To make improvements in Hospital Consumer Assessment of Healthcare Providers and Systems survey scores and patient satisfaction, health care-associated infections, staffing issues and more, environmental services (ES) managers need metrics to drive that progress. These data will help the ES manager to focus his or her staff and resources on what's important.

The range of metrics that the leader can employ varies from those that are mandatory for legal, safety or contractual purposes to those that track increases in efficiency, reductions in complaints, cost-savings or other outcomes.

Overall, metrics should reflect and support strategies for all aspects of the ES department, including finance; standards; and patient, family and visitor expectations. Metrics indicate the priorities of the ES department and provide a window on performance, ethos and ambition.

Good metrics will drive the strategy, direction and focus of the department, and assist the leader in making informed decisions. Good metrics will drive change and help the department evolve with successful monitoring and follow-up. Ultimately, good metrics will produce good internal and external public relations (e.g., staff, patient, resident and physician satisfaction).

There are primarily two types of metrics: operational and financial. Operational metrics are represented by departmental performance or service levels. Common examples include bed turnaround times; full-time equivalent (FTE) overtime and paid leave; staff turnover; square feet per FTE; patient and resident satisfaction scores; and linen use per patient day. These metrics can help to identify the root of a discrepancy, weakness or inefficiency.

Financial metrics judge the ability of the ES department to convert operational performance into financial goals. Such metrics include supply purchases, equipment repairs, staffing and contracted services. Because the ES department is essentially an expense-producing department within the health care arena, it is imperative to know what it costs to run the department.

ES managers need to ask these questions: What are we trying to accomplish as an ES department? How do we make the health care system revenue increase faster, reduce costs or both? How do our efforts support these initiatives? This requires going outside our comfort zones and seeking other ES leaders. We need to create relationships and understand what's important. Then we need to figure out how ES supports and drives the organization's overall business initiatives.

The members of the C-suite may not understand the intricacies of an ES program, but they do understand that it matters. When ES can be linked to a revenue-generating opportunity or a cost-reduction opportunity — thus allowing the initiative to be done more safely through reduced infections, more quickly through faster bed turnarounds and with greater efficiency — that's a huge win.

By Kent L. Miller, MHL, CHESP, immediate past president of AHE, and director of environmental services and co-safety officer at Jackson Hospital and Clinic, Montgomery, Ala.

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

• Terminal Cleaning in the OR. Using a real-world case study, our experts will present an innovative and collaborative approach to operating room cleaning that resulted in sustainable and improved outcomes. Attend this valuable webinar, which is free for AHE members and $139 for nonmembers. It's on May 16 at 1 p.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