BACKGROUND : Good housekeeping plays an important role not only for patient satisfaction, its role in prevention of hospital acquired infections has been established beyond doubt. Satisfaction surveys are ways to finding patients’ perception of cleanliness, but for improving cleanliness accountability and monitoring performance play important role. AIM: The objective of this study was to evaluate the impact of random surprise visual inspections/audits on cleanliness in the in-patient wards of a tertiary care hospital in the National Capital Territory, India. METHODS: Surprise inspections/audits were conducted based on key performance indicators to objectively assess the cleanliness at variable intervals of time in the various patient care areas like medical, paediatric, surgical, and critical care units. The areas were sub-classified into staff, patient and common sub-areas each with measurable element like cleaning of toilets, cleaning equipment, patient beds, etc. for which “yes” (=1) or “no” (=0) was marked. Percentages were calculated for the scores achieved. Analysis for Chi square linear trend in proportions was also done. Data which were non-normally distributed in two groups Wilcoxon sign rank test was used. RESULTS: Deficiencies observed in the first audit were poor general cleaning of toilets, non-availability of supplies, poor general cleanliness of nursing station, office and sanitation equipment, staff duty room, walls, floors, window panes, window sills, bedside screens and tables, curtains and fixtures. As audits progressed, there was a steady progress in the cleanliness observed, overall scores progressed from 47 % in August (n=1), 60 % in September (n=05), 78 % in October (n=11), 83 % in November (n=04) but dipped to 76% in December (n=07). CONCLUSION: Regular surprise hospital cleanliness inspections/audits led to significant improvement of cleanliness which was then sustained till the inspections were carried. Keywords: hospital, audit, cleaning, India Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:Table Normal; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:8.0pt; mso-para-margin-left:0cm; line-height:107%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:Calibri,sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Times New Roman; mso-bidi-theme-font:minor-bidi;}