Linen is a consumable medical product that has significant monetary value, yet some hospitals pay no more than cursory attention to the impact that linen processing and replacement costs have on their overall budget. A typical 300-bed acute care hospital can spend over $200,000 annually to maintain an adequate supply of linen in inventory.
While linen does not typically represent a major percentage of a hospital supply budget, it is important to the organization as a whole, since the quality and quantity of hospital linen has an impact on patient perception of care. Therefore, hospitals need to commit adequate attention and resources to protect their linen asset and design programs to prevent linen loss and abuse, just as they would other medical supplies and equipment.
DEFINING LINEN LOSS
The loss of hospital linen inventory can be separated into two categories, true loss and artificial loss.
True Loss: True losses are those that are not retrievable and represent a permanent depletion in circulating inventory. Examples of true loss are deliberate and inadvertent theft of product, linen that is thrown into the trash instead of the soiled hamper after use, or linen that is abused, i.e. used inappropriately, and must be removed from service prematurely.
Artificial Loss: Artificial loss occurs when the linen is not accessible in the circulating inventory, but is still retrievable. The most common examples of artificial loss include overstocking linen carts and closets, hoarding of product in “informal stocking locations,” or scrub garments that are accumulating at the bottom of a doctor’s closet after having been worn home from the hospital and not yet returned.
Unfortunately, linen theft is one of the leading contributors to linen loss and replacement. Linen theft can be deliberate or inadvertent.
Deliberate theft occurs when a person removes linen from the hospital for personal use or resale, knowing that doing so is not acceptable.
Inadvertent theft occurs most often when patients take linen home because they think it is allowable, just as they are encouraged to take home the disposable medical supplies that are left in their room. Patients may also feel that the cost of the hospital stay is so expensive that they are justified in taking items home. This is most common with baby linen, but may also occur with pediatric and adult pajamas, underpads, bath towels, bath blankets and spread blankets.
Sadly, one of the most frequent forms of linen theft is among employees. Many hospitals have historically turned a blind eye to the problem of employees failing to return scrubs, often because the physicians are some of the biggest offenders. Regardless of the cause, each form of theft directly affects the financial health of the hospital, since any losses of linen inventory, true or artificial, must be replaced to maintain an adequate amount of product in circulation.
Here are some reasons to suspect theft is a major contributor to linen loss in a hospital:
• Patient census and linen usage have remained constant, but linen replacement costs have increased significantly.
• You are experiencing continual shortages on specific products, such as scrubs, baby blankets and pajama pants, despite frequent replacement purchases of these items.
• Administration believes that linen replacement costs are a disproportionate amount of the total linen budget.In order to control linen theft, a linen manager must first examine some of the common factors that can contribute to both deliberate and inadvertent theft, and take steps to address them. These factors exist among patients and visitors, employees and staff, and others who have reason to be in the facility, like construction personnel or emergency medical technicians.
Patients and Visitors
• Visitors have easy access to linen carts and closets because the rooms are unlocked and/or located near an exit.
• Low-income patients are allowed to take linen home because employees feel sorry for them.
• Patients and nurses feel that the cost of the hospital stay justifies free linen.
• Nursery linen is given to new mothers as a starter kit for which the hospital does not get reimbursed.
• Patients believe that linen stored in nightstands or bassinettes can be taken home because it was in their room.
Employees and Staff
• Employees, physicians, and students take large quantities of scrubs home to stock up for the future.
• Unauthorized scrub users take hospital-owned scrubs rather than buying their own scrubs to wear to work.
• Employees are taking linen home for personal use or for resale.
• Ambulance personnel are allowed unrestricted access to all linen.
• Linen is transferred along with the patient to another hospital or long-term care facility.
• Linen is transferred to the mortuary with an expired patient.
• Linen is used for drop cloths and clean up and removed as rags.