LAS VEGAS — As operations manager of consultative services for Standard Textile Co. in Cincinnati, Barb Williams has examined her share of healthcare linen systems, both good and bad.
And when inventory control is lacking, Williams tells a seminar audience, it’s time to take a cue from a popular TV show and embark on an Extreme Makeover: Linen System Edition.
“Linen management is an organized, systematic approach to managing the laundry/linen system in an efficient, cost-effective manner,” Williams says. “How you drive efficiencies in your system, and how you do it at the lowest possible cost.”
Critical success is achieved by reducing activity-based costs while increasing service quality, she adds.
The foundation of an effective linen system, Williams says, consists of four parts: product, quantity, place and time.
Balance product specification (ensure that the purchasing agent is acquiring the products you request) and standardization (can you combine items or eliminate duplicates?) with quality assurance (having clean, functional products) and the lowest cost per use.
Regarding quality assurance, Williams recommends setting quality standards, educating staff about how to determine when an article no longer meets them, establish a process to retrieve unacceptable linen, maintain records of discards, and consider other uses (emergency room, rags, etc.) for an item once it is no longer suitable for a particular application.
A planned purchasing program helps to ensure an even flow of goods into your linen system as well as on-time deliveries, while eliminating “panic buying” or keeping too much inventory in the storeroom.
“As unfortunate as it is, you’re always going to have some linen loss,” Williams says. “The goal is to make sure that you know what that loss is and you put that linen back into the system on a consistent basis.”
It’s probably time to adjust a hospital unit’s par standards if there are shortages (“You’re watching the linen coming off your ironer having to go right into a cart and into the building”) or excesses, if the patient census fluctuates greatly up or down, or if it’s been longer than 12 months since the standards were last reviewed.
“A lot changes in a year,” Williams says. “There is a lot of turnover of employees, lot of changes in linen practices, (and) possibly product change.”
When it’s time to act, complete a usage study, develop new linen standards based on this analysis, then post the new standards and communicate them to users.
“Giving your customers what they need when they need it is going to eliminate hoarding and eliminate oversupply,” she says.
“Make sure the linen is getting to the right locations,” Williams says. “You have to know every distribution location in every one of your facilities.”
If the laundry service is located off-site, its delivery personnel need to make certain they deliver the proper carts to the right location in the hospital, then the linen management personnel on site must make certain the right carts are then delivered to the proper locations on the assigned floors.
It’s preferred that carts be delivered to a secure area such as a lockable utility room near a nurses’ station. “Clean linen can be lost very quickly off a floor, especially when it’s close to an exit or a dock,” she says.
Using exchange carts is a common linen-distribution method. They’re frequently used in inpatient and high-volume outpatient areas. They minimize linen handling, reduce time needed for linen distribution, maximize nursing floor space, and ease monitoring of linen usage. But these carts offer limited space, require large stocking areas, are often accessible to the public and require an investment to maintain them.
Floor closets, which are commonly found in facilities where distribution space is limited, are stationary sites with shelves that are filled to pre-established levels.
They open up space in the linen room, eliminate the possibility of incorrect cart deliveries and are less accessible to the public, but they make hoarding easier, take up nursing floor space and may necessitate rotating of stock, Williams says.
Different floors in a hospital require linen at different times, Williams says, and one key to providing consistent delivery is getting the linen room organized.
Clearly mark linen storage shelves, and designate areas for bulk and exchange carts, labeling their proper locations on the floor, walls or ceiling.
Organize exchange carts to match the sequence of deliveries to the floors. Dedicate space to linen activities and then keep it clear of clutter.
Creating an environment like this should produce positive results:
• A consistent work flow.
• Exchange carts are being completed daily.
• Daily assignments are being completed due to proper staff scheduling.
• There is a consistent linen delivery schedule.
• All soiled linen is being picked up, and there is a sufficient return of clean linen.
Ty Pennington, host of TV’s Extreme Makeover: Home Edition, reveals the new home his crew builds each week by yelling ‘Move that bus!’
No matter how you announce the changes you make, Williams says, customers will applaud your improved service and staff will applaud system gains designed to make their jobs easier.