The hospital environment and the management thereof are paramount to a patient’s well-being and healing. The environmental services department, responsible for hygiene, safety and overall appropriateness of the environment, supports clinical processes, provides the tactical arm of the epidemiological phalanx and underpins the quality of a patient’s overall experience.

Experience is a primary factor in a patient’s choices about health care; and there is definitely competition for patient loyalty, retention and health care dollars, especially in light of the Affordable Care Act, designed to expand coverage and make it more efficient.

Among the various tools to help gauge patient perspectives, satisfaction and loyalty, the HCAHPS survey can be an effective one in quantifying performance, benchmarking and goal setting.

The survey asks recently discharged patients 32 questions about their hospital stay. Questions applicable to environmental services include:

• During this hospital stay, how often were your room and bathroom kept clean?

• During this hospital stay, how often was the area around your room quiet at night?

• Using any number from 0 to 10 … what number would you use to rate this hospital during your stay?

To make a difference in HCAHPS scores, environmental services managers first should review relevant HCAHPS scores and feedback to determine improvement opportunities. From there, develop departmental performance dimensions, such as goals and performance indicators to monitor service and quality.

Celebrated business author Philip Crosby often has said that the term “quality” is simply adherence to a certain standard or specification, and not a vague, subjective concept of “goodness.” It is imperative to recognize that our patients set the standard. Develop service/quality goals that align with patient-centered standards, and focus on improvement related to one or more relevant HCAHPS questions.

Environmental services managers should keep their fingers on the HCAHPS pulse, periodically evaluating departmental performance. Display current results in appropriate areas, and continuously communicate with staff about the goals, status, what can move the proverbial needle and the importance of each individual’s ownership and contribution.

Lloyd Duplechan is a retired hospital chief operating officer and is owner and principal of the health care environmental consulting firm Duplechan & Associates.

Practice guidance available

Practice Guidance for Healthcare Environmental Cleaning, second edition, helps to define and advance the professionals responsible for care of the health care environment to ensure high-quality outcomes and healthy communities.

This manual provides evidence-based research, guidance and recommended practices that should be considered for inclusion in health care environmental services departments. Because each facility has its own needs, this resource has been designed to enhance an existing program.

For more information, visit

Certified Healthcare Environmental Services Technician Certificate

This certification focuses on critical areas of competency for front-line technicians, including infection prevention, quality of care, patient outcomes and experience.

For more information, visit

Environmental Sustainability Certificate Program

AHE has launched a certification to acknowledge the environmental and ecological sustainability efforts of environmental services departments.

For more information, go to