ROANOKE, Va. — I have been employed in the healthcare laundry market for more than 40 years, starting as a washman in a healthcare laundry in Salt Lake City, Utah, in June 1972. I have often marveled at the changes in the laundry industry over the past four decades. The industry has been unpredictable at times, but I have always found my work enjoyable and interesting.
In this month’s column, I project what the laundry industry will be like in 20 years. Now, I know my crystal ball is not perfect, and I claim no special ability to predict the future, but a little common sense can go a long way in predicting what might happen.
My expertise is in the area of healthcare textiles, so I will deal only with this segment of the business. There are four main areas that will affect our industry: national healthcare, environmental concerns, energy, and textiles.
In the year 2033, the U.S. healthcare laundry market will look very much like the Canadian laundry market does today. The majority of U.S. healthcare will be controlled by the government through its single provider network. Because government is the major source of all revenue, it will be actively involved in helping to control costs on all levels.
Administrators have for years looked at linen service in a healthcare facility as an unavoidable cost. They have continually looked at ways to reduce the costs associated with this service by outsourcing to lower-cost providers, using contract management companies, limiting the number of items in the linen inventory, and re-introducing cost-effective reusable products.
Sometime between now and 2033, the politicians will focus on commercial laundries that want to make a profit off of sick people, and the inefficient in-house laundries, and make the decision government always makes: they can do it better. Just like Canada, the U.S. government will establish a network of healthcare authority laundries that will provide predictable-quality linen service to all healthcare facilities.
This move will probably happen at or near the point when the brain trust in Washington similarly takes over the food service programs at hospitals, moving the majority of food preparation to regional, off-site central kitchens.
The commercial laundry industry will, of course, fight this development, but in the end it will lose.
This development of government-operated central laundries will also eliminate all contract management business in the healthcare laundry market. A number of provider companies will find themselves in a position to sell their facility to the government or face owning a facility that has no customers.
The need to lessen our collective impact on the environment will continue to be heralded over the next 20 years. It will reach the point that all laundries will need to treat their wastewater and reuse it. (We currently reuse a little more than 50% of our water used in processing linen.) Over the next 20 years, substantial research-and-development dollars will be spent in all industries to make it possible for them to clean and reuse water. Once the technology is available, all laundries will be required to use it.
Similar improvements will be found in boilers, dryers and ironers, reducing our use of energy but forcing the industry to quickly utilize the newest technologies.
Government planners will mandate the use of reusable linen surgical packs and other items. Government-run laundries will make and sterilize surgical packs for use in the operating rooms. They will provide reusable underpads and isolation gowns. Every effort will be made to lessen the amount of trash that needs to go into a landfill. New fabrics will be developed that are easier to wash but present additional challenges in the finishing area. Some of these products may eliminate the need for ironers altogether (more on that later).
Washroom chemicals will need to be developed based on their ability to clean and their effect on the environment. All products will have to be biologically safe and have a minimal effect on the environment. This will require our universities to train a new breed of enviro-chemist. These chemists will understand how various chemical properties will affect the environment. Over the years, they will greatly expand our knowledge in this area, as we learn from our mistakes and get better at predicting the unintended consequences of our actions.
Environmental consequences will be the driving force behind our energy policies. The internal combustion engine will continue to be Public Enemy No. 1. To effectively reduce pollution from automobiles and trucks, the government will continue to allow oil prices to increase. The steady increase in fuel processing which will create higher gasoline and diesel prices will cause consumers and companies to reduce their use of these products. This reduction will be heralded as a major achievement for the environment.
Some companies will switch their vehicles over to natural gas, and this will help for a while. But the current excess supply of natural gas will quickly disappear and the government will move to limit fracking as an environmentally hazardous way to get this energy source.
This energy policy will affect the number and location of government-run central healthcare laundries. These plants will be designed to provide services to healthcare facilities in a well-defined geographic area. Gone will be the days of operating a depot in a far-off city! Distance and possible weather-related problems will determine the location of healthcare laundries. Gone will be the days of several laundries competing to serve the same geographic area. Each area will be carefully planned, and healthcare providers will find themselves assigned to the government-run laundry in their area. The government will do away with the VA laundry system.
Nursing homes and other non-acute care healthcare facilities will also be directed by the government into one of these government-controlled laundries. The power of the U.S. government will be based on the control it can exert as a single payer.
It does not take a lot of imagination to see the development of a new line of products that will enhance the healing process and decrease bed sores. The current reimbursement system will penalize facilities for skin care problems that develop during a patient’s stay in a facility.
Recently, I have seen several linen items just coming to the market that have clinical proof of their success in this area. The washing and finishing requirements for these products are dramatically different from our traditional linen. Early prototypes do not require the use of an ironer to finish the sheets, and they dry much faster than traditional linens.
The driving force in this area will be the improved health of patients due to their use of this type of linen. I predict that healthcare facilities will demand that laundries provide these items despite being more expensive for the laundry to purchase and driving up the cost per use over traditional linen items. The added cost of treating in-hospital skin problems will make these higher linen costs seem like a small investment.
My favorite Star Trek movie calls the future the “undiscovered territory.” We are free to dream and make it whatever we want. It’s my belief that the forces I cite in this article will impact the laundry industry as described unless we do something to change the current course of human events. I happily leave those efforts to others.