Words: Tim McDonald
With the Australian flu season now upon us, bringing with it rising transmission, shifting strain dynamics and softening vaccination uptake, infection risk stretches across a longer horizon that goes beyond reactive hygiene. This breadth of risk calls for a coordinated, system-level response grounded in science, behaviour and execution.
“We’ve already seen the patterns: influenza arrives earlier, peaks climb higher, overlapping respiratory threats complicate diagnosis and containment,” Avondale University professor Brett Mitchell says. “What once followed a predictable seasonal arc now unfolds as a layered and persistent public health challenge that places renewed pressure on healthcare settings, aged care environments and high-traffic commercial spaces.”
Across this shifting public health terrain, hygiene and cleaning have assumed a far more consequential purpose, operating as active defences rather than procedural formalities.
“Within this evolving landscape, hand hygiene and environmental cleaning carry a sharper definition,” Mitchell says. “These practices move beyond routine expectation, focusing on deliberate interventions that influence reduced transmission outcomes in real time.”
A longer, more complex season
As global surveillance data and local health signals begin to align around prolonged flu activity and increased transmissibility, the traditional boundaries of ‘flu season’ start to dissolve into a broader infection cycle that requires continual vigilance across multiple environments.
Northern hemisphere trends have already pointed toward earlier onset and sustained waves of respiratory illness, and those patterns continue to echo across the Asia-Pacific region. The result is a more volatile risk profile where healthcare systems face compounding pressures and workplaces encounter increased absenteeism and operational disruption.
This shift demands clarity in how infection prevention is understood. Because short-term responses lose effectiveness when risk persists, static protocols struggle to keep pace with changing conditions.
“A more adaptive model becomes necessary,” Mitchell says. “One that integrates behavioural science, environmental controls and frontline execution into a cohesive strategy.”
Within that model, hygiene becomes a system where every touchpoint matters and every lapse carries consequence.
Rethinking transmission
As scientific understanding of influenza transmission continues to evolve in the wake of the COVID saga, the balance between airborne and surface-mediated spread becomes clearer, prompting a recalibration of how infection prevention strategies are designed and deployed.
Texas State University chair and professor at the College of Health Professions, Dr Rodney E Rohde explains that current evidence points toward a multimodal transmission model where aerosols play a dominant role in many indoor settings.
“The best current evidence indicates that influenza transmission is multimodal but aerosol-dominant in many real-world settings,” he says. “Surface-mediated spread, while possible, appears to have a minimal effect on infection risk, whereas inhalation of virus-containing aerosols better explains observed transmission dynamics.”
This emphatic shift sharpens the importance of cleaning, positioning environmental hygiene within a broader infection control framework that includes ventilation, air quality and respiratory protection, with each element carrying a defined role while forming a unified layer of defence.
While cleaning does target high-touch surfaces and shared environments, contamination can still occur. Hand hygiene interrupts transfer pathways between people and surfaces while air management addresses inhalation risk. The strength of the system lies in how these elements interconnect.
The chemistry behind the clean
As disinfectant technologies evolve in response to emerging pathogens and heightened expectations, the industry faces growing pressure to distinguish genuine innovation from incremental improvement and to anchor product claims in meaningful, real-world outcomes.
Laboratory efficacy has long stood as the benchmark, where products prove their ability to eliminate microorganisms under controlled conditions. Yet that standard now comes under scrutiny as real environments introduce variability, human behaviour shapes outcomes and application methods influence performance.
Rohde argues that the evidentiary bar must rise. “The field should move beyond ‘does it kill microbes in the lab?’ to ‘does it reduce transmission in the real world, safely and reproducibly?'” he says.
This reframes how products are evaluated, placing importance on transparent, independent validation, giving durability and safety a sharper focus. The goal extends beyond microbial reduction into measurable impact on infection outcomes.
For cleaning professionals, this demands a deeper level of understanding where product selection carries strategic weight, dwell times shape effectiveness, application techniques drive outcomes and chemistry becomes embedded within capability.
From tasks to judgement
As infection risks intensify and environments grow more complex, the limitations of traditional cleaning training models begin to surface, particularly in high-risk settings where procedural knowledge alone cannot account for the variability and consequence of real-world conditions.
Crest Clean, general manager training, safety and wellbeing, Liezl Foxcroft, sees this first-hand across medical centres, aged care facilities and high-traffic environments where expectations extend far beyond task completion.
“Traditional models tend to focus on task completion, ‘clean this surface’, ‘use this product’, ‘follow this schedule’,” she says. “That approach works in low-risk environments, but it breaks down quickly when the stakes are higher.”
The gap lies in judgement. Procedural training teaches the steps but rarely explains the stakes. “In medical and high-risk environments, a missed plug hole or inadequately cleaned basin is not just an aesthetic issue, it can be a direct infection risk,” Foxcroft says. “Traditional training rarely communicates that weight of responsibility to the people doing the work. An incorrect sequence introduces exposure. The consequences move beyond appearance and into health outcomes.”
Embedding capability across systems
Many organisations are getting on the front foot, looking to strengthen infection prevention across diverse environments, from isolating training initiatives to integrating systems that connect people, processes and performance in a continuous loop of improvement.
“Accredited, sector-specific training establishes a baseline of competency,” Foxcroft says. “Teaching the reasoning behind tasks builds ownership and accountability while visible oversight ensures standards translate from policy into practice.”
Regular site visits and quality assurance audits reinforce expectations while providing real-time feedback supported by communication channels that enable rapid response when issues arise, all grounded in a culture that underpins the entire system.
“Treat cleaning staff as health professionals,” Foxcroft says. “When we position our teams as contributors to public health outcomes, the standard of care reflects that.”
This perspective shows how cleaning is embedded in the healthcare ecosystem, with the workforce aiming at infection prevention goals, using language that supports that role.
Hand hygiene compliance: Moving beyond the audit
As facility managers and infection prevention teams scrutinise compliance data across healthcare, aged care and high-traffic commercial settings, inconsistent hand hygiene continues to reveal a challenge misaligned with product availability, pointing squarely at system design and organisational culture.
Gojo head of regulatory and science for Australasia, Christine Mikhail, argues that sustainable improvement in this area demands more than targeted product placement or periodic education campaigns. “Sustainable improvements in hand hygiene compliance are rarely achieved through a single intervention,” she says. “The strongest evidence continues to support multimodal strategies that combine accessible product placement, innovative product, workforce education, leadership engagement, behavioural reinforcement and ongoing performance feedback.”
From a structural standpoint, the positioning of hand hygiene products within a facility carries measurable consequences. Research consistently demonstrates that when healthcare workers must interrupt care processes or move outside the patient zone to access products, compliance rates decline. Mikhail says this is one of the most actionable and frequently overlooked interventions available to facility operators. “One of the most effective structural interventions is ensuring hand hygiene products are positioned at the point of care and integrated naturally into the workflow,” she says. “If healthcare workers need to interrupt care processes or leave the patient zone to access products, compliance rates are consistently impacted.”
Behavioural strategies reinforce what structural design enables. Facilities that treat hand hygiene as a core organisational value, evidenced through visible leadership commitment, peer accountability frameworks and regular education rather than an audit-driven compliance exercise, tend to demonstrate sustained improvement over time. The distinction matters because compliance that exists only under observation collapses the moment scrutiny lifts.
“Facilities that embed hand hygiene into organisational culture rather than treating it as a standalone audit requirement tend to achieve more sustainable outcomes,” Mikhail says. “This includes visible leadership support, peer accountability, regular education and creating environments where staff understand not only when hand hygiene is required, but why it remains one of the most critical infection prevention measures available.”
Technology as a tool, not a solution
The growing accessibility of electronic auditing systems, dispenser usage sensors and digital monitoring platforms has introduced new possibilities for understanding hand hygiene behaviour at scale, and the appetite for these tools across healthcare and aged care environments continues to grow. However, the integration of monitoring technology into compliance programmes carries risks that facilities must confront before implementation rather than after.
Mikhail identifies a critical failure point that emerges when technology is positioned as the primary driver of compliance improvement. “Monitoring technologies can provide valuable insights into hand hygiene activity, but there is a significant risk in viewing technology as a standalone solution,” she says. “If facilities introduce electronic auditing systems or dispenser sensors without first establishing a strong culture of education, accountability and staff engagement, the technology may be perceived as punitive rather than supportive.”
When monitoring is experienced as surveillance rather than support, staff disengagement follows, and the very behaviours technology is intended to reinforce become harder to sustain. The risk compounds when leadership involvement is inconsistent and data generated by monitoring systems fails to translate into meaningful feedback or operational change.
“One of the key risks is focusing too heavily on numerical compliance metrics without understanding the behavioural and operational factors influencing them,” Mikhail says. “Staff may become disengaged if monitoring is seen purely as surveillance, particularly if there is limited feedback, inconsistent leadership involvement or inadequate education around the purpose of the system.”
The volume of data generated by these platforms presents a further challenge. Facilities can find themselves rich in monitoring outputs yet unable to act on them effectively without the trained personnel and structured processes required to convert insights into practice change. Technology may disclose patterns, but only people, systems and culture can determine the response.
“There is also the risk of generating large amounts of data without meaningful action,” Mikhail says. “Technology can identify trends, but facilities still require trained infection prevention teams, engaged leadership and practical workflow improvements to translate that information into safer outcomes.”
For the cleaning and hygiene industry, Mikhail’s perspective reinforces a broader principle that has emerged consistently across expert opinion: culture precedes capability, and capability precedes technology. “Hand hygiene improvement is driven by culture first and technology second,” she says. “Facilities that achieve the best long-term outcomes are those that use monitoring tools as part of a broader infection prevention strategy centred on education, accessibility, transparency and shared accountability across the organisation.”
Measuring what matters
As infection prevention matures into a system-level function, the question of measurement is highlighted, prompting a move away from process-driven metrics toward outcomes resulting in actual risk reduction and health impact.
Rohde highlights the importance of integrating environmental hygiene into broader infection prevention and control frameworks. “In complex settings like healthcare and aged care, the next evolution is shifting environmental hygiene from a task-based compliance model to a risk-based, system-integrated infection prevention function,” he says. “The goal is simply to prove that cleaning reduces transmission risk and improves patient and resident outcomes in measurable, reproducible ways.”
Achieving this requires a shift in how data is used, where risk stratification identifies high-priority spaces and surfaces through surveillance systems that reveal infection patterns. Cleaning protocols can then be adapted in response and performance assessed against outcomes rather than activity.
This approach elevates the role of environmental services teams, enabling them to operate as partners within infection control systems. Their work connects directly to patient safety and public health outcomes.
The frontline of prevention
As Australia navigates a more complex flu landscape shaped by evolving pathogens, changing behaviours and rising expectations, the role of cleaning professionals continues to expand, placing them at the centre of a system that protects health across every shared environment.
The work carries precision. It demands knowledge. It requires adaptability. Each surface cleaned, each protocol followed, each decision made contributes to a broader defence that extends beyond individual sites and into the fabric of public health.
The message for the industry comes through with clarity. Infection prevention now operates as a system where science, behaviour and execution intersect. Success depends on how well those elements align.
In the months ahead, as flu activity builds and pressure intensifies, the organisations that have invested in capability, embraced evidence and integrated their systems will stand apart, and their outcomes will show it.
This article first appeared in the winter 2026 print edition of INCLEAN Magazine
