphosphate (ATP) testing, the hospital’s ATP pass rate was 99.8% in 2019.
On other fronts, the EVS team is using state-of-the-art bed tracking software to improve turnover rates at the 203-bed facility. The system that sends a notification to EVS staff telling them a discharge clean is needed has helped cut bed turnaround time from roughly 87 minutes in 2018 to approximately 57 minutes in 2019.
Mattice also praised the facility’s innovative e-waste program for discarding and recycling electronics, batteries and medical equipment. In terms of handling and transporting trash, the EVS team conducts a minimum of 30 monthly observations of employees handling trash to determine whether the trash was overfilled and in the right receptacle.
“This EVS department is very progressive,” Mattice says. “They are out there setting benchmarks for other departments to follow.”
In terms of overall success, all team members at every level share a commitment to performing at their highest levels. The EVS director and supervisors are frequently on the front lines assisting their team in everyday work. Leaders take a hands-on approach to their work, according to Apostolou, who was nominated for the prestigious Northwell Health Presidents’ Leader of the Year award.
Apostolou says one basic philosophy is key to his success. “I lead by example. I will never ask anyone to do something that I’m not willing to do myself,” he says. “And if a staff member is coming in at 8 a.m., I’ll be there an hour before to make sure they have the tools they need to do their job.”
As a leader, he stresses the importance of honest communication and having empathy for the various cultures, backgrounds and ages that make up the staff. The department, which maintained its employee retention rate in 2019, seeks to retain staff but also provide the opportunity for advancement, including outside the EVS department.
Members of the EVS team have been individually recognized by the other departments for their dedication to patients and their families in ways that often extend beyond their day-to-day tasks. For example, staff have been recognized for pausing for a moment of prayer with a parent or holding the hand of a patient during a painful moment.
“Every single team member shares this attitude of compassion and caring for our patients,” Apostolou says. “At the end of the day, even just seeing a patient smile is extremely rewarding.”