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Hygiene in Healthcare – A Diagnosis

Fortis Hospital Ltd, Mulund

Improving Ambience & Cleanliness

“ While an impressive entrance makes all the difference to any patient or visitor, the clean and hygiene factors get much noticed in private hospitals, given the fact that a more educated crowd gets treated at these premises,” says V Vijayarathna, Regional General Manager, Fortis Hospitals Ltd.

Any private healthcare facility mainly focuses on two aspects – one, on the clinical part relating directly to patient’s health and two, on the hospitality services which include keeping the premise, the patients’ rooms and the environment clean. Apart from hospital inmates undergoing treatment, the large number of outpatients who spend considerable time in the hospital, also get exposed to the environment.

Given the limitations of operating in the same premise of Wockhardt hospital that was designed 10 years back, the Fortis Hospital in Mulund, Mumbai, has its unique maintenance challenges. “Even though the fundamental principles of the two organisations have a number of similarities, there are significant differences as well,” says Dr Vijayarathna. The Fortis group emphasises a lot on the way the facility is designed and kept up. “We are already working on the design changes to improve the ambience. This would involve the flooring, the entire surrounding, change in the complete interiors with totally different kind of a material, etc. We have two blocks – the 120,000sqft block which is about 10 years old, the other 180,000sqft about a year old out of which 80,000sqft is operational now – and there is a huge difference between the two.

“In all our new projects, the project team designs the entire premise involving the architect and the interior designers. In the old projects, the operational team gives their feedback to the team about what exactly is happening and what are the requirements with a project report.”

Fortis has a system of getting feedbacks on the ambience and cleanliness from visitors and patients. “Even in areas where the ambience cannot be altered for various reasons, we ensure that the fundamental cleanliness is always maintained. Our focus is primarily on clinical programmes and the required technologies & inputs but patient care always comes on the top. No compromises are made on cleanliness and healthcare delivery.”


“Our focus is primarily on clinical programmes and the required technologies & inputs but patient care always comes on the top. No compromises are made on cleanliness and healthcare delivery.”

Since, the inpatients or outpatients visiting the hospital come from educated background, littering is not an issue. “Besides, the environment is very clean and the required facilities like dustbins and washbasins are placed in key areas, especially where people gather.” As far as the team maintaining the premises is concerned, the housekeeping boys and the girls undergo a rigorous training and it is an ongoing training programme. “They are clearly instructed and informed on maintaining the cleaning standards. Further, we also educate our employees to respond to any situation or area that is not up to expectations. Irrespective of what level of organization we belong to, when something unclean is spotted, we either clean it up ourselves or get someone immediately to clean up. Each of our senior managers has been assigned an area in the hospital and they ensure it is kept clean.”

While the housekeeping has been outsourced to Sanjay Maintenance Services, the in-house maintenance team consists of chief engineer-building maintenance, executive housekeeper and the overall maintenance in charge. There are170 housekeeping workers at the janitorial level. Fortis has recently appointed an executive housekeeper with a hospitality background and well versed with the hospital infection-free environment requirement. Equipment, tools and cleaning agents required for maintaining cleanliness are jointly decided by the executive housekeeper and the outsourced team.

“We have very sound SOPs in keeping with the corporate organisation of a hospital and the JCI regulations. The cleaning and infection control regulation are very stringent and an important part of hospital environment.” “Whoever gets on board has to have the basic understanding of what the hospital is. All housekeeping staff undergo a five-day training course on simple processes like holding the broom or the mop the right way, the cleaning process and self protection, especially on wearing gloves in areas where it is most needed. In case of any discrepancy in the expected standards, the origin of the problem is identified. We ensure that the person responsible is put back into the training session. The same strictures are followed at the laundry right from segregating soiled linen to delivery of clean linen.”

Discrepancy can occur given the high attrition rate of housekeeping staff. “At times, owing to staff shortage or work pressure, people are pushed to perform. We make a conscious effort to avoid such situations. We emphasise that even in case of staff shortage, on priority the critical areas need to be covered adequately. At no point, an untrained worker should be allowed to get into the system. That would be more damaging than not having the premise clean.”

Currently, there are 240 operational beds and in two years time, this hospital will have 500 beds after the new block becomes functional. A floor with 52 beds has been opened up and still there are four more floors to go.


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