This month’s editorial calendar centers on “High-Performance Health Care,” which got me thinking about the lessons the HVAC community learned after more than a year of health care sheltering in place. Each one of us probably has a family member or friend who was scheduled to visit a hospital in 2020, and, of course, no one was allowed to go with this person into the hospital due to COVID-19. From a health care acquired infection (HAI) point of view, this chronic problem associated with health care facilities most likely took a dip in HAI cases in 2020 when compared to 2019, but that research study hasn’t been taken yet.

Assuming my 2020 versus 2019 assessment is correct, why would there a dip in HAI cases? First off, there were less people coming and going into these facilities. Second, the facilities received extra attention by the operation and maintenance staff, housekeeping, and health care staff themselves. All of them were far more proactive in 2020 following standard cleaning and hygiene procedures than in the past, not to mention that stricter rules were put in place to combat COVID-19. Most important were the restrictions placed on visitors who were accompanying the individual who had scheduled the appointment.

Now, some may dispute these statements, but I’ve seen firsthand health care policy and procedures pre-COVID-19, and I’m confident I’m more right than wrong. If you deduct the hospital’s entire staff and focused strictly on those people coming and going prior to 2020, it’s safe to estimate 40%-50% of those visiting the facility were just that, visitors and not patients. On the patient room floors, visitors were used to coming and going, often in small groups. Let’s estimate the number of visitors exceeded the number of patients by a two-to-one ratio, if not more in pre-COVID-19 days. It’s also safe to say that before 2020, most visitors did not follow the hospital’s hygiene guidelines that were in place. And health care workers within the facility didn’t always follow their hospital’s own infection control guidelines, especially when compared to 2020, “the COVID year.”

Going forward, health care facilities that strive to retain or achieve high performance should implement a quality-control study to capture before, during, and after a pandemic to improve their current cleaning and hygiene protocol as well as seriously revisit the facilities visitor rules and regulations. Before COVID-19 implemented restrictions on visitors, coming and going from the facility would be considered infringing on patient and visitor rights, but now, our lessons learned prove HAI cases can be reduced when hospitals put restrictions on their open-door policies for the benefit of the hospital staff, patients, and visitors. An often-quoted 2013 U.S. Center for Disease Control and Prevention (CDC) review identified nearly 1.7 million hospitalized patients annually acquire HAIs while being treated for other health issues and that more than 98,000 patients (one in 17) died due to these infections. In that year, the economic burden to the U.S. may be as high as $45 billion per year. What would that financial projection be today?

If health care facilities would take into account the lessons learned from their past open-door policy, one could say this would be a high-performance win-win-win for the hospital’s operating budgets, the occupants, patients, visitors, and the reputation of the health care organization.