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Geisinger Health developed a plan to help its environmental services technicians achieve CHEST certification.

Let’s face it, in the past, environmental services (ES) technicians in health care were to be seen and not heard. Their job was to clean patient areas and to do so with little, if any, interaction with patients, families or, for that matter, clinical staff. Do your job, get in and get out. That was the expectation.

How times have changed. Expectations for ES staff are high and getting higher. Today, an ES department is expected to meet customer-service expectations and standards for both internal and external customers, enhance the patient experience, aid in patient throughput and flow, meet or exceed turnaround-time goals, help to improve patient and worker safety, perform quality services with no errors or misses, report identified issues to other departments and the list goes on. This is a lot to achieve and a lot to remember.

Overhauling job description process 

In June 2016, the Association for the Healthcare Environment (AHE) launched a “We Are Environmental Services” campaign. The marketing campaign included educating the field on the health care environmental services industry standard. Additionally, senior ES leaders focused on creating a career path for ES technicians.

Staff who provide cleaning and disinfecting services within health care facilities carry a lot of responsibility and were (to a great degree in some circumstances) overlooked and undervalued even though they are valuable members of the health care delivery team. How do we elevate this profession to be recognized as a key player in the overall patient experience? What can we do to retain and recruit good qualified candidates?

The first step was to evaluate the job descriptions within environmental services. It turns our there are many and with a potpourri of titles; EVS worker, support associate, floor technician, bed technician.

Geisinger Health’s management team was in the midst of conducting a job description redesign, and learned of AHE’s CHEST program (Certified Healthcare Environmental Services Technician), which assisted in the decision to narrow ES front-line staff job descriptions to three categories. After a thorough review and detailed analysis of all the job titles and the responsibilities, the categories were narrowed to ES technician, certified ES technician and team lead. Next, after receiving approval for the revised job descriptions, the management team worked with the compensation department to obtain an upgraded pay scale for each job category.

On the track to certification 

Hospital administration also granted approval to launch a CHEST certification program within the hospital. Budget considerations for the program encompassed not only the cost of the program itself, but also the cost to backfill assignments while staff attended the training and testing, as well as staff transportation, catering and overnight accommodations for staff who would have to travel more than two hours to get to the ES training center. Costs associated with training five trainers also were evaluated.

Five members of the ES management team attended “Train the Trainer” for CHEST in Tampa, Fla. In March 2016, senior leaders established a goal to train 50 ES technicians systemwide for the first fiscal year.

As soon as the job description reclassifications and associated compensation were fully approved, planning the first class for July 2016 began. An internal CHEST committee and application process were developed. The committee consisted of the five CHEST trainers as well as the ES directors for each campus. The committee met biweekly to review applications and to determine the candidates for each class. Initially, the application process included a face-to-face applicant interview, which required at least one CHEST committee member to be involved. Over time, the application process was streamlined to eliminate the need for a face-to-face interview, because the focus shifted from the interview process to a thorough review of the applicant’s work-performance history.

Additionally, the committee prioritizes applicants based on their current work assignments. Staff assigned to inpatient room cleaning are scheduled ahead of staff who rarely clean inpatient areas. It was determined during the job description redesign that anyone currently in a team lead position would have one year to attain CHEST status, and any new team leads are required to be certified prior to accepting the position.

The first class consisted of 18 students from across the system, and all 18 were successful in completing the classes as well as passing the exam.

At the conclusion of the first class, a marketing campaign about the program ensued. This afforded the ES team the opportunity to tell the department’s redesign story, highlighting the staff’s professional development opportunity and its relation to enhancing the patient experience.

A year in review

In looking over the first year of the CHEST program, there were a lot of lessons learned. Those lessons assisted in enhancing the entire process and experience for staff as well as in streamlining the application and approval process for the ES management team. The initial first-year goal of 50 CHEST certifications was surpassed, and, in fact, 124 candidates will complete the program by the end of the year. The candidates chosen to attend must be committed to customer service and assist with mentoring and training others, especially in serving as a role model for other ES staff. Additionally, the management team expects flexibility and adaptability because of the fast-paced environment in which front-line staff work coupled with the high demand for superior internal and external customer service.

The CHEST program not only provided Geisinger a clear career-ladder strategy for environmental services employees across the entire system, but it also provided a way to recognize best-in-class ES staff for their dedication to patient safety shown through their commitment to maintain an environment that is consistently and correctly cleaned and disinfected.

Jane Martin, RN, CIC, T-CHEST is the director of environmental services performance improvement, education and analytics at Geisinger Health. She can be reached at