Healthcare environmental hygiene is often described as a “cleaning” challenge. In reality, it is a patient safety system—with regulatory pressure, high-stakes decision-making, and a web of stakeholders who all influence what gets approved, what gets used, and what gets repeated.

That was the line of thought during a recent ISSA Healthcare panel discussion moderated by Linda Lybert, founder and executive director of the Healthcare Surfaces Institute, and featuring Rich Feczko, president and founder of Elevate Innovation Group and chair of the ISSA Healthcare Innovations and Solutions Task Force; Nancy Schlossberg, nurse and former program director of Digestive Health Services at John Muir Health; Barbara Strain, principal of Barbara Strain Consulting LLC; and Joanna Mills, director of Infection Prevention at John Muir Health.

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The conversation focused on how environmental hygiene decisions are made, why silos slow progress, and what cleaning leaders and solution providers need to understand to succeed inside a healthcare facility.

One message landed early and kept resurfacing: in healthcare, you are never working with “just a supervisor.” As the moderator put it, “you’re actually working as part of a patient safety or patient care team.” That changes everything—from how products are evaluated to how EVS is perceived, measured, and held accountable.

Mission and margin intersect

A core theme was the business reality behind clinical expectations. Schlossberg captured it simply: “their mission and their margins intersect.” In other words, a facility can value the best possible solution and still need to justify the cost, the workflow impact, and the downstream outcomes.

That is where the “current condition” comes in. Strain emphasized that value analysis is not a person—it is a process that starts with a hard question: do we actually have a need? “We have to look at our current condition,” Strain said. In a healthcare setting, that current condition might include quality measures, workflow constraints, infection trends, readmission penalties, staffing, and training gaps. If a solution provider does not understand the facility’s baseline, the pitch is likely to miss the mark.

Feczko tied this back to a practical strategy. Facilities vary by region and state, and much of their performance data is public. “You can look at their healthcare-acquired infection rates,” Feczko said (click here for more information). The point was not “show up with a chart.” The point was to do informed discovery, so conversations begin with the facility’s reality, not the vendor’s assumptions.

From product pitch to solution discipline

The panel repeatedly encouraged suppliers and service providers to stop treating healthcare like a typical sales environment. “Please go in and have conversations,” the moderator said. “Just don’t go through the door selling a product because it simply doesn’t work that way.”

Strain framed the risk of shallow selling with a story about a porous sound-mitigation product that looked promising—until a facility manager asked, “okay, so how do I clean it?” The supplier had not considered cleanability. What was intended as a solution became a liability.

That single moment highlights a decision-making standard that cleaning managers live with every day: anything introduced into the environment becomes part of the cleaning and disinfection system. If it cannot be maintained safely, it does not belong—no matter how impressive the innovation looks on a brochure.

Validation is a team sport

If the healthcare marketplace feels slow, the panel’s explanation was blunt: the approval process is deliberately rigorous, and it should be. Strain described validation as “a team sport in a well-run health care facility,” because any new product, device, or service touches multiple departments. “We have infection prevention and control, we have quality folks, we have nurses, we have physicians, we have key leaders like biomed,” Strain said, adding that depending on the solution, there may also be C-suite stakeholders involved.

Schlossberg warned suppliers to expect intensive documentation requests. “You are going to get a big, fat packet,” she said. “They’re going to want your cleaning instructions. They’re going to want your FDA clearances.” She added that the pressure is often amplified by overstretched procurement and value analysis resources, meaning when the request comes, it may come fast: “You’ll get a call. They’re going to want it immediately.”

Feczko reinforced that validation now includes not only products, but also the tools used to measure cleaning. Devices like tablets and phones can enable audits, time stamps, and trending—but they also have to be “cleanable” and compatible with high-risk environments. “Those devices need to be cleaned and disinfected on a regular basis,” Feczko said, especially as they move through surgical areas, EDs, ICUs, and other units.

Decision-making, in other words, is not just about whether something works. It is about whether it fits inside the facility’s clinical, regulatory, operational, and infection prevention realities.

The hidden gatekeeper: IT

Healthcare buyers do not just evaluate what a product does—they evaluate what it introduces. Schlossberg called out a factor that surprises many vendors the first time they hit it: “has IT done their technical assessment of this? And IT is a bug of bear.” Any tool that connects to networks, stores data, or relies on apps can trigger a deeper review. For cleaning managers and EVS leaders, that reality matters because it can delay implementation even after the operational case is clear.

The practical lesson: if technology is part of the pitch, the work starts earlier. A solution provider needs a complete readiness story—security, workflows, device cleanability, training, and how data will be used—before the facility feels safe saying yes.

Infection prevention: from policing to partnership

One of the more candid moments came when the moderator shared feedback heard from EVS professionals: “they don’t communicate with IPs unless they need to know about bugs,” or they only hear from infection prevention when something has gone wrong.

The panel’s response was not to scold EVS. It was to reframe the relationship. Schlossberg encouraged teams to “turn it from policing to partnership.” She described inviting infection prevention into routine rounds and asking them to explain the “why” behind requirements—because healthcare is full of internal language that can isolate teams. “Everybody has their own little language,” she said. “Make sure you’re communicating.”

Strain’s perspective was direct and human: infection prevention is about “protecting the health care worker and protecting patients.” When those goals are shared openly, the work stops feeling like compliance theater and starts functioning like a coordinated safety program.

Data, tools, and the future of ‘proof’

The panel addressed whether tools like ATP, audits, and infection metrics are impactful today—or whether the industry needs to make them more meaningful.

Feczko acknowledged the limits: ATP “does not tell you what pathogen is on a surface,” but it can indicate that something remains and that cleaning was incomplete. He also pointed to emerging technology that may help identify what is on surfaces more specifically, while emphasizing the same operational constraint: any new tech must be cleanable and fit the environment.

The panel also described how organizational routines can make data more actionable. Schlossberg referenced a hospital-wide daily huddle in which departments reported out, shared packets, and made quality issues visible across the organization. The underlying idea is powerful for cleaning managers: if EVS wants influence, it needs visibility, and visibility often comes through the same shared reporting structures leadership uses to manage risk.

Why EVS gets clinical expectations without clinical authority

When asked why EVS is often held to clinical expectations without being given authority, the panel pointed to a familiar operational reality: staffing. “Everybody is short-staffed,” Schlossberg said, and in a crunch, “a body is a body sometimes.”

That reality can create scope creep, but the panel also described it as a potential opportunity—if handled deliberately. Feczko shared an example of an organization that expanded into patient sitting, built a playbook, followed guidelines, and turned the added responsibility into measurable value for the facility.

Strain added a critical control point: service level agreements and clear escalation pathways. The question is not only “can EVS do it?” It is “who is authorized to assign it, who is trained, and when does it need to escalate?” In a healthcare facility, those lines protect patients and staff—and protect EVS from being set up to fail.

A practical takeaway for healthcare cleaning managers

For cleaning managers, the panel’s guidance can be summed up in four actionable moves:

1. Build relationships before there is a problem. Invite infection prevention in early and make collaboration routine.
2. Speak the facility’s language. Translate requirements into shared understanding so compliance becomes purpose driven.
3. Treat validation like a workflow, not an event. Know what documentation and cleanability questions are coming and prepare teams to respond fast.
4. Use data to earn influence. Align EVS metrics with what leadership already tracks: risk, throughput, patient safety, workforce safety, and operational stability.

Healthcare environmental hygiene is not a side function. It is a core piece of patient care. When EVS leaders build bridges across silos, anchor decisions in validation, and communicate in the language of safety and outcomes, they are no longer “the cleaning team.” They become what the facility already needs them to be: a trusted, long-term partner in care.

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