• Peter R Chai, Haipeng Zhang, Guruprasad D Jambaulikar, Edward W Boyer, Labina Shrestha, Loay Kitmitto, Paige G Wickner, Hojjat Salmasian, and Adam B Landman.
• Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States.
• J. Med. Internet Res. 2019 Jun 19; 21 (6): e13588.

BackgroundRestroom cleanliness is an important factor in hospital quality. Due to its dynamic process, it can be difficult to detect the presence of dirty restrooms that need to be cleaned. Using an Internet of Things (IoT) button can permit users to designate restrooms that need cleaning and in turn, allow prompt response from housekeeping to maintain real-time restroom cleanliness.ObjectiveThis study aimed to describe the deployment of an IoT button-based notification system to measure hospital restroom cleanliness reporting system usage and qualitative feedback from housekeeping staff on IoT button use.MethodsWe deployed IoT buttons in 16 hospital restrooms. Over an 8-month period, housekeeping staff received real-time notifications and responded to button presses for restroom cleaning. All button presses were recorded. We reported average button usage by hospital area, time of day, and day of week. We also conducted interviews with housekeeping supervisors and staff to understand their acceptance of and experience with the system.ResultsOver 8 months, 1920 requests to clean restrooms in the main hospital lobby and satellite buildings were received. The hospital lobby IoT buttons received over half (N=1055, 55%) of requests for cleaning. Most requests occurred in afternoon hours from 3 PM to midnight. Requests for cleaning remained stable throughout the work week with fewer requests occurring over weekends. IoT button use was sustained throughout the study period. Interviews with housekeeping supervisors and staff demonstrated acceptance of the IoT buttons; actual use was centered around asynchronous communication between supervisors and staff in response to requests to clean restrooms.ConclusionsAn IoT button system is a feasible method to generate on-demand request for restroom cleaning that is easy to deploy and that users will consistently engage with. Data from this system have the potential to enable responsive scheduling for restroom service and anticipate periods of high restroom utilization in a hospital.©Peter R Chai, Haipeng Zhang, Guruprasad D Jambaulikar, Edward W Boyer, Labina Shrestha, Loay Kitmitto, Paige G Wickner, Hojjat Salmasian, Adam B Landman. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 19.06.2019.

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