Follow the trolley

Most outbreak reviews start with the surfaces. Which ones were missed, which product was used, how often the rails were wiped. That matters. But in my experience it is rarely where the problem is moving.

Through the aged care work I did across around 30 Victorian facilities, the teams were mostly doing what their procedures asked. The surfaces were cleaned. The outbreaks kept coming back anyway.

So we stopped looking only at surfaces and started following movement. Who walks from where to where. What equipment goes between rooms. What leaves a ward and comes back without being touched in between.

In one group, the answer was the food trolleys. They travelled between the wards and the kitchen all day, and nobody had a defined step for cleaning them in between. Every room could be done perfectly and the trolley would still carry the problem from one end of the building to the other.

The fix was not complicated. A clean-down point for the trolleys between trips, a change to how equipment moved between areas, and training so the team could hold the new routine on a busy day. It became standard practice across the group.

The lesson has stayed with me on every site since. A cleaning schedule covers surfaces. An outbreak follows people and equipment. If you only check the first, you can miss the second entirely.

So when we walk a site now, we ask a different question first. Not "what gets cleaned?" but "what moves?"

Trolleys. Linen. Mop buckets. Shared tablets. Staff moving between wings. Each one is a path. Find the path, put a step in it, and the process starts working with the building instead of against it.