Shot of healthcare workers wearing hazmat suits and sanitising a room during an outbreak
The full scope of impact from Covid-19 won’t be known for some time. While in the midst of unprecedented adversity, there is also an invaluable learning opportunity for hospitalists to improve processes now and in the future.
Disinfection Focus
The handling of an overwhelming influx of Covid-19 patients has been a true testament to hospital quality of care, as evidenced by the inspiring dedication of healthcare workers on the frontline. Simultaneously, dire circumstances revealed extraordinary agility, particularly in the area of sanitation, where accelerated adoption of new technologies and procedures occurred in a matter of weeks, rather than years. Environmental service and infection prevention teams became more receptive to using heretofore unknown disinfection methods, alternative chemicals, ventilation systems, electrostatic equipment, and so on. In fact, electrostatic sprayers are now so widely accepted, it’s as if they’ve always been used for disinfection when, mere months ago, the technique was unheard of.
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Prior to the pandemic, cleaning happened behind the scenes and disinfection was low on the list of daily protocols. Now, not only has the entire cleaning industry been thrust into the spotlight, disinfection has become everyone’s top priority. In hospital environments, the need for frequent and consistent disinfection became pivotal to maintaining patient and personnel safety.
Though hospitals have dealt with contagious epidemics before, nothing compared or prepared them for the scale and longevity of Covid-19. It’s been made abundantly clear that reactionary responses fueled by panic only result in impractical or ineffectual decision-making that can even worsen matters. Consequently, another paradigm shift has occurred in the way the industry approaches crisis, from triage and disaster management to proactive planning and infection prevention.
We’re just beginning to quantify the economic fallout associated with Covid-19 but, hindsight has become foresight. Organizations are now painfully aware of the exorbitant costs stemming from a major outbreak. Thus, budget priorities have shifted along with disinfection perceptions and more funds are being allocated to enhanced infection prevention.
It is no small feat that an entire industry has unilaterally altered its perception of the importance of disinfection.
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Collaboration & Education
When communicable outbreaks occur, advice from infection preventionists (IPs) is crucial. However, there simply aren’t enough IPs to go around. Consequently, the responsibilities for infection prevention have been tacked on to other job descriptions without the benefit of training. Suddenly, hospital staff members are tasked with new IP duties. Business-owners are required to be IP experts to protect employee and customer health. School and university administrators are now healthcare admins as well. Meanwhile, the roles of custodians and janitorial crews transformed into guardians of public health overnight.
New budget priorities will mean more IPs for each hospital and teams will be trained to assist with IP tasks as well. Even so, gaps in knowledge and experience continue to exist at every level. We’ve come to realize the key to mitigating disconnects lies in integrated communications and coordinated collaboration. In times like these, information sharing among all parties, from IPs to clinicians, hospitals and health systems, between government agencies and scientific experts, across professions, industries and countries, is not only beneficial to situational awareness but essential to our future survival. Today, infection prevention is everyone’s responsibility.
Trust in Data
Predictably, the pandemic opened the door to opportunists, many with no prior disinfection experience, and new cleaning technologies that usually require specialized training for safe implementation became commoditized. Moreover, unqualified sources flooded the market with misinformation, capitalized on public hysteria, and contributed to “hygiene theatre,” which not only distracted from important issues but also caused inappropriate use of chemicals or equipment and provoked hyper-disinfection.
Between a plethora of false information and constantly changing Center for Disease Control and Prevention (CDC) guidelines, it became more and more difficult to discern the best approach. Instead, hospitalists turned to science-based data for direction and confirmation of cleaning protocols. Further, reliance on third-party certifications and performance verifications escalated as data-driven reinforcement for successful and safe procedures.
Managing Risks
The pandemic served as a glaring reminder that patients and patrons aren’t the only ones at risk. In a highly contagious environment, hospitals must also monitor the physical and emotional health of care teams and cleaning crews. Frontline workers are subject to potential exposure to infectious diseases, as well as hazardous cleaning chemicals. Therefore, more policies are necessary for protecting staff welfare, while also outlining operational strategies to withstand workforce fluctuations.
Beyond Covid-19, plans are already in progress for managing future emerging pathogens. Though virtually impossible to prepare for every scenario, recent experience has taught us the value of developing multiple sets of strategies and protocols that are quickly and easily scalable in the event of an outbreak. Now is the time to reevaluate IP systems, test new approaches, create new programs to foster more productive workflows, establish new standards for training and processes, and identify new ways to ensure results are repeatable in a variety of situations.
Reevaluating Solutions
It’s also time to reevaluate supply chains. Our previous approach to emergency preparedness was to stockpile supplies to sustain a few weeks. The pandemic showed us how quickly those resources are depleted by unexpected spikes in demand. Going forward, the game plan is to establish a reliable ecosystem of vendors with the capacity to scale up and deliver during catastrophes lasting an extended period of time. However, plans should also purposefully strive to reduce the negative impact on human health and the environment by allowing for more sustainable solutions and healthier alternatives to harsh disinfectants. Additionally, to prevent over-cleaning, indicators must be clearly defined for when to ramp up, with thresholds that must be met before implementing more extreme interventions. With proper guidelines in place, along with more education on less toxic chemicals and the proper use of new technologies, greater outcomes will be achieved as we prepare for future outbreaks.
The pandemic has been a defining moment in the healthcare and cleaning industries alike. Both have risen to the challenge and become more proactive yet fluid, prepared to act immediately or over the long haul, able to work collaboratively and make more informed decisions and invest smarter to prevent infectious outbreaks before they ever reach pandemic proportions.
Jeremiah Gray is the chief innovation officer and co-founder of EarthSafe.
Since EarthSafe’s inception in 2014, Jeremiah has led the development of safer, more sustainable chemistries, pioneered responsible use of disruptive electrostatic spray technologies, and forged numerous innovative programs in the healthcare, education and cleaning spaces. Under Jeremiah’s leadership and guidance, EarthSafe developed the EvaClean Infection Prevention System, which has since become the leading authority on healthier disinfection. Jeremiah heads up EarthSafe’s Innovation Department, which is responsible for setting strategic initiatives and developing new products and technologies to enhance and expand the Evaclean infection prevention programs into more comprehensive and holistic environmental hygiene solutions that deliver total building health. www.evaclean.com
