Last summer, Noreen Gorero, RN, patient service manager, Cardiac Intensive Care Unit (5-1), looked around her unit and thought, "This place could be cleaner."
She also reviewed her unit's Press Ganey Scores for cleanliness, and thought, "Hm, these scores should be higher." Gorero sat down with the CICU's primary Environmental Services (EVS) associate and asked him if he had any ideas on how they could improve the CICU's scores. Jakar Taylor, a 6-year YNHH veteran, said he did have some ideas, and together they forged a plan that would involve almost every staff person on the 14-bed unit to improve the unit's cleanliness.
How patients grade their environment is becoming increasingly important. After discharge, patients rate the cleanliness of their environment at YNHH on their Press Ganey survey, and also answer questions that Medicare asks.
Each month, at hospitalcompare.hhs.gov, Medicare publicly reports how patients rated their hospital experience. Medicare pegs how it reimburses hospitals to how patients grade their experience. The practice is called valuebased purchasing and those hospitals which do not score well with patients on staff responsiveness, quietness and cleanliness will be reimbursed at a lower rate based on their poor scores.
Environment scores and Press Ganey results also contribute to PIP results. For this quarter, Environment scored 60 percent, above the threshold score of 57 percent, and Press Ganey scores — which includes cleanliness — scored 89.1 percent, slightly above the threshold of 88.9 percent.
Taylor and Gorero agreed that his goal was to achieve the highest score for cleanliness — a high hurdle few units achieve — within the year. Working with nurses, PCAs and BAs, Taylor developed a plan that would target exactly what the patient wanted him to do. After introducing himself, he asks "What do you need?"; "What else in your room do you want cleaned?"; "Before I leave, is there anything else I can do for you?"
Part of 5-1's successful plan is that staff members serve as watchdogs and alert Taylor when something needs his attention; BAs give him the list of patients who are going home so he can better plan his work. Taylor also works closely with Nakia Matheny who cleans and polishes the unit's floors. Matheny coordinates his work so patients are not in the room when he has to do buffing that will disrupt sleep.
"Last summer, I challenged Jakar to work with the whole team to improve our cleanliness results and he did just that," said Gorero. "He coordinates with Nakia on the floors and works well with the entire staff, and our scores show it."
When he was rounding on the CICU recently, Richard D'Aquila, president and COO, met Taylor and was impressed with his commitment to maintaining a spotless environment for his patients.
"Jakar has a clear vision of how important it is to connect with patients and their families," said D'Aquila, "and he knows the importance of working well with his team. He embodies the qualities of the Service Excellence Pledge and knows how his efforts directly and positively impact the patient experience."