Improving Bed Turnover/Throughput – Environmental Services
How many EVS FTE’s and shifts are required to achieve best practice of bed turnover in 60min.
Current issue that we are facing is capacity within the hospital. Our system is at 105% capacity which means severe delays in the emergency department. One limiting factor is the FTE requirement and time it takes to have a bed/floor cleaned to accept patients. Environmental Services (EVS), has an FTE budget of 149 employees. The shifts and FTE’s are as follows; Days = 84 (7a-3p), mid shift = 52 (3p-11p), and nights = 13 (11p-7a). We have a vacancy rate of 14% which we can’t seem to overcome, and maintain 10% on disability. At shift change it takes approximately 1.5hrs to restock cart prior to cleaning which increases delays. Each clinical floor takes approximately 5 hours to clean and we have 8 clinical floors. In addition we have 4 critical care floors, and 2 separate OR’s containing 27 rooms. A separate but attached facility with 24 procedural rooms and 60 patient rooms. Best practice for bed turnover is 60min. Our current rate is 116min. In addition to the floors that need to be cleaned, we have an average of 170 patient rooms requiring to be cleaned daily. This excludes the OR and procedure rooms. Out of the 170, 80% of beds become dirty between 1p-8p.
I suggest to get in close touch with the a number of the EVS staff and to draw with them the process of cleaning phase by phase and then in each phase to write precisely in each phase the related activities, later on to discuss with them the activities one by one to see how they can reduce those activities that don’t add value to the process and to delete those ones from the cleaning process, at another end to measure the time required to get each activity in the process done and to see the possibility of reducing the time of each activity. this solution is called the value chain management or the FishBone analysis. the aim is to increase efficiencies without adding more resources.
Another solution is to run an exercise to outsource the EVS and to call for a tender to get a technical and financial proposal from a specialized cleaning companies to take over this job ” if this is still provided in-house “.
I would make sure that you have enough FTE’s based on the square footage of space you have to clean
I also recommend staggering shifts especially during your busy time frames
Carts should be stocked at the end of each shift so that they are ready to go the next day or another option is having the night shift stock all carts since there is more downtime
Most hospitals are contracting out either EVS all together or contracting out managment of EVS so it can be run more efficiently.
Good luck