As hospitals raise the levels of patient satisfaction, incorporating the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and scores is of growing importance. Improving HCAHPS scores and reducing infections can be a very daunting responsibility, but a necessary one that requires environmental services (ES) leaders to answer the following questions:

What quality improvement strategies are needed? There should be policies and procedures outlining a quality control program, cleaning standards and schedules, staffing models and infection control procedures. Substantial and strong leadership support, involvement, commitment and visibility are important in making significant changes. Commitment from other hospital personnel also is necessary.

Who should be involved in the department's quality strategic plan? Many individuals should be involved — the front-line staff members being one of the most critical groups. No single group outside of nursing spends more time in the presence of patients and families. Administrators and managers are responsible for evaluating the work of front-line staff. However, it takes all groups working together to create a positive patient experience.

What roles do administration, management and staff have in a strategy map for HCAHPS improvement? The function of management is to provide a supportive role, seek proper resources and provide training to front-line staff to produce favorable outcomes in quality control. This can be accomplished by providing education and training, performing competency assessments and being actively involved in the facility's quality improvement team. Management also should network with others in the ES field. Organizations such as AHE can provide information about this and other topics through webinars, conferences and online networks. Departmental staff and administration should engage in dialogue to ensure that adequate resources are available and the time for cleaning patient areas meets recommendations of AHE and the Association for Professionals in Infection Control and Epidemiology.

What are some of the processes? The core component of any improvement strategy will use more than one quality tool system. There should be a real-time daily measurement system in place (i.e., patient interviews, patient-centered initiatives, environmental monitoring and inspections). A good quality improvement program requires problem identification, timely reporting, continuous monitoring, both intra- and interdepartmental communication, and testing and validation that quality objectives are being achieved.

Concrete steps need to be taken to address perceived problems from the patient's perspective. The process should be action-oriented, utilizing detailed reports to determine opportunities for improvement at all levels. Each department needs to establish ownership.

Finally, all employees should be provided with opportunities to develop competencies and receive continuing education to improve outcomes.

By Robert M. Hodnik, CHESP, director of facilities management at UPMC Health Plan, Pittsburgh, and vice president of AHE.

AHE insight

Valuable resources available

AHE is the membership organization of choice for a wide variety of professionals caring for the health care environment. Here are a few of the many resources that AHE offers.

• EXCHANGE 2013. Attend the industry's premier conference and trade show at the Indiana Convention Center in Indianapolis on Sept. 15–18. New ideas for this year include a poster presentation session and an educational focus. More information is available at

•Employee Engagement: Myth Busters. Examining both myth and reality, our experts take you on a hunt for the truth to uncover what works and what doesn't in the world of employee engagement. Attend this valuable webinar, which is free for AHE members and $139 for nonmembers. It's available on June 13 at 11 a.m. CST. For more, go to

• AHE Seal of Review and Recognition Program. Designed to be a comprehensive review and formalized recognition process that promotes quality and safety, this program allows a company's or organization's cleaning procedures, in-service training or programs to receive AHE's seal for content excellence. For more information on the program, go to