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Perception Of Cleanliness Toolbox


The Center is happy to announce the launch of the new topic toolbox: The Perception of Cleanliness. Each toolbox contains a library of newly-created and Center staff-curated content - research findings, expert insights, strategies, tools, and other useful resources. 

Environmental cleanliness affects the patient experience, patient satisfaction, perceived service quality, and actual quality in terms of infection prevention. Successfully achieving certain levels of cleanliness requires an interdisciplinary approach that involves the building design, operational and policy changes, education of personnel, and cultural changes to the organization. 

The Perception of Cleanliness Toolbox Contains:


An Issue Brief and Executive Summary

Five Interviews

  • "Perception is Reality When it Comes to Cleanliness", an interview with Cindy Barr, RN, EDAC, describes the frustrations associated with maintaining clean spaces, the ways designers and architects can set the state for maintaining clean spaces, and the importance of training staff to observe patient behavior.
  • "Building Sustainability Into Hospital Design", an interview with Janet Howard, provides insight into using green cleaners to improve patient satisfaction scores around the perception of cleanliness, the negative health impacts associated with traditional cleaning products, and the healthier interiors challenge to reduce the use of harmful chemicals.
  • "Cleanliness: Where Do We Go From Here?" an interview with Roger Ulrich, PhD, EDAC, discusses the importance of considering patients’ perceptions of cleanliness, the ways to look beyond patient perception of cleanliness to create a truly clean environment, and things architects and designs can do to help create clean spaces.
  • "Cleanliness: Time for a Change", an interview with Gary Vance and Terry Thurston  provides insight into the key cleanliness issues facing the healthcare industry today, the issues that drive patient perceptions about cleanliness, and the ways architects and designers can help improve perceptions of cleanliness.
  • "Strategic Design Can Improve Patient Perception of Cleanliness and Quality", an interview wtih Jaynelle Stichler, DNS, RN, EDAC, NEA-BC, FACHE, FAAN, delves into what patients really judge when evaluating a facility's cleanliness, why patient perceptions of cleanliness directly impact reimbursements, and ways hospitals can improve patients’ views of cleanliness, quality, and safety. 

Two Project Briefs



Design Strategies


  • "Environmental Cleanliness Evaluation Checklist" is a tool that can be used to evaluate the implementation of design strategies for improving environmental cleanliness. Mark relevant environmental, operational, and people measures that have been implemented.

Three Blogs

Lessons Learned: 

  • The following are compiled from research literature, case studies, interviews, and other materials to provide an overview on the topic of perception of cleanliness

Related Resources: 


Click here to view Perception of Cleanliness Toolbox resources that are free to all

Click here to view Perception of Cleanliness Toolbox resources available only to A+ members*

* Want to learn how to become an Affiliate+ member?  Contact Lynn Kenney, lkenney@healthdesign.org