The health care industry is growing fast as America’s older population ages and younger generations reach record numbers. Hospitals are expanding at a rapid pace to meet the new demand for health care services; however, during this process, it is important to not lose site of important facility programs, including pest management.

While renovations bring great changes, the process can often disrupt normal services, pausing normal sanitation schedules, interrupting maintenance routings, and increasing traffic and visitors. One unhealthy side effect can be that pest control services get shelved. However, renovations tend to be when pests pose the largest threat to health care facilities. When outdoor habitats are disrupted for new construction or pest control routines are abandoned during upgrades, it can lead to problems. Mice, rats and other rodents can scurry inside if their outdoor homes are disturbed. So, if you do come across any rodents on your property, you should call a professional pest control service, or manage the situation yourself by using something like a pellet pistol (if you find them in your garden), to ensure that they don’t interfere with your lives. These aren’t the only pests that can disappear if you don’t catch them quick enough though. Cockroaches and other insects also can take root if moisture seeps into foundations. And termites can run the show if construction debris isn’t discarded properly. Termites are everywhere and any waste will certainly attract them. The only way to remove them is to have a professional come and perform Termite Control in Phoenix, LA, or wherever you may be.

Patients can leave negative reviews or complain to auditors if pests are found, and rightly so. Everyone expects a high level of sanitation and cleanliness at hospitals, doctors’ offices and clinics.

Because pests carry harmful pathogens and the potential to ruin a hospital’s reputation, it’s essential to take a proactive approach to pest control before, during and after renovations. By taking preventive measures and working directly with a pest management professional, with measures like reading through a guide to how to get rid of spiders at pestsmartcontrol or calling them directly before a renovation or expansion, facility owners and operators can ensure a patients’ stay is healthy, and also keep on top of a construction timeline and budget.

Phase I: Planning for Pests Before Renovation

Being proactive about a pest management strategy from the start has long-term benefits. Managing pest control issues during construction typically falls on the contractor, who should create an integrated pest management (IPM) program. Effective IPM practices aim to limit pests’ access to the resources they need to survive and reproduce, typically food, warmth, shelter and water.

IPM is most effective when a property is evaluated beforehand to determine which pests already are located around the property, how large their populations are and in which season they are most prevalent. For example, this information could affect a decision to start a construction project in the driest part of the year if mosquitoes and flies are a problem in a particular area. This may prevent entry from swarms of mosquitoes or flies that could occur if the construction started during wet or humid months.

Materials also have the potential to be problems or – when chosen wisely – solutions. When sourcing building materials, choose those that have the potential to deter pests, such as concrete, fiber-cement siding or non-cellulose insulation. Facility owners also need to inspect all incoming materials for signs of pests, as sometimes they hitch a ride onto the construction site with the new materials. Things to look for include droppings, chewed surfaces, or even dead rodents or insects.

A pest management provider can work with the contractor to treat for termites and other insects as walls and foundations are poured and installed. Owners (or hired contractors) will also want to carefully inspect walls and foundations for cracks that rodents and ants could use as an entry point into the structure, and may ven want to read through sites that ran a recent post about how to ensure the beds are kept clean and safe for use. Newly emptied rooms can be treated with a growth-regulating product to prevent insect pests from breeding before construction begins. New carpets also can be pre-treated for pests before installation.

Additionally, facility owners and maintenance personnel must be proactive about maintaining a clean and clutter-free construction site from the beginning of a renovation. After all, a single leftover lunch could cause a full-fledged infestation of roaches, ants or flies.

Phase II: Implementing Best Practices During Renovation

During renovations, it’s important to grade a property properly so that water drains away from the foundation. Standing water is particularly attractive to mosquitoes, and moist, disturbed soils can be the perfect hiding grounds for termites. While grading the property, place baits around the perimeter to prevent termites before they find a way inside the facility.

Any new landscaping installed during a renovation should be kept trimmed and placed at least 2 feet away from buildings to reduce rodents’ accessibility to upper levels and building roofs. Pests will be further deterred from entering the property by installing LED lights (as some studies have shown are less attractive to flying insects than traditional lighting).

During renovations, it’s important to revisit the most common methods that pests use to enter the property. For instance, entry doors (loading docks, front or back entrances, garage doors, etc.) should remain closed as much as possible to reduce entry of rodents or pests with wings, like birds and flying insects. Double sliding doors are recommended at major entrances to create an additional barrier. If windows must be left open, they should be properly screened. Any utility openings should also be closed off.

For frequently used entrances, air curtains (which are fans mounted against the doorway) and plastic strips help to prevent pests from getting in and conditioned air from getting out. These are often a good idea to install at loading docks or supply areas. Steel or copper mesh can be used to seal walls so that rodents can’t gnaw through to the building’s wires and electrical systems.

At the end of each workday, it’s important that construction crews cover all building materials to protect against the elements, especially rain. No one wants to find fungus, larvae or full-grown pests hiding in wet building materials.

Phase III: Maintaining Pest Management After Renovation

Even when a renovation is complete, pest management is not. Work with a pest management professional to update an IPM program based on new additions to the hospital or clinic. Certain areas of a health care facility need special attention and certainly any new food service areas will need to have a strong pest management plan in place.

Education is the key to long-term prevention of pests following renovation. Health care staff – particularly those who work with food, laundry or patients – should be trained on prevention and inspection techniques. After all, they are on the front lines of pest threats, and they should be encouraged to report and log any pest sightings.

As health care providers, it’s essential to be proactive about pests as renovations occur. By maintaining effective pest management practices before, during and after renovation, a health care facility can provide high-quality care to patients and continue to be a place where health and wellness can thrive.

Tim Husen, Ph.D., BCE is a technical services manager at national pest control company Orkin LLC. A board-certified entomologist specializing in urban entomology, he has more than a decade of experience in the industry. For more information, email thusen@rollins.com or visit www.orkincommercial.com.

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Antimicrobials in Healthcare was developed as a response to independent third-party testing that has repeatedly confirmed that routine cleaning is not enough to keep health care environments clean to a standard that meets their needs. Additionally, it is a response to the constant efforts by the health care industry to find better products, materials and equipment to support keeping surfaces cleaner for longer periods of time.

According to the white paper, embedded antimicrobials are antimicrobials incorporated into products during their manufacture, and become a permanent part of the product. Antimicrobial technologies are currently used in a wide range of health care-related products already, including in storage and transport equipment, building materials, procedural tools and administrative supplies and equipment.

While these products are already in use by many health care facilities, the goal of the white paper is to provide health care decision-makers with a basic understanding of “embedded antimicrobials,” an overview of the benefits of antimicrobial solutions and to address common misconceptions about the use of these products to further encourage their use. The white paper offers further information and benefits of these products to continue the encouragement of further and widespread use of these antimicrobial technologies.

“The role of embedded antimicrobials as part of an overall ‘systems approach’ to creating cleaner surfaces in the health care environment is an important topic to examine,” said Dr. Gina Sloan, director of innovations at Microban and author of the white paper, in a recent statement. “The incorporation of built-in antimicrobials complements good hygiene practices by providing an added level of protection, keeping products and equipment cleaner between cleanings, at a microscopic level.”

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During Part I of this two-part series, it covered the importance of transition planning during new hospital construction or renovations. Through the transition planning process, health care organizations receive invaluable intangible deliverables including the breakdown of department silos through increased appreciation for work in other departments, elimination of duplicative processes and cross-training of staff, as well as the benefits of change management and culture development.

Specific sequencing is paramount. There may be staff turnover from the original design teams to the phase of transition and activation.  New members and decision makers need to see and understand the reasons for design decisions and new standards.

One major process that comes up in almost every transition planning engagement includes more effective and better ways to deliver medications to patients while minimizing unnecessary steps for the nursing staff.  The patient needs to receive the right drug, at the right time, in the right dose and route, every time. From the nursing perspective, medications need to be easily accessible, as close to the bedside as possible and available when needed. Pharmacists are concerned about the appropriate storage, accurate dispensing and controls to the distribution point of care. Balancing the needs of these various group to find a solution that works for everyone is possible if the right processes are employed.

Testing new processes through mock scenarios and drills is also integral to effective transition planning.  These drills help to test the new processes to assure that they fit the design of the new facility.  Typically, mock drills and simulations are staged approximately two-three weeks prior to activation after all equipment and supplies are in place. Those processes with the most change are tested and simulated with staff to ensure correct understanding of location of critical equipment, supplies and flows of patients, visitors and staff.

At Castle Rock Adventist hospital, the transition team managed the process beautifully. “In working through transition planning for the opening of our new acute care facility, the Transition Team provided the detailed guidance needed in designing an operation plan,” says Vicki Mettlach, Project Manager/Director of Quality Resources.  “This involved creating policies and procedures, developing process flow and testing mock patient scenarios.  This was very beneficial to us in our preparations to open successfully and smoothly by keeping us on track and on top of the overwhelming details that could otherwise be overlooked.”

Lean tools are the root of effective transition planning. Without good tools, it is impossible to create customer value, eliminate waste, promote flow, or test processes, all steps that are instrumental in eliminating waste.  The process map is an important tool that transition teams employ to establish roadmaps and guides for decision making in multiple healthcare processes and procedures.

Enthusiasm, Energy + Improved Care Delivery

Working hard to ensure the smoothest transition, a large proportion of staff will have put in extraordinary time in the months prior to the move. Day one is a time to celebrate. But in the months and years that follow, real success will always be measured by the care that is given. How seamless that care is, and its delivery will depend on the work that was done in the transition planning phase from the old facility and to processes in the new. The net result – patient safety, patient satisfaction, and operational efficiency — is ultimately the chief goal.

Optimizing the value of transitioning with all attendant changes is a significant moment in an institution’s history, which can depend not only on unique talent and expertise, but also extraordinary levels of enthusiasm and energy. Health care leaders can decisively include transition planning in their project scope from the outset, leveraging the excitement as well as bringing clarity and improvement to new facility processes.

Terry Thurston is the Healthcare Operations Planner with Indianapolis-based BSA LifeStructures. She can be reached at tthurston@bsalifestructures.com or 317.819.7878.

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As health care continues to undergo significant change, health care organizations are looking for innovative solutions, new approaches, proven processes and best practices that mirror their increasing focus on the patient-caregiver experience. There is growing interest in anything that can enhance patient and caregiver experiences and improve the quality of ambulatory medical care.

Most health care organizations understand that the patient-caregiver interaction at the point of care is a foundational element of effective health care. However, many organizations fail to fully recognize how the point of care ecosystem affects the overall experience, including clinical outcomes.

Traditionally, caregivers viewed a patient visit as everything that happened during the direct patient-caregiver interaction. While the interaction in the exam room is a focal point, the point of care ecosystem actually encompasses everything that happens within the practice or clinic, as well as experiences that occur outside of this environment.

As engaged health care organizations work to better understand the point of care ecosystem through the lens of a complex integrated system, they quickly realize just how disconnected some of these processes and components truly are.

Seamless Patient Experience

A fully connected point of care ecosystem is becoming more of a reality as new technologies with greater connectivity are introduced to the industry. This connected ecosystem integrates processes, equipment and caregivers at the point of care to significantly enhance the patient and caregiver experience and improve the quality of ambulatory care. It also ensures a more satisfying and seamless patient experience by providing a platform where organizations can leverage new technologies, incorporate best practices and employ greater standardization to improve care and outcomes.

1. Greater Visibility

Today’s medical practices are complex organisms, often featuring many disconnected processes, devices and components. Most health care organizations find it difficult to determine exactly how their practices are performing and where opportunities exist for improvements or efficiency gains.

However, new technologies and tools are helping bring visibility to existing processes, giving organizations the insight they need to make data-driven business decisions. As organizations gain greater awareness of the entire ecosystem, they are better positioned to make additional optimizations to ultimately enhance patient care.

For instance, real-time locating systems (RTLS), which have been used in hospitals for many years, are quickly becoming a key component of a connected point of care ecosystem in outpatient facilities.

This data-driven understanding of workflows provides in-the-moment situational awareness of the ecosystem. This allows healthcare professionals to proactively escalate responses to problem areas and monitor key performance indicators in real time.

2. Standardized Approach

The continuing consolidation of medical practices is occurring at such a pace that many organizations are finding it difficult to establish network-wide operational and clinical standards. Many health systems simply tolerate the variability in outpatient environments, not realizing the costs associated with having little to no key performance metrics in place.

Standardization helps organizations develop clinical protocols that drive better outcomes. It can also create efficiencies and cost savings, as well as minimize human variables that increase the likelihood of errors that can contribute to inaccurate diagnoses. One area where this is evident is blood pressure (BP) measurement, which continues to be one of the most inconsistently performed tests in a clinical environment. But, it also has perhaps the strongest connection to point of care diagnosis, patient risk stratification and medication dosing.

A fully connected point of care ecosystem helps facilitate and ensure a level of standardization to minimize human variables and maximize consistency and data accuracy. Connected diagnostic devices used in conjunction with a connected exam table that automatically positions the patient to achieve an accurate reading allow caregivers to measure blood pressure more consistently through established electronic checklists. It can also directly import patient data into electronic medical records (EMR) and help facilitate the adherence to a health system’s clinical guidelines for proper technique in achieving BP readings.

3. Greater Efficiency

A fully connected point of care ecosystem allows caregivers to not only identify opportunities to improve efficiencies, but to also more easily and accurately measure progress and success.

For example, one area where efficiency gains can be realized is vital signs acquisition. The vital signs process hasn’t changed significantly in the last 30 years, and today’s processes often include multiple stopping points in a facility to capture base vital signs (height, weight, pulse, temperature and blood pressure). Some of these locations are in semi-public spaces. These disconnected processes result in significant inefficiencies and lost patient and caregiver time.

A Midmark study examined potential workflow efficiencies during the acquisition of vital signs, as well as the interaction between patients and caregivers, in an effort to identify near-and long-term implications for efficiency. Care interaction was observed from the time the patient was called from the waiting room, through vital signs acquisition, to the time the patient was ready to see the physician. The average time was five minutes, seven seconds.

Results of the Midmark study indicated that minor changes in workflow and design, such as collecting vital signs in the exam room and implementing automated vital signs connected directly to an EMR, could reduce conveyance and acquisition time by as much as 36 percent per patient.

4. Enhanced Patient-Caregiver Interaction

Patient-caregiver interaction in the exam space is a foundational element in the continuum of care. Traditionally, the face-to-face exam was seen as the only significant interaction between the patient and the primary care provider. However, growing focus on population health is encouraging health care organizations to think in broader terms. With the advent of the patient-centered medical home, care is often delivered by care teams that can include providers, nurses, ancillary staff and care coordinators.

When viewed from the lens of a point of care ecosystem, the patient-caregiver interaction becomes every touch point that the patient has with the health care organization, including, but not limited to, face-to-face time in the exam room. For instance, consider the waiting room. While traditionally not viewed as part of the patient-caregiver interaction, it could potentially have a negative impact on the patient experience — especially if the patient wait time is perceived to be too long or the room is not seen as being comfortable or inviting.

As workflow software continues to advance, health care organizations are gaining a better understanding of how rooms and equipment are being utilized and the amount of time patients and staff spend with specific processes. New technologies, such as RTLS, can tell health care organizations how much time a patient spent in the waiting room before being called to an examination. It can also provide visibility into the patient experience when they leave the waiting room and are taken to the exam room.

Jon Wells is responsible for driving product strategy, product development and marketing efforts within Midmark’s medical division. He is a supporter of patient accessibility standards in medical facilities and has testified regarding accessibility requirements for medical devices to the United States Access Board.

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