The report evaluated the staff sufficiency, job scope, and efficiency of housekeeping staff in Wards 43 and 64 through time and motion studies, finding that majority of staff did not meet the ideal work-to-break ratio due to insufficient manpower, tasks varied between positions but were generally feasible, and staff in Ward 43 performed more efficiently though both wards showed room for improved time management.

1. Time and Motion Study
By Claudia Tang Shuning
As part of Saw Swee Hock’s School of Public Health Field Practice Programme
Submitted to:
Environmental Services Department

2. i
Preface
This report presents the results of the Time and Motion Study carried out on the Housekeeping Department of
Environmental Services, specifically the service partner, ISS.
As stated in Section I Introduction, the purpose of this study is to ascertain the sufficiency of staff deployment
per ward, evaluate the efficiency of each staff and discuss the job scope of each staff type. The job scope data
were collected by performing time and motion studies on staff during their shifts at Ward 43 and Ward 64.
Staff deployment sufficiency data consisted of work-to-break ratio, task completions, subjective comments
made by staff during work and personal observation. Efficiency of each staff was based on comparisons
between staff with identical tasks and responsiveness to ad hoc tasks.
Acknowledgements
I would like to thank my supervisor, Hui Min, for her patience and care as I carry out the time and motion
studies. I would also like to thank the manager, senior supervisor and coordinators of ISS, for extending their
help in whichever ways I needed and arranging for me to go to the wards to carry out the time and motion
studies.
Last but not least, my appreciation goes to individual staff – cleaner, housekeeper and food service specialist
(FSS), for their cooperative efforts as I followed them through their jobs.

3. ii
Table of Contents
Section Page
Preface i
Acknowledgements i
Table of Contents ii
List of Tables iii
Summary iv
I Introduction 1
II Data 3
III Staff Deployment Analysis 13
IV Job Scope Evaluation 15
V Ward comparisons: Ward 43 vs. Ward 64 17
VI Shortfalls/Drawbacks of Study 19
VII Recommendations 21
VIII Personal Views 24
IX Biblography 26
X Appendix 27

4. iii
List of Tables
Table Page
1 Working Hours of Ward Housekeeping Staff 1
2 Cleaner’s Regular Tasks and Time Taken to Complete Tasks 3
3 Cleaners’ Other Common Task(s) and Time Taken to Complete Task(s) 3
4 Cleaner’s Periodic Cleaning and Time Taken to Complete 3
5 Cleaner’s Ad-hoc Tasks and Time Taken to Complete Tasks 4
6 Housekeeper’s Regular Tasks and Time Taken to Complete Tasks 5
7 Housekeeper’s Other Common Task(s) and Time Taken to Complete Task(s) 5
8 Housekeeper’s Ad-hoc Tasks and Time Taken to Complete Tasks 6
9 FSS’ Regular Tasks and Time Taken to Complete Tasks 7
10 FSS’ Periodic Cleaning and Time Taken to Complete 8
11 FSS’ Periodic Cleaning and Time Taken to Complete 8
12 FSS’ Ad-hoc Tasks and Time Taken to Complete Tasks 9
13 Total Time Taken to Complete Various Types of Tasks 9
14 Work-to-Break Ratio of Housekeeping Staff 13
15 Percentage of Time Taken to Perform Various Task Types 15

5. iv
Summary
The Time and Motion Study Report of staff activity in ward 43 and ward 64 consists of five distinct aspects:
(1) an evaluation of staff sufficiency, (2) a study on job scope of each position, (3) a comparison of staff
performance and efficiency between the two wards, (4) a discussion on room for improvements as well as
recommendations to streamline certain processes, and (5) personal views on the overall role of Housekeeping
Department.
(1) Staff sufficiency was evaluated based on the analysis of work-to-break ratio. Majority of the observed
housekeeping staff did not reach the ideal ratio as they had too many tasks to complete in the ward. Not all
tasks were completed in each ward as well, implying that staff deployment is insufficient. The best solution is
to deploy more staff to each ward, so that the tasks can be better shared amongst the staff and be executed
with good quality.
(2) Under the consideration of ISS’ compulsory training programme and staff feedback, the tasks of
housekeeping staff were assessed as feasible. This supports the deduction of insufficient manpower in each
ward. The job scopes of housekeeping staff were concluded to be ever-changing and thus, staff has to be
flexible and quick-witted to handle all possible situations with good time management. It was also observed
that staff performed tasks that were out of their scope because other hospital staff failed to do so, resulting in
even more work to do.
(3) Overall, the housekeeping staff of ward 43 fared better than the staff of ward 64. They were more efficient
and more thorough in ensuring good hygiene. However, they were relatively poorer in time management for
certain tasks, such as food preparation and bed discharges. Comparisons highlighted the importance of good
team effort and a sense of responsibility.
(4) Every study has its own limitations and disadvantages. A Time and Motion Study is not always a true
reflection of what actually happens. There are also some shortfalls pertaining specifically to this study.
Problems may arise from the ‘study participants’, in this case, the housekeeping staff; and they may arise from
the ‘study observer’. To overcome these shortfalls, execution of time and motion study may be improved in
terms of time, duration and participants. To target the efficiency of housekeeping staff, recommendations such
as re-training of staff and provision of sufficient equipment were given. Other suggestions based on personal
interactions and/or observations were made as well.
(5) The role of the Housekeeping Department is very important as it forms part of the backbone of the
hospital. Indeed, there are rooms for improvements, such as increased staff efficiency and higher standards of
cleanliness. However, one must take into consideration that housekeeping staff are human-beings too and
should not be treated like robots to continuously perform tasks after tasks. It is important not to take
housekeeping staff for granted, but show them the appreciation and respect they deserve.

6. 1
I. Introduction
National University Hospital (NUH) outsources its housekeeping services to ISS Facilities Services (ISS). In
the NUH Housekeeping Department, there are staff employed under NUH Environmental Services (ES) and
staff employed under ISS, but both managed by ISS. The staff hierarchy begins with cleaner, who will
promote to housekeeper, then food service specialist (FSS), supervisor and so on. This Time and Motion study
focusses on cleaner, housekeeper and FSS.
In each ward, there is one cleaner, one housekeeper and one FSS. Their working hours are shown in the table
below:
Position
Working Hours
ES ISS
Cleaner 7am to 3pm, 1pm to 9pm 8am to 5pm
Housekeeper 7am to 3pm, 1pm to 9pm 8am to 9pm
FSS - 7am to 8pm
Table 1: Working Hours of Ward Housekeeping Staff
The composition of housekeeping staff for each ward is fixed, unless one of them receives a promotion or
resigns. Only at night, will the night shift staff be deployed to the wards according to needs. This Time and
Motion study focusses only on fixed housekeeping staff of ward 43 and ward 64.
On top of their daily routine, all three staff has to perform periodic duties such as wall cleaning and handle ad-
hoc tasks such as cleaning up after a patient has passed motion on the floor. Altogether, these add up to
numerous things to do each day. Cleaning and housekeeping are essential and important, especially in the
hospital setting, as hygiene plays a major part in healthcare. It is therefore relevant, to study the works of
housekeeping staff.
Objectives:
(1) To ascertain if there is enough housekeeping staff per ward
(2) To find out whether the cleaning schedule and tasks are feasible
(3) To evaluate the efficiency of housekeeping staff

7. 2
For both wards 43 and 64, each housekeeping staff was followed and observed throughout his/her entire shift.
The observant noted down on a template (refer to Appendix A1), each activity carried out by the staff and
time taken to complete it. During the course of it, the observant also had interactions with the staff and
received “informal” information regarding staff deployment and problems faced. A few personal findings
were made as well, through silent observation and comparisons.
The terms used – regular task, ad-hoc task, periodic cleaning -- are defined as follows:
“Planned task to be performed every day, part of daily routine; examples include washing of basins and
replenishing PPE.”
“Unexpected and unplanned task, not in cleaning schedule but must be attended to quickly; examples include
patient urinating on the floor and blood spillage from syringe.”
“Planned task to be performed at fixed intervals such as weekly or monthly, to be incorporated into daily
regular routine; examples include wall cleaning and metal surface polishing.”

8. 3
II. Data
Table 2: Cleaner’s Regular Tasks and Time Taken to Complete Tasks
CLEANER Ward 43 Ward 64
RemarksOther Common
Task(s)
Time taken per
cubicle/bed/item
Total Time
Taken
Time taken per
cubicle/bed/item
Total Time
Taken
Cubicle Cleaning
(sink, bin’s top,
napkin dispenser,
soap dispenser,
mirror)
3.53 minutes per
set
60 minutes 2.6 minutes per
set
26 minutes
(5) Ward 64 took
a significantly
shorter time.
Table 3: Cleaners’ Other Common Task(s) and Time Taken to Complete Task(s)
CLEANER Ward 43 Ward 64
Remarks
Periodic Cleaning
Time taken per
cubicle/bed/item
Total Time
Taken
Time taken per
cubicle/bed/item
Total Time
Taken
Crash Programme - - - 43 minutes
(6) Ward 43 did
not fulfill task.
Table 4: Cleaner’s Periodic Cleaning and Time Taken to Complete
CLEANER Ward 43 Ward 64
RemarksRegular Tasks &
Time Given
Time taken per
cubicle/bed/item
Total Time
Taken
Time taken per
cubicle/bed/item
Total Time
Taken
Wash Water Jugs
and Top-up Water
for Individual
Patients
(60 minutes)
2.33 minutes per
bed
105 minutes 1.81 minutes per
bed
80 minutes
(1) Ward 64 took
a significantly
shorter time.
Replenish Ward
Supplies, Check &
Touch Up Toilets
(105 minutes)
- - - -
(2) Both wards
did not fulfill this
task.
Collect Trash
(75 minutes)
2.6 minutes per
bin
78 minutes 1.95 minutes per
bin
84 minutes
Collect Soiled
Linen (40 minutes)
1.875 minutes
per basket
30 minutes
1.67 minutes per
basket
5 minutes
(3) Ward 64 took
a significantly
shorter time.
Isolation Room
Cleaning/
Thorough Wash
Common Toilets,
Touch Up Toilets
(125 minutes)
10.5 minutes per
toilet/shower
room
105 minutes
31.5 minutes per
common toilet
63 minutes
(4) Ward 64 took
a significantly
shorter time.
Tidy Up DU,
Housekeeping
Trolleys
(15 minutes)
- 20 minutes - -

9. 4
CLEANER Ward 43 Ward 64
Remarks
Ad-hoc Task(s)
Time taken per
cubicle/bed/item
Total Time
Taken
Time taken per
cubicle/bed/item
Total Time
Taken
Collect Virex256
from Level
Housekeeping
Room
- 15 minutes - -
(7) Ward 43 took
a significant
amount of time to
fulfill task.
Refill Hand Soap
at a Cubicle
- - - 3 minutes
Wait for MRSA
Cubicle Cleaning
Trolley
- - - 3 minutes
Perform Bed
Discharge
- -
16.3 minutes per
bed
49 minutes
Change curtains
for MRSA Bed
- - - 3 minutes
Perform Terminal
Cleaning
- -
35 minutes per
bed
35 minutes
Sweep - -
1 minute per
area
12 minutes
Collect Soiled
Cups from Tea
Break
- - - 10 minutes
(8) Ward 64
performed task of
another staff.
Patient Requested
for Jug of Water
and Ice
- - - 2 minutes
Patient Requested
for Change of
Mattress
- - - 12 minutes
Table 5: Cleaner’s Ad-hoc Tasks and Time Taken to Complete Tasks

10. 5
Table 6: Housekeeper’s Regular Tasks and Time Taken to Complete Tasks
HOUSEKEEPER Ward 43 Ward 64
RemarksOther Common
Task(s)
Time taken per
cubicle/bed/item
Total Time
Taken
Time taken per
cubicle/bed/item
Total Time
Taken
Sweep
2.2 minutes per
area
22 minutes
1 minute per
area
19 minutes
Mop
9.67 minutes per
area
29 minutes
11.5 minutes per
area
69 minutes
Clean Assisted
Patients Toilet/
Shower
- 8/3 minutes - 12/4 minutes
Isolation Rooms
Cleaning
21 minutes per
room
42 minutes
7.5 minutes per
room
15 minutes
(14) Ward 64
took a shorter
time.
Tidy Up Pantry - 22 minutes - 7 minutes
(15) Ward 64
took a shorter
time.
Table 7: Housekeeper’s Other Common Task(s) and Time Taken to Complete Task(s)
HOUSEKEEPER Ward 43 Ward 64
RemarksRegular Tasks &
Time Given
Time taken per
cubicle/bed/item
Total Time
Taken
Time taken per
cubicle/bed/item
Total Time
Taken
Assist FSS with
Breakfast Food
Service
(45 minutes)
- 46 minutes - 43 minutes
Clean Ancillary
Areas (30 minutes)
- - - -
(9) Both wards
did not fulfill this
task.
Bed Making
(60 minutes)
3 minutes per
bed
9 minutes
7.67 minutes per
bed
23 minutes
(10) Ward 64
took a
significantly
longer time.
Cubicle Cleaning
(sink, bin’s top,
napkin dispenser,
soap dispenser,
mirror, toilet,
shower room)
(45 minutes)
19.5 minutes per
set
39 minutes - - (11) Ward 64 did
not fulfill task.
Tidy Up DU,
Touch Up Toilets
(30 minutes)
- 15 minutes - 11 minutes
Assist FSS with
Lunch Food
Service
(60 minutes)
- 58 minutes - 63 minutes
Replenish Ward
Supplies
(120 minutes)
3.63 minutes per
area
87 minutes - - (12) Ward 64 did
not fulfill task.
Assist FSS with
Dinner Food
Service (60
minutes)
- 18 minutes - -
(13) Ward 64 did
not fulfill task.

11. 6
HOUSEKEEPER Ward 43 Ward 64
Remarks
Ad-hoc Task(s)
Time taken per
cubicle/bed/item
Total Time
Taken
Time taken per
cubicle/bed/item
Total Time
Taken
Wait for
radiographer to
complete X-Ray,
to clean cubicle
- 10 minutes - -
Collect Virex256
from DU
3.33 minutes per
time
10 minutes - -
Clean Cleaning
Trolley
- 4 minutes - -
Perform Terminal
Cleaning
30.5 minutes per
bed
61 minutes - -
Perform Bed
Discharge
22 minutes per
bed
22 minutes
19.5 minutes per
bed
39 minutes
Patient Requested
for Food – go to
Ward 44 to take
bread, warm and
serve with jam
- 10 minutes - -
Clean Individual
Room
- 8 minutes - -
(16) Ward 43
performed an
extra task.
Push Linen
Trolley to Correct
Position
- 4 minutes - -
Settle EMD Bed - 5 minutes - -
Patient Defecated
on the Floor
- 7 minutes - -
Patient Urinated
on the Floor
- 4 minutes - -
Autoscrub
Common Toilets
Because Floor is
Dirty and Wet
- -
3 minutes per
toilet
12 minutes
Change Waste
Plastic Bags for
Each Bed
- -
0.43 minute per
bed
6 minutes
(17) Ward 64
performed an
extra task.
Collect Virex256
and Glance from
Level
Housekeeping
Room
- - - 2 minutes
Manually Write
Down Discharge
Information
Because eHIMS
Was Down
- - - 4 minutes
Settle Issue of
Foreign Object
Found in Food
- - - 7 minutes
(18) Ward 64
performed an
extra task.
Table 8: Housekeeper’s Ad-hoc Tasks and Time Taken to Complete Tasks

12. 7
Table 9: FSS’ Regular Tasks and Time Taken to Complete Tasks
FSS Ward 43 Ward 64
RemarksRegular Tasks &
Time Given
Time taken per
cubicle/bed/item
Total Time
Taken
Time taken per
cubicle/bed/item
Total Time
Taken
Check Fridge
Temp, Spot Clean
and Check Ward
(45 minutes)
- 30 minutes - 12 minutes
(19) Ward 64
took a
significantly
shorter time.
Pre-Breakfast
Preparation
(15 minutes)
- 9 minutes - 8 minutes
Breakfast Serving
& Collect Soiled
Trays (60 minutes)
- 39 minutes - 47 minutes
Bed Making
(60 minutes)
3.29 minutes per
bed
23 minutes 5.4 minutes per
bed
27 minutes
(20) Ward 64
took a longer
time.
Serve Biscuit to
DM Patients
(15 minutes)
- - - -
(21) Both wards
did not fulfill this
task.
Cubicle Cleaning
(sink, bin’s top,
floor, toilet &
shower room
cleaning)
- - - -
(22) Both wards
did not fulfill this
task.
Pre-Lunch Service
Preparation
(15 minutes)
- - - 9 minutes
Serve Lunch &
Collect Soiled
Trays (60 minutes)
- 44 minutes - 57 minutes
Hi-Touch
Cleaning
2.5 minutes per
cubicle
15 minutes - -
(23) Ward 64 did
not fulfill this
task.
Serve Milo &
Collect Soiled
Cups (45 minutes)
- 42 minutes - 49 minutes
Food Ordering via
eMOS
(30 minutes)
9.17 minutes per
cubicle
55 minutes
8.33 minutes per
cubicle
50 minutes
Touch Up Toilets
(15 minutes)
- - - -
Pre-Dinner
Preparation
(15 minutes)
- 12 minutes - 6 minutes
Serve Dinner &
Collect Soiled
Trays (60 minutes)
- 45 minutes - 40 minutes
Send Soiled Trays,
Last Round Check
Ward Cleanliness,
Return PDA &
Apron to Office
(15 minutes)
- 6 minutes - 10 minutes

13. 8
Table 10: FSS’ Other Common Task(s) and Time Taken to Complete Task(s)
FSS Ward 43 Ward 64
Remarks
Periodic Cleaning
Time taken per
cubicle/bed/item
Total Time
Taken
Time taken per
cubicle/bed/item
Total Time
Taken
Crash Programme - 58 minutes - -
(25) Ward 64 did
not fulfill task.
Replenish all
chemicals &
stocks needed for
the week from
Main
Housekeeping
Room
- 30 minutes - - (26) Ward 64 did
not fulfill task.
Bring down/Clear
Confidential
Papers to Level 5
Housekeeping
Room
- - - 9 minutes (27) Ward 43 did
not fulfill task.
Table 11: FSS’ Periodic Cleaning and Time Taken to Complete
FSS Ward 43 Ward 64
RemarksOther Common
Task(s)
Time taken per
cubicle/bed/item
Total Time
Taken
Time taken per
cubicle/bed/item
Total Time
Taken
Sweep
1.05 minutes per
area
21 minutes
0.94 minutes per
area
17 minutes
Tidy Up Pantry - 20 minutes - 29 minutes
Tidy Up DU - 21 minutes - 17 minutes
Mop
11.3 minutes per
area
68 minutes
5.78 minutes per
area
52 minutes
(24) Ward 64
took a
significantly
shorter time.
Collect Soiled
Linen
- 10 minutes - 14 minutes

14. 9
FSS Ward 43 Ward 64
Remarks
Ad-hoc Task(s)
Time taken per
cubicle/bed/item
Total Time
Taken
Time taken per
cubicle/bed/item
Total Time
Taken
Disinfect Spotted
Patch of Blood
Stain
- 7 minutes - -
Fix Air-con Leak - 12 minutes - -
Nurse Spilt Food
on the Floor
- 2 minutes - -
Wait for Missing
Bed to Perform
Bed Discharge
- 3 minutes - -
Bed Making
5 minutes per
bed
10 minutes - -
Patient Urinated
on the Floor
- 8 minutes - -
Perform Bed
Discharge
22 minutes per
bed
44 minutes
12.3 minutes per
bed
37 minutes
(28) Ward 64
took a
significantly
shorter time.
Collect Virex256
from Level
Housekeeping
Room
- - - 3 minutes
Fill Up Bed
Making Form
- - - 4 minutes
Patient Spilt Water
on the Floor
- - - 2 minutes
Replenish Paper
Cone Cup & Soap
- - - 5 minutes
Clean Standing
Fan for Isolation
Room
- - - 11 minutes
(29) Ward 64
performed an
extra task.
Patient Dirtied
Bed
- - - 10 minutes
Configure PDA
Settings with
Level Supervisor
- - - 12 minutes
Arrange HPV
Gassing Schedule
with Staff Nurse
- - - 10 minutes
Table 12: FSS’ Ad-hoc Tasks and Time Taken to Complete Tasks
Tasks
Ward
Cleaner Housekeeper FSS
Regular Period Ad-hoc Regular Period Ad-hoc Regular Period Ad-hoc
Ward 43 398 min - 15 min 398 min - 145 min 460 min 88 min 86 min
Ward 64 258 min 43 min 129 min 266 min - 70 min 444 min 9 min 94 min
TOTAL 656 min 43 min 144 min 664 min - 215 min 904 min 97 min 180 min
Table 13: Total Time Taken to Complete Various Types of Tasks

15. 10
Remarks
Important note: Housekeeping staff’s other common tasks fall under the term ‘Regular Tasks’, but were not
inside the official work schedule given by ISS.
All data summarized above were taken from the raw data collected by the observer – subjected to personal
interpretations and presentations (refer to Appendix A2, A3 and A4).
(1) Ward 64 Cleaner took a significantly shorter time to wash water jugs and top-up water for individual
patients – There were more than sufficient number of jugs in ward 64, so the cleaner could give out all the
jugs and collect back the soiled jugs. However, in ward 43, there are lesser jugs. The cleaner had to first
collect back some of the soiled jugs and wash them, before filling them up with water and distributing back to
the patients.
(2) Cleaners of both wards failed to perform the task of replenishing ward supplies, check and touch up toilets
– In ward 43, this task has been transferred to the housekeeper to perform and in ward 64, it has been
transferred to the nurses.
(3) Ward 64 Cleaner took a significantly shorter total time to collect soiled linen – There are fewer linen
baskets in ward 64 than in ward 43. The linen baskets are only placed in common toilets and assisted patient
shower room. In ward 43, the linen baskets are placed in each cubicle as well as assisted patient shower room.
However, their average time taken per basket is very close.
(4) Ward 64 Cleaner took a significantly shorter total time to wash all toilets and perform isolation room
cleaning – There are only two common toilets (one female one male) on top of the assisted patient toilet and
shower room for ward 64, while there are toilets and shower rooms in each cubicle on top of the assisted
patient toilet and shower room for ward 43. This also accounts for why ward 64 took three times the time
taken to clean each toilet as compared to ward 43.
(5) Ward 64 Cleaner took a significantly shorter total time to perform cubicle cleaning on sink, bin’s top,
napkin dispenser, soap dispenser and mirror – There are three of each items to clean in each cubicle of ward
43; while there is only one set in each cubicle of ward 64. In addition, there are no mirrors in ward 64’s
cubicles so less time is needed to clean one set. Moreover, ward 64 cleaner was not performing the task
correctly. He used a less thorough method that took shorter time to complete.
(6) Ward 43 Cleaner did not perform crash programme - The cleaner in ward 43 is an exception, an ES staff
who works only one shift 7am to 3pm. His job scope does not include performing of any crash programme.
(7) Ward 43 Cleaner took a significant amount of time to collect Virex256 from the level’s housekeeping
room – The room was unexpectedly locked and thus, cleaner needed some time to call his supervisor to get
the passcode and unlock the door to assess the chemical dispenser.

16. 11
(8) Ward 64 Cleaner performed the task of FSS to collect soiled cups from tea break – FSS had to settle
several issues after serving tea break and hence, cleaner took over the role and collected back the soiled cups.
(9) Housekeepers of both wards did not perform the task of cleaning ancillary areas – In ward 43, this task
was missed out only on that particular day when the study was carried out; because there was a lack of
manpower in the ward and the housekeeper was the only staff then, so he had to prioritize other matters. In
ward 64, this task has been transferred to the FSS to perform.
(10) Ward 64 Housekeeper took a significantly longer time to perform bed making – There were more beds
that needed bed making, as the nurses in ward 64 did not help with bed making in the morning. Also, the
housekeeper was relatively less efficient than the housekeeper in ward 43 when making the beds.
(11) Ward 64 Housekeeper did not perform cubicle cleaning of sink, bin’s top, napkin dispenser, soap
dispenser, mirror, toilet and shower room – This task has been transferred to the cleaner to perform.
(12) Ward 64 Housekeeper did not perform the task of replenishing ward supplies – In ward 43, this task has
been transferred to the housekeeper to perform and in ward 64, it has been transferred to the nurses.
(13) Ward 64 Housekeeper did not perform the task of assisting FSS with dinner food service – The
housekeeper in ward 64 worked morning shift 7am to 3pm, thus unable to perform task.
(14) Ward 64 Housekeeper took a significantly shorter time to perform isolation rooms cleaning – The
isolation rooms in ward 64 do not have their own toilet/shower rooms, thus require less time to clean. Also,
the housekeeper of ward 43 was more thorough in cleaning.
(15) Ward 64 Housekeeper took a significantly shorter time to tidy up pantry – The pantry in ward 64 was less
often dirtied or messed; as compared to ward 43, whose pantry had a lot of soiled cups or water spillage or
other forms of mess.
(16) Ward 43 Housekeeper performed an additional task of cleaning an individual room – Ward 43 converted
part of its visitor lounge into an individual patient room, thus requiring cleaning.
(17) Ward 64 Housekeeper performed an additional task of changing waste plastic bags for each bed – This is
originally part of bed-making, a responsibility largely shared with nurses. Since the nurses in ward 64 did not
change the waste plastic bags for each bed, the housekeeper did the task.
(18) Ward 64 Housekeeper performed an additional task of settling issue of foreign object found in food –
This was a one-off case, as a patient found a foreign object in his meal. The housekeeper was alerted and
informed the hospital kitchen, which later sent up representatives to resolve it. The housekeeper accompanied
them while they spoke to the affected patient.

17. 12
(19) Ward 64 FSS took a significantly shorter time to check fridge temperature; spot clean and check ward in
the morning – The housekeeping staff on night shift in ward 64 had already ensured that the cleaning trolleys
were well-stocked, relieving the FSS this part of the task. Ward 43 FSS had to stock up the cleaning trolleys,
resulting in much longer time taken.
(20) Ward 64 FSS took a longer time to perform bed-making – The FSS in ward 64 was relatively less
efficient than the FSS in ward 43 when making the beds, causing difference in time taken to perform bed-
making per bed, but the total time taken was similar.
(21) FSS of both wards failed to perform the task of serving biscuits to Diabetes Mellitus patients – The
dietetics department has asked for this task to be removed from the daily routine of FSS.
(22) FSS of both wards failed to perform cubicle cleaning of sinks, bin’s tops, floor, toilets and shower room
cleaning – In ward 43, this task has been transferred to the cleaner and housekeeper to perform; while in ward
64, this task has been transferred to the cleaner to perform.
(23) Ward 64 FSS failed to perform hi-touch cleaning – This task has been transferred to the housekeeper,
who is also trained, to perform.
(24) Ward 64 FSS took a significantly shorter time to mop the ward – The FSS in ward 43 was relatively less
efficient than the FSS in ward 64 when performing the task. At the same time, the FSS in ward 64 was
relatively less thorough when mopping the floor.
(25) Ward 64 FSS did not perform crash programme – There were many discharges on that day to attend to
and so the FSS did not have any time to perform crash programme.
(26) Ward 64 FSS did not perform the task of replenishing all chemicals and stocks needed for the week from
the main housekeeping room – The FSS had already performed the task on another day of the week.
(27) Ward 43 FSS did not perform the task of bringing down and clearing confidential papers to level 5
housekeeping room – The FSS had already performed the task on another day of the week.
(28) Ward 64 FSS took a significantly shorter time to perform bed discharge – The FSS in ward 43 was
relatively more thorough in cleaning, disinfecting twice at some areas instead of just once. Also, the FSS in
ward 64 had help from the housekeeper for two of the discharges performed.
(29) Ward 64 FSS performed an extra task of cleaning the standing fan for one isolation room – It was a
special request by the patient to have a standing fan in his room and so when he discharged, the FSS had to
clean the fan as well.

18. 13
III. Staff Deployment Analysis
To ascertain if there is enough housekeeping staff per ward, balance between work and break was analyzed. If
there was a good balance between work and break, this means that there is enough staff in the ward to cope
with the workload. On the other hand, if there was a poor balance, there may be inadequate number of staff to
cope with the workload.
A research conducted by the Draugiem Group using DeskTime, found that the most productive people
followed a 52:17 pattern – 52 minutes of work followed by 17 minutes of break (Gifford J., 2014). This not
only ensures productivity of a staff, but also promotes healthy work life for him. Staff deployment analysis is
very important as it also translates to staff efficiency and task feasibility.
The total work time and break time taken by each housekeeping staff was compared against the 52:17 ratio.
Housekeeping Staff Work-to-Break Ratio
Ward 43 Cleaner 413 : 67 ≈ 52 : 9.25
Ward 64 Cleaner 404 : 75 ≈ 52 : 9.65
Ward 43 Housekeeper 543 : 157 ≈ 52 : 15.04
Ward 64 Housekeeper 336 : 72 ≈ 52 : 11.15
Ward 43 FSS 634 : 109 ≈ 52 : 8.94
Ward 64 FSS 547 : 131 ≈ 52 : 12.45
Table 14: Work-to-Break Ratio of Housekeeping Staff
As seen from Table 14, none of the housekeeping staff’s work-to-break ratio hit the ideal 52:17 ratio.
Although it is just a guide, most of the housekeeping staff’s resting time is much shorter than ideal. This
suggests that the work is aplenty and there is lack of manpower to finish the work.
With reference to Section II Data, housekeeping staff failed to perform several tasks due to various reasons.
For example, the housekeeper of ward 43 failed to clean the ancillary area in the morning because there was
shortage of manpower that day and he had to prioritize other tasks first. Based on personal observations,
housekeeping staff were constantly performing tasks after tasks. After completing a task, they are immediately
on their way to perform the next task at hand. Yet, they are unable to complete their work schedule every day.
Of course, it may be due to feasibility of task (Section IV Job Scope Evaluation) or efficiency of staff (Section
V Ward Comparisons). However, with insufficient staff, even if tasks are feasible and available staff is highly
efficient, tasks will still be unfulfilled. Also, all the tasks given are important, urgent and necessary.
Housekeeping staff should be able to and should complete them each day.

19. 14
When the observer conversed with the staff, they gave feedback on inadequate manpower. Quite often, they
will forgo their crash programme of the day, so as to perform bed discharges and daily routine tasks.
Otherwise, they have to use their break time to perform more tasks so that they can complete most of their
work for the day. However, this should not be the norm because crash programmes are equally important.
When a crash programme is postponed to the following day or even the next week, cleanliness and infection
control are compromised.
Based on all these analyses, it is fair to say that current staff deployment is insufficient. The best solution is to
assign more staff to each ward, so that the total number of tasks to do can be better shared amongst the staff.
They will be able to keep to the schedule and maintain high standards of hygiene every day.

20. 15
IV. Job Scope Evaluation
As mentioned in Section III Staff Deployment Analysis, staff sufficiency and task feasibility are closely
linked.
Tasks given to individual housekeeping staff should be feasible and doable alone, any additional staff only
serves to reduce time taken. Otherwise, it would be unreasonable to allocate a task meant for two staff to only
one staff. ISS conducts a 3-day training programme for all incoming housekeeping staff and pairs each
newcomer with an experienced housekeeper in each ward. Individual staff from both wards also told the
observer that each task is doable by one person. Hence, it can be concluded that task feasibility does not
negatively affect the analysis of staff sufficiency and instead, supports the deduction that staff deployment is
currently inadequate.
With regards to the nature of job scope, time spent on different tasks types was evaluated.
Cleaner Housekeeper FSS
Regular Tasks 77.8% 75.5% 76.5%
Periodic Cleaning 5.1% - 8.2%
Ad-hoc Tasks 17.1% 24.5% 15.3%
Total 100% 100% 100%
Table 15: Percentage of Time Taken to Perform Various Task Types
Table 15 shows that all three housekeeping staff – cleaner, housekeeper and FSS spent a majority of their time
performing Regular Tasks, followed by Ad-hoc Tasks and finally Periodic Cleaning. As regular tasks are part
of a staff’s daily routine, it is expected that staff spend a large portion of time on them. Periodic cleaning are
also planned tasks to be incorporated into the daily regular routine, just at fixed intervals. However, that was
not observed during the time and motion study. Periodic cleaning is of lower priority than ad-hoc tasks and
thus, staff spent the least time on performing them. When something crops up suddenly, staff will attend to it
first and put aside any periodic cleaning they were performing.
In fact, housekeeping staff spend a significant amount of time attending to ad-hoc tasks. With reference to
Table 13, cleaners of both wards spent more than 2 hours performing ad-hoc tasks, housekeepers of both
wards spent close to 3.5 hours performing ad-hoc tasks and FSS of both wards spent 3 hours performing ad-
hoc tasks altogether. This highlights the reoccurring problem of uncompleted tasks. As staff continuously
dealt with unplanned and unexpected tasks, they sacrificed the time needed to complete periodic cleaning or
other tasks. Tasks that could not be completed on that day were pushed to the following day to continue. If
this continues on, there will be an accumulation of tasks left undone.

21. 16
The job of a housekeeping staff is never the same each day, as the ad-hoc tasks he is faced with change on a
daily basis. A housekeeping staff needs to be quick on his feet to analyze a situation, so that he can settle it in
the shortest time possible. For example, when a patient urinated on the floor while the FSS in ward 43 was
collecting soiled trays, she immediately put down her trays and disinfected the area quickly. Concurrently, she
informed the housekeeper to continue collecting the soiled trays so that the kitchen staff was not delayed in
bringing back the food trolleys.
A housekeeping staff also has to be flexible and smart to streamline certain processes on his own, so that he
can perform all the tasks faster and better. For example, while FSS in ward 64 was waiting for patients to
finish eating their meals so that he could collect back the soiled trays, he tidied up the pantry and collected
soiled linen. This way, he completed more tasks in the same amount of time than if he had just followed the
work schedule rigidly.
With reference to Section II Data, housekeeping staff are performing tasks that are out of their job scopes. For
example, nurses were supposed to bring the soiled linen to the DU after they have made the beds. However,
they left the linen in the cubicle toilet’s linen baskets. So, housekeeping staff had to do an extra task of
bringing more soiled linen to the DU and this translated to a few more trips to make. Another example would
be the checking of food and collecting of diet chits. Ideally, nurses are to check all patients’ food and take
away their diet chits before patients enjoy their meals. However, the nurses in both wards failed to execute it
and the FSS had to spend more time on meal service.
To conclude, the job scope of a housekeeping staff is highly dynamic. As such, proper training is required for
them to be able to handle a wide range of situations that may unexpectedly crop up. It is also important for
staff to manage their time well so that they can complete every task at hand, on top of the ad-hoc tasks, all in a
day’s work. Finally, all hospital staff should fulfill all tasks that fall under their responsibilities. Although staff
can and should help one another, it should not become another staff’s duty to discharge.

22. 17
V. Ward Comparisons: 43 v.s. 64
Ward 43 and ward 64 differ in their layout and structure. This affects the time taken by each ward to complete
each task. As such, comparisons were made on a per-item basis. For example, comparison was made for time
taken to make one bed instead of one whole cubicle, which differs in number of beds between the two wards.
Personal observations and special exemptions were also taken into consideration.
Overall, housekeeping staff of ward 43 were more efficient and diligent than housekeeping staff of ward 64 in
the following ways:
Productivity
With reference to Table 2, ward 64 cleaner took a shorter time to collect trash per bin but took a longer time in
total. He was slower in his movements and took his time to perform the task as compared to ward 43 cleaner.
With reference to Table 6 and Table 9, ward 64 housekeeper and FSS took a significantly longer time to
perform bed-making per bed. Since the size of bed and number of bed equipment remain the same, the
difference is attributed to the efficiency of staff. The staff of ward 43 was faster in their actions, more efficient
in cleaning and changing the linen.
Hygiene
While performing cubicle cleaning on sinks, bins’ top, napkin dispensers, soap dispensers and mirrors, ward
43 cleaner was more thorough as compared to ward 64 cleaner. Ward 64 cleaner also used the wrong method
and chemicals to clean. He missed out the bottom and sides of the sinks.
The staff in ward 43 was also more thorough in sweeping and/or mopping the floor. They were detailed in
cleaning the corners and ensured that there was no dirt debris left before proceeding to the next cubicle.
With reference to Table 7, ward 64 housekeeper took a significantly shorter time to perform isolation rooms
cleaning. Despite taking into account the lack of private toilet inside the room, it was still a significant
difference from the performance of ward 43’s housekeeper. It can be inferred that ward 64’s housekeeper was
not as meticulous in cleaning the rooms.
When performing bed discharges, staff in ward 43 took the extra step to disinfect each area twice instead of
once. When asked by observer, they replied that patients deserve the cleanest environment recover and rest in.
Lastly, the staff in ward 43 were proactive in ensuring cleanliness of the ward. Whenever they saw litter on
the floor, they immediately picked it up or disinfected the area when necessary. On the other hand, the staff in
ward 64 were more calculative in only performing tasks that are within their responsibilities.

23. 18
Despite the weaknesses of the housekeeping staff in ward 64, they should also be commended for their
efficiency in other areas. The staff in ward 64 performed bed discharge faster than the staff in ward 43. They
were able to hit the Key Performance Indicator (KPI) of 15 to 20 minutes. Also, the FSS performed food
ordering via eMOS more efficiently and took lesser time for pre-meal preparations, freeing up more time to
perform other tasks.
Though the two wards work differently, they have their merits and are still able to achieve the main aim of
ensuring a clean ward for patients to recuperate in.

24. 19
VI. Shortfalls/Drawbacks of Study
Every study has its own limitations and disadvantages. A Time and Motion Study is not always a true
reflection of what actually happens.
1. Observers are not always proficient in the field of work being studied.
2. Actions of individuals are not always reflective of the group as a whole.
3. Several sections may include observer’s individual expertise and judgment.
4. Study participants may be pressurized during observation, increasing mistakes made.
5. Study participants may use the model methods which they usually do not.
Pertaining to this particular study, here are some shortfalls identified.
1. Observer was merely an intern working under NUH ES department, and so she was not well-versed in
housekeeping issues. This makes the study questionable, since a non-expert is defining an expert’s job
scope and efficiency.
For example, the observer will be inaccurate in determining whether time taken by a cleaner to wash a
bathroom is acceptable; or whether the FSS is pushing the food trolley correctly.
2. Several wards differ in terms of their layout and structure. This affects the time taken by each ward to
complete each task, in turn affecting the comparison results.
For example, in ward 43, there is a bathroom and a toilet in each cubicle; while in ward 64, there is a
common toilet/shower area along the corridor, one for female and one for male. This leads to varied
time taken by cleaners to wash the toilets.
3. Part of the time and motion study fell on the fasting month of Muslims, causing alterations in the
working schedule. This leads to incomplete data for the study.
The housekeeper in ward 64 is a Muslim and during the fasting month, she switched to morning shift
every week instead of alternate weeks of morning and afternoon shifts. As a result, there was missing
information on afternoon shift of housekeeper in ward 64.
4. The dynamic nature of the jobs of housekeeping staff makes it challenging to capture the work they
do every day, as it differs on a day-to-day basis. This creates flaws in the evaluation of job scope, as
the activities carried out by the staff may be varied each day.
For example, on days when the number of discharges is exceptionally high, housekeepers and FSS
have to put aside their routine cleaning and go back to it after performing bed discharges. This may
translate to the workload being too high, when it is manageable on days with average discharges.

25. 20
Similarly, the ad-hoc tasks each day take up different durations. When there is spillage of blood or
when a patient defecates on the floor, the housekeeper takes a longer time to disinfect the area as
compared to collecting Virex256 from the main housekeeping room of that level.
5. The observer was made known to the housekeeping staff of each ward and interacted with them on a
personal level as well. This causes inaccuracy in collection of data as staff being observed may put on
their best behavior instead of doing what they usually do.
For example, in ward 43, the FSS’ performance was good and she executed everything correctly.
However, after the study, there were feedbacks from other sources that her work often does not meet
expectations and she shrinks from certain responsibilities. Staff Deployment Analysis showed that
there was insufficient staff in her ward due to her lack of break time and continuous work. However,
it was only the few days of time and motion study that she worked so hard and did not take the
afternoon break due to work. Hence, the results drawn from this study data are not fully reliable.
6. Performance is very subjective and can differ from one housekeeping staff to another. There are other
factors that contribute to the performance of a staff, such as own efficiency and motivation to work.
This implies that analysis done in this report cannot be applied directly onto housekeeping staff. The
results of one staff does not equate to the rest of the staff.
For example, in ward 43, the housekeeper appears to have taken the longest break time and some may
say that she is not working hard enough. However, the truth is that she works very efficiently and
thus, manages to take enough breaks. So, in other wards there might be an increase in staff
deployment to solve the problem when the room problem is the individual staff’s lack of efficiency.
7. The “ES or ISS” composition of housekeeping staff differs between each ward, resulting in differing
work shifts and number of hours clocked by each staff. Since the conditions of study were not similar,
comparisons and conclusions drawn are imperfect.
For example, the housekeeper in ward 43 is an ISS staff working from 8am to 9pm while the
housekeeper in ward 64 is an ES staff working from 7am to 3pm or 1pm to 9pm. This translates to 13
hours compared to 8 hours, a 5-hour difference.

26. 21
VI. Recommendations
To counter the shortfalls of this study, here are some suggestions on how to improve on it.
1. Have a ground staff to carry out the next time and motion study. People who are doing the work can
better improve on their own work. When housekeeping staff observe their own work, they can
identify time-wasters and ideas for increasing quality service with efficiency.
By involving housekeeping staff in the study, they will feel more empowered and enthusiastic about
working together to create a better working environment.
2. When selecting wards to carry out the study on, take note of the ward’s layout and choose two (or
more) wards with an identical layout and same number of rooms/basins/toilets to clean.
3. Ensure that the study period falls within a suitable time frame. There should be no or minimal
alternation in working schedule, be it due to religious purposes or personal leave.
With regards to the efficiency of housekeeping staff, there are a few recommendations to consider.
1. Continuously train and re-train staff such that they are very clear on their daily routine and periodic
cleaning. This means that they should be well-versed in what task they should perform, how they
should perform the task and how often they should perform it. It is important to perform a task the
correct way, as it affects the quality of performance. Cleaning an item quickly does not translate to
true efficiency, there should be an element of effectiveness – disinfecting thoroughly. Currently, ISS
only offers a 3-day training programme for newcomers and following that, each staff is on his own to
learn and adapt to the ward.
When a staff is unsure of his tasks at hand, he will lack efficiency. He takes time to find out how to
perform a task correctly and does it slower as compared to one that is habitually performing the same
task correctly.
2. Reduce the working hours of housekeeping staff so that they have enough energy to work the
subsequent day. Currently, the working hours of ISS staff are about 13 hours and 6 days in a row.
Although this includes lunch break, tea break and lunch break, many of the housekeeping staff do not
get to rest this much in reality. This is because there are too many bed discharges to perform and they
still have to complete their routine cleaning. By the 4th
or 5th
consecutive day, housekeeping staff are
already too exhausted to perform at their best.
By having shorter working hours, it will keep the housekeeping staff’s morale up as well. They are
motivated to work hard and actually have the energy to work hard as they want to and should do.

27. 22
3. Provide sufficient equipment in each ward for housekeeping staff to execute their tasks capably and
cut down on unnecessary time taken to cope with inadequate items. For example, the cleaner in ward
43 takes a significantly longer time to wash water jugs and top-up water for individual patients. There
were not enough jugs, so the cleaner had to collect back some of the soiled jugs, wash, fill up with
water again and distribute to the patients.
Similarly, the housekeeper and FSS in ward 64 take longer time to collect soiled linen as they can
only tie one linen bag to a trolley as compared to two bags, so they have to take additional round to
finish collecting all the soiled linen. When there are enough of these equipment, housekeeping staff
are able to perform their tasks better and more efficiently.
4. Encourage mutual sharing of cleaning methods among housekeeping staff so that most effective
methods may be used. Although there are standard protocols to follow for most of the tasks, some
tasks can be performed better. In ward 43, the cleaner cleans the mirrors with dry hand towel and the
results are indeed shinier and cleaner. The housekeeper is able to perform bed makings and bed
discharges very quickly and excellently, because she has already worked many years and has
developed a certain routine that she sticks to each time.
When housekeeping staff share their most effective and correct cleaning methods, every ward can be
kept cleaner and at a more efficient speed.
Other suggestions include:
v Design a more suitable and comfortable uniform, especially for FSS.
Despite the light-weighted aspect of the uniform, it does not absorb sweat or dissipate heat easily,
causing huge discomfort for the housekeeping staff while they go about their daily chores such as
mopping the entire ward or washing the toilets. Also, it is not hygienic nor does it looks professional
for these staff to sweat profusely while performing bed discharge or carrying out hi-touch cleaning.
On top of that, during food service, FSS are expected to don an apron, which is of a relatively thick
material. Professionalism is a must, but it will be preferred if they can have both a professional look
and physical comfort to carry out their services with better quality.
v Foster good relationships among housekeeping staff in the same ward.
If each housekeeping staff is calculative in terms of only doing what he is tasked to do and not help
out in other areas, problems such as uncompleted tasks arise. Time is very limited in the wards as
there are so many tasks to be performed by each housekeeping staff. As the saying goes, ‘more hands
make light work’. When housekeeping staff work together hand-in-hand, they can help one another
complete tasks in shorter time frames.

28. 23
For example, when a FSS is on his way to the DU to collect virex256 and sees the linen baskets in
cubicle bathrooms filled with soiled linen, and he knows that the cleaner is still refilling jugs for
patients; he easily lends a helping hand to bring them to the DU and saves the cleaner time.
In addition, having a friendly happy working environment is very important. The housekeeping staff
will enjoy his work more and thus perform better.
v Cultivate respect among staff and to recognize the importance of housekeeping staff.
It is vital that everyone treats each other equally, despite their ranks and positions. Many people seem
to put housekeeping staff at the bottom of the hospital hierarchy and do not give them the respect they
deserve.
However, when other hospital staff show appreciation to them, they will not feel inferior but feel
proud of what they do and be motivated to carry on with their tasks to the best of their abilities.
v Develop better storage and infrastructure for waste and linen.
Currently, housekeeping staff need to collect all the trash in the ward and use a L-shaped trolley to
transport them to the waste holding area of that level. They are required to manually lift all the heavy
trash bags into the 600L waste bins, which is a very time-consuming and ergonomically unfriendly
process. Housekeeping staff already have lower back problems from long periods of bending down to
clean, and this worsens their conditions.
If the 600L bins or other waste holding bins have ledges at the side of the bins instead of lids on the
top of the bins, it will be better for anyone to transfer the trash bags, be it in or out of the bins. In the
ergonomic aspect, housekeeping staff do not have to lift up trash bags so high but slowly slide the
bags into the bin through the ‘side door’. In the economic aspect, staff at the main trash holding areas
and the housekeeping staff have lower risks of getting back injuries and reduced chances of taking
medical leave due to being physically unfit.
Similarly, for linen, staff also have to lift the heavy linen bags onto the trolleys, which are then
transferred to another trolley, brought to the basement, transferred to a holding site and finally
transferred to a trolley to be sent to the laundry. This is a very inefficient system that takes up time
and manpower, both valuable assets.
If there are trolleys that can be used to bring the soiled linen from the wards all the way to the laundry
truck, it will save up a lot of time and manpower. It will also reduce back injuries of the linen staff.

29. 24
VIII. Personal Views
“ During a visit to the NASA space center in 1962, President John F Kennedy
noticed a janitor carrying a broom. He interrupted his tour, walked over to the man and said,
"Hi, I'm Jack Kennedy. What are you doing?"
"Well, Mr. President," the janitor responded, "I'm helping put a man on the moon." ”
(Nomo J., 2014)
To many of people, housekeeping staff are just cleaners of the hospital, performing jobs that most shun away
from, such as clearing rubbish or cleaning toilets. In reality, housekeeping staff are doing very important jobs
– they ensure good hygiene and cleanliness in the hospital, so that health professionals can better treat
patients. Unfortunately, people tend to take housekeeping staff for granted. Only when things go wrong or are
different from the usual, such as uncollected trash accumulated in the wards or dirty doctor on-call rooms,
people put the blame on housekeeping staff and reprimand them.
Through this time and motion study, I learnt to appreciate housekeeping staff much more. Even though
sometimes they have to do unpleasant things, they do not ever complain. When a patient urinates on the floor,
one can trust a housekeeping staff to clean up the mess, but cannot and will not expect them to do so with a
smile. However, it may take you by surprise that they actually do! The housekeeping staff whom I followed
all put on smiles whenever they interacted with the patients. They reassured patients that they would clean up
the mess, not to worry but rest well. They ensured patients had their meals piping hot and never hungry. They
encouraged patients not to give up and genuinely cared for them.
A significant number of housekeeping staff comes from foreign countries. Many of them have spouses and
children back in their hometowns, awaiting for their return once every two or three years. As a family-oriented
person, I can sympathize with them how much they miss their families. These staff work so hard just for their
families to lead better lives while they learn to cope with loneliness.
The working hours of housekeeping staff are long; many of them said that they leave their house before the
break of dawn and only reach home after dusk. They devote all their time and energy into the ward’s work, to
provide an alternate but important healthcare service from nurses or doctors. However, most people simply do
not give them the respect they deserve. When a housekeeper mopping the floor accidentally slid his mop near
a doctor’s shoes, the doctor shot him a look angrily. When a housekeeper sweeping the floor was near a
patient’s bed, the visitor conveniently threw his tissue on the floor for the housekeeper to sweep it up. While it
is the housekeeping staff’s job to mop and sweep the floor, one should not cross the line in treating him like a
servant or someone of lower rank.

30. 25
Similarly, while we evaluate the performance of housekeeping staff through this study and discover rooms for
improvement, we must not forget that they are human-beings too. Indeed, staff efficiency can be increased and
quality of execution can be better. However, we must keep in mind not to treat them like robots, to
continuously perform tasks after tasks and churn out results one after another. Everyone needs rest and
welfare.
The NUH Environmental Services is like the backbone of the hospital, giving it support and structure. The
NUH housekeeping department is one of the vertebra that makes up the vertebrae. Other service partners are
also pieces of vertebra, glued together by gel-like discs - the staff of ES department. Just as the vertabrae
allows the body to move and bend, the entire ES department allows the hospital to stretch its resources and
maximize its operations.
Just like how the janitor in NASA played a part in putting a man on the moon, a housekeeping staff in NUH
plays a part in saving a patient’s life.

31. 26
IX. Biblography
Gifford, J. (2014). The Rule of 52 and 17: It’s Random, But it Ups Your Productivity. Retrieved 2015, from
http://www.themuse.com/advice/the-rule-of-52-and-17-its-random-but-it-ups-your-productivity
Nomo, J. (2014). What a NASA Janitor Can Teach Us About Living a Bigger Life. Retrieved 2015, from
http://www.bizjournals.com/denver/how-to/growth-strategies/2014/12/what-a-nasa-janitor-can-teach-us.html

32. 27
X. Appendix
A1: Template Used to Record Time and Motion
Building: Main
Building
/
Kent
Ridge
Wing Position: Cleaner
/
Housekeeper
/
FSS
Ward: Name
(if
applicable):
Date: Time:
___________
-­‐
____________
Time
Activity Remarks/
Comments
Time
Motion
Study
on
NUH
Housekeeping

33. 28
A2. Time and Motion Study Raw Data of Ward Cleaners
Picture 1: Cleaner of Ward 43 (ES)
Picture 2: Cleaner of Ward 64 (ISS)
Building: Ward: 64 Time: 8am
-­‐
5pm Position: Cleaner
8.05am 8.10am
8.10am 9.24am
9.24am 9.30am
9.30am 9.45am
9.45am 10.09am
10.09am 10.27am
10.27am 10.53am
10.53am 10.55am
10.55am 10.58am
10.58am 12.01pm
12.01pm 12.06pm
12.06pm 12.43pm
12.43pm 1.43pm
1.43pm 2.01pm
2.01pm 2.18pm
2.18pm 2.21pm
2.21pm 2.53pm
2.53pm 2.59pm
2.59pm 3.11pm
3.11pm 3.30pm
3.30pm 3.38pm
3.38pm 3.40pm
3.40pm 3.42pm
3.42pm 3.54pm
3.54pm 4.18pm
4.18pm 4.42pm
4.42pm 4.54pm
4.54pm -­‐
Patient
requested
for
change
of
mattress
-­‐
must
attend
to
it
immediately
-­‐
exchanged
with
another
bed
Perform
Bed
Discharge
(1
Discharge)
End
Work
Crash
Programme
-­‐
Spot
Cleaning
(walls,
signs,
rails)
Collect
Soiled
Cups
Pour
Away
Leftover
Milo
Patient
requested
for
jug
of
water
and
ice
-­‐
must
attend
to
it
immediately
Collect
Trash,
Empty
at
Collection
Point
(10
Bins)
Crash
Programme
Wait
for
Cleaning
Trolley
(MRSA
side)
Thorough
Wash
Common
Toilets
(2
-­‐
Male
and
Female)
Sweep
Nurse
Station,
DU,
Equipment
Room
Staffroom,
Clean
Utility,
Bed17-­‐24/25-­‐32/35-­‐42/9-­‐16/43-­‐50/1-­‐8,
Isolation
Rooms
(12
Areas)
Collect
Soiled
Linen
(3
baskets)
Perform
Bed
Discharge
(2
Discharges)
LUNCH
BREAK
Collect
Trash,
Empty
at
Collection
Point
(10
Bins)
Terminal
Cleaning
-­‐
Change
Curtains
Prepare
for
Terminal
Cleaning
Perform
Terminal
Cleaning
(MRSA
Bed)
-­‐
Wipe
All
Surfaces,
Change
Curtains
Rest;
see
if
there
are
anymore
discharges
Go
Restroom
Collect
Trash,
Empty
at
Collection
Point
(13
Bins)
Collect
Trash,
Empty
at
Collection
Point
(10
Bins)
Cubicle
Cleaning
(sink,
bin's
top,
napkin
dispenser,
soap
dispenser,
mirrors)
(10
of
each)
Refill
Hand
Soap
at
Bed
43-­‐50
Time Activity
Check
&
Touch
Up
Toilets
Wash
Water
Jugs
and
Top-­‐up
Water
for
Individual
Patients
(44
Beds)
Put
Away
Clean
Jugs
Main
Building
Building: Ward: 43 Time: 7am
-­‐
3pm Position: Cleaner
7.00am 7.15am
7.15am 7.30am
7.30am 7.35am
7.35am 8.35am
8.35am 10.10am
10.10am 10.25am
10.25am 10.35am
10.35am 10.50am
10.50am 11.15am
11.15am 11.45am
11.45am 12.08pm
12.08pm 1.00pm
1.00pm 1.15pm
1.15pm 3.00pm
3.00pm -­‐ End
work
Collect
Trash,
Empty
at
Collection
Point
(15
Bins)
Staff
Lunch
Break
Time
Motion
Study
on
NUH
Housekeeping
Activity
Cubicle
Cleaning
(sink,
bin's
top,
napkin
dispenser,
soap
dispenser,
mirrors)
(17
of
each)
Wash
Water
Jugs
and
Top-­‐up
Water
for
Individual
Patients
(45
Beds)
Staff
Tea
Break
Collect
Soiled
Linen
(8
Baskets)
Put
Away
Clean
Jugs
Collect
Trash,
Empty
at
Collection
Point
(12
Bins)
Collect
Virex256
from
Housekeeping
Room
Main
Building
Collect
Trash
-­‐
Biohazard
Waste,
Empty
at
Collection
Point
Time
Cubicle
Cleaning
(toilet
&
shower
room
cleaning)
(5
of
each)
Tidy
Up
DU
-­‐
Sweep
DU
Collect
Soiled
Linen
(8
Baskets)
Tidy
Up
DU
-­‐
Sweep
DU

34. 29
A3. Time and Motion Study Raw Data of Ward Housekeepers
Picture 3: Housekeeper of Ward 43 (ISS)
Building: Ward: 43 Time: 8am
-­‐
9pm Position: Housekeeper
7.55am 8.15am
8.15am 8.24am
8.24am 8.34am
8.34am 8.51am
8.51am 9.00am
9.00am 9.19am
9.19am 9.30am
9.30am 9.50am
9.50am 10.00am
10.00am 10.22am
10.22am 10.25am
10.25am 10.44am
10.44am 10.52am
10.52am 10.55am
10.55am 10.59am
10.59am 11.55am
11.55am 12.04pm
12.04pm 12.25pm
12.25pm 12.50pm
12.50pm 12.55pm
12.55pm 1.18pm
1.18pm 1.23pm
1.23pm 1.31pm
1.31pm 1.51pm
1.51pm 2.01pm
2.01pm 2.43pm
2.43pm 2.47pm
2.47pm 2.55pm
2.55pm 2.59pm
2.59pm 3.20pm
3.20pm 3.33pm
3.33pm 3.40pm
3.40pm 4.06pm
4.06pm 4.20pm
4.20pm 4.53pm
4.53pm 4.55pm
4.55pm 5.55pm
5.55pm 6.10pm
6.10pm
6.13pm
6.13pm 6.18pm
6.18pm 6.23pm
6.23pm 6.45pm
6.45pm 6.53pm
6.53pm 7.04pm
7.04pm 7.09pm
7.09pm 7.19pm
7.19pm
7.49pm
7.49pm 7.55pm
7.55pm 7.59pm
7.59pm 8.06pm
8.06pm 8.10pm
8.10pm 8.42pm
8.42pm 8.45pm
8.45pm 8.50pm
8.50pm 9.01pm
9.01pm 9.03pm
9.03pm 9.05pm
9.05pm -­‐
Send
Food
to
Dialysis
Patient
Time
Motion
Study
on
NUH
Housekeeping
Main
Building
Time Activity
Assist
FSS
with
Breakfast
Food
Service
Cubicle
Cleaning
(toilet
&
shower
room
cleaning)
(2
of
each)
Collect
Soiled
Linen
(8
Baskets)
Collect
Soiled
Trays
Bed-­‐making
(3
Beds)
Replenish
Ward
Supplies
(7
Cubicles,
Nurse
Station)
Sweep
2
Cubicles
Staff
Tea
Break
Wait
to
clean
cubicle,
as
there
was
a
radiographer
carrying
out
X-­‐ray
on
patient
Mop
2
Cubicles
Collect
Virex256
to
clean
toilets
Isolation
Room
Cleaning
(2
Rooms
with
Toilets)
Refill
Virex256
into
mop
Clean
Bed
45
room
Clean
Assisted
Patients
Toilet
Clean
Assisted
Patients
Shower
Collect
Soiled
Cups
Clean
Cleaning
Trolley
Staff
Lunch
Break
Prepare
for
Food
Service
Assist
FSS
with
Lunch
Food
Service
Perform
Terminal
Cleaning
(MRSA
Bed)
-­‐
wipe
all
surfaces,
change
curtains
Patient
request
for
food,
serve
food
(FSS
finish
terminal
cleaning)
Collect
Soiled
Trays
Wash
jugs
left
in
the
pantry
basin,
tidy
up
pantry,
wipe
ward's
food
trolley
Tidy
up
DU
-­‐
Mop
Floor
Cubicle
Cleaning
(sink,
bin's
top,
napkin
dispenser,
soap
dispenser,
mirrors)
(2
of
each)
Patient
request
for
food,
go
ward
44
to
take
bread,
warm
up
and
serve
with
margarine/jam
Tidy
up
DU
Staff
Dinner
Break
Assist
FSS
with
Dinner
Food
Service
Keep
Food
for
NBM
Patients
Refill
chemical
for
cleaning
Push
linen
trolley
into
correct
position
Staff
Tea
Break
Collect
Trash,
Empty
at
Collection
Point
(7
Bins)
Collect
Soiled
Linen
Perform
Bed
Discharge
(2
Discharges)
Replenish
Ward
Supplies
(7
Cubicles,
Nurse
Station)
Replenish
Ward
Supplies
(7
Cubicles,
Nurse
Station)
Return
extra
stocks
back
at
DU
Prepare
for
Terminal
Cleaning
Someone
shitted
on
the
floor
-­‐
must
clean
immediately
Someone
urinated
on
the
floor
-­‐
must
clean
immediately
Collect
Trash,
Empty
at
Collection
Point
(5
Bins)
Replenish
PE
aprons
Perform
Bed
Discharge
(1
Discharge)
Clear
away
used
cups,
refill
cream
crackers
Mop
staff
room,
tidy
up
pantry
Settle
EMD
Bed
Last
Round
ofCheck,
Replenish
Ward
Supplies
End
Work
Perform
Terminal
Cleaning
(MRSA
Bed)
-­‐
wipe
all
surfaces,
change
curtains
Tidy
Up
DU
Tidy
Up
Pantry
-­‐
Wash
jugs
left
in
the
pantry
basin
Sweep
Ward
Tidy
up
DU

35. 30
Picture 4: Housekeeper of Ward 64 (ES – Morning Shift)
Building: Ward: 64 Time: 7am
-­‐
3pm Position: Housekeeper
6.59am 7.03am
7.03am 7.10am
7.10am 7.33am
7.33am 7.39am
7.39am 7.46am
7.46am 7.48am
7.48am 7.50am
7.50am 8.11am
8.11am 8.20am
8.20am 8.25am
8.25am 8.28am
8.28am 8.33am
8.33am 8.44am
8.44am 8.53am
8.53am 8.56am
8.56am 9.00am
9.00am 9.10am
9.10am 9.16am
9.16am 9.18am
9.18am 9.33am
9.32am 9.41am
9.41am 9.57am
9.57am 10.00am
10.00am 10.44am
10.44am 10.56am
10.56am 11.00am
11.00am 11.45am
11.45am 11.50am
11.50am 12.15pm
12.15pm 12.43pm
12.43pm 12.50pm
12.50pm 12.55pm
12.55pm 12.59pm
12.59pm 1.02pm
1.02pm 1.04pm
1.04pm 1.11pm
1.11pm 1.17pm
1.17pm 1.50pm
1.50pm 1.54pm
1.54pm 2.02pm
2.02pm 2.05pm
2.05pm 2.09pm
2.09pm 2.44pm
2.44pm 2.48pm
2.48pm -­‐
Tidy
Up
DU
-­‐
Sweep
DU
Autoscrub
Female
and
Male
Toilet
(Cause
floor
wet
and
dirty)
Prepare
for
Bed
Discharge
Mop
2
Cubicles
Activity
Tidy
Up
Staff
Pantry
Mop
resident's
room
Time
Motion
Study
on
NUH
Housekeeping
Main
Building
Time
Bed-­‐making
(2
Beds)
Change
Waste
Plastic
Bags
for
Each
Bed
(14
Beds)
Collect
Virex256
and
Glance
for
Housekeeping
Room
Isolation
Room
Cleaning
(2
Rooms)
Collect
Trash
(2
Bins)
(Cause
bins
full)
Prepare
for
Bed-­‐making
Mop
Assisted
Patients
Toilet
&
Shower
Prepare
for
Food
Service
Assist
FSS
with
Breakfast
Food
Service
Send
Food
to
Dialysis
Patients
Chat
with
team
about
FSS
Briefing
Tidy
up
DU
Autoscrub
Female
and
Male
Toilet
(Cause
floor
wet
and
dirty)
Collect
Soiled
Trays
Sweep
Ward
Clean
Assisted
Patients
Toilet
Clean
Assisted
Patients
Shower
Staff
Lunch
Break
Prepare
for
Food
Service
Assist
FSS
with
Lunch
Food
Service
Bed-­‐making
for
Resident's
Room
Staff
Tea
Break
Collect
Soiled
Linen
(1
Basket)
Mop
2
Cubicles
Sweep
Bed17-­‐24/25-­‐32,
clean
utility
room
(3
Areas)
Tidy
up
DU
Settle
food
issues
at
Bed
13
(Sodexo
representatives
sent
up
fruits
basket
as
compensation)
Perform
Bed
Discharge
(2
Beds)
Collect
Soiled
Trays
Sweep
nurse
station,
common
area,
Bed1-­‐8/Bed9-­‐16/Bed35-­‐42/Bed43-­‐50
(6
Areas)
Warm
up
food
for
patients
that
just
returned
from
procedures
Prepare
for
Bed
Discharge
(eHIMS
down,
need
to
write
down
manually
from
nurse
station's
TV)
Tidy
Up
Pantry
-­‐
Clear
away
'kept'
food
in
pantry
End
Work
Check
if
can
perform
bed
discharge
on
Bed
2
and
Bed
4
as
well
Go
Restroom
Tidy
Up
Pantry
-­‐
Clear
away
'kept'
food
in
pantry
Prepare
for
Hi-­‐touch
Cleaning
Hi-­‐Touch
Cleaning
(6
Cubicles)

36. 31
A4. Time and Motion Study Raw Data of Ward FSS
Picture 6: FSS of Ward 43 (ISS)
Building: Ward: 43 Time: 7am
-­‐
8pm Position: FSS
7.07am 7.25am
7.25am 7.30am
7.30am 7.38am
7.38am 7.45am
7.45am 7.50am
7.50am 7.57am
7.57am 8.06am
8.06am 8.34am
8.34am 8.45am
8.45am 8.55am
8.55am 9.18am
9.18am 9.20am
9.20am 9.28am
9.28am 9.58am
9.58am 10.10am
10.10am 10.25am
10.25am 11.33am
11.33am 11.35am
11.35am 11.42am
11.42am 11.45am
11.45am 12.00pm
12.00pm 12.24pm
12.24pm 12.30pm
12.30pm 12.36pm
12.36pm 12.45pm
12.45pm 12.50pm
12.50pm 1.07pm
1.07pm 2.05pm
2.05pm 2.20pm
2.52pm 3.00pm
3.00pm 3.34pm
3.34pm 3.42pm
3.42om 3.55pm
4.00pm 4.10pm
4.10pm 4.12pm
4.12pm 4.15pm
4.15pm 4.43pm
4.43pm 4.45pm
4.45pm 5.05pm
5.05pm 5.18pm
5.18pm 5.51pm
5.51pm 6.03pm
6.03pm 6.33pm
6.33pm 6.55pm
6.55pm 7.02pm
7.02pm 7.10pm
7.10pm 7.14pm
7.14pm 7.50pm
7.50pm 7.54pm
7.54pm 7.57pm
7.57pm 8.00pm
8.00pm -­‐
Staff
Dinner
Break
Collect
Soiled
Trays
Last
Round
Check
Ward
Cleanliness
Return
PDA
and
Apron
to
Office
End
Work
Collect
Soiled
Trays
Patient
urinated
on
the
floor
-­‐
must
disinfect
immediately
Collect
Soiled
Trays
Sweep
Ward
(1st
Half)
Spot
a
patch
of
blood
stain
-­‐
must
clean
immediately
Sweep
Ward
(2nd
Half)
Serve
Dinner
Food
Ordering
via
EMOS
(2
Cubicles)
Collect
Soiled
Trays
Collect
Soiled
Linen
Bed-­‐making
(7
Beds)
Tidy
up
DU
Sweep
Ward
Replenish
all
chemicals
needed
for
the
week
-­‐
collect
from
housekeeping
storeroom;
replenish
all
stocks
needed
for
the
week
-­‐
collect
from
level
6
Aircon
leak
-­‐
must
fix
immediately
Staff
Tea
Break
Mop
5
Cubicles,
Staffroom
(6
Areas)
Nurse
accidentally
split
food
on
the
floor
-­‐
must
clean
immediately
Perform
Bed
Discharge
(1
Bed)
Prepare
for
Bed
Discharge
Receive
signal
to
perform
bed
discharge
-­‐
but
problem
of
missing
bed
Time
Motion
Study
on
NUH
Housekeeping
Main
Building
Time Activity
Tidy
Up
DU,
Check
Cleaning
Trolleys
Well-­‐stocked
Tidy
Up
Pantry
-­‐
Check
Fridge
Temperature
Replenish
Pantry
Supplies
Pre-­‐Breakfast
Preparation
-­‐
Check
EMOS
for
new
patients/NBM
cases,
Dilute
Coffee
and
Tea
Serve
Breakfast
Food
Ordering
via
EMOS
(4
Cubicles)
Serve
Lunch
Send
Food
to
Dialysis
Patient
Tidy
Up
Pantry
-­‐
Wash
jugs
left
in
the
pantry
basin
Autoscrub
and
Mop
1
Cubicle
and
Common
Area
Tidy
up
DU
and
Pantry
Prepare
for
food
service
-­‐
check
if
all
patients
are
present
and
who
is
NBM
Collect
Soiled
Trays
Warm
up
food
for
patients
that
just
returned
from
procedures
Autoscrub
and
Mop
1
Cubicle
Prepare
to
serve
tea
break
(trolley,
bread,
biscuits,
milo)
LUNCH
BREAK
Hi-­‐Touch
Cleaning
(6
Cubicles)
Serve
Tea
Break
Tidy
Up
DU
-­‐
Wash
cleaning
containers
and
equipments,
Clear
Biohazard
Waste,
Soiled
Linen
Tidy
Up
Pantry
-­‐
Wash
jugs
left
in
the
pantry
basin
Crash
Programme
-­‐
Wall
Cleaning
Received
signal
to
carry
out
bed
discharge
for
Bed
13,
prepare
Perform
Bed
Discharge
(1
Bed)
Bed-­‐making
(2
Beds)
Tidy
Up
DU
-­‐
Wash
cleaning
containers
and
equipments

37. 32
Picture 7: FSS of Ward 64 (ISS)
Building: Ward: 64 Time: 7am
-­‐
8pm Position: FSS
7.00am 7.07am
7.07am 7.12am
7.12am 7.20am
7.20am 7.30am
7.30am 7.36am
7.36am 7.40am
7.40am 7.48am
7.48am 7.51am
7.51am 8.14am
8.14am 8.21am
8.21am 8.24am
8.24am 8.30am
8.30am 8.47am
8.47am 8.55am
8.55am 9.14am
9.14am 9.16am
9.16am 9.19am
9.19am 9.23am
9.23am 9.28am
9.28am 9.36am
9.36am 9.50am
9.50am 9.52am
9.52am 9.55am
9..55am 10.15am
10.15am 10.21am
10.21am 10.49am
10.49am 10.59am
10.59am 11.37am
11.37am 11.41am
11.41am 11.50am
11.50am 12.00pm
12.00pm 12.05pm
12.05pm 12.08pm
12.08pm 12.10pm
12.10pm 12.15pm
12.15pm 12.21pm
12.21pm 12.30pm
12.30pm 12.33pm
12.33pm 12.58pm
12.58pm 1.59pm
1.59pm 2.10pm
2.10pm 2.25pm
2.25pm 2.30pm
2.30pm 3.00pm
3.00pm 3.08pm
3.08pm 3.40pm
3.40pm 3.51pm
3.51pm 4.00pm
4.00pm 4.10pm
4.10pm 4.12pm
4.12pm 4.15pm
4.15pm 5.05pm
5.05pm 5.08pm
5.08pm 5.17pm
5.17pm 5.20pm
5.20pm 5.35pm
5.35pm 5.47pm
5.47pm 5.50pm
5.50pm 5.56pm
5.56pm 6.19pm
6.19pm 6.25pm
6.25pm 6.35pm
6.35pm 6.38pm
6.38pm 6.46pm
6.46pm 6.49pm
6.49pm 6.52pm
6.52pm 6.55pm
6.55pm 7.50pm
7.50pm 7.55pm
7.55pm 8.00pm
8.00pm -­‐
Arrange
with
nurse
regarding
HPV
gassing
schedule
Tidy
Up
DU,
clean
discharge
trolley
Collect
Soiled
Trays
Tidy
Up
Pantry
-­‐
Wash
jugs
left
in
the
pantry
basin
Tidy
Up
Pantry
-­‐
Wash
jugs
left
in
the
pantry
basin
Bring
down
confidential
papers
to
level
5
housekeeping
room
Tidy
Up
Pantry
Staff
Tea
Break
Configure
PDA
Settings
with
Level
Supervisor
Refill
cream
crackers
in
pantry
Prepare
for
food
service
-­‐
check
if
all
patients
are
present
and
who
is
NBM
Serve
Dinner
Send
food
to
dialysis
patient
Prepare
to
serve
tea
break
(trolley,
bread,
biscuits,
milo)
Serve
Tea
Break
Tidy
up
pantry
Collect
Soiled
Cups
Patient
dirtied
bed
-­‐
must
change
bed
sheets/
perform
bed-­‐making
immediately
Tidy
up
DU
Collect
soiled
linen
Food
Ordering
via
EMOS
(6
Cubicles)
Serve
food
to
patients
that
went
for
procedure
beforehand
Collect
Soiled
Trays
Staff
Lunch
Break
Clean
standing
fan
Perform
Bed
Discharge
(1
Bed)
Collect
Soiled
Linen
ISS
Briefing
Activity
Tidy
Up
Pantry
-­‐
wash
used
cups/jugs/utensils
left
overnight
Time
Motion
Study
on
NUH
Housekeeping
Main
Building
Time
Tidy
Up
DU,
Check
Cleaning
Trolleys
Well-­‐stocked
Tidy
Up
Pantry
-­‐
top
up
milo
bottle,
utensils
in
pantry
Serve
Breakfast
Keep
food
for
NBM
patients
Tidy
Up
Pantry
-­‐
Wash
jugs
left
in
the
pantry
basin
Collect
soiled
linen
Sweep
common
area,
bed
1-­‐8/9-­‐16/35-­‐42/43-­‐50,
corridor
and
nurse
station
(6
Areas)
Mop
pantry,
nurse
staffroom,
nurse
station
and
common
area
(4
Areas)
Clean
Ancillary
Areas
Tidy
up
DU
-­‐
soiled
linen
Pre-­‐Breakfast
Preparation
-­‐
Check
EMOS
for
new
patients/NBM
cases,
Dilute
Coffee
and
Tea
Fill
up
bed-­‐making
form
Sweep
Ward
Go
Restroom
Mop
DU,
duty
room
(2
Areas)
Collect
Soiled
Trays
Prepare
for
bed-­‐making
Bed-­‐making
(5
Beds)
Tidy
up
DU
-­‐
soiled
linen
Collect
Virex256
from
Housekeeping
Room
End
Work
Mop
3
Cubicles
Sweep
common
area
and
nurse
station
(2
Areas)
Prepare
for
food
service
-­‐
check
if
all
patients
are
present
and
who
is
NBM
Patient
spilt
water
on
floor
-­‐
must
clean
immediately
Prepare
for
bed
discharge
Settle
some
issues
Perform
Bed
Discharge
(1
Bed)
Settle
some
issues
Perform
Bed
Discharge
(1
Bed)
Serve
Lunch
Send
Food
to
Dialysis
Patient
Patient
requested
for
rice
-­‐
must
attend
to
it
immediately
Keep
food
for
NBM
patients
Replenish
paper
cone
cup
and
hand
soap
Tidy
up
DU
Collect
Soiled
Trays
Return
PDA
and
Apron
to
Office
Last
Round
Check
Ward
Cleanliness
Staff
Dinner
Break
Prepare
for
Bed
Discharge
Collect
Soiled
Trays