Piddocke, Pamela

This report is an examination of cleaning services and monitoring mechanisms at St. Paul’s Hospital in Vancouver, British Columbia. It was prompted by concerns that the safety of Greater Vancouver hospitals and long-term care facilities has been compromised since the privatization of housekeeping services in 2003. Nurses and other care providers in the Vancouver Coastal Health region are alarmed by deteriorating standards in cleanliness and by communication difficulties with cleaning contractors. In particular, hospital staff are deeply worried that infection control practices are slipping. They are concerned that the Vancouver Coastal Health Authority does not have a monitoring system that can accurately gauge the cleanliness of facilities, the soundness of infection control practices, and the capacity of vendors to deliver knowledgeable, responsive, and stable cleaning services. They are troubled that nurses must spend an inordinate amount of time making service requests, which means less time for direct patient care. They are concerned that cleaning problems are contributing to back-ups in the Emergency Department and hence to slower responses to the public. Risks to patients, the community, workers, and the health care system itself appear to be on the rise. The project is a collaboration of the B.C. Nurses’ Union and the Hospital Employees’ Union in consultation with the Health Sciences Association. Our members wanted a systematic and credible means of assessing the state of cleaning and infection control practices since privatization. To this end, we conducted an environmental scan of one facility – St. Paul’s Hospital, with a particular emphasis on the Emergency Department – and gathered data from the hospital’s health care team. We also examined scientific literature regarding relationships between hospital cleanliness, hospital-acquired infections, and privatized housekeeping services; reviewed documents from the health authority; and interviewed experts. The project does not claim to be a full research study but rather a preliminary data collection and analysis that identifies key problems and future avenues for study and action.