Labor Management Project consultants Paul Padial, Francois Philippe, and Mike Shay recently shadowed environmental service workers at Maimonides hospital in order to understand more fully the work of the teams they had been asked to support as part of the EVS Self-Managed Work Teams Project. When a worker suggested that they wear EVS uniforms, the LMP consultants thought it would be an even better way to experience working in the department. “In order for us to engage in any meaningful work with the Maimonides Environmental Service Department, we had to understand the work they do on a daily basis,” says Padial. The consultants did the work side-by-side with EVS workers during every shift: morning, evening, and night.

The consultants developed an even deeper respect for the work of environmental services as they struggled to keep up with the physically demanding and time-pressured work of cleaning beds and floors and generally ensuring a clean and safe environment. Padial described the lack of respect and basic courtesy afforded to him by some of the hospital staff, who walked right by without any acknowledgement when he was dressed in an EVS uniform.

The EVS Self-Managed Work Teams Project aims to develop the EVS workforce as “self-managed problem-solvers,” focused on performance improvement and patient satisfaction. It was developed in response to the economic uncertainties being driven by the Affordable Care Act, Medicaid redesign, managed long-term care, the Hospital Acquired Conditions Reduction Program, and other paradigm shifts in the healthcare financial model. As a result of these forces, hospitals need to maximize resources to improve patient satisfaction and patient safety while reducing costs. EVS employees play a critical role in the hospital setting, directly affecting revenue and clinical outcomes. They also help ensure that patients do not acquire hospital-borne infections and that beds are filled to maximize hospital reimbursement.

Maimonides, a major research and teaching medical center located in Brooklyn, provides care to a diverse population in an area where a number of hospitals have closed within the past five years. LMP consultants are helping workers there strengthen systems, relationships, and team functioning. This shadowing experiment gave them a better understanding of the significant daily contributions and experiences of EVS workers, providing them with a solid basis from which to engage labor-management teams in systems improvement.

“The importance of EVS to infection control and the smooth operation of the ED during periods of crisis and chaos was nothing I understood until I tried working side by side with an experienced EVS worker,” says Mike Shay.

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