Integrated Cleaning and Measurement (ICM) is an open source unified-systems approach to institutional and industrial cleaning that uses measurement as a product and process selection, enhancement and validation tool. ICM is a trademark of Kaivac, but as an open-source platform, ICM is open to product and method substitution (e.g., non-Kaivac products and methods) based on outcome data. While the ICM approach in part incorporates a variety of scientific devices that measure microbial, particulate or other contaminant presence to evaluate cleanliness, a primary purpose of ICM is to create unification of elements and a holistic view of building environments, and to use measurement as a means to assess progress and track the benefits of synergies.
The open-source nature of ICM has garnered considerable interest from the cleaning industry as a whole, with several major trade publications and organizations calling attention to it:
• Cleaning and Maintenance Management (CMM) - August 2008
• International Facility Management Association (IFMA) - August 2008
• Food Safety Magazine (FSM) – August / September 2008
• International Executive Housekeepers Association (IEHA) – September 2008
According to proponents, among the areas where ICM holds promise is in helping to reduce the number of hospital acquired infections (HAIs) as part of a multifaceted approach. Although the need for handwashing and behavior modification to encourage handwashing, aseptic surgical procedures, patient screening and other measures have been well-documented or advocated for, a major missing element - and one ICM directly impacts - is integrating the effective cleaning of environmental surfaces with measurement of outcomes, then incorporating that data in a multi-pronged, and continuously improved, intervention plan.
Since visual inspection for microbial contamination is ineffective, Adenosine Triphosphate or ATP detection devices as well as bacterial cultures are being utilized in healthcare facility measurement programs. ATP testing measures microscopic organic matter or bioburden on surfaces which itself may constitute microbial growth or may provide a food source for microbial growth.
According to the UK study titled 'A modified ATP benchmark for evaluating the cleaning of some hospital environmental surfaces,' by Lewis T, Griffith C, Gallo M, Weinbren M:
'Visual inspection … can be misleading…[and] calls have therefore been made for a more objective approach to assessing surface cleanliness … ATP testing can be used to provide instant feedback on surface cleanliness, and was found to be a powerful way of demonstrating deficiencies in cleaning protocols and techniques to staff.'
ATP devices are often utilized in ICM programs for this reason.
Types of ICM Measurement
ATP, fungal enzyme, RODAC plate, Petrifilm, particle counter, airborne dust mass, infrared/moisture detection, and other device and measurement platforms are available as methods of microbial/particulate and other contaminant detection.
General ICM Testing Procedure
1. Measure. Use one or more measurement tools to determine which areas in the facility need to be cleaned most as well as how effective current cleaning methods are. This creates a baseline of current practices.
2. Compare. ICM establishes and provides benchmark data, based on scientific tests by participants. This data will be available through an ICM Web portal. The database will allow for comparison and improvement of cleaning practices.
3. Experiment. Facility managers will try new and varied forms of cleaning, disinfection, as well as integration of methods to determine what works best.
4. Implement. The experimenting phase completes when new effective methods have been determined, and in turn are put into regular practice, followed by additional measurement to establish a continuous improvement cycle.
Allen Rathey is the principal of the Healthy Facilities Institute (HFI), director of the Indoor Wellness Council (IWC), and author of articles about best practices in cleaning and indoor environmental management.
*The Healthy Facilities Institute (HFI) and the Indoor Wellness Council (IWC) do not endorse products.