Cleaning beds, chairs and rooms

A treatment space is not free the moment a patient leaves it. In the Emergency Department model a freed space is held until it is cleaned, and the cleaning takes time and someone to do it. The Spaces tile reads “The beds, chairs, hallway spots and resus bays a patient is treated in, each cleaned before its next patient.”

When a patient leaves, the space hands over to a patient of the type Clean. That happens at the Notify step of the space’s path. The space is held until it is cleaned, and only then can the next patient have it.

Beds and resus bays are cleaned by the EVS crew. The steps are Notify EVS, which takes T(2, 6, 15) minutes before a clean starts, Clean by EVS, and Mark Clean by EVS. A bed clean takes T(6, 12, 25) minutes and a resus bay clean T(15, 25, 45).

Chairs and hallway spots are cleaned by a nurse of the main ED. The steps are Notify the nurse, which takes T(0, 1, 5) minutes, Clean by a nurse, and Mark Clean by a nurse. A chair clean takes T(1, 2, 3) minutes and a hallway spot clean T(3, 5, 8).

EVS crew is a resource, sized one for every 2.5 patients an hour, which is 2 at 25,000 visits a year. It is charged all day, under the cost centre EVS (ED rooms). Like every other size it changes with the visits in the box Your ED: visits a year, and an item you change by hand keeps your value. See Visits a year and sizing.

A care model that adds spaces cleans them with its own staff.

• Provider in Triage: the PIT RN cleans the PIT rooms. The box is Clean time, PIT room.
• Results Waiting Area: the monitoring RN cleans the results chairs. The box is Clean time, results chair. The bed a patient leaves for a chair is cleaned by the EVS crew.
• Vertical Flow: the Vertical RN cleans the recliners. The box is Clean time, recliner.
• Fast Track: the Fast Track tech cleans the rooms. The box is Clean time, Fast Track room.
• Super Track: the Super Track RN cleans the chairs. The box is Clean time, Super Track chair.
• Ambulance Offload Nurse has a box, Clean time, Offload Bay.

Each box shows in a scenario when its care model is switched on. See Care models and Care models for the front door and the streams.

The Spaces tile holds two variables, v_CleanScale and v_NotifyScale. Both are integers, and both start at 100. v_CleanScale is a percent scale on every clean time. v_NotifyScale is a percent scale on every wait before a clean starts. At 100 the times stay the ones the research gave; 50 halves them and 200 doubles them. They are ordinary variables, listed in the Logic Builder.

The model also holds the patient types Clean, Huddle and Bed Opening, which the cleaning and the bed board use, and Medication with the ED Pharmacist care model. See The Emergency Department palette.

A space that hands over can be measured in a PM Optimizer study. The response Handed Over %, in the Resources group of Add Response, reads “How much of the time the resource you pick was handed over, for example being cleaned.” It is listed only in a model where a space hands over, as the Emergency Department’s cleaning does. See PM Optimizer responses.

• The Emergency Department palette: the Spaces tile.
• Admissions, boarding and going home: the bed or room is held until the patient leaves, then cleaned.
• Add, move and remove a care model: where the cleaning steps stand inside a care model’s frame.
• Visits a year and sizing: how the EVS crew is sized.