Clean Hospitals Day 2024: the technical domains of healthcare environmental hygiene

Clean Hospitals Day is celebrated each year on the 20th of October. Its purpose is to raise global awareness of healthcare environmental hygiene (HEH) and increase engagement of healthcare facilities (HCFs) around the world. The theme of this year’s Clean Hospitals Day campaign is “The 6 Technical Domains of Healthcare Environmental Hygiene”.

Healthcare-associated infections (HAIs) are among the most common adverse events in healthcare settings, causing harm to patients, visitors, and staff, and imposing a heavy burden on health systems, including increased costs [1]. HEH is a crucial pillar of infection prevention and control, yet general level of HEH in HCFs is shockingly low across all resource levels [2]. Pathogens such as MRSA, VRE, norovirus, Clostridioides difficile, Candida auris, and Acinetobacter spp. are often transmitted through the healthcare environment [3]. Transmission through the healthcare environment occurs both through fomite transmission and as a result of hand contamination [4,5,6,7,8]. Although the total burden of HAIs due to the healthcare environment is still unknown, there are current estimates that at least 10-30% of all multi-drug resistant organisms are transmitted to patients through the healthcare environment [9].

HEH comprises several technical domains as well as several human factors, and both are essential for a well-functioning HEH program. The HEH technical domains include surfaces, air control, water control, device reprocessing and sterilization, laundry, and waste management. Improvements in HEH have been shown to improve patient outcomes and reduce HAIs with successful interventions often being multimodal and involving at least one of the six HEH technical domains [10].

As there is currently no international consensus on HEH best practices, it is necessary for HCFs to turn to available national guidelines, facility- level guidelines, or product manufacturer’s recommendations for guidance. Awareness raising and interventions in HEH are also a smart use of HCF budgets, as IPC interventions generally generate a high return on investment, with programs yielding a 7 to 16-fold return on every $1 invested [1].

Organizing the scope of the healthcare environment into the 6 domains may facilitate HCF efforts in better managing their HEH programs, identifying areas for improvement or allocating resources. A promotional toolkit for HCFs has been developed and is available at no charge: https://cleanhospitals.com/promotional-toolkit-2024/. The toolkit includes several posters (Fig. 1), a screensaver, a selfie board, tiles for social media and a frame for profile pictures. HCFs are encouraged to use them in their own campaigns to celebrate Clean Hospitals Day around the world.

Fig. 1

Clean Hospitals Day 2024 – main campaign poster

For people that would like to take a more active role in their HEH programs, the Healthcare Environmental Hygiene Self- Assessment Framework (HEHSAF) tool is available for free: https://cleanhospitals.com/hehsaf/. This comprehensive tool is available in twelve languages, is organized around a multimodal improvement strategy, and covers all of the six HEH technical domains as well as human elements for implementation. By using it, HCFs can analyze their scores, compare themselves to other facilities or regions, and start to create a roadmap towards excellence in HEH. Celebrate Clean Hospitals Day and share your success!

AP is the scientific lead of the Clean Hospitals Association, PP is the vice-chair of the Clean Hospitals Association, and DP is the chair of the Clean Hospitals Association. This Correspondence was supported by the Infection Control Programme (Faculty of Medicine, University of Geneva, Geneva, Switzerland). The authors alone are responsible for the views expressed in this Correspondence and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated.