The new normal demands a new approach to infection prevention to help keep people safe.
By Cathy Campbell, National Director of Service Delivery, ABM; CHESP, CMIP
There's an elephant in the room that we have to talk about. As I've advised hospitals and healthcare facilities about infection prevention, I've had to face this truth. And now, as uncomfortable as it is, COVID-19 has brought us all face to face with it.
People want to know they're safe. That's where we have to start. This is the corner we've all turned together, whether we wanted to or not. We can't buy groceries without being reminded of how COVID-19 has changed us. And every other interaction we have, in every space we step into, is no different. Going to work or getting the business of life done — no matter the task at hand — every time a person enters a building, that's another environment that they've been exposed to. Another risk they've taken.
People put a lot of trust in a facility's leadership. If you are responsible for a facility, that's a lot to take on. And facility leaders will ask: how can I guarantee that people (team members, team leaders, students, patients, clients, customers, guests — our colleagues, our families) in my facility won't get sick? That's a natural thing to ask for. I wish there were a perfect guarantee.
The truth is that, as leaders responsible for the facilities and spaces people share, we have to focus on what is possible. What we can do is implement best practices in infection prevention. We can follow official guidance, put it into practice, and take action to keep shared spaces healthy. And we can help people understand what's being done to protect them, so they can feel sure it's okay to focus on being that great team member, or good student, or satisfied client.
Before the outbreak of COVID-19, disinfection may not have been a core competency of your business. When you compared the benefits of facility service providers and in-house cleaning, that was likely a factor. Now we are here, and your business' core competencies may not have grown to include disinfection, but your business' core needs have now changed drastically. Cleaning and disinfection are now a priority, if not a clear requirement, for maintaining healthy spaces in a facility.
Putting a people-first strategy into place will take some dedicated effort. You will want a disinfection plan that takes the latest safety, infection control, and cleaning protocols recommended in official guidance from the CDC, WHO, and OSHA. You'll want your procedures to use EPA-registered disinfectants that have been designated for use against SARS-CoV-2. You'll want to build clear, ongoing, and effective procedures for cleaning and disinfection and make sure the team members executing those procedures are properly trained to safely and correctly implement them.
That's a lot of work. The research is there, and there are experts you can reach out to for help. I know it can be done because I'm one of those experts. My specialty is infection prevention. It is possible to design and implement a program that upgrades your cleaning process. If you don't already have a robust cleaning and disinfection program in place, this may not be the time to start from scratch. Even if you do have cleaning and disinfection protocols, it may be time to consider moving to a certified disinfection program.
No matter how COVID-19 has impacted your facility up to this moment, people's safety will continue to be your priority. The safety you can provide in the buildings you control will depend on adherence to consistent protocols. And those must not stop with a one-time clean. This will require a sustained effort. It's both a strategic and practical shift needed to keep spaces healthy for people.
ABM's CleanDesk program brings safety to individual spaces as well as shared spaces.
To navigate this change and help keep your facility open, to build comfort for people who are trying to come back together, you can answer uncertainty with a certified program backed by experts. Let me explain what I mean by certified, because there are two important considerations. One is the certification of the program itself. Experts in industrial hygiene and infection prevention have come together to vet the program's procedures and educational components. A clear process is outlined for documenting and demonstrating competencies.
There's another level, and that's accreditation of the training program that will prepare the disinfection specialists. An accredited training program verifies that training has been effectively designed to build required competencies. Each trained specialist should be able to demonstrate knowledge-in-action, that they know how to implement each process: how to disinfect with the recommended tools, how to properly don and doff the required personal protective equipment (PPE), how to choose the appropriate chemical for cleaning and disinfection, and how to carry out work instructions effectively and consistently.
Certification is one key strength of a turnkey disinfection strategy. A provider capable of an enterprise level solution will also have benefits you may need to rely on going forward. For instance, sourcing of tools, disinfectants, and PPE, like masks, can be a logistical concern. You'll want to ensure, to the extent possible, that teams in your facility have what they need to both provide a healthy environment and stay healthy themselves. A turnkey service provider should have purchasing power they can use for your facilities' benefit.
You may be tired of hearing that things are changing, but new, verified information is a good thing. Our scientific knowledge of COVID-19 is expanding. Further actions we can take are being designed, explored, and vetted. As we go forward, it's going to help you to have access to experts in infection prevention and hygiene to inform your decision making.
That's another reason to outsource and bring in a certified disinfection program. If the provider you choose has taken on the responsibility of keeping their program certified, they are already working with expert advisors to vet technologies and maintain accredited training. You won't have to hire a consultant every time something comes up, like a change in official guidance or a new technology.
For instance, in my role on ABM's Expert Advisory Council, we're now focused on testing procedures for verifying disinfection in the space. We're evaluating pilot programs based on the results so we can recommend testing, measuring, and verification procedures going forward. We're also advising on and evaluating implementations of ultraviolet (UV) disinfection technology and the microbiocidal capabilities of bipolar ionization, which is a technology that introduces ions into an airflow.
Many clients have asked us about antimicrobial coatings. We don't advise antimicrobial coatings because the data doesn't support them as an effective infection prevention strategy1.
Let's take a step back from the details of the plan and look at how the people in the building perceive it. One lens we can use is the idea of employee engagement. Think back to before the outbreak, about how many factors influenced the average employee's engagement. Top of mind was the amenities in the workplace, as well as facility-based factors like temperature controls, good lighting, indoor air quality, and of course, health and safety concerns. Some were less directly about the physical space, like research showing preferences for sustainability policies or opportunities to grow skills and advance.
For some of us, health and safety concerns now dominate that list. Everyone's situation is different, but there are sources of stress everywhere. Some have children or other family members that require additional attention or care at home. Some may constantly worry about exposure at work and bringing that worry home. Some may feel the economic pressure of having to stay healthy. How easy will it be, every day, to put all of that aside, and truly engage with the business at hand, to put words like productivity and innovation and margin at the top of their priorities?
A cleaning and disinfection program should also have the goal of helping the people that share a space feel supported and secure. The success of a disinfection plan, no matter how aggressive, won't help people feel supported and secure if they can't see it.
Results from 2020 ABM client survey conducted by Kingsley Associates.
A cultural shift around the way we clean is so important. Before COVID-19, cleaning was something that mostly happened backstage. Everyone wants a clean space, but they don't want the act of cleaning center stage. Or they didn't. Now it's of the utmost importance for cleaning and disinfection to have that time in the spotlight. People need to know action is being taken to keep spaces healthy.
There are two main recommendations here for facilities.
Recommendation 1: Make sure cleaning and disinfection tasks are shared across shifts, not just during off-hours. While it will be important to use periods of reduced occupancy for broader disinfection, cleaning and disinfection should also be prioritized during the day. It's recommended that frequently touched surfaces receive regular attention throughout the day. That's the physical need. There's also the psychological need of seeing it done, knowing that a dedicated professional has accomplished the task of disinfecting that high-touch surface.
Compare that, for the moment, with a company policy that it's somebody's responsibility to wipe down the conference room table after a meeting. Even in these extenuating circumstances — given your experience with people and say, company break room policy — do you think that conference room turnover will always be done, 100% of the time, at 100% the level it should? How many times will one employee have to notice that someone else forgot, or nobody was assigned to do it, or someone was in a rush to get to their next meeting, and barely gave it a few swipes — how long will it take for distrust and worry to set in, that really, spaces and surfaces aren't clean or disinfected?
We have to keep that distrust off the table. A clear presence, with professional disinfection procedures, gives everyone visual proof of action taken. They can see it, right in front of them, with the right application of disinfectant, the attention to detail, and the obvious presence of personal protective equipment, used properly. That's not just action taken, that's a culture of health and safety reinforced.
That reinforcement depends on all of the program elements coming together and presenting a full picture that people can see, every day. Team members needs supplies and equipment on hand. They need an accredited training program so they can confidently complete procedures correctly and professionally, every time. Securing supplies and providing ongoing training requires a dedicated effort.
Recommendation 2: Make sure everyone in the space knows about the disinfection done in off-hours, when they can't see it. Clear signage is key here. You'll need messaging you can share during safety meetings and materials ready for your communication team to share with your internal and external channels, as needed. That's another reason to bring in a comprehensive program with expert backing. Such a program should have materials, vetted by those same experts, that clearly explain the actions taken and their effectiveness.
The ABM EnhancedClean™ program is a three-step approach that delivers healthy spaces through disinfection specialists and expert-backed processes.Infection prevention happens in an environment. That means factors beyond direct disinfection have an impact, such as indoor air quality. For instance, humidity is known to affect droplet size, which can influence how far an airborne droplet travels before dropping, or how fast droplets accumulate on a surface. As you step back and consider the physical changes to spaces, like adding plexiglass shields, or 2 signs that encourage traffic patterns that support social distancing, it's important to consider the role of facility assets.
The CDC currently recommends increased ventilation to maintain a healthy indoor environment, as well as improving air filtration to the level of MERV-13 filters. An assessment of your HVAC system for 3 airflow, filtration, and efficiency, should be a part of your disinfection strategy. Look at everything from setting controls to meet your indoor air quality needs, to preventive maintenance that avoids ventilation system failure.
In addition, facility choices from landscaping to parking can have an impact. Cutting back trees can increase natural UV light from sunlight in a facility. Contactless parking systems and parking automation can reduce interactions with frequently touched surfaces or bottlenecks in waiting areas. A provider of turnkey disinfection services may have a wider menu of facility solutions. If they have experts available to coordinate a holistic disinfection plan, that kind of comprehensive assessment is a great tool for moving your facility forward quickly and completely.
Everyone is going to remember how the institutions, businesses, and facilities around them responded to this watershed moment. A certified program helps you deliver on the promise of prioritizing the health of people in your facility. You can be sure you have qualified processes in place, put into practice by disinfection specialists trained through an accredited program. You'll have a clear and consistent presence of disinfection that people in your shared spaces can see.
The ABM EnhancedClean program is a three-step approach that delivers healthy spaces with a certified disinfection process backed by experts. To learn more, visit EnhancedClean or call 866.624.1520 and press 3.
Cathy Campbell, National Director of Service Delivery, ABM (B&I); CHESP, CMIP
With over 25 years of experience in the development and implementation of infection prevention
programs, Cathy has contributed to product innovations, sustainability efforts, and technical training.
Cathy earned her bachelor's degree in Healthcare Administration and Applied Management and later
received a Certificate of Mastery in Infection Prevention from The Association for the Healthcare
Environment (AHE). She established herself as a subject matter expert for Healthcare Environmental
Services during her career in a variety of roles focused on standardized work programs.
3 https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html
