Planning a Cleanliness Drive

Cleanliness is a habit not an act. However starting a campaign or drive highlights the issue, builds champions and brings focus on the task at hand. This also further leads to internalizing and inculcating cleanliness as a matter of habit and routine.

Planning a cleanliness drive in a hospital

1. The Hospital In-charge should decide on a date for starting and managing a ‘Swachh Hospital Abhiyan’. The cleanliness drive can be started with a Swacch Hospital Week wherein the focus is on an intensive effort spread over a week to clean the facility followed by maintenance and further improvements.
2. Key steps for implementing Cleanliness Drive include - An internal meeting to be held in the facility with all the staff to explain the aims, objectives, key activities and develop a plan which includes gaps, key areas of attention and actions required. This would be undertaken for each department of the facility.
3. Actions would be categorized as those for which resources could be mobilized internally and second set of activities for which support would be needed from the Rogi Kalyan Samiti (RKS) and those actions which would require additional resources.
4. The facility in charge should allocate responsibility within the team, in which individuals are accountable for actions in their designated areas.
5. A meeting in coordination with the District Administration and Local Municipal Body may be scheduled to obtain support and commitment, provide visibility which will enable participation of other departments such as PWD, Horticulture, Public Health Engineering Department, Local Municipal Body/ PRI. External agencies like municipality and out-sourced organisations managing the biomedical waste disposal should be contacted and their presence is ensured during and after the drive to ensure that the waste is cleared from the hospital dumps and disposed properly.
6. Compost pit of appropriate size should be dug as per standard norms. The facility may plan to have Vermi-compost as well, which yields rich manure.
7. IEC Material should be displayed to highlight the work, its importance and methodology. IEC Material should also include educational posters for the patients and other visitors and on how they can help in keeping the area clean.
8. The cleaning staff is provided with necessary equipment like brooms, bins, mop cloths,personal protection equipment, detergents, etc.
9. For the cleanliness drive support should be mobilized from hospital staff, visitors and community at large to undertake ‘shram daan’ or voluntary labour during the week/ month in order to publicize the effort and get the community actively engaged in the task.
10. The DM/CMO/facility-in-charge should also pro-actively identify and seek participation from charitable and faith based organizations, community organizations, corporates etc. for cleanliness and upkeep of the facility.
11. Care should be taken that in areas where there is potential for injury, contamination or exposure to infections, the public is kept away, and cleaning is undertaken by trained hospital personnel.
12. In public health facilities, often large spaces are occupied by un-serviceable equipment,broken furniture and old vehicles. Intensive efforts are required to be undertaken to clear such spaces. Those items which can be repaired should be sent for repairing and put in use as soon as possible. Those beyond economic repair (BER) should be disposed off as per procedures and protocols of the state.
13. Special areas such as water tanks, fire tank, etc. should also be cleaned by following laid down procedure. Assistance of other department may betaken to achieve this.
• A special drive should be started to keep all stray dogs and animals out of the campus. Methods will be used to discourage the animals from coming back, Phenyl can be sprinkled in areas where they usually sit / rest / feed.
• Waste bins with appropriate liners should be placed wherever required and a schedule is laid down for removal of waste and cleaning of the bins.
• Segregation of general waste into biodegradable and recyclable should be done at the point of generation to facilitate disposal.
• Segregation of the biomedical waste should be done at the point of generation of waste.
14. Before starting of the cleanliness drive, ‘As-Is’ status of the facility should be assessed on the tools, given in the Annexure ‘Q’. Photographs can also be taken & kept as an record for comparison with the result of the cleanliness. This can be used to motivate the staff and encourage them to continue with their efforts to keep the hospital clean.

Training of the staff on the under-mentioned topics may be carried out during the drive:

• 5-‘S’ methodology
• Hand-washing techniques
• Segregation of waste
• Handling and treatment of biomedical waste
• Cleaning of special areas - OT, Labour Room, Nursery ,ICU, Emergency.
15. Follow up actions: After the successful completion of the intensive cleaning drivea systematic and periodic follow-up is required for maintaining the achieved level of the cleanliness. Such short intensive drives can be implemented on a quarterly / as required basis to augment routine efforts. This will help in emphasizing the importance of process and the result will enable a change in the mindset of the stakeholders.

5 S Methodology

There are five 5S phases: They can be translated from the Japanese as “sort”, “straighten”,“shine”, “standardize”, and “sustain”.

Seiri (Sort)

• Remove unnecessary items and dispose them properly
• Make work easier by eliminating obstacles
• Reduce chance of being disturbed with unnecessary items
• Prevent accumulation of unnecessary items
• Evaluate necessary items with regard to cost or other factors
• Remove all parts not in use
• Segregate unwanted material from the workplace
• Need fully skilled supervisor for checking on regular basis

Seiton (Systematic Arrangement)

• Can also be translated as “set in order” , “straighten” or “streamline”
• Arrange all necessary items so they can be easily selected for use
• Prevent loss and waste of time
• Make it easy to find and pick up necessary items
• Ensure ‘first-come-first-served’ basis
• Make workflow smooth and easy
• All above work should be on regular base

Seiso (Shine)

• Can also be translated as “sweep”, “sanitize”, “shine”, or “scrub”
• Clean your workplace completely
• Use cleaning as inspection
• Prevent machinery and equipment deterioration
• Keep workplace safe and easy to work
• keep work place clean

Seiketsu (Standardize)

• Standardize the best practices in the work area.
• Maintain high standards of housekeeping and workplace organization at all times.
• Maintain orderliness. Maintain everything in order and according to its standard.
• Everything in its right place.(Chilled totes in chilled area, Dry totes in dry area.)
• Every process has a standard

Shitsuke (Sustain)

• To keep in working order
• Also translates as “do without being told” (though this doesn’t begin with S)
• Perform regular audits
• Training and Discipline
• Training is goal oriented process. Feedback on the impact of training is necessary monthly.

Source: Swachhta Abhiyaan Guidelines for Public Health Facilities