As a key strategy in preventing healthcare-associated infections (HAIs), environmental cleaning in healthcare facilities not only enhances patient safety by reducing the presence of pathogens in patients’ surroundings but also significantly impacts other important healthcare outcomes, such as patient satisfaction and healthcare cost.
However, it is increasingly evident that many cleaning practices act as a double-edged sword by producing unintended harmful effects on human health, as well as the environment.
Cleaning chemicals may cause human health effects, such as asthma and dermatitis, and contribute to environmental pollution and ecosystem deterioration. In addition, cleaning staff also may suffer from musculoskeletal disorders associated with certain cleaning procedures (Markkanen, Quinn, Galligan, & Bello, 2009).
Green cleaning—A systematic approach
A growing number of health organizations are increasingly engaged in green cleaning or sustainable cleaning, a new interdisciplinary and systematic approach to cleaning in healthcare. This systematic approach involves the integration of a variety of cleaning methods, including the selection of green benign cleaners and other green products, optimizations in building design, and improvements in operations (see Figure 1 in the file attachments at the bottom of this page).
The aim of green cleaning is at least three-fold: (1) to maintain environmental cleanliness and prevent HAIs; (2) to protect patients and staff from potential harmful health effects of certain cleaning products and procedures; and (3) to reduce environmental impact and enhance sustainability.
The implementation of green cleaning at a particular healthcare organization is influenced or shaped by external and internal factors, such as federal or state regulations and hospital infection prevention culture. The success or effectiveness of green cleaning should be measured against its multiple goals.
HHI green cleaning project
With the development of green cleaning, it is increasingly urgent to examine current common practices of green cleaning and evaluate the effectiveness of these practices based on empirical data. In order to promote research in this area, The Center for Health Design (CHD) engaged with Health Care Without Harm (HCWH) and the Healthier Hospitals Initiative (HHI) to launch a Pebble research project.
Under the guidance of an advisory committee comprised of industry experts, the CHD research team conducted interviews with five major hospitals across the country to examine the components, implementation, and effects of their green cleaning programs. The team also conducted an online questionnaire survey to gather opinions regarding high-priority research questions on green cleaning.
The case study and questionnaire protocols were developed based on the conceptual framework of green cleaning, as shown in Figure 1 (found in the file attachments at the bottom of this page), and were tested and modified according to feedback from the advisory committee.
Case studies
Five hospitals voluntarily participated in the case study interviews. The facilities included:
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