The Toppel File


  • Regional manager, environmental services, OSF HealthCare
  • Director of support services, OSF HealthCare Saint James


  • AHE board president
  • Certified Healthcare Environmental Services Professional
  • Master trainer and curriculum development for Certified Healthcare Environmental Services Technician program
  • AHE subject matter expert


  • Certificate of Mastery in Infection Prevention for Environmental Services Professionals

Pam Toppel, CHESP, M-CHEST, T-CSCT, president of the Association for the Health Care Environment (AHE) and an environmental services (ES) regional manager at OSF HealthCare, shares her thoughts on why ES is an integral part of the patient care team, and how AHE is helping its members to meet health care’s complex demands.

How did you choose health care as a career?

I always had a desire to be in health care, but didn’t believe that emotionally I could handle being in a clinical role. Seventeen years ago, I began my career cleaning doctors’ offices, and that is where I found my passion and affirmation that I did not have to be in a clinical role to contribute to positive patient outcomes. I quickly realized how passionate I am about infection prevention and the alignment to the care environment.

In my tenure with OSF HealthCare, ES has always been a part of my reporting structure. Prior to becoming a regional manager for ES, I held a leadership role as support service director for a single facility within OSF HealthCare. When the opportunity presented itself to become a regional leader of ES, I had no doubt that this is where my heart was, and that is where I am today.

What are your responsibilities at OSF HealthCare?

First and foremost, my role is to embody and serve our OSF HealthCare mission — serving with the greatest care and love. The leadership responsibilities focus on multidisciplinary collaboration across the continuum of care to provide a safe healing environment. Our regional ES teams are empowered to make on-the-job decisions by equipping them with the knowledge they need to be consistently high performers. Even more important is that they understand the “why” behind what they do. OSF HealthCare is generous in allowing me to provide the resources for evidence-based, best-practice education. This facilitates the staff’s ability to acquire the additional skill sets needed to prioritize, provide exceptional customer service and understand basic microbiology as it relates to their critical role in ensuring a safe, clean healing environment.

How has ES evolved since you first entered the field?

When I first started in health care, the consensus was that anyone could run ES. If it looked clean, it was considered safe. Today, there is clear evidence that the environment has an impact on the safety of the patient care environment and can affect outcomes. Yes, aesthetics plays a role, but the biggest role is the care of the environment. Most specialty area cleaning/disinfecting was serviced by clinical staff (i.e., surgery, neonatal intensive care units, burn units and mental health). Super bugs were nonexistent, and room turnover was expected to be five or 10 minutes at the most. Today, those same environments require 12-40 minutes to be serviced properly, depending on the severity of the case and the team’s responsibilities.

As recently as five years ago, ES technicians were seen but not heard nor were they considered part of the care team. They were housekeepers. Today, they are skilled technicians working in critical areas of our facilities, and interacting with clinical staff. Front-line technicians must demonstrate a series of competencies that require education on topics like basic microbiology. To perform proper cleaning and disinfection, they have to understand the life cycle of microorganisms, why and how organisms are transmitted and how to eliminate them from the environment.

Today, ES has a more in-depth or, in some cases, a sole responsibility when it comes to maintaining and disinfecting patient care equipment and specialty areas. Infection prevention and patient safety require A-team-caliber employees, and the same caliber of education and training is required. A clean, safe patient environment has to be an investment to achieve the goal of positive outcomes.

What are some of the biggest challenges facing the ES field today?

The uncertainty of where health care as a whole is headed. The ability to implement new innovations and technologies is hampered by financial constraints. As a nonrevenue-generating cost center, it’s often difficult to obtain the finances for additional technologies. Leaders must be skilled communicators to be able to articulate and make a business case for resources and capital and how they can contribute to a positive variance when it comes to the return on investment.

More critically, to be an asset to a health care organization, ES leaders have to think strategically and be innovative in thinking about the business model of the future as care shifts from acute care to ambulatory care. We need to scale and shift our current care model to suit the care environment needed, be it ambulatory surgery, home care or medical office maintenance, or risk being replaced or obsolete. 

How does AHE help to prepare front-line technicians and leaders to face these challenges?

As a recognized authority in caring for the care environment, AHE is an advocate for our profession on all levels. But we can’t just say we are the recognized authority, we have to demonstrate it every day. The AHE portfolio of educational offerings meets the needs of every level of the profession, from novice to tenured professional. A generous amount of education is included in membership and some are fee-for-service, but you have to take advantage of it to reap the benefits.

We need to be active participants in our destiny, and AHE is behind us every step of the way. The changes in health care are happening faster than at any other time in recent memory. We have to be nimble, fast thought leaders and skilled communicators. We have to be forward thinkers willing and able to get out of the isolation we have experienced historically. We have to join the executive leadership conversations rather than wait for an invitation. AHE provides the tools to help us get there, but it’s up to us to take advantage of the opportunities. If we are standing still, we aren’t moving forward and someone else will step in. AHE has everything the profession needs to be the tip of the sword. The technical expertise and experience of the membership are resources to be utilized and networked.

What is your advice to ES professionals who wish to advance their careers?

Become an AHE member. The value of membership speaks for itself in what you receive. Further your knowledge by utilizing the complimentary educational opportunities available to you as part of your membership. For $165, you receive nine webinars and a full portfolio of online self-directed and facilitated courses that also include discussion groups. Utilize the AHE signature programs and AHE’s relationship with The Ohio State University hospitality management program that now offers an online health care certificate program specific to ES.

We should be actively involved on AHE committees, not only to provide the technical expertise to AHE staff, but to keep learning from our peers.

Obtain your Certified Healthcare Environmental Services Professional (CHESP) credential. Demonstrating competency is vital to the profession. CHESP illustrates your competency and credibility no matter how long you have been in the field. Collaborate with other leaders, demonstrate the value ES brings to your organization and be a voice at the table. Build the knowledge, skill set and credibility of your teams. Educate them and provide opportunities to become Certified Healthcare Environmental Services Technicians. Network with your peers on MyAHE, a great resource. Now is our time, and AHE provides the pathway to opportunities to showcase our profession.

Jamie Morgan is associate editor at Health Facilities Management.