WHITE PAPER

YOUR GUIDE TO INFECTION

CONTROL PROGRAMS FOR THE
HOSPITALITY INDUSTRY
OUTLINE
1. Introduction
2. What is a POSI Program?
3. The Elements of a POSI Program
a. Management
b. Risk Assessment
i. Stages of Risk Assessment
1. Infection Information
2. Operation / Activity
3. Hazard by Transmission Vector
4. Control Measures
5. Implementation
6. Monitoring
7. Residual Risk
8. Review
c. Infection Control Procedures
d. Operational Alterations
e. Training
f. Evaluation and Improvement
4. Summary

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INTRODUCTION
The COVID-19 pandemic has likely required various aspects of your crisis response
program or business continuity plan to activate in response. As markets re-open,
travel resumes, and consumers return to a “new normal,” the hospitality industry must
be more diligent and particular than ever when it comes to safety and hygiene. This
white paper seeks to provide applicable POSI response program knowledge.

We discuss:
• What is a POSI Response Program?
• The Elements of a POSI Response Program
• How is an Infection Risk Assessment conducted?
• How are Infection Controls Implemented?
• What is effective POSI Communication?

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WHAT IS A POSI
PROGRAM?
POSI is an acronym that stands for Prevention of the Spread of Infection.

A POSI Program is an all-encompassing infection control program designed to enable

key personnel to assess the level of infection risk as it applies to the operation
of a hotel. This assessment ensures all guests, staff, property, and relevant third
parties remain protected from illness. Additionally, a POSI program demonstrates to
interested third parties that sufficient safety measures are in place.

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THE ELEMENTS OF A
POSI PROGRAM
To implement a coordinated POSI program, everyone involved must understand the six
elements of the POSI process. These elements include:
• Management
• Risk Assessment
• Infection Control Procedures
• Operational Alterations
• Training
• Evaluation & Improvement

Management
The first step in a successful infection control program is effective management.
Management begins with a commitment from high-level leadership to support
POSI activities, the program’s infrastructure, resource allocation, funding, and
communication.

Next, management must appoint an infection control team leader. Infection control
team leaders establish teams that can dynamically respond to the challenges of
preventing the spread of infection across all aspects of hotel operations, like food and
beverage operations, housekeeping, and maintenance.

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Risk Assessment
The second element of a coordinated POSI response program, infection control risk
assessment, refers to a systematic process of identifying infection hazards, analyzing
the risk of exposure, and establishing control measures necessary to eliminate,
minimize, or mitigate such risks. This assessment should ensure that efforts focus
on hazards with the highest level of risk exposure and prioritize control measures
according to the hierarchy of effectiveness (more on this later).

Infection control risk assessment involves eight critical steps. They are:
1. Gathering information on potential infections
2. Identifying at-risk operations and activities
3. Analyzing potential transmission vectors
4. Selecting appropriate control measures
5. Implementing control measures and supporting procedures
6. Establishing monitoring processes
7. Addressing residual risk
8. Conducting regular and necessary reviews of the risk assessment

Gathering Information
To begin, gather detailed and accurate information on infections that potentially
pose issues for your property. The research could include reviewing current and
historical infection data for a region and addressing the most ubiquitous international
infections.

Examples of such infections include:

• COVID-19, a coronavirus such as the common cold and the SARS virus
• The highly contagious and easily transmittable Norovirus also dubbed the
“winter vomiting bug.”
• Waterborne infections such as Legionnaires Disease
• Localized parasitic infections such as amoebic dysentery

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Infection data includes name, symptoms, severity, vulnerable groups, and transmission
vectors. The World Health Organization (WHO), the US Centers for Disease Control
(CDC), Public Health England, and local governmental scientific agencies are all reliable
resources of infection information.

New issues and information arise regularly, and scientific data changes with it.
Therefore, gathering information is a continuous process.

Assessment of Transmission Vectors

Once constructed, hotels must overlay their infection profile onto operational
activities to identify all points of transmission. To do so, the infection control team
needs an in-depth understanding of the hotel’s various operations and activities.

Operational knowledge of how staff, guests, and visitors interact with these points
helps produce an accurate assessment of risk and appropriate control measures. Staff
who work and clean specific areas are excellent sources of information on operational
activities.

For example, a door left open (and therefore not often touched) presents a less
transmission risk than the play feature touched by several small children that enter
the area.

The success of an assessment of transmission vectors, or touch hot spots, depends

on the understanding of a physical environment and how guests interact with this
environment.

Control Measures
With potential points of transmission established, next comes evaluation. Each
transmission point must be evaluated based on the hierarchy of effective control
measures.

Risk assessments allow for grouping potential transmission points under control
measures that work for all aspects of that group. Layered control measures work
together to ensure that the presence of another mitigates failure of one.

When determining which control measures to use, consider the likelihood of human
error or equipment failure. Where possible, layer control measures in a way that
ensures foreseeable chinks in your armor.

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Implementation
Control measures are only useful if implemented correctly and continually managed.
They must fit the operational practices of the business. After all, there is no point in
developing strategies that will never work.

Monitoring
Once control measures are in place, we move onto monitoring. Formal monitoring
should consider:
• What impact could controls have on preventing the spread of infection?
• What aspects of the control measures have the potential to fail?
• How would we know if our control measures failed and what would the
seriousness of failure be?
• How easily can monitoring be established?
• Can the monitoring system be automated and immediate?

Residual Risk
The goal of risk assessment is to eliminate the risk of infection. However, the reality
of this is unlikely in all cases. Understanding residual risk allows for the use of barriers
methods such as PPE or managing the exposure of vulnerable groups.

Remember that risk exposure continually evolves and changes. Reviewing risk
assessments ensures that the infection control program continuously adapts to the
environment. Feedback from the review process helps to fine-tune or rethink the way
that infection control arrangements function.

Infection Control Procedures

The next element of a POSI response program is to establish and implement infection
control measures.

The average uncontrolled rate of infection is three people for every infected person.
Even though this risk exists, infection control measures such as enhanced hygiene
and disinfection protocols, operational alterations, and more can serve as mitigators.

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Of course, not all control measures are created equal. To help decide which control
measures to implement, start by consulting the hierarchy of effectiveness of hazard
controls. This hierarchy includes:
• Elimination
• Substitution
• Engineering controls
• Warnings
• Training
• PPE

Elimination of a hazard enables us to remove the possibility of exposure altogether

and should act as the first point of defense. Removing a complimentary fruit basket
from the front desk or removing the decorative pillows from beds are both examples
of eliminating a potential source of infection and breaking the chain of transmission.

If elimination is not possible, move to substitution. Substitution is a means of

replacing hazards. For example, to transition from a traditional door where guests
need to touch a handle to installing an automated door requiring no physical contact.
Here the hazard still exists, but a substitution makes it less likely to impact guests.

When one cannot substitute, we have the option of engineering controls to mitigate
risk. Engineered controls range from simple installations or operational changes to
significant infrastructure alterations. Major alterations should only occur where the
reduction of risk proportional to the investment required.

Next, warnings promote awareness on behalf of workers and guests. Signs, visuals,
guidelines, etc. all serve as warnings in your facility. Training requires workers and
their employers to act as a means of controlling hazards.

PPE, or personal protective equipment, is your hotel’s final line of defense when all
other hazard control options fail or are unavailable as options. Many people mistakenly
treat PPE as hazard control. PPE does nothing to eliminate hazards – it is merely a
barrier. While PPE is a crucial aspect of preventing the spread of infection, removing or
managing a hazard’s source takes priority.

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Operational Alterations
The COVID-19 crisis will require a multitude of temporary operational alterations as
an immediate response to preventing the spread of infection in a re-opened market.
However, some changes to the operation may turn permanent.

As with infection control procedures, operational alterations depend on the individual

property and unique aspects of their operations. Operational modifications provide
tangible means of preventing the spread of infection via well-established protocols
such as social distancing, physical protection, increased personal hygiene practices,
enhanced disinfection protocols, and more.

The following groupings represent potential operational alterations your hotel may
need to adopt:
• Guest information
• Physical protection
• Social distancing/safe interactions
• Food and beverage alterations
• Staff precautions
• Hotel sanitation methods
• Service reductions
• Guest management

Guest Information
Providing guests with the information they need to contribute to preventions
actively instills confidence in the hotel’s ability to maintain everyone’s safety. This
benefits the hotel, the brand, its key stakeholders. Use brief documents, brochures,
infographics, social media, signs, etc. to communicate valuable messages to guests,
employees, suppliers, and third parties.

Physical Protection
Physical protection measures are engineered controls designated to alter the physical
environment, change required behavior and manage interactions between individuals.

Examples include protective screens in place at reception, queuing barriers to enable

social distancing during check-in/out, restaurant entry, social distancing ground
markers, direction indicators, and contactless payment.

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Social distancing/safe interactions
Physical protection methods should be used in tandem with behavioral changes.
Enforced behavioral changes that ensure social distancing include:
• Modified no-touch greetings and gestures
• Maintaining a respectful distance
• Hand hygiene demonstrations
• Respiratory hygiene demonstrations
• Luggage handling alteration
• Arrival briefings
• Appointment of hygiene wardens that enforce queues and social distancing
requirements

Food and Beverage Alterations

Due to the nature of the COVID-19 pandemic, food and beverage alterations are
perhaps the most significant changes to hotel guest experiences. Hotel operations
must balance customer service expectations and overall experience with these
changes. If communicated properly, guests will interpret these changes as proactive
safeguarding of their health and safety.

Staff Precautions
Safeguarding staff wellness is of equal importance to protecting the general public.
Proactively manage personnel in ways that reduce the likelihood of contracting an
infectious illness on the job using measures like medical screening, hygiene training,
illness recordkeeping, and reporting, symptom detection, disinfection/sanitation of
equipment, staff grouping, enforcement of procedures and protocols, and more.

Hotel Sanitation Methods

An enhanced hygiene and disinfection program is essential to breaking the chain
of transmission of communicable infections. An effective POSI program includes
heightened standards and protocols for hotel sanitation and hygiene, such as direct
cleaning and disinfecting, disinfectant fogging, ozone treatment, cooking, heat
treatment, and ultraviolet C treatment.

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Service Reductions
Although the backbone of hospitality is to provide exceptional guest experiences,
some service offerings present such a significant risk that they must undergo
temporary reduction or alteration. Examples include spa facilities, kids clubs,
entertainment, discos, and excursions.

Temporary cancellation may also be in order for activities involving body contact, such
as face painting, dance lessons, massage, etc..

Guest Management
Encourage guests to follow guidelines and actively participate in a coordinated POSI
program. To ensure all guests follow POSI procedures, implement and strictly enforce
guest management protocols. Transparency and communication demonstrate to
guests why their participation is necessary.

Examples of managing guest behaviors are:

• Implementing on way systems and seating separation arrangements
• Utilizing outdoor seating areas to increase the distance between guests
• Allocating guests to specific areas to reduce the risk of exposure
• Establishing personal hygiene conditions of entry
• Grouping both staff and guests to limit the potential interaction within
these groups

Training
Without awareness-level training of POSI principles, procedures, resources, and
expectations, the ability to prevent the spread of infection suffers. Training applies to
and requires active participation from staff, guests, suppliers, and key stakeholders.
Instruction should cover roles & responsibilities, infection control methods, symptom
identification, procedures for managing symptomatic guests, and illness reporting
requirements.

Evaluation and Improvement

The fifth and final element of a POSI response program is evaluation and
improvement.

By collecting key performance indicators such as illness report results, cleaning

records, and internal audit results, you can evaluate and continuously improve upon
the success of your POSI program.

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CONCLUSION
When we have all of the elements discussed in place, the outcome is a coordinated
POSI program which enables us to control the spread of infection while maintaining
the core function of providing an exceptional guest experience. A coordinated POSI
program whose elements are visible to guests is also a crucial first step in regaining
consumer trust.

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FURTHER LEARNING
For in-depth instruction into developing your hotel’s POSI response program, including
detailed examples of enhanced hygiene and safety protocols, consider our brand new
Protek™ course, Hospitality Management Principles for Preventing the Spread
of Infection. Built and led by hospitality industry experts, this fully online course
helps hotel managers, food and beverage managers, and other high-level supervisors
understand key COVID-19 safety protocols, respond dynamically to the risk of
infection beyond coronavirus, and empower their teams.

Learn More

Tailored Agenda
Understand key safety protocols
for the hotel industry

Certification
Show customers your
commitment to safety

Real-world Expertise
Intertek Cristal’s experts carry 200
years of combined experience

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