Beautiful Friendship: How IPs, EVS Work Best Together

In the best hospital settings, infection preventionists (IPs) and environmental services (EVS) teams collaborate, says Sharon Ward-Fore, MS, MT(ASCP), CIC. In 1 of 3 brief tutorials Ward-Fore does for Infection Control Today®, she offers practical advice on how to make this partnership work. There should be some give-and-take when it comes to developing best approaches to cleaning hospitals, says Ward-Fore, who is a member of ICT®’s Editorial Advisory Board . It also doesn’t hurt for IPs to acknowledge the job that EVS does. “I would always say to them, ‘You know, you’re an infection preventionist, just from a different side of the patient experience. You’re at the bedside preventing those infections.’ And nothing brought a bigger smile to their faces than acknowledging how important the work is that they do.”

Infection Control Today®: What’s the best approach that infection preventionists can use for keeping track of environmental services?

Sharon Ward-Fore, MS, MT(ASCP), CIC: I think IPs and environmental services typically work very collaboratively. Part of a team, including others, nursing managers and supply chain, to help keep things moving in a hospital setting. I don’t think that’s changed. Maybe with COVID, it’s an even tighter collaboration, I would hope. Because we know during the surge of COVID, there were shortages of disinfectants and cleaning supplies. We’re hoping that maybe now that things in some areas slowed down, it gave them a chance to sit down with all the stakeholders and figure out what do we need to do in the way of our cleaning and disinfecting supplies moving forward. And probably one of the things they should be thinking about is—I don’t want to say hoarding—but kind of stockpiling, what they may need. And then using their products, judiciously. Making sure that staff is trained on appropriate dilutions, and just kind of monitoring the usage of the product so that they don’t run out.

ICT®: How closely do infection preventionists and the managers of EVS teams work together, in your experience?

Ward-Fore: I worked very closely with the managers of EVS, and I know at other facilities IPs also work with those managers. Although EVS is in charge of the cleaning process IPs work carefully with them to make sure the process is followed by auditing it frequently. And both sides provide feedback to each other just to make sure everything follows best practices. A lot of places with turnover, you need to keep on top of what’s actually happening out on the hospital floors. And a really good collaboration helps make that happen.

ICT®: There are no turf wars over anything like that?

Ward-Fore: Well, I mean with anything when this is not your area, per se, you need to tread lightly. And in healthcare, most people know that we’re all on the same page. It’s patients and staff safety first. And if you’re not criticizing but contributing to best practices for the staff, in my experience, it was well received. You know, EVS sees things from their side. IPC thinks a little differently. So that the two working together really, I think it’s a good way to keep things copacetic.

ICT®: When you saw a team really function well—and it seems like you alluded to your own experience—what was the secret sauce that made that cooperation work?

Ward-Fore: Well, for me, I think it was I didn’t come into their department as the expert on EVS. I came into their department, asking them to show me what they do so I can learn. And I think when you let the experts be the experts and then share their knowledge, it builds trust. And when I did have suggestions, they were suggestions. It wasn’t hardball: “You need to do this. You need to do that.” It was pretty much maybe we should try this kind of an approach. I think, treading lightly and respecting departments for the experts they’re supposed to be, but then also adding your opinion or what you’ve read in the literature, kind of opens it up for discussion. And I think discussion is important. Rather than Draconian rules: “You will do this this way.”

ICT®: Ever any need to call in a referee and who would be the referee?

Ward-Fore: With the managers, of course, there’s always a director. But in my experience, at least, the managers were very well invested in doing the right thing for patients and staff. The EVS staff workers who actually did the cleaning were very prideful and proud of their work. And I think the thing that went the farthest was thanking them each and every time I encountered them for being there doing the great job that they do. I would always say to them, “You know, you’re an infection preventionist, just from a different side of the patient experience. You’re at the bedside preventing those infections.” And nothing brought a bigger smile to their faces than acknowledging how important the work is that they do.

ICT®: How important will that work be going forward and how can infection preventionists help them, starting, of course, with COVID-19?

Ward-Fore: COVID-19. In some instances, environmental services was removed from actually cleaning the COVID positive patient rooms just because there was a need to minimize exposure. How that is in some places now, with fewer patients, EVS is probably back in there doing their job. And I think healthcare workers and IPs can acknowledge that it’s dangerous for them. They’re in those rooms for an extended period of time. It’s really important to acknowledge that there is some level of risk to them. It’s important to make sure that they’re trained in competency on how to wear their PPE and how to take it off. And just acknowledge them for being willing to go into these high-risk rooms and do their job to the best of their ability. Again, I think it’s all about understanding how people feel and acknowledging that

ICT®: Any final words of advice for your fellow infection preventionists and also your colleagues who are in EVS going forward? And again, you can’t avoid COVID-19 as being part of that advice.

Ward-Fore: I think moving forward, again, IPs need to…. It would be nice if IPs would collaborate with EVS workers on their units and the areas they cover and acknowledge that they do a great job in preventing infections at the bedside. And thank them for all their hard work. They have been … during COVID-19 they have stepped up, they have been right in the midst of it. Everything. And I think they’ve done a great job overall. They’re sort of unsung heroes. And they don’t want to say heroes, but they’re hard workers who have really given it their all.

This interview has been edited for clarity and length.