First impressions are important, as are common courtesy and patient-centric processes when a health care organization is trying to build trust and loyalty with its patients.

Survey reporting identifies cleanliness, appearance and safety as being highly important aspects of the health care environment. And the field is realizing an increased emphasis on the patient experience, third-party reviews, social media, décor of the facility and on-demand patient services.

Concurrently, health care facilities remain challenged by opportunistic viruses, bacteria and fungi. The increase of multidrug-resistant superbugs and difficult-to-contain pathogens requires a much greater focus on the environment of care, demanding that environmental services (ES) professionals play a critical role on the patient care team.

While ES professionals were once considered as housekeeping staff, ES slowly is being recognized for the essential departmental functions of infection prevention, financial administration, waste management, laundry and linen management and pest management. However, ES technicians, considered the first line of defense for infection prevention in the environment of care, still often receive the least amount of consideration for staffing, investment in training, development and career path opportunities.

ES provides services for all facility users and must perform at a consistently high level to meet standards, expectations and to be compliant with multiple regulatory agencies. Support and resources must be made available to it.

Facing the challenges

Perhaps the most important time spent by ES leaders is in developing talent. Succession planning and providing career path opportunities for ES staff are often overlooked areas by ES leaders. They should meet individually with everyone on the ES staff to discuss their vision and what success looks like for them. Investing in the front-line staff and understanding their dreams and desires are paramount to becoming a well-rounded professional.

Allowing ES staff to explore their areas of responsibility and achieve success as they define it will result in more effective dialog and increase loyalty between ES leaders and front-line staff. Exposing front-line staff to decision-making processes and remaining transparent with timely communication that produces root-cause thinking provides the basis for success in their growth and development.

A strong leadership team inclusive of front-line staff embraces the opportunity to contribute with collaborative decision-making and failure-tolerant empowerment. Each failure can bring leaders closer to success when critical thinking is applied and metrics guide decisions. By exposing their own failings, leaders can create a greater connection with staff, not limiting them to a distinct or isolated group.

Leaders who are flexible with how staff use their paid time off (e.g., meal breaks, sick leave, vacation and family leave) build trusting and respectful relationships, and improve morale, loyalty and productivity. Leaders should avoid the sometimes-misplaced desire to micromanage skilled staff because it limits creativity and can be demoralizing.

Illuminating positives and utilizing strengths of individuals will provide greater opportunities for success and enhance continuity of performance, according to Eric Rubino, principal at The Extreme Group, Scranton, Pa.

“When a leader starts a meeting or conversation by stating the issue or concern, then provides [his or her] idea to solve it, and lastly follows up with ‘but what do you think we should do?’ the team is most likely to agree with the manager or restate the manager’s idea in other words,” Rubino recently wrote on LinkedIn. “Rather than fostering idea cultivation, this essentially eliminates the potential for a true productive meeting to brainstorm for solutions. Be the leader who isn’t afraid to appear stupid by asking multiple questions to better understand the team’s perspective and to cultivate the team’s innovative skills. Instead of giving your team the answers, lead your team to the answers.”

This gives the ES leader a chance to coach and guide the team. Notable coaches avoid the urge to solve every problem, which can be difficult. More than likely, it is this behavior that contributes to a leader’s being recognized and advancing in his or her field. These routines will enhance a leader’s failure-tolerant practices to a level of trust and respect that transcends the common leader bond with front-line staff.

Effective ES leaders can set the standard for support services professionals in health care. They can support the vision of their organizations and initiate change that will set the pace for others who may be on the fence with new processes and top-down directives.

The dynamics of an empowered team become seamless and resilient when faced with new challenges (e.g., a matrix-management structure), according to Brian Carney and Isaac Getz in the article, “Give Your Team the Freedom to Do the Work They Think Matters Most,” which appeared in the September 2018 Harvard Business Review.

“For example,” they wrote, “every morning, a liberated company’s manager would ask whether there is anything preventing her team from doing their best. That may not sound unusual, but here’s the first twist: When her team shares a problem or an opportunity with her, she will not offer a solution. Instead, she asks them to find their own — after ensuring that there isn’t something she’s doing that would get in the way.

“When a new project comes in, the manager does not devise a plan to complete it. Instead, she asks the team to do so. In making these choices, she accomplishes two vital things. She places herself in service of her team, rather than above them as a supervisor and this, in turn, has a direct impact on the behavior of her team: It starts to liberate them to act on their own initiative, rather than passively awaiting direction from above.”

Agility becomes an important component of building the ES leader’s value within the organization. Choosing to fly under the radar or playing it safe can stunt the growth of a career and impede the personal and professional appeal of the leader to an organization. To further enhance personal value, leaders should seek opportunities to contribute in new arenas, building skills that can provide a path to promotion and increased visibility. Additional skill sets and exposure to various functions in a health care facility will present options for senior leaders to consider when aligning organizational talent.

A key driver for ES leaders is to keep their focus on what’s working to accentuate improvements and maintain continuity with departmental operations. ES leaders can find themselves distracted with day-to-day irritations and seemingly wasted efforts directed by others, but they must stay the course, maintain the drive and focus to achieve the results they desire.

ES leaders also should exhibit pride. They may have found success professionally challenging, overcoming obstacles that helped to form a foundation of potent positive energy and creative processes for improvement. However, caution must be exercised so that pride does not become egotism. An egotistical leader does not demonstrate the value of others, but is self-absorbed and unaware of the disconnect they have with staff. ES leaders must remain mindful of the impact they have on others. Their actions, behavior and decisions are always being observed and measured for consistency and integrity. A solid leader will be an exceptional listener and will exhibit humility while maintaining a calming presence in the face of adversity.

When regulatory surveyors visit the facility, staff will look to the leader for reaction and responses to provide stability and assurance. It’s important to confirm with staff that their base of knowledge, skill sets and efforts to attain excellence are valued. A leader should model the culture he or she is trying to build in the department by being respectful and appreciative of the qualities each individual brings to work each day.

Bringing a team to the forefront in an organization requires a constant, steady regimen of basic principles applied routinely. Keeping the mission, vision and values as the foundation of every decision and reinforcing them with front-line staff are essential to creating a high-performing team. ES leaders also earn greater credibility by maintaining strong technical knowledge and a firm understanding of the challenges front-line staff face every day. Walking in their shoes is meaningful and a bridge to building trust with the staff. Collaborating with staff throughout the organization and helping the team take ownership of their responsibilities and processes contribute to their morale and overall job satisfaction.

ES leaders who encourage risk taking allow the team to feel safe. Their confidence grows without fear of embarrassment or punitive action when offering suggestions, asking questions or making a mistake.

Also, not to be overlooked is the significance of communication. Listening skills are perhaps the most difficult to accomplish, but provide the greatest return in building and sustaining meaningful relationships.

Effective ES leaders understand the importance of sharing their knowledge through open, honest conversation. Providing timely and specific feedback that focuses on learning is also a positive and productive opportunity to engage staff, solicit their ideas and solve problems.

Significant shift required

Successful health care administrators and prominent health care organizations recognize the significant shift required to maintain the high standards and expectations of today’s health care field.

These progressive and innovative senior leaders require excellence and demonstrated competencies from their ES teams.

They emphasize the importance of ES and provide greater support to ensure that ES receives the necessary access to senior leaders, and that budget allocations are sufficient enough to mitigate health care-associated infections, maintain aesthetically pleasant surroundings and contribute to a positive patient experience.

Advancing the health care organization with a properly staffed, trained and supported team that emphasizes the vital contributions of the ES department, improves the entire organization and positively impacts its financial resources and community support as well as brand loyalty for the organization.

Tom Mattice, CHESP, T-CHEST, is director of environmental services for Montefiore-Nyack (N.Y.) Hospital. He can be reached at