1. Background

The South Houston area is home to 13 dialysis treatment clinics, all of which are owned and managed by Fresenius Kidney Care (FMC). These facilities, some newly operational and others with decades of history, serve a range of 14 to 72 patients daily. Given the critical nature of dialysis care, maintaining a clean, safe, and comfortable environment is paramount to both patient safety and staff satisfaction. However, these facilities were facing significant challenges in maintaining high cleanliness standards, leading to numerous issues that ultimately required intervention.

2. The Problem

The clinics in the South Houston area were plagued with chronic issues regarding the quality and consistency of cleaning services. Several key problems were identified:

• Inconsistent janitorial presence: On some days, the cleaning staff did not show up. On the days they did, they failed to address the critical issues.
• Neglect of critical cleaning tasks: Routine reminders were needed to ensure that A/C vents and diffusers were cleaned regularly. Floors in treatment rooms, particularly those with new Mannington flooring, were not adequately scrubbed, leading to a deterioration in appearance and hygiene standards.
• Patient and staff complaints: Patients and staff frequently complained about the cleanliness of the clinics, adding pressure to clinic management. Complaints centered around unsatisfactory floor conditions, dirty vents, and general uncleanliness, which affected the overall experience for patients.
• CMS inspection failure: A surprise inspection from the Centers for Medicare & Medicaid Services (CMS) revealed cleanliness deficiencies, underscoring the severity of the problem.

Previous contractors failed to address these issues, and their poor performance left the clinics struggling to maintain even basic cleanliness standards.

3. Trident’s Approach

Trident was brought in to overhaul the cleaning and maintenance processes at the South Houston clinics. Through a combination of targeted outreach and strategic marketing, Trident connected with FMC during its acquisition of another cleaning company, recognizing an opportunity to offer a more effective solution.

Key Steps Taken:

• Implementation of the Mannington Floor Care Program: Trident worked closely with FMC’s procurement department to implement a long-overdue floor care program specifically designed for Mannington flooring. This included the use of standardized chemicals, equipment, and cleaning protocols to ensure the floors were properly maintained.
• Introduction of a Digital Quality Assurance System: To ensure consistent quality, Trident introduced the OrangeQC digital quality assurance system. This system was used to document the initial status of the clinics, track the improvements, and monitor ongoing conditions daily and weekly. By utilizing a digital system, the cleaning process became fully transparent and accountable, enabling real-time adjustments.
• Regulatory Compliance Focus: Trident ensured compliance with CMS regulations by incorporating their standards into the quality assurance program. Early warning metrics were established to flag potential issues before they became significant problems, ensuring the clinics never fell behind on cleanliness standards again.

By taking a systematic approach that combined proven cleaning protocols with modern technology, Trident was able to address both the immediate cleanliness concerns and establish a long-term solution to prevent future issues.

4. Results and Outcomes

Trident’s intervention delivered significant and measurable improvements across several key areas:

• Improved NPS Scores: Patients, who had previously expressed dissatisfaction with the cleanliness of the clinics, reported a markedly improved experience. Net Promoter Scores (NPS) improved as a result, indicating higher patient satisfaction and loyalty.
• Deficiency-Free CMS Inspections: Following Trident’s intervention, the clinics passed subsequent CMS inspections without any deficiencies related to cleanliness. This success not only avoided potential fines and penalties but also reinforced FMC’s reputation for maintaining high standards of care.
• Zero Complaints from Staff and Patients: Both patients and clinic staff stopped reporting cleanliness issues to the director of operations, reflecting the overall improvement in the facilities’ conditions. Staff were able to focus on their core responsibilities, and patient show rates for treatments improved, as patients felt more comfortable in the clean and well-maintained environment.

5. Conclusion

Trident’s comprehensive approach to cleaning and facility maintenance in the South Houston dialysis clinics demonstrates the critical value of effective cleaning services. By implementing specialized programs, leveraging advanced technology, and ensuring regulatory compliance, Trident alleviated the numerous pain points that FMC had been experiencing for years.

The transformation achieved reflects Trident’s broader mission of delivering reliable, high-quality cleaning solutions that not only meet but exceed industry standards. With a focus on patient safety, staff satisfaction, and operational excellence, Trident stands as a partner that facilities can trust to handle the critical task of maintaining clean, safe, and compliant environments.

Through our consistent, accountable, and quality-driven services, we reduce the pressures facility managers face, allowing them to focus on what matters most—providing exceptional care to their patients. By partnering with Trident, dialysis facilities can trust that their cleanliness standards will remain top-notch, fostering a positive environment for both patients and staff alike.