Chiropractic + Naturopathic Doctor

Dr. Clean: Why restrooms need special attention

Anthony Lombardi   

Features Business Management

The way we prepare ourselves and our clinic to receive and serve patients can have a significant impact on our future – and theirs.

Our work becomes philosophical because it directly impacts patients’ lives. Think about the patients for a second. They are interrupting the routine of their lives to visit your office – not another office. They chose to see you or someone else working at your clinic. They allowed you into their lives and now the reflection of your work will influence everything they do that day. But, if the reflection of your work and preparation makes a more significant impact, you can influence everything they do for the rest of their lives.

From assessment, treatment, follow-up appointments, and case management – each of these things need to be completed at optimum quality to ensure a memorable patient experience. However, there is a very important detail that practices sometimes neglect: the restroom. It’s because the restroom itself is a place our patients take personally, so in my practice I aim to make it the best experience possible. The restroom represents how we do the little things and our patients will see that if we take the little things seriously then their health is in our good hands.


It pays to be clean
According to Dave Mesko, senior director of marketing for Cintas Corporation, a big custodial restroom cleaning company, the most common complaint they hear goes something like, “The restrooms are dirty and don’t have any toilet paper.” A recent survey revealed that 94 per cent of U.S. adults would avoid a business in the future if they encountered a dirty restroom.

In speaking with different chiropractors who work as associates in clinics, they told me that patients have actually submitted unwanted online reviews of the dirty restrooms in the clinic in which they practice. To avoid this from happening in your facility I recommend that you implement an ongoing restroom care program that ensures that the restroom is cleaned and maintained several times per day so that supplies are always stocked and areas are always clean – so patients feel comfortable using your facilities.

In some cases, a facility’s restroom can also be a source of praise worthy of an online review of its own. For instance, our Hamilton Back Clinic restroom is rated on Cintas Mobile App: Where to Wee. If you have a clean restroom and want to drive traffic to your business, make sure your clean restroom is listed and rated so users know where to go.

Three Cs of restroom maintenance
No one likes a dirty restroom. According to Cintas, Americans and Canadians cite dirty or sticky floors as an indicator of a dirty restroom (92 per cent), so don’t forget to keep the floors clean. Having restroom supplies in stock is also critical to both your patients’ experience and keeping your restroom spotless. Further, because air dryers have been shown to spread bacteria between three and six feet from the device, paper towels are preferred because they are less likely to contaminate other restroom users.

When it comes to restroom design the more inventive the better. Glass sinks and counters, chrome plumbing and fancy light fixtures may be your taste. Or it can be as simple as choosing the right trashcan. I make sure the garbage can is an attractive and trendy focal point of the restroom because it’s the last thing people look at before they leave. If your trashcan is broken, over flowing or dirty, it will prime your patients with unconscious preconceptions about everything else in your clinic. On the other hand, if your restroom is trendy, roomy and immaculate, it gives a positive vibe that your patient takes with them.

Don’t be afraid to use receptive paint colours and accent walls to welcome your patients into the restroom. Mesko says that while it might not seem significant in the grand scheme of your operation, organizations that provide an exceptional restroom experience will see an increase in customer loyalty. He feels that from colour to cleanliness, paying attention to the details in a restroom can make the difference between a positive and negative guest experience.

The meaning response
There is science behind a positive restroom experience, as I’ve written about before; it’s called the meaning response.

Previously known as the placebo/nocebo effect, it’s the brain’s perception of the surrounding environment that elicits a physiological response, which decreases or increases sympathetic tone. Dr. David Neuman, a medical doctor who studies the meaning response, said, “A neurohumoral reaction takes place in response to the patients’ surroundings when they perceive and infuse meaning in activities around them that impact their brain.”

In a positive neurohumoral reaction, the release of endorphins flood pleasure centres in the brain. This causes a relaxation reflex in the arteries of the central and peripheral circulatory systems, which provide oxygen-rich blood to neuromusculoskeletal tissues.

So, if a clean restroom is important to our patients then we have a good opportunity to elicit a positive response. If our restroom is neglected, however, we run the risk of triggering a negative impression highlighted by increased sympathetic tone.

In another related study, former Target statistician, Andrew Pole discovered that if Target was able to engage people during significant times of life change, specifically during their child raising years, then they would be more likely to shop at Target for the rest of their lives. This is why having a baby changing table in your restroom could help increase future patient traffic. For parents of young children, it brings a sense of relief when their child needs a diaper change. This means so much to parents that the likelihood they will return to use your services again is very high.

Broken windows theory
This theory was introduced by social scientists in 1982, and it assumes that landscape communicates to people.

Under the broken windows theory, an orderly and clean environment – one that is properly maintained – sends the signal that the area is monitored and that actions different from the status quo will not be tolerated. You will find that people who use a clean restroom in a clinical environment will also try to keep and leave the restroom clean.

Conversely, a restroom that is not well maintained will not motivate users to clean up after themselves, and they are more likely to leave it dirty. In the original theory, a city with broken windows, graffiti and excessive litter give the impression that the area is not monitored, and that inappropriate behavior is tolerated by the people in that environment. Former New York City Mayor Rudy Giuliani is credited with using the broken windows theory in the early 1990s to police and clean up NYC. By the end of the decade, violent crime had dropped by 56 per cent.

Daily game plan
These are the guidelines I give my staff members who address restroom maintenance on a daily basis:

• Always turn on bathroom fan when cleaning and sign checklist if you are the first to clean that day.

• Every morning please take the mop in the closet with some light bleach or white vinegar (found in bathroom cupboard) and pass the mop on the floor.

• Use the bathroom cleaner to clean all wall surfaces and reachable baseboards (all four walls), because bacteria lives here.

• Make sure to get behind and under the toilet bowl especially near the spout at the base. Also clean under the glass along the edges where water marks form.

• In addition to the seat and surfaces, please clean the outside of the bowl and sides down to the base. The inside of the bowl is cleaned automatically by a bleach cleaner in the top of the tank.

• Use environmentally friendly, hypoallergenic cleaning spray to disinfect and wipe all surfaces of the baby changing station thoroughly.

• Clean door handles, areas around door handles on the door, sink handles, light switches, garbage can, and toilet lever with bathroom cleaner – bacteria is spread this way.

• Lastly, sign the restroom cleaning checklist and date and time stamp it so our patients can see how serious we are about taking care of them.

A clean restroom encourages positive feelings in customers about your business. Customers equate the cleanliness of your company’s bathroom with the cleanliness of your entire business.

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