Clinical question: What has been the experience of environmental services (EVS) employees working during the COVID-19 pandemic?
Background: EVS employees play an essential role in preventing the transmission of infectious diseases due to their work cleaning and sanitizing the hospital environment. However, they’re among the lowest-remunerated health care workers and had reported feeling undervalued even prior to the onset of the pressures associated with the COVID-19 pandemic.
Study design: Semi-structured interviews, followed by qualitative thematic analysis
Setting: Quaternary care academic medical center in Colorado
Synopsis: 16 of 305 EVS employees were interviewed, of whom 70% identified as female, 50% as black, and 31% as Hispanic. The research team identified four core themes of the up to one-hour interviews. First, is the need for training and education, including translation and protocol refreshers. Second, is emotional strain, such as seeking meaning through their interactions with patients, the suffering they are observing in the COVID-19 patients, and the stress of exposure risk. Third, resource challenges, such as adequate personal protective equipment, staffing, turnover, and burnout. Lastly, the lack of recognition as frontline workers, both in mainstream media and in their day-to-day jobs. Interviewees highlighted the negative impact of hospital hierarchy, yet they also noted that acknowledgment and support from interdisciplinary colleagues played a role in mitigating the lack of recognition.
The authors take the results of these structured interviews and make recommendations for hospital systems. They recommend advocating for increasing the benefits of EVS employees to be more in line with other health care workers’, enhancing native language education, and creating intentional appreciation programs.
Bottom line: The COVID-19 pandemic has exacerbated the stressors already facing our EVS colleagues; hospital systems must do more to provide training as well as financial and emotional support.
Citation: Jordan SR, et al. Forgotten frontline workers: Environmental health service employees’ perspectives on working during the COVID pandemic. J Hosp Med. 2022;17:158-168. doi: 10.1002/jhm.12781.
Dr. Gordon is an associate program director of the internal medicine residency at Maine Medical Center, Portland, Maine, an assistant professor at Tufts University School of Medicine, Boston, and a hospital medicine physician.