The role of the environmental services (ES) department leader is more challenging than ever with shrinking budgets and fewer staff to complete the many processes required.

Yet, it is important that managers instill in their team professionalism and customer service skills needed to play an enhanced role in the patient's perception of quality health care. The ES manager needs to provide training, encouragement and guidance so the department's value will be noticed by the C-suite.

Demonstrating professionalism

With that reality, it is important for ES department leaders to demonstrate that they have moved into the 21st century and developed professional processes and sophistication beyond the days when ES was known as a housekeeping or janitorial function.

The following four strategies will help accomplish this goal:

Know the direction of the organization. Health care today is subjected to a wide range of influences that make the job of planning difficult. An ES leader may not be a member of the board, but it is his or her responsibility to know the board's mentality and the direction it wants to take the organization.

With revenue streams being sliced and diced, a department leader must look for ways to reduce cost and expenditures, while improving service and quality.

The old cliché is more prevalent today than ever: "Do more with less."

This means better planning by using new technology and looking at other industry methods to enhance value. If a facility has a process improvement department, the ES leader can use his or her extensive knowledge and methods to help review the department's work practices and find ways to streamline.

Six Sigma principles used by companies worldwide also provide management processes to reduce inefficiencies. If the facility has a Six Sigma program, ES leaders should search them out and allow their department to become a Six Sigma project.

ES leaders must never be complacent, and always search for ways to improve the services they provide. The ES staff also should be made aware of the direction of the organization.

ES leaders need to know their organization's mission and value statements and implement them in their performance. They should keep their staff informed with huddles, bulletin boards, emails and by making daily rounds. If ES leaders let their staff know the "whys" of what they do, their management role will be easier.

Track and improve satisfaction. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is perhaps the most important driving force in health care today.

The ES department thus becomes one of the most important in the hospital, as patrons' perceptions are processed once they enter the facility. If visitors' initial impressions are of a clean and comfortable environment, they will know that the facility will be safe and sanitary for both them and their loved ones.

Score low on the cleanliness question in the HCAHPS survey and it may lead to lower scores and reduced reimbursement.

ES leaders and staff need to understand the vital role their department plays in reimbursement to the organization. Leaders need to mentor their staff and develop not only fundamental cleaning techniques, but practices that will make the patient and visitor experience one they will remember positively.

This can be done with service cards the staff pass out as they clean patient rooms or by presenting a simple flower such as a daisy to each patient. It is also important for the staff to explain what they are going to do as they enter the patient room. Some call this scripting, but providing a script is just part of the strategy to improve service.

Practicing the art of implementing the script is crucial in its effectiveness. Working with staff individually often is the most effective way of helping them become comfortable with their presentation. Each individual has to find his or her comfort zone to be able to present the script naturally. Once this is accomplished and implemented, the patients' perception of cleanliness will be reinforced visually and audibly.

Anybody who works in a hospital setting knows that AIDET is a prevalent acronym that stands for "Acknowledge," "Introduce," "Duration," "Explanation" and "Thank You." Teaching the ES staff to use this method when communicating with patients is important.

ES staff will need continuous encouragement to do this initially, as they may feel awkward, but ES leaders eventually will see results. Leaders need to hold their staff accountable for high-quality work, great customer service and compassionate patient care. As scores continue to improve, the C-suite will notice.

Make rounds. An ES leader is always out surveying the building and looking for opportunities to improve.

While that is critical for managing an ES department, it also is just as critical to make rounds with other managers to see what they see. This allows ES leaders to hear firsthand from their colleagues what needs to be addressed.

If possible, ES leaders should find time to interview patients together with the unit manager. This will give an ES leader an opportunity to see the unit manager's commitment to quality and may provide ideas for directing ES staff.

ES leaders also should seek regular opportunities to make rounds with C-level executives. Monthly facility tours with them will provide an opportunity to see the ES department's successes and learn about their challenges, concerns and expectations.

Leaders also will want to join in various committees and high-level meetings so they can address concerns directly to executives in their organizations. ES leaders must show that they are ready with answers, suggestions and solutions to environmental concerns. This means they need to stay abreast of new trends and ideas in the workplace.

ES leaders must be open to possibilities that can make their departments more efficient. When looking at new methods or products, it is vital to include the hospital's infection control department in the discussion. It can help the ES department assess products, and assist in developing practices that provide the best sanitary conditions.

Having strong ties to infection control colleagues also will assure ES leaders that they are providing safe practices for staff and patients. Additionally, it will demonstrate to C-level executives the ES leader's willingness and eagerness to work collaboratively with clinical staff.

Demonstrate expertise. Continuing education is critical for any professional. Attending conferences and seminars in the ES field is necessary to keep abreast of the rapid changes in the industry. ES leaders must stay up to date with podcasts, teleconferences, online classes and articles from professional journals.

There also are certifications available to help ES leaders show the C-suite that they are dedicated to attaining the highest level of proficiency in the field.

For instance, the Association for the Healthcare Environment (AHE) encourages its members to become Certified Healthcare Environmental Services Professionals, which is part of the American Hospital Association's certification programs. It helps demonstrate that an ES leader has a vast and well-rounded knowledge of ES management.

AHE also has many online educational programs that ES leaders and their staff may find useful. Opportunities for education also can be sought from vendor trade groups or other professional societies. Certification and education will help ES leaders distinguish themselves as knowledgeable and current in their field.

ES leaders also may use their expertise outside the facility and within the community. They can make themselves available as resources to outside organizations, vendors and colleagues. Having an educated, experienced expert in the ES department is worth more than dollars and cents to an organization. It can demonstrate leadership, direction, vision and cohesion.

Working in a multidisciplinary environment and providing the same approach to education and training as the clinical side will show executives that the ES leader is moving the department and the facility in the right direction.

Open the doors to excellence

ES leaders need to bring new ideas, innovation and teamwork into their department's daily routines. They also need to work well with all the other disciplines in the health care facility.

If ES leaders and their staff open the doors to excellence when they open the doors to their facility, the C-suite certainly will take notice.

Raymond Irby is manager of environmental services at Centra Virginia Baptist Hospital, Lynchburg, Va. He can be reached at