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Housekeeping audit finds problems at Arrow Lakes facility

ALH scores lowest of five large regional hospital
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A view of the interior of the emergency department at the Arrow Lakes Hospital.

Officials from Interior Health have stepped up supervision and training at the Arrow Lakes Hospital after the facility failed a housekeeping audit last summer.

The changes were made after the hospital scored 83.92 out of 100 in cleanliness, below the provincial target level of 85.

The hospital was the only one of six hospitals in the West Kootenay to fall below the provincial standard.

The external audit, conducted by Westech Systems in July 2017, found cleanliness problems in several areas of the hospital, prompting managers to take action.

“Is it common for our sites to fall below 85? No it isn’t, as a rule the majority of our sites score well above 85,” says John Evans, the manager for support services for Interior Health overseeing the area. “But with the changes… we have seen an increase in scoring.”

Trained auditors went through each hospital, checking for issues with housekeeping, from overall cleanliness and appearance to possible health hazards.

Inspectors checking ALH found dust and dirt on windowsills and doorframes, grime on the floors in corners, and dirty baseboards. Most of the problems inspectors found were on fixtures, floors and furnishing, though there was blood found on a bed in a trauma room and dust and dirt on wheelchairs and walkers. Traces of feces and urine were found around toilets in one of the hospice rooms and an inspected washroom.

The main entrance to the building got the lowest score, at 66.55 per cent, while the Physio room and ER Bay 3 scored perfect 100s. Acute care and ORs scored in the mid-70 range. Two rooms examined in the Residential Care ward scored 94 per cent for cleanliness.

Managers decided to step up supervision and training after the failed annual inspection, says Laresa Altenhoff, Interior Health’s area manager for for support services, after determining that a once-monthly visit by a supervisor from Nelson wasn’t enough.

“We decided to make changes, and we hired a supervisor who oversees Kaslo, Nakusp and New Denver, and she’s there at every site weekly,” Altenhoff told the Arrow Lakes News. “She is working with staff diligently to address the issues specific to housekeeping and the audit, and doing regular audits.”

The results are starting to pay off.

“Our latest review, an internal audit [done in December], Arrow Lakes was 91.1 per cent, and New Denver was 90.77 in scoring,” she says. “So it has progressively increased for the last few audits we have done.”

“The prescence of a supervisor there weekly instead of monthly, and the ability to spend more time to educate our staff more fully, has definitely been beneficial to the staff and the organization and ultimately patients that visit the facility,” adds Evans.

(New Denver had scored an 89.7 in the summer audit.}

Altenhoff also says the external audit last summer came at a bad time, when the floor cleaning machines in both Nakusp and New Denver had broken down, and hadn’t been replaced before the inspector’s visit.

“We had to buy new ones. To get new ones, that was capital funding, as they are over $5,000, we had to ask for emergency funding,” she says. “So we did replace them, but it took a month or so, so everything had to be done by hand instead of scrubbing by machines.”

Atlenhoff says said that IH uses the audit process as a learning opportunity for its staff. Cleaning at IH hospitals is done in-house by unionized workers.

“We do a lot of review with staff, so they understand what these audits are about and they understand the critical areas of cleaning, and if the room does score low we do corrective measures with the staff and we do education at the same time, on what was missed and why, and have those learning times with our staff.”

“It’s not a regular housekeeping anymore. There’s a lot of education that goes into this job, and a lot of knowledge they need to have in order to fulfill cleaning and sanitizing in the facility and help with patient care.”

“The staff is dedicated and they want to do the best they can for patients and the community.”

During the summer audit, each room was examined on 19 different categories, subject to eight decision-making criteria. Rooms are assigned one of four risk categories: Risk 1 or Very High, to Risk 4, or Very Low. An operating room or emergency area would be Risk 1, while adminstrative space would be Risk 4.

The average score of all the rooms is then used to score the overall facility.

Results from the 2017-18 audit, obtained by the Black Press, were:Castlegar’s Talarico Place scored 90.03 — nine out of 30 rooms came in under 85 per cent, three of which were very high or high-risk rooms;

Grand Forks’ Boundary Hospital scored 89.87 — five out of 25 rooms came in under 85 per cent, all of which were very high or high-risk rooms;

Trail’s KBRH scored 87.78 — 19 out of 58 rooms came in under 85 per cent, 11 of which were very high or high-risk rooms;

Nelson’s KLH scored 87.78 — 14 out of 40 rooms came in under 85 per cent, 10 of which were very high or high-risk rooms;

Nakusp’s ALH scored 83.92 — 11 out of 18 rooms came in under 85 per cent, 10 of which were high- or very high-risk rooms.

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The Arrow Lakes hospital scored below the 85 per cent benchmark for cleanliness in a housekeeping audit conducted last summer.
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ALH scored lowest of five largest regional hospitals