Lakhasly

Identification of Environmental Cleaning and Managerial Best Practices for Integration in Competitive Bidding Documents for Outsourcing of Housekeeping Services in Tertiary Care Hospitals in India
Kausar Mohammad, Amit Lathwal1, Vipin Koushal2, D. K. Sharma3
Department of Hospital Administration, AIIMS, Bilaspur, Himachal Pradesh, India, 1Department of Hospital Administration, AIIMS, New Delhi, India, 2Department of Hospital Administration, PGIMER, Chandigarh, India, 3Medical Superintendent, Department of Hospital Administrative, AIIMS, New Delhi, India
Abstract
Aim: This study aimed at the identification of environmental cleaning and managerial best practices for integration in competitive bidding documents for outsourcing of housekeeping services in tertiary care hospitals in India. Materials and Methods: This study design was cross‐sectional. The sample comprised of tender documents of eight government super‐specialty hospitals/corporations and housekeeping contract agreements of five private ones. Convenience sampling was used‐current tenders of most popular government hospitals available online and housekeeping agreements of consenting popular private hospitals were considered. Excel sheet was used for the analysis. Results: Hospitals outsourced housekeeping services on performance or human resource basis, use risk classification (23%) of hospital areas for determining intensity of cleaning, and outlined scope of services (50%). Fifteen percent tenders provide comprehensive lists of material. Scrubber requirements ranged from one per 25–250 beds. In 40% tenders, scope included handling of biomedical waste. Workforce included managerial cadres. There is a focus on occupational health and safety. Quality assurance is inbuilt in the contracts including bid evaluation criteria for selecting competent agencies and penal provisions such as in case of adverse report (INR 10,000) and unsatisfactory survey reporting (1% of monthly payment). Conclusion: Since successful outsourcing must focus on above‐mentioned parameters, this study provides necessary guidance for health‐care administrators for patient satisfaction, positive image, reducing hospital‐acquired infections, and ensuring provision of quality care services.
Keywords: Competitive bidding, health‐care facilities, hospital, housekeeping, workforce, outsourced services, sanitation, services
IntroductIon
It is an established fact that environmental cleaning reduces hospital‐acquired infections and patient length of stay. However, many low‐ and middle‐income countries still lack access to basic water, sanitation, and hygiene services.[1] Infrequent cleaning, shortage of disinfectants, water, and staff are encountered.[2] Many hospitals also lack cleaning protocols, supervision, and training.[1] In India, housekeeping services have been outsourced in many public hospitals. Outsourcing requires robust contracts to ensure quality control and acceptable performance by outsource agency. Auxiliary services such as cleaning are one of the most obvious targets for cost savings.[3] Services are outsourced to gain
access to quality service.[4] Results of the studies on the costs and benefits of outsourcing have been mixed.[5] However, studies have demonstrated that outsourcing is associated with a greater incidence of hospital‐acquired infections.[3,6] Others have shown lesser infections with modified cleaning
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