Disinfecting hospitals during COVID-19 – we were built for this moment

Even as new cases of COVID-19 patients are rising in some regions, most hospitals are beginning resume elective surgeries and other everyday operations.

Administrators want to assure patients and medical professionals that their facilities are safe and utilize trusted partners to clean them. Infection prevention – always a top priority – is even more so in this “new normal” environment.

During the COVID-19 pandemic, health systems and hospitals across the country have called upon Crothall Healthcare’s decades of expertise and experience in environmental services. As the pandemic spread throughout New York City this spring, Crothall provided the highest-level of environmental services to ensure COVID-19 patients were treated quickly and in the safest possible environment.

Working closely with Mount Sinai Health System and New York City Health and Hospitals (NYCHH), Crothall was responsible for cleaning and disinfecting patient rooms in 28 different hospitals that treated thousands of COVID-19 patients. This included hundreds of patient rooms that were converted into Airborne Infection Isolation (AII) rooms that isolate airborne pathogens to a safe containment area.

As the disease moved through the city’s five boroughs and new care facilities had to be opened, Crothall was continually called on to provide its expertise. When the Javits Center was turned into an auxiliary hospital with 1,700 beds to handle the overload of patients, Crothall was chosen to clean and disinfect the makeshift facility before the first patient was moved in, as well as during daily operations.

The company was also charged with cleaning and disinfecting approximately 200 COVID-19 testing sites throughout New York City, as well as cleaning and disinfecting The Samaritan’s Purse Emergency Field Hospital, a pop-up hospital in Central Park with 14 tents and a 68-bed respiratory care unit.

Everything Was in Place to Handle the Pandemic 

With our cleaning technicians often working 24 hours each day, the intensity of the pandemic meant that Crothall had to elevate its level of service for several long, grueling weeks. But because the company already had in place the highest standards available, Crothall didn’t need to make any changes in its processes or cleaning programs to ensure that all facilities were safe for patients and the medical staff.

Working in conjunction with the COVID-19 command centers at Mount Sinai and NYCHH, where all 11 hospitals were converted to COVID-19 units, we used our comprehensive infection prevention approach to develop a strategy that combined the right products, frequency of use and technology to initiate a rigorous cleaning and disinfection program.

“At the onset of the pandemic, Crothall provided us with a comprehensive, tiered plan to ensure we were well prepared if and when the situation escalated.  Once it was clear that we were going to be hit hard, Crothall worked with our Central Office HR team to fast-track the training of over 250 workers to undertake increased cleaning needs, picked-up two crucial programs that our other vendors couldn't cover, and brought in new solutions to help us meet the demand for heightened cleaning. They were a true partner every step of the way and in so many ways, a lifeline to us,” said Mercedes Redwood, Assistant Vice President-Supply Chain, NYC Health and Hospitals. “Their professionalism, dedication, and genuine concern to do well was crucial in our success weathering this unprecedented crisis. And Crothall continues to support us as we work together to try to return to whatever the new normal looks like.”

How the Five Pillars of Infection Prevention Works

Our well-defined approach to reducing Healthcare Associated Infections (HAIs) is a major reason the company was so well positioned to help US hospitals operate safely during the pandemic and now as they begin to reopen their facilities to elective procedures and a wider range of hospital admissions.

Several years ago, Crothall identified its Five Pillars of Infection Prevention as the foundation for its cleaning and disinfection approach. The pillars are an evidenced-based, integrated cleaning and disinfecting program that is deployed in nearly 600 US hospitals as the most effective way to reduce HAIs. Using the Five Pillars to Infection Prevention approach, Crothall already had a structure in place prior to the pandemic to clean and disinfect patient rooms, and intensive care units and other critical facilities to meet guidelines set by the Centers for Disease Control and Prevention (CDC).

The five pillars are:

  • Hand hygiene. Patients and healthcare personnel are the leading causes of transmitting HAIs. For example, a bed rail in a patient room can transfer pathogens if hand washing disciplines are not followed. Crothall associates understand this risk and follow strict disciplines in hand hygiene.
  • Established processes. These protocols focused on associate education and training consist of practices to protect patients, staffs and visitors from acquiring pathogens, and the right product for every situation.
  • Measurement. To measure the cleaning effectiveness of all surfaces, Crothall uses the Adenosine triphosphate (ATP) verification system nationwide to reduce Clostridium Difficile (C. diff) and other pathogens.
  • Augmentation. For high-risk situations, Crothall was the first company to augment its standard cleaning protocols with the use of ultraviolet radiation technology to destroy microorganisms – a technology also used to clean patient rooms during COVID-19.
  • Emerging solutions. Crothall has formed strategic partnerships with product manufacturers in order to access emerging cleaning and technology solutions.

Our Cleaning and Disinfection Approach During the Pandemic

At the beginning of the COVID-19 pandemic, Crothall’s comprehensive cleaning and disinfection process at all New York facilities included the following:

  • Patient rooms received a floor-to-ceiling cleaning and were disinfected after a patient was discharged and before a new patient was admitted. Due to the influx of patients, we cleared as many as 50 room in a day, approximately five times more than the normal amount.
  • In the intensive care units and operating rooms, we used Ultraviolet-C technology to disinfect up to 120 beds per day, up from the usual 40 beds per day.
  • Bleach-based products were used as disinfectants since they kill bacteria and other microorganisms almost immediately rather than quaternary ammonium compounds, which usually take 8-10 minutes to disinfect a surface.
  • To verify all rooms were clean for new patients, we deployed Hygiena’s Adenosine triphosphate (ATP) cleaning verification system to ensure all pathogens were eliminated on surfaces and equipment near patients and staff. This process provided an additional level of confidence to hospital administrators and the medical staff.
  • To detect airborne pathogens caused by coughing or sneezing, we deployed Scientific Air Management‘s (SAM) air purification and disinfection system. This technology removes bacteria, virus, mold, particulates, and odor from the air through the use of continuous ultraviolet light, HEPA filtration, and a carbon odor management system. Before the novel coronavirus outbreak, Crothall already used this technology in four major healthcare systems, including Elmhurst Medical Center in Queens, a facility that housed hundreds of COVID-19 patients.
  • Regular, daily use of electrostatic spraying was used to disinfect surfaces and objects in the hospitals’ public areas.

Our Role as a Catalyst to Find New Solutions

Crothall works closely with product manufacturers and hospital officials to bring to life the fifth Pillar – emerging solutions through strategic partnerships. Under the leadership of Rich Feczko, the company’s National Director of Systems, Standards, Innovation & Global Support, the Crothall Infection Prevention Summit was convened in 2016 to develop a strategy in collaboration with manufacturers to test and analyze new cleaning products to reduce HAIs.

And we never stop looking for ways to do things better, more safely, and more efficiently. We regularly work with key officials at major US hospitals and third-party infectious disease and infection prevention and control experts on clinical testing of newly-identified solutions. These organizations include some of the nation’s largest acute care hospitals, such as Novant, MedStar Georgetown University Hospital and Hackensack Meridian Health System. 

Several new technologies have recently made a significant impact in reducing HAIs. For example, at Hackensack Meridian Health Jersey Shore University, HAIs dropped to zero in the medical Intensive Care Unit when the Surfacide’s UV-C disinfection system was used as part of the daily housekeeping routine.

The ability to rapidly and seamlessly deploy our Five Pillars of Infection Prevention served New York hospitals well this spring when COVID-19 threatened to incapacitate the area’s hospital systems. As we move forward in what the “new normal” settles out to be – and as the nation prepares for a potential second round of infections – hospitals across the nation can benefit from adopting the comprehensive Five Pillars approach.

Regardless of whether we are in the midst of a global pandemic or are able to operate without the reality of a massive public health challenge, we will continue to do what we’ve always done – follow best practices and use the science behind cleaning and disinfecting, including an emphasis on high-touch surface cleanliness, to keep safe the people we serve. This culture of safety will continue to mitigate HAI events and make a world of difference for patients, medical staff, and our communities.

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