HOSPITAL HOUSEKEEPING

SERVICES

PRADNYA KARDEDR. SULAKSHANA

INTRODUCTION

• The technological development in the modern era and knowledge explosion has

revolutionized the concept of care in the hospital. Good housekeeping has got the direct effect on the health comfort and morale of patient, doctors, health care workers and visitors. This is the area which serves the broader social need and has a history of rapid changes in function and organization.

• The housekeeping era started in the middle of the 17th century

• George Washington, considered housekeepers indispensible in his household, in order to relieve Mrs. Washington.

• Florence nightingale also emphasized Housekeeping as a specialty on its own.

Continued -•The hotel industry initiated with the housekeeping

services. Later the concept of housekeeping got incorporated in health care set up.

•Hospital Administrators/ Trustees/ Board of Directors felt in the middle of the 20th century that the hospital housekeeping is the specialty on its own. The house keeping departments work has advanced rapidly in recent years and requires knowledge, skill and understanding of management tools.

•Good housekeeping has proved to prevent and control hospital acquired infection, and thus reducing the Average Length of Stay (ALOS), which in turn reduces the drug cost and also prevents lots of suffering.

Continued -•It’s an activity upon which all the health giving

services of the hospital depend.•The work of housekeeping is simplistic but

when one considers maintaining a house of several hundreds of rooms and numerous public areas, the task becomes gigantic.

DEFINITION•Housekeeping department has the duty of

cleaning and sanitation of all the hospital. The hospital housekeeping function is defined to include all labor transportation, equipment material supplies management coordination and supervision required to perform the hospital housekeeping services,

•It’s the department which is the non revenue producing service department, but has a widest scope in the hospital as it maintains the image of the hospital.

OBJECTIVES

• To Achieve the aesthetic appeal of the hospital,• Achieve maximum efficiency possible in the care and

comfort of the patient and the smooth running of the hospital,

• To provide quality health care by personalized services,

• To increase public demands and awareness- need for public image of the highest degree of hospital

• To improve patient care, to control and prevent hospital acquired infections,

• To develop highest specified standards of property maintenance of the hospital.

• To ensure high standards of cleanliness and general upkeep in all the areas.

STRUCTURE

PHYSICAL STRUCTURE

LOCATION:

•Housekeeping department serves for all the areas and departments of the hospital, thus it needs to be centrally located and close to vertical transport system to facilitate easy movement of materials and equipment used in housekeeping.

•Office for the Housekeeping Manager

STRUCTURE

PHYSICAL STRUCTURE

LOCATION:

•Clerical work area•Chiefs office keepers desk and bulletin

board to put up daily duty charts and other housekeeping information.

•Store room for housekeeping equipments and materials

Continued -• Housekeeping closets on the floors of the hospital

for the with the space and shelves for housekeeping equipment and materials, an trolleys as a mailer of routine, supplies for daily use should be delivered to the respective closets directly.

Housekeeping Control Desk: • The housekeeping desk is the nerve centre for the

entire department and its efficiency determines the smooth functioning and effectiveness of housekeeping. It is the focal point for dissemination of information and communication to various points in the housekeeping department as well as to other departments for better coordination.

Continued- THE AREA OF CONTROL DESK MUST HAVE:

INFORMATION BOARD: • Duty chart for housekeepers and sweepers• Cleaning schedules• Hospital staff room accommodation• Other general information and important announcements.

KEY BOARD:• Patient room• Key office room• Entrance Keys• Others

 

CONTINUED- REGISTERS FILES FORMS:•  Housekeeping equipments and supplies list• Attendance register for sweepers• Request form for supplies and equipments from

stores• Request form for repairs to be carried out in other

wards• Inventories of supplies and equipments• Checklists for patient rooms• Year planning calendar• Inventory for furniture and furnishing• Inventory of linen• Personnel data• Progress reports

ORGANIZATIONAL STRUCTURE

HOUSEKEEPING MANAGER

ASSISTANT MANAGER

CHIEF HOUSE KEEPER

SUPERVISORS

LEADERS (MUKADAM)

HOUSEKEEPING TRAINEES WORKERS SWEEPERS GARDENERS

Qualities of Housekeeping manager

•Basic knowledge of health care hygiene and sanitation

•Ability to plan, administer and develop all phases of a comprehensive housekeeping program that will provide a suitable environment for the institutions medical and administrative activities

•Demonstration of personal qualities of leadership and skill in coordinating a major activity within the administrative program

•General working knowledge of cleaning operations and interior decoration

Qualities of Housekeeping manager

•Ability to assign, supervise and evaluate the

work of subordinate supervisors and their

personnel

•Ability to develop the departmental budget and

to direct the expenditure of monies.

HOUSEKEEPING MANAGER

Function:• Collaborate with other departments to

ensure delivery of quality services• Interview, select, train, evaluate and

counsel staffs of housekeeping department

• Instruct and advice staffs on changes in policies, procedures or working standards

• Listens to the problems if any of the housekeepers, sweepers and try to solve them

• Conduct meeting to exchange ideas and solve problems

Continued -

• Attend to the complaints and queries if any or other

departments and patients related to housekeeping

services

• Rounds to inspect housekeeping services in work area

• Conducts hospital housekeeping surveillance audits

• Work closely with the administrators on day to day

housekeeping requirements,

• Training induction and on job training of housekeeping

staffs

Continued -

•Monitor departmental activities to ensure

maximum efficiency in the services being

provided

•Assist in developing, delegating and

monitoring departmental goals, objectives and

programs to ensure timely completion

• Reporting to the management

Interdepartmental Relationship

Housekeeping

Civil, BMED and Other

Departments

Maintenance

Laundry,

Security Kitchen and

Catering

Human Resource and Personnel

Dept.

Stores

Nursing

ASSISTANT MANAGER

•Daily rounds to inspect housekeeping services in work area

•Assisting the Housekeeping Manager in administrative work

•Monitor the use of supplies and equipments and prepare a monthly purchase request and issue request as and when required or as per the hospital protocol

•Reports to the housekeeping managers

CHIEF HOUSE KEEPER

Functions:• Cooperates with the staffs of other

departments• Deployment supervision control and

training of the staffs• Checks the standards of cleaning of all the

areas in the hospital• Keep inventories and records of the

equipments and supplies• Supervise and instruct the sweepers on

day to day activities• Enhance the décor of different areas of the

hospital

Continued –

•Control and supervision of the work in linen room

•Train new recruits'•Check all safety items on the allotted

floors•Record all lost and found items as per laid

down norms

• Reports to the asst. housekeeping managers.

SUPERVISORS

• Organization of work, planning of task

• Directing the work of those responsible to him

• Co-ordinate the resources under his direction

• Control workers and resources

• Supervising and guiding the housekeeping staffs

and getting quality work done

• Evaluate the job performance of HK staffs

• Identifying the training needs and planning the same

Mukadam (Leaders)

•Their main responsibility is to allocate the

duty

•And supplying adequate staffs to the

respective areas

•Arranging the workers in case of

shortage.

•Cooperates with the staffs of other

departments

SWEEPERS Functions:

• Receive the allocation of the

floor and area of cleaning

• Clean the rooms at least

twice in a shift

• Clean the toilets and

bathrooms of the allotted

department at least twice in

a shift

Continued - •Follow instruction and cleaning procedures given by the supervisor

•Use supplies economically

•Maintain polite and dignified attitude towards patient

•Report and hand over all the lost and found articles to the supervisor

•Reports to : Housekeeping Manager

GARDENER

Function:

•Clean and maintain the garden•Taking care of newly cultivated

plants•Water and prune the plants

Reports to: Housekeeping Supervisor

CommunicationFactors to be considered:• workers should understand clearly what is expected of

them • Unwanted actions should be avoided- use simple and

clear languages• Adopt demonstration methods to explain the work

procedures,• Proper job specification• Two way communication is essential to avoid miss

understanding of the work procedure• Guidelines given to the workers should neither be over

commanding, nor easy. They should be moderated.• New policies and procedures should immediately be

explained to the workers and their queries should be clarified,

Selection criteria for housekeeping staff

•Edu. Qualification: Min. 12th pass

•Age: 18 to 20 yrs (as per hospital policy)

•Health and appearance: He/ She should have a good health and should clear the medical fitness test.

Responsibilities

Direct Indirect

Responsibilities Responsibilities

Responsibilities of the housekeeping department

•Direct:

Daily cleaning

•Periodic cleaning. Ensuring clean

linen supply

Bed making, dusting

Continued - •Pest control Pest Control is a

major job of the Housekeeping Department. No matter how clean one keeps ones surroundings, you cannot avoid pests. It is not only embarrassing but also speaks badly of a hospital where one sees rats, cockroaches, and lizards running around. Thus a protocol should be there for regular pest control and it has to be supported by a proper documentation

Continued -

•Preventing spread of infection•Creating an aesthetically pleasant

atmosphere•Waste constitutes a problem, the

size of the problem varying with the size of the institution, because waste must be disposed of economically and efficiently, and in a sanitary way.

Continued -

•Safety against fire, prevention of cross-contamination by infectious materials, odor control, and pest control are all included in waste disposal procedures.

•A carefully planned program of waste disposal will safeguard not only personnel and patient but also the community.

Continued -

•Safety and security of the hospital•Gardening•Making necessary arrangements for the

meetings, programs and workshops.

Continued -

Indirect responsibilities•Saving electricity by switching off the lights•Ensuring economical use of supplies to save

cost•Maintaining helpful and courteous caring

attitude towards patients and visitors•Promoting safety and reporting dangerous

conditions whenever observed•Maintaining harmonious working relation

with other departments

In service education/ Training

• The basic training schedule for HK staffs should

be planned for a specific period and should

cover all aspects of housekeeping.

• After the training staffs should be evaluated on

their understanding of the housekeeping

services.

• After the evaluation well trained staffs should be

allocated to appropriate areas.

The training schedule can include following topics•Introduction to housekeeping•General rules and regulation•Hospital work culture and values•Housekeeping and patient relationship-

better communication skills•Job description•Orientation •Ward management•Water tank cleaning and chlorination•Importance of checklist•Safety at work place

Continued-• General infection control protocols relevant to them e.g

waste segregation, handling soiled and infected linen etc,

• Protocols on safety related to occupational exposure to blood and body fluid. E.g Needle stick injuries

• Waste segregation protocol of hospital• Spill management (blood and mercury)• Housekeeping procedures like

▫Bed making▫Dusting▫Cleaning▫Disinfection e.g Bacillocid, Sodium hypochlorite,

Ecoshield etc.▫Patient transportation▫Lift cleaning etc,

Work schedule

•Standard cleaning•Planning schedule•Frequency of cleaning•Areas and zoning

▫High risk areas eg. OT Transplant units requires highest possible standards of cleaning

▫Medium risk areas e.g Kitchen & toilets requires high standard of cleaning

▫Low risk areas e.g Office waiting areas, coorridors requires good standard of cleaning

Usage area Cleaning agent Dilution Time for cleaning agent to act Frequency of usage

Floor,tiles,waetergent 20ml,5 litre,8gm/wash basin/toilet Direct Twice a dayToilet close all stain removal HarpicNo dilution Direct Once a dayMopping the Cleaning the toilet Pursue18ml/ litre Direct Twice a daySeptic tank-lkg/washA water tank-500gms/wash Bleaching powder No

dilution 2 mins Septic tank weekly Water tank-monthlyBrass items BrassoDirect Special cleaningDrawers,wardrobes, sinks Napththalcnc balls Direct WeeklyToilet odour control Odonil Direct WeeklyDisinfections Dettol 100ml./ 5litre Direct Daily

Handling the difficult workers• Find out the reasons for the problem- health,

personal problems or problem with the work procedures

• Arrange refresher training if required• Frequently monitor and supervise the work• Ask them to repeat the work if found

unsatisfactory• Motivate him to adopt new procedures and

techniques adopted by the department• Encourage the worker through incentives and

bonus for festivals.

Continued-

•Overtime•Sick leave•Change the duty when they require for

genuine Reason•Help him out with advance payments if

they are in need•Festival bonus

Welfare of the staff To keep up the ,morale of the staff and to motivate

them it is important to provide a good working atmosphere in the hospital.

• Good working conditions• Good working relationship and accessibility • Incentive bonus• Best employee award• Statutory wedges(Provident fund, gratuity etc.)• Medical facilities• Sick leave and maternity leave• Meals when on duty• Proper work method

Housekeeping ManualA good housekeeping department must have

a written manual, which should include:

•The organization and brief outline of the hospital

•Rules like hours, leave, lunch, locker rules, safety rules etc,

•Special rules like training for specific areas•Methods of supervision•Housekeeping procedures•Equipment supply and control of inventory.

•Separate budget to the department

•In future depending on the cost analysis if required these services can be outsourced.

Issues and Challenges• Maintaining effective interdepartmental relationship• Effective communication• Absenteeism • Alcoholism • Work allocation• Conflict management• Time management• Procedures of housekeeping should be in

conjunction with nursing procedures• E.g. bed making after sponge bath• Prevention of cross infection• Noise pollution• Variation in work methods at different work places

“The very first requirement in a hospital is that it should do the sick no harm.”

---Florence Nightingale

THANK

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