Fix for Poor Hygiene in 40% of Care Homes

Are you working in Healthcare, Cleaning, Hospitality or Tourism industry sector? This article will discuss a real Lean Six Sigma project that will  help you to improve the tidiness, cleanness and housekeeping standards of your company.

Research with said results

Recent research by the Consumer Organization revealed that 40% of care homes has very bad standards concerning hygiene and sanitation in the Netherlands. 47 out of 121 contacted organization were not even willing to take part of the hygiene test. So probably the results are even worse.

Is hygiene important in your business? If you are one of the above sectors it is essential because your clients, patients and guests are exposed to infections, viruses and diseases.

Lean Six Sigma Case Study: Improving Housekeeping

This led me to write you about a recent Lean Six Sigma project which I have coached at a group of Care Centers for 1000 elderly.

Clients and employees were not satisfied about the hygiene and cleanliness of one the location. We set up a project team consisting of Housekeeping employees, the Supervisor, the Facility Manager and the director of the care centre.

We had a long discussion about “when is something clean” You know in my Lean Six Sigma projects the problem (in this case the tidiness) must be measurable. Why? Otherwise it is merely an opinion if the tides is improved or not.

Find out more on how to achieve measurable (not-discussable) improvements in your organization:

Measurement system…but do you trust it?

After some meetings we have set up a scoring system to judge every room of the building based on certain elements (like window, floor, garbage, smell, etc.). Using this scoring system we could measure (quantify) the cleanliness of any area of the building…but we were not done yet…

In every Lean Six Sigma project, you learn that having data is not equal to having reliable data! That is part of the second phase of the projects called Measure Phase.

Sadly, I come across all kind of data collection systems, questionnaires that are widely used in the Healthcare, costing sometimes $20,000 to have it implemented WITHOUT testing its reliability first. What a waste of money, time and energy!

It may be worth another article, but for now let me give you this: do not trust your data blindly. Test your data collection (measurement system) on repeatability (if I measure now and tomorrow, do I get the same results) and reproducibility (if I measure and my colleague measures the same, do we get the same results).

In our specific case (and I almost always see this) we did not have a reliable scoring system at first to judge the cleanliness of the rooms. The results were depending on who measured what.

Results: reliable system to measure cleanliness

Before we could continue the Lean Six Sigma work with our team, we had to improve the scoring system to make it reliable. And we succeeded. See below graphs. The left graph shows the BEFORE situation where the fist green bar shows that more than 80% of variation in the measurements was due to the system itself (Gage R&R). This has be reduced to an acceptable level of 21% as shown on the right graph.

Now that we have a scoring system that even you and I can use without any experience in housekeeping and still we both get a very similar score about the quality of the housekeeping.

No discussions, no over-doing of cleaning, no inefficiencies but OBJECTIVE data.

Do you want to set up your own reliable scoring system to judge the cleanliness of your location?


Or do you want me to help you do it?

Call me at +31 655301094 or email me at

Warm regards,


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