ECJ EUROPEAN Cleaning Journal

Clean Hospitals is a new network of relevant stakeholders who have formed an international collaboration with the aim of improving hospital environment hygiene as it relates to patient safety. ECJ spoke to Professor Didier Pittet, who is heading up the initiative.

Didier Pittet, MD, MS is professor of medicine, the hospital epidemiologist and director of the Infection Control Programme and World Health Organisation (WHO) Collaborating Centre on Patient Safety at the University of Geneva Hospitals and Faculty of Medicine in Geneva, Switzerland.

In 2004, Pittet was approached by the WHO World Alliance of Patient Safety to lead the First Global Patient Safety Challenge under the banner ‘Clean Care is Safer Care’. The mandate was to galvanise global commitment to tackle healthcare associated infection, which had been identified as a significant area of risk for patients in all United Nations member states. WHO Guidelines for Hand Hygiene in Healthcare were developed under his leadership in consultation with international experts.

‘Clean Care is Safer Care’ has now been endorsed by ministers of health in 142 countries worldwide representing coverage of more than 95 per cent of the world population. ‘Save Lives: Clean Your Hands’ is the annual campaign encompassing World Hand Hygiene Day, designated by WHO as May 5.

Now Pittet is heading up a brand new initiative called Clean Hospitals. This is a network of relevant stakeholders who have formed an international collaboration focused on improving hospital environmental hygiene in the context of patient safety. He explains: “We have been focusing for a number of years on hand hygiene, and the global campaign with the World Health WHO has been very successful. For me it was natural the hospital environment would be our next focus.”

There are a number of reasons for this Pittet says. “There have been some things happening in hospitals which need further investigation. For example, floors in areas that are not receiving patients are being cleaned with disinfectants when it is not necessary – and this is also expensive. The wrong products are often being used for the task and the area.

Redeployment of skills

“There has been something of a revolution in how healthcare settings are maintained and a redeployment of processes and skills is required.”

Pittet says he has also witnessed variance in different countries with regards to hospital cleaning standards. “We really need a universal vision for cleaning and maintenance,” he continues. “Most activities are not evidence-based – cleaning is very much lacking in this domain.”

It was Rob den Hertog at RAI Amsterdam who invited Pittet to investigate what could be done about creating a more scientific approach to hospital cleaning, and the first Healthcare Cleaning Forum was held during Interclean Amsterdam in 2018.  “This was more successful than we expected,” says Pittet, “and we realised there is a real need to explore the issues around cleaning adding value and increasing patient safety.”

So a group of scientific experts and relevant manufacturers from the cleaning sector was assembled and from there the Clean Hospitals strategy was constructed. “We are bringing together five pillars – surfaces; air; water; waste management; and sterilisation/device reprocessing - covering a
huge domain.

“Considering how much is invested in hospitals and in antimicrobial resistance, the environment and hygiene are of paramount importance. Nobody wants to be hospitalised in a place where they’re not safe.”

Pittet says there have not been many scientists involved in the field of cleaning up to now. “The formation of Clean Hospitals allows us to change that. And it enables us to ensure we optimise the
hospital environment.”

In today’s hospital environment the focus is budget, he adds. “We still have cases where outbreaks happen but the managers do not want to raise the cleaning costs. The challenge of modern medicine is that hospitals are not handled by experts in patient care, but by managers. Their priority is to lower costs.

“Managers consider only the cost of cleaning, when the cost of infections within hospitals is far higher. But that’s a different budget so the thinking is not joined up.”

Skills also need more attention and more investment he believes. “Cleaning operatives must be sufficiently trained in the responsibility they have for patient care. They must have the correct skills and those skills must be deployed in the correct areas of the hospital. Each hospital is facing the same challenge in my view.”

Training essential

Pittet is critical of some contract cleaning companies that work in hospitals. “Often they do not have the correct expertise and they are not qualified for healthcare environments. Training them to the right standards is essential, and that means there must be guidelines.”

Clean Hospitals aims to take a worldwide approach in establishing and maintaining those guidelines, through academic research, education, training and awareness raising.

Be involved

“To start with we are working with companies at all levels of the industry, and we will implement training in different disciplines,” he explains.

Enough companies supplying hygiene products to the sector are convinced about the need for a more cohesive approach to get the Clean Hospitals initiative started. They are helping to fund the programme, and relevant research teams are giving their time.

“It’s my duty to get involved in this type of issue,” he continues, “ and the more companies we have involved too, the better. Some businesses work on surface cleaning, others in sterilisation. None are experts in everything. Some are better equipped in awareness raising, mapping or distribution. And others are more inclined to focus on the educational, academic element.

“We will pool the experience, then add the science – the clinicians. That could mean we are able to change products, adapt them for specific outbreaks perhaps. When we bring people together, we are much stronger.”

The official launch for Clean Hospitals is at the International Conference on Prevention and Infection Control (ICPIC) in Geneva in September, where the group will hold a symposium. There will be a follow-up Healthcare Cleaning Forum at Interclean Amsterdam 2020 next May.

Email: marianne.kemmer@cleanhospitals.com to find out how to become involved.