The Hospital Employees’ Union says that B.C.’s annual hospital housekeeping audits fail to provide health care decision-makers and the public with a complete picture of the state of hospital cleanliness in this province.
The union notes that Burnaby Hospital surpassed established cleaning standards according to independent audits conducted in 2009 through mid-2011, despite the fact that the hospital was experiencing endemic rates of C. difficile infections at the same time.
The province and B.C.’s health authorities have contracted Westech Systems to conduct annual housekeeping audits since 2005. The audit reports are based on visual inspections with scores weighted to the area of the hospital inspected.
But HEU says that the audits fail to investigate other issues critical to hospital cleanliness and infection control such as the intensity and frequency of cleaning, the training of cleaners, the workload of cleaners, and the adequacy of cleaning supplies and equipment.
In a letter made public earlier this week, a group of Burnaby Hospital doctors have asked for a review of hospital cleaning operations linking the issue to “sustained endemic rates” of C. diff. at the facility.
HEU secretary-business manager Bonnie Pearson says that the public needs to be secure in the knowledge that housekeeping audits are comprehensive in nature.
“Right now, the quality of hospital cleaning is based on visual appearances only,” says Pearson.
“But there are a range of factors involved in ensuring that our hospitals are clean and safe including enough cleaning staff, with the right tools and training, to deliver this critical health service.”
HEU represents more than 1200 workers employed by Fraser Health at the hospital and an additional 70 cleaning staff employed by Aramark.
Pearson notes high levels of workload are consistently identified by union members as an issue at the hospital.
Over two and a half years, from 2009 to mid-2011, Burnaby Hospital recorded rates of C. diff. that ranged two to three times higher than national and provincial averages.
During that period, the cleaning audit reports show that Burnaby Hospital passed with flying colours – scoring 86.13 per cent over 409 audits conducted between April 2010 to March 2011; 91.95 per cent over 127 audits conducted between August 2009 to March 2010; and 88.28 per cent over 121 audits conducted between August 2008 to March 2009.
The established benchmark standard in the provincial cleaning audits is 85 per cent.
The situation was similar at Nanaimo Regional General Hospital in 2008-2009 when cleaning audits showed that the hospital exceeded the benchmark despite a third and prolonged outbreak of C. diff. at the facility.
At that time, the B.C. Centre for Disease Control (BCCDC) and the Vancouver Island Health Authority’s chief medical health officer both launched investigations into the outbreak and both concluded that there were not enough cleaning staff and that more and better training was required.
BCCDC recommended VIHA “review the environmental cleaning contract and audit their environmental services to ensure appropriate levels of staffing and cleaning protocols are being adhered to...”
The Fraser Health Authority contracted out cleaning services in 2003 to Sodexo, a Paris-based multinational facilities management company.
U.S.-based Aramark took over the cleaning contract at Burnaby Hospital in 2010.