A Simple Tool to More Objectively Evaluate Housekeeping\Cleaning Activities for Health, Safety and Aesthetics in Community Institutions

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Housekeeping in institutions, whether they be day care centers, university dorms, nursing home rooms, hospital rooms, or jail and prison housing, rely on in-house labor and simplified methodologies to minimize health and safety risks; while providing some level of aesthetic cleanliness is most desirable. Epidemiological studies have detailed minor disease outbreaks in correctional facilities linked to common-touch and chronically wet surfaces such as showers and toilet areas. In addition, analysis of injury and incident reports involving trips, slips and falls within hospitals and correctional settings focus on housekeeping methods and outcomes, and to a lesser degree, maintenance.

In a recent court case involving plaintiffs, defendants and court-appointed monitors (all Registered Sanitarians), the evaluation of housekeeping activities by all parties was widely disparate; with less than 50% agreement because of subjectivity and personal bias precluding objective outcomes. The parties conducting the inspections initially agreed to use a simplified sampling strategy adapted from MIL-STD-105E (ANSI/ASQ Z1.4) and develop a matrix of ten readily-observable cleaning and cleaning-related parameters as an inspection tool. The matrix parameters were constructed to easily conform to a Boolean logic (it was clean or it was not clean)(+/-); definitions and inspection methodologies were precisely detailed and acceptable quality levels (AQL) established for each separate facility inspected.

The outcomes demonstrated both the precise strengths and weaknesses in the overall housekeeping programs. In turn, these were used for quality improvement and ultimately, for quality assurance such as modifying the institution’s existing Standard Sanitation Operating Procedures (SSOP). The inspection matrix was designed so that all inspectors would be within a ≥80 percentile agreement. The methodology for this exercise can be adapted to any institutional program where environmental health and safety parameters are evaluated.