The Admis­sion, Dis­charge, and Trans­fer (ADT) soft­ware is the back­bone IT sys­tem in the hos­pi­tal. It man­ages the most impor­tant activ­i­ty: admit­ting and dis­charg­ing patients and get­ting paid for the ser­vices. A hos­pi­tal does much more than sell­ing bed space, but at its core, admit­ting new patients is what keeps the hos­pi­tal finan­cial­ly viable.

Mak­ing sure the emp­ty, dis­charged beds turnover quick­ly to clean, infec­tion-free rooms avail­able for admis­sion is also very impor­tant. This is a key func­tion of an Envi­ron­men­tal Ser­vices Depart­ment, so of course, the EVS depart­ment needs to be inti­mate­ly involved with the ADT sys­tem.

How­ev­er, it is a cost­ly mis­take to think that an ADT soft­ware has all the tools nec­es­sary to man­age Envi­ron­men­tal Ser­vices. Here are the key areas where only an Envi­ron­men­tal Ser­vices Soft­ware can opti­mize the hospital’s sec­ond largest work­force.

Overall Staffing Numbers

Discharges, Transfers, and Isolation cleans, which can be tracked in the ADT system, are only part of the the EVS department’s cleaning responsibilities and budget.

Smart Facil­i­ty Soft­ware has per­formed thou­sands of staffing analy­ses for hos­pi­tal EVS depart­ments. We con­tin­u­al­ly find that patient room dis­charge cleans account for only 10 — 20% of the total FTE (full-time employ­ee) bud­get. (Depart­ments where this is less than 10% tend to be over­staffed — and depart­ments where this is more than 20% tend to be under­staffed.)

The oth­er 80–90% of the bud­get­ed FTEs that can­not be man­aged in the ADT sys­tem are:
• Occu­pied patient room cleans
• Dai­ly cleans, polic­ing, and project work for every room, cor­ri­dor, ele­va­tor, entrance, and stair­well in the hos­pi­tal.
• Lock-ins for between-case clean­ings and mul­ti­ple shift cov­er­age.
• Trash removal, meet­ing set-ups, sup­ply stock­ing, linen dis­tri­b­u­tion, etc.
• Breaks and non-pro­duc­tive time of FTEs (e.g. vaca­tion and sick time).
• Man­age­ment FTEs

So, the ADT sys­tem can­not pro­vide the num­ber of FTEs need­ed to clean the full hos­pi­tal.

HAIs do not lim­it them­selves to only patient rooms dur­ing dis­charges. Our envi­ron­men­tal ser­vices soft­ware, ES Opti­miz­er, has 91 room types, only 4 of which are patient rooms.

 

Daily Work Assignments

In addition to missing cleanable space, an ADT system does not house project work, tasks and frequencies required to build daily assignments.

 

ADT sys­tems track all the patient beds in a hos­pi­tal and assign them to zones which are asso­ci­at­ed with dai­ly clean­ing assign­ments for ES Tech­ni­cians. An ADT sys­tem usu­al­ly does not, how­ev­er, list any of the oth­er rooms, cor­ri­dors, entrances, stair­wells, and ele­va­tors that need to be cleaned dai­ly, policed, and between-case cleaned. It also doesn’t address the fre­quen­cy of clean­ing (e.g. 5 or 7 days/week). Final­ly, an ADT soft­ware does not man­age the project work (e.g. floor fin­ish­ing, buff­ing, sham­poo­ing, wall wash­ing, etc.) for all these rooms.

All of these clean­able spaces along with fre­quen­cies need to be in the soft­ware to build equi­table dai­ly work assign­ments for ES Tech­ni­cians that make sense from a geo­graph­ic stand­point. ES needs to have the right num­ber of peo­ple in the right place at the right time, not only to do dis­charges, but also per­form the oth­er 80%-90% of the work that needs to be done 24/7/365.

ADT sys­tems can­not pro­vide these work assign­ments since they do not house the data ele­ments to do so.

 

Quality Assurance

Some ADT sys­tems pro­vide a mea­sure of Qual­i­ty Assur­ance (QA) capa­bil­i­ty. But once again, typ­i­cal­ly only for patient rooms. ES

Opti­miz­er has a QA sys­tem for all clean­able space in the hos­pi­tal, includ­ing dis­charge cleans.  The inspec­tions that are being run for the EVS depart­ment needs to be incor­po­rat­ed into the dis­charge and patient room dai­ly cleans. You only want to run one QA sys­tem for ES func­tions so that the data is com­pa­ra­ble and coher­ent.

Apps run­ning on smart devices syn­chro­niz­ing with a web-based data­base is how an ES man­age­ment tool should han­dle QA.

 

Census-Based Scheduling

Flexing the daily work assignments for the day’s census.

Cen­sus-Based Sched­ul­ing is not as big of a com­po­nent for EVS depart­ments as it used to be. Rarely do you find hos­pi­tals these days with a 10% or more lev­el of clean and emp­ty patient rooms ready to be occu­pied every morn­ing. How­ev­er, if your hos­pi­tal is run­ning less than 90% cen­sus, then the ES depart­ment needs a sys­tem to flex dai­ly work assign­ment cov­er­age up or down.

The only true vari­able in a Hos­pi­tal EVS depart­ment work­load is cen­sus, dis­charges, and trans­fers. The rest of the clean­ing is typ­i­cal­ly fixed; it was cleaned, or it was not cleaned. If cen­sus does fluc­tu­ate, then the EVS depart­ment needs to be able to flex the vari­able clean­ing (dai­ly, dis­charge, trans­fer, and iso­la­tion cleans) with fixed clean­ing such as nurse’s sta­tions, wait­ing areas, restrooms, etc. An ADT sys­tem does not incor­po­rate the rooms for fixed clean­ing and, there­fore, can­not be used as a cen­sus-based sched­ul­ing tool.

Days-On/Days-Off Scheduling

ADTs lack full EVS scheduling capabilities.

With­out EVS soft­ware, sched­ul­ing per­son­nel with work assign­ments typ­i­cal­ly tends to be done in Excel spread­sheets that are saved as a new file every cou­ple of weeks. This leaves behind a trail of con­fus­ing his­toric files.

A web-based data­base appli­ca­tion built specif­i­cal­ly for EVS depart­ments orga­nizes all the employ­ees and the work assign­ments. The uncov­ered assign­ments can be eas­i­ly be searched and paired with open employ­ees. Open employ­ees that match the assign­ment can be found through a fil­tered search as well. Assign­ments can be applied to cal­en­dar dates and eas­i­ly changed by super­vi­sors, who have the abil­i­ty to print out sign-in sheets and ros­ters. This is much more effi­cient and error-free.

ADTs have none of these capa­bil­i­ties oth­er than show­ing what employ­ee was assigned to each zone and which beds they cleaned.

 

Scheduling and Tracking Project Work

A typ­i­cal hos­pi­tal has thou­sands of projects aside from dai­ly clean­ing that need to be sched­uled and tracked. Since an ADT sys­tem tracks patient rooms, per­haps the floor fin­ish­ing, buff­ing, etc. could be run through an ADT. How­ev­er, ADT sys­tems can’t sched­ule the main lob­by wait­ing area to be sham­pooed. EVS soft­ware includes data for these spaces and the abil­i­ty to add to work assign­ments, sched­ule staff, and record its com­ple­tion. See ES Opti­miz­er’s Project Assign­ment screen to the right.

 

Employee Training and Records

 

An ADT sys­tem can’t keep track of all the in-ser­vices need­ed for a suc­cess­ful ES depart­ment, or record employ­ee com­men­da­tions and con­sul­ta­tions. A web-based data­base designed for and used by ES Depart­ments will.  With ES Opti­miz­er’s train­ing man­age­ment mod­ule, reports on train­ing his­to­ry can be run instant­ly for the Joint Com­mis­sion.

EVS Software is needed in addition to an ADT System

While Admis­sions, Dis­charges and Trans­fers sys­tems are an essen­tial tool in hos­pi­tals, they are not built to han­dle all func­tions of Envi­ron­men­tal Ser­vices. Bed track­ing infor­ma­tion is key to man­ag­ing envi­ron­men­tal ser­vices and EVS man­agers should be very involved with the ADT sys­tem.  But, EVS man­agers also need a soft­ware tool, like ES Opti­miz­er, built specif­i­cal­ly for their depart­ments in order to reach their full pro­duc­tiv­i­ty and effi­cien­cy at keep­ing the entire hos­pi­tal clean and infec­tion free.

 

Author: Shawn Wright
Shawn Wright is one of the own­ers of  Smart Facil­i­ty Soft­ware. He has over 25 years of expe­ri­ence in ES con­sult­ing and imple­ment­ing soft­ware in envi­ron­men­tal ser­vices depart­ments nation­wide.