Making "green cleaning" more of a priority is indeed prudent. Switching to high-quality, eco-friendly products, services and practices can not only provide superior cleaning results and a rapid return on investment, the move may also boost staff morale and strengthen facilities’ competitive advantage.

"Sustainable cleaning practices are an essential part of sustainable building. Traditional cleaning products present a variety of human and ecological concerns. They may contribute to poor indoor air quality and contain chemicals that cause cancer, reproductive disorders, respiratory ailments – including occupational asthma – eye and skin irritation, central nervous system impairment, and other human health effects," the University of Chicago Medical Center reports. Further, some products contain persistent bioaccumulative and toxic chemicals (PBTs), are classified as hazardous waste, and/or otherwise contribute to environmental pollution during their manufacture, transport, use, and disposal.

Facilities that haven’t yet transitioned to more eco-friendly cleaning supplies and vendors for fear of over-priced, inadequate products should take another look. Not only is the green cleaning product portfolio ever-expanding, quality and efficacy is on the rise, and, in many cases, price points are falling, sources told Healthcare Purchasing News.

"Overall, green cleaning products have improved tremendously over the last several years in terms of cleaning effectiveness and costs," confirmed Kevin McGarr, founder and CEO of McGarr Service Corp., a Boston-based contract cleaning company that has worked with a number of healthcare facilities, including the prestigious Dana Farber Cancer Institute.

There’s more to green cleaning than products alone, however. More than ever, vendors are witnessing their hospital customers take a more holistic approach to Environmental Services.

"More healthcare facility managers are taking a 50,000-foot perspective on things, which brings better efficiency, cost-efficiency and buy-in to green cleaning products and approaches," reasoned Danielle Yarber, director of Central and Eastern US sales for xpedx, a national supplier of top-branded cleaning supplies and equipment. "Now, more often, it’s typically a team approach: housekeeping, purchasing, EVS, infection control, and safety directors."

As one vendor expert further explained, hospital operations and risk management professionals are concerned not only with the environmental impact of cleaning products and procedures, but also the social and economic aspect.

"They are addressing such questions as, ‘How will green cleaning impact the environment in our community? How can it support the health of our patients and our staff? How will it affect the perception of the operation? What impact will it have on our total operational cost and our bottom line?’ These are some of the questions being addressed by cross-functional teams within hospital organizations," noted Jacquel Kelly, senior market development manager-healthcare for Georgia-Pacific Professional, Atlanta, GA. She further pointed out that there’s far more focus from customers, consumers and the government on ensuring that green claims for products can be substantiated.

Another notable trend is that environmental services and infection prevention practitioners are looking at cleaning as a set of products and processes that can be monitored and improved, added Linda Homan, BSN, CIC, senior manager of clinical and professional services for Ecolab Healthcare, St. Paul, MN.

"In the past, the main focus was on chemistry, but that is shifting to now include water, energy, time, labor, and employee safety," said Homan. "We are able to show our customers how the combination of the right tools, products, dilution system, training, outcome monitoring, and feedback can significantly improve cleaning with less water and chemicals."

The need for a comprehensive approach to cleaning led Ecolab to develop its EnCompass Environmental Hygiene program. Launched in February, EnCompass is a clinical program aimed at helping hospitals improve patient room hygiene and reduce the spread of infection. The program includes cleaning tools, products, dispensing equipment, auditing processes and cleanliness monitoring to help hospitals clean patient rooms more quickly, consistently and effectively.

"Healthcare organizations recognize the important role that proper cleaning plays in infection prevention, yet research has found that on average fewer than half of the high-touch surfaces are cleaned in patient rooms in most hospitals," noted Paul B. Chaffin, vice president of Ecolab Healthcare North America. "Ecolab developed EnCompass to help healthcare providers improve hygiene and reduce the environmental transmission of pathogens that cause infections."

Clinical research has shown that patients admitted to rooms previously occupied by individuals infected with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enterococcus (VRE) are at greater risk of acquiring these pathogens, most likely from environmental surfaces contaminated by the previous patients. With the EnCompass program, Ecolab Healthcare offers hospitals a way to reduce those risks, including cleanliness auditing and reporting, whereby Ecolab works with hospital representatives to evaluate whether the housekeeping staff are cleaning and disinfecting rooms properly by using a fluorescent gel testing solution that glows under black light. Accurate dispensing, effective chemistry and efficient tools also play a key role in the EnCompass Program’s success. The EnCompass system helps ensure that appropriate levels of disinfectant are delivered to critical surfaces. The system also uses color-coordinated microfiber cloths and mops with ergonomic modular cleaning stations, which help separate clean and dirty items to minimize cross contamination. EnCompass cleaning products provide clinically-tested concentrated disinfectants, ready-to-use cleaning solutions, wipes, hard surface cleaners, and odor counteractants. The program has been shown to improve cleaning results, while reducing discharge cleaning time by as much as 15 percent, and also reducing the use of water and chemistry in the cleaning process.

Kimberly-Clark Professional’s WETTASK Refillable Wet Wiping System is a greener alternative to laundering cotton cloths.

Among the most immediate and significant pay-offs with green cleaning, sources say, is adopting more sustainable, environmentally-sound floor care products and practices.

"In order to implement a robust green cleaning program, a hospital must first identify a sustainable floor care system that employs metal-free floor finish that has the ability to last at least 12 months between stripping and refinishing of the VCT surfaces," McGarr stressed.

Because janitorial costs typically comprise nearly a third of a facility’s expenses, 3M is one manufacturer keenly focused on driving down those expenses, while improving indoor air quality and floor surface durability. Part of the advantage of adopting such products is that it allows facilities to further their green cleaning efforts by moving past recycling programs and engaging more proactively in reuse strategies.

"If we never create the waste, we don’t have to invest to reuse or recycle. A good example is products coming to market that postpone or eliminate floor maintenance activities," reasoned Kevin McNulty, business development manager for 3M’s Building and Commercial Services Division. The Scotchgard Ultra Durable Floor Finish System, for example, not only helps reduce an organization’s operating expenses, but also reduces the environmental footprint generated by a traditional acrylic floor finish system. It provides gloss, as well as stain-, scuff- and scratch-resistance with one application lasting up to 24 months, with no burnishing required.

"The key differentiating factor of this product in terms of the environmental benefits is that it reduces use of water and chemicals traditionally used in the floor cleaning process," McNulty said, adding that in doing so, it also reduces the hospital’s maintenance expenses, which can offer material and labor savings of 40-50 percent.

Microfiber floor care solutions are also catching on in healthcare. Despite an initial investment, abandoning traditional string mops in favor of a quality microfiber product can offer a rapid return on investment – in terms of improved outcomes and labor efficiencies, extended reuse capability, and reduced water and chemical consumption.

"Microfiber is resonating with more and more people in [the healthcare environment]," and the key driving factor is the quality outcomes provided by a well-implemented microfiber program, assured Ying Zhang, senior product manager, hard surface care, Rubbermaid Commercial Products.

When used properly, microfiber solutions can clean floors 45 percent better than string mops, while reducing water and chemical consumption by up to 90 and 95 percent, respectively, Zhang said.

What’s more, microfiber mop heads are designed for repeated use – with some of the leading products on the market designed to withstand 500 detergent laundering cycles (200 when bleach is used).

RCP’s HYGEN Microfiber features uniquely split fibers that trap and remove dirt, bacteria and other surface contaminants. But Zhang insists the efficacy of the HYGEN Microfiber platform lies in the proper use of the complete system, which, aside from the microfiber mop heads and cloths, includes hardware, carts and, above all, extensive user training.

Technical Concept’s SaniCell Wall from Rubbermaid Commercial Products with Purinel SC, a super concentrated cleaning formula

Antimicrobial microfiber systems are also available. PerfectClean with Micrillon, for example, features a chemical additive that is incorporated into a synthetic fiber at the raw material stage. The Micrillon fiber attracts chlorine molecules in the wash water, which binds it to the surface of the fiber. "The chlorine molecule remains anchored to the fiber whether the textile is dry or wet and is consumed when it comes in contact with a microorganism," noted UMF PerfectClean’s founder and CEO George Clarke. The Micrillon fiber is then "recharged" and the efficacy is fully restored during a standard commercial laundering process that includes an EPA-registered bleach product.

"Micrillon micro-denier fibers are four to six microns in size, resulting in an enormous surface area within the textile. This anchors thousands of parts per million of chlorine throughout the textile, yielding an unrivaled antimicrobial efficacy against a broad range of microorganisms [as confirmed by independent lab testing results]," Clarke continued. PerfectClean products are also available without Micrillon.

K-C Professional’s WypAll microfiber cloths with Microban protection are also available, and designed to inhibit the growth of stain- and odor-causing bacteria. The cloths remove up to 99% of bacteria from non-porous surfaces, without the use of chemicals, and continue providing Microban protection for up to 300 washings, the company notes.

As eco-savvy healthcare organizations are aware, the products themselves are just one component of the big green cleaning picture. If they’re not used properly, any efforts to become more environmentally-conscious will be in vain. Using too much or too little product are amongst the biggest cleaning mistakes, sources stressed.

"Properly calibrated, automated dispensing systems can help ensure the disinfectants being used by housekeeping staff are consistent and correct in concentration," said Ecolab’s Homan.

Not only can dilution control systems and processes increase safety, reduce costs, simplify cleaning and product efficacy, they can also reduce the number of products needed, while reducing chemical and packaging waste. Further, concentrated formulas also lighten shipping loads, which further reduces the carbon footprint in the supply chain, according to national supplier xpedx. The company also provides healthcare and environmental service managers with advice on containing and reducing the cost of labor and supplies, while offering insight on waste reduction, proper product usage and how to create a clean, sanitary and safe environment.

Kimberly-Clark Professional’s WETTASK Refillable Wet Wiping System is one environmental surface cleaning product designed to help facilities control amount of chemical usage, while reducing water and detergent waste associated with laundering cotton rags.

Touchless dispensing is also gaining momentum in the marketplace – a move that not only reduces product waste, but may help prevent the spread of germs by minimizing surface contamination.

Georgia-Pacific Professional, for example, offers hands-free systems for janitorial paper and wiper products, and the company’s soap, sanitizer and scrub products received the "Champion" designation from the EPA’s Design for the Environment Program as part of the agency’s Safer Detergent Stewardship Initiative. The company’s enMotion with Lotion towel dispenser delivers one towel at a time, which helps minimize waste and manages facility costs, noted Kelly.

Ecolab’s new cleaning carts have bins to soak microfiber cloths, using as much as 94 percent less water than traditional mops, while maintaining accurate chemical dilution and contamination control.

The automated, touchless dispensers haven’t gone unnoticed by patients and visitors, either. A survey conducted by Georgia-Pacific Professional found that 82 percent of patients and visitors acknowledged the dispensers, with the majority believing that their presence indicated that the hospital "cares" about preventing the spread of germs.

Rubbermaid Commercial Products offers hands-free soap and skin-care product dispensers, as well as automatic cleaning systems. Its newly-introduced Sani-Cell automatically and continuously cleans toilet fixtures and urinals (RCP offers 30-, 45- or 60-day refills). The system functions through an in-line plumbing connection, so a precise amount of cleaning agent is delivered wherever water travels, thereby cutting manual cleaning by up to 50 percent on toilet and urinal fixtures, according to Brian Heun, RCP’s product manager for fixtures and surface care.

"On average, customers are seeing an 80 percent reduction in chemical usage," he said, and waste is also minimized because all components are recyclable. Another added benefit: Sani-Cell’s formula helps prevent drain clogging by preventing uric scale formation, while also reducing 99.99% of odor-causing bacteria.

Less is also more when it comes to the number of products EVS staff have at their disposal. Increasingly, manufacturers are developing high-performance cleaning products that are environmentally safe and multi-purpose. Hydrogen peroxide-based products are a prime example.

Although they won’t offer heavy-duty disinfection, "they can be used for glass cleaning, all purpose cleaning, light-duty degreasing, and carpet spotting," said Dan Freedman, market development manager for Andover, MD-based Freedman & Sons Inc., a green cleaning product distributor. "To set up a facility with two to three products versus the five or six they used to have is now the norm."

Water- and surfactant-based formulas are also showing real promise, with some products offering biodegradable antimicrobial protection. Hospital-grade Ygiene by BioNeutral Group based in Newark, NJ, is an antimicrobial and "bioneutralizer" designed to address hospital-acquired infections, including C. difficile and MRSA.

"In independent testing, it has proven to eradicate microorganisms and spores in as little as 20 seconds," said the company’s chief scientist Andy Kielbania, Ph.D. "Current products on the market can take up to 20 minutes." Ygiene is currently approved in Germany, and the line is expected to be available in the US in mid-2010.

Ozone products are also making headway in the marketplace. One such line of products, the Lotus PRO by Tersano Inc., turns tap water into liquefied ozone. When the water is charged, it is 50 percent more powerful than bleach, while carrying a 0-0-0-A health and safety rating, which means it wouldn’t cause harm if someone accidentally drank it, according to Steve Hengsperger of Tersano Inc., Oldcastle, ON. "In most applications, this will allow users to get down to a single product solution, as our product is a great cleaner, deodorizer, stain remover – and [provides] a proven kill up to 99.999 percent of harmful bacteria and viruses."

Even equipment maintenance products are going green, and their use may play an important, yet often under-appreciated, role in cleaning efforts. One equipment lubricant on the market, LiQuifix, for example, is non-toxic and non-carcinogenic, odorless and non-staining, as well as non-aerosol, so it emits no carbon dioxide. After cleaning, equipment often has to be re-lubricated; however, LiQuifix attracts no airborne dust, which means it’s a benefit in terms of environmental cleaning.

"LiQuifix fits right in to the green cleaning movement and allows facilities to extend their requirements for non-aerosol, non-toxic products," explained John R. Cullinane, president and CEO of LiQuifix LLC, Stamford, CT."We are also working on statistics regarding the health benefits of LiQuifix in terms of its non-toxic/carcinogenic ingredients. People who clean for a living may be exposed to toxins at much higher levels, and more frequent." LiQuifix, which is cost-comparable to aerosol lubricants on a price per net ounce, is long-lasting – allowing facilities to extend their preventive maintenance schedule – and will not corrode aluminum, nylon or rubber, Cullinane added.

One aspect of green cleaning where the "less is more" mantra doesn’t apply is vendor support – and documentation to back up efficacy claims.

"How the products are used will deliver more benefit for ‘green’ than anything so far around purchases," said 3M’s McNulty.

Freedman, too, underscored the notion that proper practice trumps product. "If a disinfectant’s instructions aren’t followed, then it’s quite possible that a surface wasn’t disinfected. If an employee or facility’s chemical usage is too much, or their employee-to-job function ratio isn’t realistic, then that is a ‘green’ issue," he reasoned, noting that proper management of these numbers is ‘green,’ regardless of which manufacturer’s products are being used.