"It is already a challenge given the fact that throughput is such an issue – the quicker they can turn the room over for the next patient. There is pressure on environmental services to do that. If you start cutting their staffing it is just going to exponentially add to that challenge for them," Pettis says.
Pettis says that for years hospitals have downplayed the role of environmental services in controlling HAI.
"Historically I don't think the respect and attention have been paid to the importance of environmental services," she says. "For many years we were fairly convinced that hand hygiene was the main thing we had to worry about and maybe the environment was something we didn't need to focus on."
Pettis mentions that leadership attitude has changed with new studies linking the prevalence of HAIs to environment. "The research has shown us that it is more than a single-prong approach. We need clean hands, clean patients and a clean environment. I see it as a three pronged approached to preventing infections," she says. "None of those three things are necessarily more or less important than the others."
There is also the uncomfortable issue of respect for environmental services staff. Whether consciously or not, some people in healthcare either look down upon cleaning staff, or don't bother looking at all. Cleaning staff might be first targets for layoff cuts because they occupy the bottom step of a hospital hierarchy and many of them haven't built seniority.
"They have not gotten their due," Pettis says. "The workers are typically some of the lowest paid workers in the organization, and there is turnover because of that."