Arjun Mohan, Director Facilities at VPS Healthcare

Hygiene in a healthcare setting is a sensitive affair, especially when its definition has evolved in a matter of a few months. At Clean Middle East, we speak to Arjun Mohan, Director Facilities at VPS Healthcare regarding the new hygiene practices being followed.

How has the definition of hygiene changed for you post COVID-19?

The meaning and gravity of hygiene has changed for the entire planet after the onset of COVID-19. For those of us working in facility management and especially in a healthcare setting, this word defines the distinction between life and death. From a visual sense of ‘not being dirty’, hygiene now assumes a level of sanitation and disinfection, which has been unprecedented before this pandemic.

What infection control measures are being adopted by VPS Healthcare? How are they different from pre COVID-19 measures? VPS

Healthcare, as a leader in healthcare delivery in the region, has adapted holistic and comprehensive infection control measures across the sphere of our operations. Starting from the correct and adequate usage of PPE, to frequent rounds of fumigation and terminal disinfection, we have left nothing to chance whilst battling COVID. The levels of cleaning and disinfection pre-COVID itself was quite high for VPS, however with the onset of the virus, we implemented a world-class infection control regime covering each and every touchpoint for patients, visitors and staff. Each touch point and surface was cleaned and disinfected based on a predefined frequency (based on footfall and criticality). Every surface was disinfected following usage. Appropriate and sufficient usage of PPE was made mandatory. Social distancing was strictly followed across all our premises, including staff accommodations and vehicles.

How do you ensure indoor air quality in your facilities?

The air conditioning systems have been modified to isolate high-risk areas (such as isolation rooms). HEPA filters have been brought into every critical area to ensure constant and persistent purification of air in the facilities. This has done a lot to minimize the infection risks.

Which techniques do you use for floor and surface decontamination?

All floors and surfaces are being disinfected with chemicals approved by the regulatory authorities as well as the VPS Infection Control Department. The frequencies and techniques recommended by these authorities form the basis of the disinfection procedures. Terminal disinfection is also carried out across critical care areas very frequently. We have set out deep cleaning and PPM activities as well. We focus on disinfecting constantly, persistently and in the correct way so that the infection risk is minimized.

What are the biggest challenges you face in maintaining hygiene?

The biggest challenge faced in maintaining hygiene is to ensure that all occupants of the facility - whether it be patients, visitors or staff - understand and follow the correct procedures to minimize the infection risk. Donning the right PPE without exception and intervals, minimizing contact, maintaining social distancing, etc. have all been novel and difficult habits to pick up. Further, the housekeeping staff have to protect themselves whilst serving those affected by COVID. To keep the morale up, to make sure that the staff are duly protected, and to ensure a minimal risk operation have been key challenges during COVID.

How do you overcome them?

The cohesive feeling of working as a team helped us keep ourselves and the team members motivated and energized in the face of rising COVID numbers. The infection control procedures, as well as why we needed to follow them were painstakingly educated to all team members. Education, exhortation and encouragement were key elements that kept the team fueled. The usage of specialised chemicals and machinery used for disinfection was also something that helped us minimize the threat of COVID infections.

What are your thoughts about Cobotics in healthcare facilities?

Cobotics will definitely lead to revolutionary changes in healthcare facility management. Those repetitive, highrisk tasks that can degrade human performance will be ‘outsourced to robots’. We have already seen this in high-rise façade cleaning robots and drones. With the onset of the pandemic, new avenues are being explored whereby high-risk or infection prone areas are now being considered as apt choices for robots to clean and maintain.

Have you considered the use of alternate technologies (UV, Nanotechnology, etc) for disinfection? If yes, which one and why?

We have tried out UV-based disinfection at our facilities during COVID. This has proved to be more effective and less intrusive than traditional fumigation. Further, we are presently trialing ozone-based disinfection machines, so that disinfection is carried out in areas that are conventionally difficult to disinfect (such as vents, high rise ceilings and inaccessible surfaces).

Has the concept of training changed for you? How do you train your cleaning staff?

The concept of training has acquired a whole new meaning after the onset of COVID. Training inadequacy of a single cleaner can potentially infect a large facility and multiply the infection risk many folds. We have shifted to a completely practical training programme whereby the cleaners are practically made to understand how and when to perform each of their tasks. Moreover, we educate them on why a particular task needs to be done, and the consequences of not doing so properly. Such a cause and effect explanation helps them understand the importance of each of their tasks, and hence, take ownership of the tasks assigned. Periodic refreshers are conducted, and individual tests carried out to assess the level of knowledge and correctness of cleaning techniques employed. This also helps to identify training needs and offer additional training in those areas identified.

How important is hand hygiene in the current times. How do you ensure compliance to it?

In this time of COVID, hand hygiene is inversely proportional to infection risk. As is common knowledge, we have to ensure that everyone washes their hands as often as possible. We have placed posters depicting the need to maintain hand hygiene across our facilities, as well as the correct hand washing and hand sanitizing techniques. Hand soap and hand sanitizer dispensers have been placed all across our facilities, and all critical areas have disposable hand gloves being made available. Further, continuous education and reinforcement regarding the need for hand hygiene helps to retain the heightened level of awareness that we need at the time of the present pandemic.

What tips and advice would you like to give to other healthcare facilities in wake of the pandemic?

One factor that helped us to a great extent is touch point mapping, and developing protocols that defined PPE requirement, identifying the right chemicals, tools and machinery for each touch point and continuous and persistent adherence to the infection control processes. Once such a touch point map of a healthcare facility is maintained, it becomes easier to maintain the requisite levels of hygiene that each zone or department warrants. This process would help healthcare facilities mitigate infection risks to a great extent by effective resource planning in cleaning.