With trickling takers and steady job-hopping, the healthcare industry is facing heavy attrition and want of trained housekeeping staff. Housekeeping heads of Apollo Hospital and Narayana Hrudayalaya in Bangalore share the manpower challenges and practices adopted in a brief discussion with Vijayalakshmi Sridhar.
Lack of trained manpower in housekeeping is a challenge faced across segments. It is more significant in healthcare, as it requires the right mindset and a thorough understanding of hygiene and infection control to work in the exclusive world that involves blood and bodies. Over and above, the housekeeping staff requires certain soft skills to interact with doctors, patients and other customers. Sadly, hospitals today do not enjoy a prerogative or much room to choose their recruits.
The NABL-accredited Apollo Hospitals follow JCA standards and have put down minimum criteria of tenth grade (passed) for semi skilled workers. They are then trained and recruited accordingly. This applies to the ground level staff, executives and supervisors too.
“Everyone, including staff and visitors think hospitals are infectious places. The job of changing this thinking lies in the hands of the housekeeping team. The in-house training at Apollo spans to around 10 hours a week, which begins with a compulsory 20-minute briefing every day. We strive to keep the environment clean and also the patients satisfied,” says Deepak K, Head-Housekeeping, Apollo Hospitals Ltd.
It is different when it comes to Narayana Hrudayalaya, says Shridhar Shetty, Senior Manager-Housekeeping. “We follow a different strategy. A regular feedback is taken from the patients to understand their specific requirements and we work towards delivering them.
“Accordingly, we tweak the services to suit their requirements. This is done during the patients’ stay in the hospital, so that their satisfaction is met with,” adds Shetty.
Hospitals follow daily cleaning schedules and also extra cleaning and deep cleaning schedules that are incorporated in the housekeeping routines to maintain a clean and hygienic environment. Even in the outsourced model, the housekeeping staff receive training on the job to suit the needs of the hospital. Many a time, when it is a manpower based contract, the facility service provider tends to put staff on multiple jobs. A ward boy is also called to give a helping hand in other departments when there is more traffic. Hence, housekeeping staff are seen doing multi-tasking rather than doing a single task that they are assigned for. In such cases, the chances of cross contamination is much higher and hygiene as a whole lacks precision.
At Apollo, night time cleaning is scheduled in certain areas, such as the main building where walk-in traffic is high during the day. Certain other areas are cleaned during the lean period, when movement is least. These areas are completely blocked for public use and cleaned thoroughly and meticulously.
As part of the smart public-satisfying strategies adopted by Apollo, a practice of assigning a single person to clean all the general toilets continuously works well as the usage of such toilets are much high during the day. The janitor in charge of public toilet cleaning is confined to this task and is not assigned any other work. Nonetheless, some of the other hospitals that Clean India Journal visited, it has been noticed that lack of supervision, especially with toilet cleaning, has led to the failure of this strategy.
Housekeepers who work in hospitals must know about the quality and the quantity/extent of hygiene that is observed there and the SOPs too.
Deepak K
Many a time, the cleaning done is very superficial which makes the toilet unhygienic. In some cases, the janitor returns to clean periodically instead of being stationed permanently in the toilet area. Moreover, the methods of cleaning being more manual, using just a mop, hygiene is sacrified in the name of cleaning. The mop used to dry the toilet floor is also used for mopping outside the toilet.
“Initially, Narayana Hrudayalaya had only western commodes. Observing the lack of awareness among visitors to use them, we made a 50-50 combination of Western and Indian commodes. There are also signages to guide the users. Above all, we have advised our staff to instruct users very kindly to use the services appropriately.”
“At Apollo, only experienced members of the staff are let to multi-task while others have specific job descriptions and duties. Simple steps ensure hygiene. For example, garbage is collected in closed bins and transported through a separate chute to the processing area,” explains Deepak.
Adding, Shetty says, “The garbage at Narayana Hrudayalaya is always collected in closed bags and wheeled out in trolleys. When the trolleys come back after disposing the waste, even the wheels are treated with disinfectant.
Further, to discriminate the housekeeping staff and keep them dedicated to their work targets, we have a separate shift team that takes care of the corresponding errands.”
Most of the cleaning in Narayana Hrudayalaya, the second largest cardiac care centre in the world, is done during the night time. “This is mainly to avoid accidents while cleaning due to heavy traffic and disruption of activities.”
More than mechanized cleaning, manual cleaning is resorted to in hospitals, particularly around patient care area or in units where there are many monitoring devices placed. The reasons for engaging manual cleaning include the mind-set of the housekeeper towards adopting professional cleaning practices or tools/machines; the lack of investment by the hospital in mechanized/ professional cleaning and lack of proper space to run cleaning machines inside the hospital.
It has been reported that most of the new recruits are poached for other blue collar jobs. Moreover, given the shunted career growth for housekeeping staff in hospitals, workers tend to migrate and the attrition rate is very high. Hospital to hospital recruitment also kills the time invested in training.
“It is a challenge to retain manpower but we resort to keeping the staff motivated through constant engagements and programs. We firstly make them understand that they are here for a cause. We train them continuously too. We groom their sense of humour and body language. We counsel them when they have problems, visit them when they are sick and maintain a good rapport. We vaccinate them against prone illness too,” says Deepak.
“Our approach lies in giving them space and time to learn the techniques of cleaning. We keep encouraging them, correct their mistakes and polish their skills. This instills a strong sense of belonging. We hire locals so that they do not lose their energy and passion for work which gets lost in the long commuting hours,” explains Shetty. The work culture also has to have a similar value-based approach, he adds.
As part of the smart publicsatisfying strategies adopted by Apollo, a practice of assigning a single person to clean all the general toilets continuously works well as the usage of such toilets are much high during the day.
Shridhar Shetty
Until now only hospitals have been investing time and effort in in-house grooming of their housekeeping staff. Now there are institutes that offer moduled training for hospital housekeeping.
“The certificate holders are taken as General Duty assistants or GDAs. We have absorbed 28 people recently from the institute and are very happy with their work,” says Deepak.
Those trained in hospital housekeeping continue to be a separate lot and the training is ingrained in them, says Shetty. “In fact, the staff who had left the hospital for some other industry have come back to work here again.”
Looking ahead, training seems to be one of the aspects that will help growth of hospitality housekeeping and be a value-addition in the long run.
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