A 'White Glove' Inspection for the Invisible

Many years ago, while serving in the military, I was exposed to a foreign concept, the “white glove” inspection. The purpose of the inspection by our military instructors was to determine if our rooms were clean. In 1982, while working in a hospital, I learned from infection control practitioners that even though a surface may look clean to the naked eye, it is not necessarily clean due to the presence of microbes that the human eye, or for that matter a white glove, cannot detect. To determine if a surface in the hospital was clean, a test was conducted using contact plates. These plates, when analyzed, indicated the colony count of organisms. We used this process (total plate count) to determine how well we were cleaning hospital rooms and surfaces, and then adopted disinfectants, tools, and procedures to minimize the presence and growth of potentially hazardous organisms that could cause cross-infections or nosocomial illness. Thus, in the 1980s, environmental and housekeeping professionals were beginning to be exposed to the rudiments of a process — and philosophy — of cleaning that is now called Integrated Cleaning and Measurement (ICM).

Integrated Cleaning and Measurement is a systematic approach to cleaning that entails using best practices to clean facilities and to measure the effectiveness of the cleaning program using a 21st century version of the "white glove” approach mentioned earlier. ICM uses scientific instrumentation to measure the effectiveness of the cleaning processes. It is defined as “open source,” since many types of best practices, chemicals, and equipment may be used to produce the final result — hygienically clean facilities, or in the vernacular, "cleaning for health."

Integrated Cleaning and Measurement is a holistic paradigm where all elements interact synergistically to enhance the quality of outcomes. ICM links people, motivation, processes, chemicals, supplies, workloading, and equipment in an interactive platform that dramatically increases the effectiveness of cleaning, as verified and enhanced by measurement. The ICM end game is that facilities both look clean (to the naked eye) and are properly clean at the micro-particulate and microbial level. But these are not the only measurable outcomes. Research indicates clean and healthy buildings using proper tools and workloading help decrease absenteeism by health improvements, directly and indirectly lowering costs and raising productivity.

ICM uses a system of measurement consistent across industries: whether in an aircraft manufacturing plant, hotel, university, K-12 school, or hospital. The cornerstone device is an ATP meter that identifies adenosine triphosphate (ATP) on a surface. According to Robert W. Powitz, Ph.D., MPH: “ATP is the primary energy transfer molecule present in all living biological cells on Earth … its measurement is a direct indication of biological activity…Simply stated: no biological contamination, no microbial growth.” The advantage of the ATP meter over the traditional methods of colony counts is that it provides data in real time (i.e., seconds instead of days) and at a low cost. This provides for immediate feedback and allows for quick corrective action as needed.

Other measurement instruments are also being used, such as handheld air monitoring equipment, water quality monitoring meters, ultraviolet revealing technology, and volatile organic compound (VOC) measuring units.

Many operations use different tailored cleaning methods, workloading and staffing strategies, and ICM encourages a creative and complete approach. Staffing methodologies include Zone Cleaning, where individual cleaning personnel are responsible for a specific area; Team Cleaning where individuals are responsible for a primary cleaning function in given areas; Day Cleaning, where cleaning personnel work during the daytime to minimize the energy consumed by night lighting, keep the buildings open while cleaned, enhance contact with customers, and increase productivity; and Green Cleaning, a systems approach using sustainable cleaning practices to minimize negative health and environmental impacts. All of these paths can be followed in the ICM process provided the outcomes — including productivity, performance, and reduced labor costs — produced by such approaches are verified by measurement. Additional components could include elements from the US Green Building Council’s guidelines for LEED and the EPA's Indoor Air Quality (IAQ) Tools for Schools (TFS) program.

There is a growing body of research demonstrating a correlation between clean facilities and lower absenteeism in institutions as exemplified by Dr. Charles P. Gerba's study, Cleaning Desktops and Other Classroom Surfaces Reduces Absenteeism, which chronicled a 50 percent absenteeism reduction when certain measurable cleaning processes were practiced. Viruses that cause influenza, diarrhea, and respiratory illness commonly occur on school-age children's desktops and other surfaces in educational facilities. Every time these surfaces are touched, viruses can be transmitted to healthy individuals. Office buildings are not exempt. During the cold season, Dr. Gerba’s group found cold viruses on surfaces in a third of offices across the country.

ICM thus has a direct impact on the environment in which people work and interact, and promotes cleaning for health and not merely appearance. Such a program can have a dramatic impact on facility operations resulting in substantial savings:
  • Labor is the most expensive component in most operations. As Dr. Gerba indicates, school absenteeism decreases as a result of cleaner and more hygienic surfaces; thus, cleaner facilities can also translate to less absenteeism at the workplace. Absenteeism is incredibly expensive to an organization; it is lost time. With a cleaner, healthier environment, as absenteeism decreases, productivity should increase as there are more people available each day to produce the required work and products. ICM will become increasingly synonymous with attendance improvement initiatives, thus, becoming critical to the effective management of any organization.
  • With the impact of healthier working environments, such as less sneezing and fewer headaches from inhalation of VOCs and other contaminants, at-work productivity and learning are also increased.
  • Better dust containment and removal processes mean less particulate is picked up by the heating, ventilation, and air conditioning systems (HVAC) and dispersed through the building. Air filters will last longer, energy costs will be reduced, and since less dirt is being circulated throughout the indoor space, the environment and surfaces stay cleaner longer.
  • Improved hard surface care will also help improve indoor air quality. With the application of low-VOC chemicals that are environmentally preferable, and fewer chemicals overall, impact on air quality in a building and related costs are minimized.
  • Meaningful feedback can be provided to cleaning departments and customers by the ICM ATP measurement process. ATP monitors will indicate if surface cleaning processes are effective, and if not, custodial staff can modify the practices, thus improving quality. Managers can eliminate practices that are not effective, further reducing costs.

There is no doubt the science of cleaning is changing. Integrated Cleaning and Measurement (ICM) practices will enable educational facilities to achieve hygienic triumphs through measurement processes such as ATP. ATP and other devices are available to measure the effectiveness of cleaning programs, and constitute the new "white glove" — one with a direct impact on the bottom line (and health) — of any organization.

Alan Bigger is director of Facilities at Earlham College, Richmond, IN, past president of APPA (Leadership in Educational Facilities), and a Registered Executive Housekeeper (REH) with the International Executive Housekeepers Association (IEHA).

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