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dc.contributor.authorLitwin, Adam Seth
dc.contributor.authorAvgar, Ariel C.
dc.contributor.authorBecker, Edmund R.
dc.description.abstractOn any given day, about one in 25 hospital patients in the United States has a health care–associated infection (HAI) that the patient contracts as a direct result of his or her treatment. Fortunately, the spread of most HAIs can be halted through proper disinfection of surfaces and equipment. Consequently, cleaners—“environmental services” (EVS) in hospital parlance—must take on the important task of defending hospital patients (as well as staff and the broader community) from the spread of HAIs. Despite the importance of this task, hospitals frequently outsource this function, increasing the likelihood that these workers are under-rewarded, undertrained, and detached from the organization and the rest of the care team. As a result, the outsourcing of EVS workers could have the unintended consequence of increasing the incidence of HAIs. The authors demonstrate this relationship empirically, finding support for their theory by using a self-constructed data set that marries infection data to structural, organizational, and workforce features of California’s general acute care hospitals. The study thus advances the literature on nonstandard work arrangements—outsourcing in particular—while sounding a cautionary note to hospital administrators and health care policymakers.
dc.rightsRequired Publisher Statement: © Cornell University. Reprinted with permission. All rights reserved.
dc.subjectemployment arrangements
dc.subjectemployment relations
dc.subjectlabor relations
dc.subjectindustrial relations
dc.subjecthealth care
dc.subjecthealth care–associated infections
dc.subjecthospital-acquired infections
dc.subjectClostridium difficile (C. diff.)
dc.titleSuperbugs Versus Outsourced Cleaners: Employment Arrangements and the Spread of Health Care-Associated Infections
dc.description.legacydownloadsLitwin15_Superbugs_vs_outsourced_cleaners.pdf: 327 downloads, before Oct. 1, 2020.
local.authorAffiliationLitwin, Adam Seth: Cornell University
local.authorAffiliationAvgar, Ariel C.: Cornell University
local.authorAffiliationBecker, Edmund R.: Emory University

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