At first glance, conducting a physical linen inventory may seem daunting. It requires a lot of time and energy, and can distract and disrupt the everyday order of things. However, with the proper organization and planning, conducting such an inventory is less complicated than it looks, and is a valuable part of a healthcare facility’s operation.
This was the basis of Taking Stock: Conducting a Linen Inventory, an audio conference presented by Janice Carter Larson, managing director of cost management services at Encompass Textiles and Interiors, and Dave Forrest, Encompass’ West Coast regional director of sales.
Larson told participants in the National Association of Institutional Linen Management (NAILM) conference that it's unfortunate that taking inventory isn’t always at the top of everyone’s “to-do list,” because the results are actually highly beneficial.
First, an inventory can provide a clearer picture of linen assets. You can obtain a more accurate amount of their cash value, the amount of linen products on hand, how often the items turn over for replacement, and how much is needed to purchase to bring circulating stock up to an adequate amount.
An inventory also clarifies the loss rate of linen items. Once an item’s rate has been determined, it can be compared to what’s considered average, Larson says. She recommends using the Phillips & Associates benchmarking report for this because it states the replacement factor – how often a product should be replaced per 100 uses – for individual items. Once the “problem children” items are identified, appropriate steps can be taken to correct the issue.
Lastly, an inventory helps to identify everything that can be considered dead stock. More often than not, overstocked linens will go for months without being used when they could have been in circulation if placed more conveniently.
Dead stock occurs in several instances, such as when linen carts are overstocked, multiple stocking locations are used in places like an emergency room (ER) or medical office buildings (MOBs), or hoarding in what Larson good-naturedly referred to as “informal stocking locations.”
“It’s amazing what you can uncover,” Larson laughs. “People can hide linen stock anywhere. I’ve heard stories about dead stock being hidden in ceiling tiles.”
Rental customers have an additional motivation to conduct a physical inventory. They’re often under contract to order a certain amount of replacement linen on a regular basis. The knowledge gained after conducting an inventory can help them determine if the contract replacement terms match their actual replacement needs.
These are all valid reasons, but what about the practicality of conducting the inventory? Will it interrupt day-to-day operations? How do you avoid irritating the patients and staff? Is there ever a good time to do this?
MINIMIZE THE HARDSHIP FACTOR
Larson is confident that all these concerns are easily addressed with the right planning and execution. She lists five simple steps to organize a successful inventory:
1. Pick a date and a time.
2. Determine how many people are needed.
3. Notify the proper staff members.
4. Make sure to explain the reason for the inventory.
5. Make it as convenient as possible for everyone.
It’s entirely possible to schedule an inventory during regular working hours as long as you minimize the “hardship factor,” she says. There’s a greater chance of getting more cooperation from people and access to as many areas as possible.
Mondays should generally be avoided because they tend to be heavier nursing days or heavy linen delivery days. Holidays and any scheduled facility events are likewise out. Weekends or late nights can be tempting, but these times have their pitfalls as well.
“Doing an inventory off-hours can bring up issues of overtime and conflicting schedules,” Larson cautions.
“A lot of times, people have conducted inventories late at night, only to find that certain areas have been locked and that the people who normally provide access to those areas won’t be back until morning,” Forrest adds. “You also have to be careful about disturbing patients. In the long run, doing an inventory at night isn’t really that convenient after all.”
It’s also essential to involve the laundry department.
“Your linen personnel are invaluable to the inventory process,” Larson says. “They are the ones who know their way around, where all the linen stocking locations are, official and otherwise, and where the deliveries are made. They need to be involved to make the inventory work.”
“Soiled-linen pick-up is one of the biggest issues when attempting to keep counted and uncounted linens separate,” Forrest adds. “You have to be able to communicate to the laundry department how long the inventory will take and how much they will need to adjust their schedule for that day.
“Soiled linens should not be counted because of safety issues and to ensure count accuracy, so there will be an unusually large amount of soiled linens that day.”
If laundry service is outsourced, linen services will need to notify the service provider of the increased amount of soiled linen so that it can send a larger truck or schedule a special pick-up, as well as alert its production department.
If laundry service is handled on premises, the laundry department will need to adjust so it can handle the increase during the inventory.
MORE IS NOT NECESSARILY MERRIER
The number of people appointed to the task also makes a big difference.
“In this case, more is not merrier,” Larson says. “Too many people can make the process more confusing and harder to handle. The general rule of thumb is that with one team of two people assigned per 100 beds, it will take approximately three hours for 14 people (seven teams) to cover 450 beds.”
Additionally, she recommends assigning separate teams to cover larger areas, such as the linen room, scrubs, the intensive care unit (ICU), maternal and child health, and MOBs. A “captain,” who doesn’t do any actual counting, should be assigned to oversee all aspects of the inventory.
If possible, consider assigning bilingual members to the counting teams working on patient floors. “It really helps when at least one of the team members can explain to the patient what they are doing,” Larson points out. “This is definitely an area of concern for facilities in places like Los Angeles.”
A LITTLE EXTRA GOES A LONG WAY
Larson stresses consulting with the administration and management since they will have final say over the inventory budget. Make sure to convey the benefits of having the information an inventory can provide. It’s highly possible that you’ll end up saving money once you learn where the problem areas are and you’re able to fix them.
Also, be sure to have enough overtime pay if necessary, and try to secure funds to provide food and refreshment for those participating in the inventory.
“It really helps if you’re able to provide a little extra something for the people helping out with the inventory,” Larson says. “Providing lunch can go a long way to getting you the participation and cooperation you need.”
Gaining the cooperation of nursing is an area of particular concern. When Larson polled audience members about their biggest challenge in conducting an inventory, 51% answered “Getting nursing to buy in and participate.”
It might help if the nursing staff receives the news from within its own department, and Larson suggests asking the nursing director or manager to handle notification.
Also, she says it helps for each of the teams assigned to the nursing floors to bring along a cart of counted linens. This way, the nursing staff will still have access to usable linens during the count and will appreciate the extra steps taken to ensure minimal disruption.
The important thing to remember is to make the inventory as easy as possible for everyone involved. The day before, take the time to remind everyone about it. “It’s easy for people to forget the advanced notice or for reminder memos to get lost,” Larson notes.
To help separate counted and uncounted linens, make sure no additional uncounted, clean linens are brought into or taken out of a department during the count, Forrest says. The counters should remove any soiled linen from their areas so that when they leave, all the linen is either clean or in use.
“If there’s a linen chute system, make sure all chute access is taped off until the inventory is completed,” he points out.
If it’s possible, start counting linens the night before in areas like ancillary departments, off-site buildings and MOBs, Larson says. Operating rooms and recovery are also a good bet after they close because you’ll have easier access; counting scrubs by size can take a long time. During the actual inventory day, the counters can concentrate on the linen room, nursing floors and the rest of the facility.
It’s OK to make special considerations for sensitive areas, such as the ER, doctors’ sleep rooms, and labor and delivery, Larson says. Their use level can be unpredictable, but in general, try to avoid early mornings and mid-afternoons; lunchtime may work best, when the fewest staff and patients are present.
“Don’t worry if there’s so much traffic that your teams have to make an estimate instead of an exact count,” she says. “It’s better to have an idea of the linen contents of the rooms than no idea at all.” Also, it’s OK to “eyeball” the amount of high turnover, low-value items like washcloths, rather than handle each item.
Conducting a physical linen inventory may seem overwhelming at first, but just take it step by step, and it won’t be as difficult as it may have looked, according to Larson and Forrest.
The longer it’s put off, the more work there will be to do. Once a physical linen inventory has been integrated into your schedule, you’ll soon wonder how you could have gotten along without it.