The Team Sport of Patient Safety: Bringing Facility Services Into the Circle of Care
In healthcare, cleanliness conversations tend to revolve around protocols, products, and compliance.
But at the 2026 Healthcare Surfaces Summit, to be held May 5-6 at ISSA headquarters in Rosemont, Illinois, one of the central questions is more human than that: who are the people making critical decisions on the floor every day, and how can the cleaning industry better support them?
To explore that question, Linda Lybert, Executive Director of the Healthcare Surfaces Institute, a division of ISSA Healthcare, sat down with Dr. Omrana Pasha-Razzak, a professor in the Department of Community Health and Social Medicine at the City University of New York School of Medicine, and the summit’s keynote speaker. Pasha-Razzak is a “hospitalist”, a title that is newer to the industry lexicon but points to a role with deep implications for how hospitals run and how clean environments directly affect patient outcomes.
What a hospitalist does
The term hospitalist is relatively new, but the function is not. Hospitalists are physicians whose full-time job is to manage the care of patients from the moment they are admitted to the hospital until discharge, nothing more, nothing less.
“In the past, internal medicine physicians, family practitioners, pediatricians who did outpatient medicine also looked after the patients when they got admitted to the hospital,” Pasha-Razzak said. “However, what we have found is that when you have dedicated physicians whose full-time job is to take care of patients when they get admitted to the hospital, there is shortened hospital stays and improved patient outcomes.”
Pasha-Razzak made that transition herself after years of traditional practice. She now coordinates care with specialists, manages medications and tests, and is fully accountable for a patient’s clinical course during their hospital stay. That singular focus, she said, is what drives the shift toward this model.
Two problems, one clean room
When asked about the day-to-day challenges hospitalists face around infection control and clean environments, Pasha-Razzak broke it into two distinct problems, both of which land squarely in the territory of environmental services.
The first is ongoing: keeping a room safe for the patient currently in it. That means managing the risk posed by staff moving between rooms, ensuring contaminants left by a previous patient are fully removed before a new admission, and maintaining a clean environment throughout an entire stay.
The second is the transition. When one patient is discharged and a new one is waiting, every minute the room sits uncleaned has consequences downstream.
“One of the biggest challenges that hospitals in the United States face currently is waiting time, especially waiting time in emergency rooms,” she said. “The vast majority of my patients get admitted through the emergency room. And if rooms are not cleaned quickly after patients leave, then the next patient is waiting in the emergency room. And emergency room crowding is a huge problem in the United States.”
The goal, she said, is a room that is turned around safely and efficiently, with nothing sacrificed on the safety side, but with the lag time between one patient and the next cut as short as possible.
From chaos to coordination
Pasha-Razzak drew on her own experience as a resident in New York City to illustrate how much the system has improved, and where the remaining gaps are.
In those earlier days, a patient could be discharged at 7 p.m. or later, and the process to notify custodial services was entirely manual. A unit receptionist would call. Custodial staff would respond when they could. By the time the night shift arrived—often a skeleton crew—multiple rooms might still be waiting. Patients sat in the emergency room.
“I, as the resident physician, would say, ‘Hey, my patient is in the ER. I’m waiting for them to come up.’ And they would tell me, ‘Well, the bed’s not clean,’” she said. “And then a few hours later, swing by again, bed’s still not clean.”
One department chair at her hospital took it upon himself to walk the floors on his way out each evening, what he called go-home rounds, checking which patients were slated to be discharged and pushing to get them out before the shift change so rooms could be cleaned while full staffing was still available.
That kind of workaround is no longer necessary in the same way. Hospitalists are now evaluated in part on how many patients they discharge by a target time, typically between 10 a.m. and noon. That shift has had a direct effect on custodial efficiency.
“If five or six rooms were to become empty on a single floor, they could go through them very efficiently one after the other,” Pasha-Razzak said. “Whereas if people were being discharged piecemeal — one person here at 10 a.m., one person on another floor at 2 p.m., and they’re having to move between floors, it takes much longer.”
Digital dashboards have helped close the loop. When a patient is discharged, the room status updates in real time, visible to both clinical staff and the facilities team, eliminating the phone call entirely.
The design problem nobody talks about
Lybert brought another dimension to the conversation: the physical environment itself.
“When hospitals are designed and constructed, they’re not designed and constructed for cleaning,” she said. “Oftentimes what happens is we have a room that needs to be turned over quickly and the products and the materials that were used in there are more difficult to clean. We really need to start from a foundation of building hospitals that are easy to clean and disinfect effectively.”
She emphasized that EVS professionals need to be trained for efficiency in room turnover—not just safety—and that both goals need to be treated as equally non-negotiable.
A seat at the table
For Pasha-Razzak, the bigger vision is cultural as much as operational. She is a proponent of what medicine calls interprofessional practice — the idea that patient care is a team effort involving nurses, physicians, social workers, physical therapists, and others who round together each morning to align on every patient’s needs and discharge plan.
She would like to see facility services included in that circle.
“What I would love to see over time is not us thinking about this in two streams, in two silos, where there’s the cleaning industry and the healthcare industry, but recognizing that our facility staff are an integral part of that interprofessional practice,” she said.
The practical upside is real. If a facilities team member sat in on morning rounds, they would know two days in advance which patients are being discharged and could plan staffing accordingly. That kind of lead time, Pasha-Razzak said, could significantly change what is possible.
“They should be recognized as an integral part of that interprofessional team,” she said. “Because we can’t function without their input.”
The 2026 Healthcare Surfaces Summit is a limited-attendance event with 120 seats, designed to facilitate the kind of close networking and project development that a larger conference does not allow. Pasha-Razzak’s keynote will carry these themes into the room, and if her conversation with Lybert is any indication, attendees will leave with more than a few things to bring back to their own facilities.
