Content about Eric Frederick

ROANOKE, Va. — It seems that making the required adjustments in your laundry operation is a never-ending process. There are a number of variables to be considered when making periodic adjustments. With this in mind, I have decided to, over the next several months, discuss the factors and opportunities available to every manager in fine-tuning his or her operation.

Let’s look at the wash room. There are certain universal principles that apply to all washing equipment, whether it is a tunnel washer or a conventional washer-extractor. The first principle is deciding how big a load you wish to put into your washing machine. Sounds simple enough, but the answer can and should vary based on the type of linen you are washing and the moisture content of the linen to be washed.

To illustrate, I will use my operation’s tunnel washer. Its rated load capacity is 110 pounds per pocket, but if I were to fill each pocket with 110 pounds, I would be dramatically under-loading the tunnel. We wash micro-filament mops through our tunnel washer. Because of the moisture content in the soiled mops, we load each pocket to 165 pounds. This load easily fits into the extractor at the end of the tunnel, and the load comes out looking clean and smelling great.

There is a danger in putting too much linen into a tunnel-washer pocket. An overly large load will not come clean, and may not fit efficiently into the extractor at the end of the tunnel or may not come out at all. Anyone who has experienced a jam up inside the tunnel washer knows that it is something you want to avoid.

There is, however, a compelling reason to accurately determine the proper load size for each type of linen. We were able to increase our average load size from 100 pounds per pocket to 125 pounds per pocket. That is a 25% increase in output without adding time or additional equipment.

We wash a large amount of reusable barrier surgical linen that each day. This linen is made from 100% polyester fibers and weighs very little per piece. If I were to load this type of linen to 100% of normal capacity, the linen would be so tightly packed in the washing machine that water may not reach the center of the load.

The key to this type of linen is to have enough goods in the washer to provide good mechanical action and effective cleaning. Underloading the washer will cause the linen to float on the water’s surface; overloading will end up producing no mechanical action at all. We have found that a general rule of thumb is to start testing at 70% of rated capacity.

The most effective way to wash linen is to do it right the first time. The wash room is not an area where you want to try to save money. Poor-quality washing will result in unhappy customers, higher labor costs and higher linen-replacement costs. Since labor and linen represent two of the largest expenses in a linen rental plant or in-house laundry, we should focus our attention on managing these costs.

It is for this very reason that I personally despise the use of guaranteed cost-per-pound-of-linen wash-room chemicals contracts. I want to be able to exercise my managerial control and to dictate the quality level coming out of my wash process. I want to be able to reduce my labor and linen replacement costs.

Many fixed-cost-per-pound contracts end up using far too much chlorine bleach (extremely inexpensive) and less-than-desirable amounts of alkali and detergents. Instead of having a chemical representative trying to find ways to make a profit on his or her fixed-price contract, I want them spending time trying to keep my quality up, my replacement costs down, and my productivity high. I personally believe that these are two entirely different types of service and are mutually exclusive.

The next area to focus on in the wash room is turnaround time. How long does it take from the time a wash cycle is completed until the next load is started? This is extremely important for conventional washers but also should be looked at for tunnel washers (hold time).

We track turnaround time for every load on our conventional washers, and have found that having a place to unload the washer into “ready” and “waiting” helps reduce turnaround time. Having the next load prepared and ready to be loaded also reduces this time.

When we first starting looking at turnaround time, we found that we were not doing a good job when it came to processing traditional wet mops. Housekeeping was bagging the mops in plastic bags and sending them to the laundry. Our soil sorters set these bags to the side until there were enough for a wash load. The cart was then taken to the wash room where, after the washer was emptied, the wash person would slowly open each bag and place the mops into the washer. This system required 30 minutes to load the washer. By having the soil sorters remove the mops from the bags and sort only the mops into the carts, we were able to greatly reduce the amount of time it took to load the washer.

Running a tunnel washer faster than the dryers can handle the linen causes the tunnel to go on “hold.” To me, a tunnel on hold is wasted time. It is better to lengthen the tunnel wash time per pocket than to allow it to constantly go into a hold situation. Proper scheduling of the linen mix going through a tunnel can help keep the equipment running smoothly. Next time, I will discuss tunnel scheduling.

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.

NATIONAL HEALTHCARE EFFECTS

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.

ENVIRONMENTAL CONCERNS

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.

ENERGY

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.

TEXTILES

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.

ROANOKE, Va. — In the battle to improve patient outcomes, many facilities are trying out low-airflow beds. These beds are designed to pump air through the mattress and provide a cooler, dryer environment to improve the skin care for high-risk patients. These beds are extremely expensive, and the good news is that almost all the bed linens currently in use work well with this new bed.

The bad news is that traditional incontinent pads are not recommended for use on low-airflow beds. The traditional barrier backing inhibits air flow and creates a zone where there is no air movement. Bed manufacturers recommend the use of a special disposable pad that is designed to allow air to flow through the pad.

These beds came to my attention when staff on several floors suddenly requested that they no longer receive reusable incontinent pads because they had just gotten these new beds. I started immediately to research the beds, the disposable pads, and if there were any reusable incontinent pads accepted for use.

Since the purpose of these expensive beds is to improve the skin care of at-risk patients, it is imperative that they contribute to a noticeable improvement in patient outcomes. Because of this need to justify the expenditure of capital funds on new beds, the hospital staff will always follow manufacturer recommendations. Therefore, it was no surprise when they stopped using the normal incontinent pads.

The problem with disposable incontinent pads is that once moisture is added to the pad, they no longer allow air to pass through the pad. The fluid-absorbent gel in the pad creates an impenetrable barrier. Since there is normally a delay between the use of a pad and when it is changed, there is a period of time when the low air-flow bed is not providing an improved micro environment for the patient.

The disposable pads also do not provide a safe product to lift or reposition the patient. The absorbent material in the disposable pads will cause major problems for the laundry if they are not removed during soil sorting and they get into a washing machine. This problem is especially severe if you use a tunnel washer.

I checked with several major linen companies to see if they had developed a pad that would work on a low-airflow bed. I was looking for a pad that would provide the benefits on a continuous basis.

Key factors to be considered are:

• Is the pad commercially washable?
• Can it be effectively dried in a commercial dryer?
• Does it wick the moisture away from the patient?
• Does the airflow feature of the pad work under dry and wet conditions?
• Is it strong enough to be used to lift and reposition a patient?

Two linen companies said they have developed pads to use with these beds. Their documentation includes air permeability studies and some clinical studies. I will be field testing these pads in the near future. Nursing has realized the potential problems with the disposable incontinent pads and is willing to look at a more effective alternative.

ROANOKE, Va. — My dad always told me that a mind was a terrible thing to waste, and I have always tried to keep his counsel as I work with my staff to improve our procedures and solve production problems. A manager must involve his staff in the process or he is wasting one of his best resources.

I like to take the time to eat lunch with my staff. By listening carefully to them while chatting over a sandwich and a Diet Coke, I can determine what problems they are seeing in the laundry and where we need to improve. It is tempting to say that “Lisa” always complains and doesn’t want to do the job the way it was designed, but I know that if I can get beyond that personal prejudice, I might find a few great ideas.

My staff complained that the incontinent pads had too many holes in the backing; workers were seeing them in older pads and new pads. They weren’t sure how to correct the problem. My supervisors confirmed their observations, and the race was on to determine the cause.

Brainstorming led us to consider a poor-quality product or a problem with one of the following: textile manufacturing, the tunnel washer (sharp edge?), press, shuttle, dryer, conveyor, folder, or chemistry. With so many possible causes, we knew we would have to be methodical in our attempts to find the problem.

We started by running new pads through one of the tunnels, its press, and the dryers. After the pads were dried, we could see they had been damaged but we could not tell where in the process the damage had occurred. We could not find any obvious problem upon inspecting the dryers, nor could we find anything wrong with the shuttle.

Next, we ran a load through the tunnel and press but inspected them before allowing them to go to the dryers. The test load contained damaged pads. We now knew it was the tunnel washer, the press, the chemicals or the pads themselves. We washed a load of new pads in one of our 275-pound open-pocket washers. They were inspected before drying, and again after being dried, and they showed no signs of damage at either point.

Next, we ran a load of new pads through the tunnel and inspected them before they were extracted. There was damage to the pads. It became obvious to the team working on the problem that this tunnel washer was the source of the problem. Since we operate two tunnels, we moved the processing of incontinent pads from tunnel No. 1 to tunnel No. 2. Immediately there was a decrease in the number of pads that needed to be patched. It took us a while to get all the pads properly patched, but the problem now seems to be corrected.

We then turned our attention to an oil-based stain that was frequently showing up on an expensive universal drape. The orthopedic doctors really like using this particular type of drape, but the stain was severely limiting the uses we were getting per sheet. This time, we got our chemical representative and his company chemists involved.

We tried a number of different rewash formulas and simply couldn’t find a way to remove the stain. After much trial and error, the chemists came up with a new blended product that seems to do the job. We get the best stain removal by pre-treating each oily spot with the chemical and letting it sit several hours before washing it on a special rewash program that also contains additional amounts of the new product. We have been able to reclaim about 99% of what previously had been considered unusable.

A side benefit is we also use the new stain-removing product in our incontinent-pad formula, and it does an excellent job of removing tape and other stickers placed on the pads. It took us more than six months to find the solution, but it was well worth the effort.

Our next goal is to find a way to increase production through two 275-pound open-pocket washers, as growth of the reusable isolation gown program has put a strain on our existing washroom capacity.

The projects I’ve described were developed because I listened to employees during lunch or a break. If you are willing to listen without judging, your employees can become your best source of information. They want to be able to take pride in their work, and they want the company to be successful. They understand that we all succeed or die together. Take time to listen to them.

ROANOKE, Va. — I have preached for years the importance of developing close working relationships between the laundry and your suppliers, and similar relationships between the laundry and its customers. Most times, suppliers and customers respect your efforts and agree to make a similar effort to work with you. By collaborating and working together, it benefits both entities.

My recent frustration comes from trying to work with a particular linen company. For purposes of this column, let’s call it Company F. I have worked with this company, in one form or another, over the past 20 years, and it has been able to service my laundry dependably. I have enjoyed working with Company F’s local representatives, who I have found to be knowledgeable and helpful. But over the past several years, I have begun to wonder about its top leadership.

Many of you will appreciate how hard it is to change the print on patient gowns. To effectively change the print requires hours of in-service training and dealing with the frustrations of having to run additional SKUs and keeping them separate while phasing in one line and phasing out the other.

For sound reasons, we made the decision several years ago to upgrade the print and the quality of the fabric used in our patient gowns. This major initiative was well received by our customer base.

During the first year of its implementation, Company F announced that it was substantially changing the print on the gowns. The new, improved print was not acceptable to me or to my customers, but Company F said the decision had been made and the production had already been switched to the new print.

I was unwilling to face the wrath of my customers, so I decided that if Company F were unwilling to continue to supply the print, I would approach Company G about making gowns with a similar print and fabric. To cover our needs for the ramp-up time, I purchased all of the gowns in my preferred fabric that Company F had available.

Company F eventually saw the error of its decision but we were already well down the path with Company G. For the past 18 months, I have been purchasing regular IV gowns and tie gowns from Company G. It has done an excellent job of being able to consistently manufacture the gown just for my facility.

I continued to work with Company F and helped it develop an additional print for this particular line of gowns that could be used for 5X IV gowns. I also finally convinced it to make a 10X non-IV gown for my facility out of the same fabric it was using to make the 10X IV gowns. I felt like I had been a valuable contributor to its product line.

We have now completed the changeover of all regular IV gowns, about 50% of the regular tie gowns, and about 25% of the 5X IV gowns and 10X tie gowns. The difficulties of introducing a new gown line were predominately behind us. Then I learned that Company F had—after Company G had gone into production of the fabric for me—filed a copyright application and was insisting that Company G immediately stop using that print.

So, here I sit with a major dilemma on my hands. My system has entered into a purchasing agreement through our purchasing group that requires me to purchase a large share of my textiles through Company G. This was not a problem earlier because I was already purchasing about 70% of my operation’s textiles through Company G, with the balanced allocated between Company F and Company H. Company G had generously allowed me to continue purchasing certain items from Company F; it respected the business relationship I had with Company F and was willing to exclude 20% of my business from the agreement.

The problem I have now is I cannot move the patient gowns back to Company F without violating the new purchasing agreement. If I cannot move the gowns back to Company F, then my only choice is to jointly develop a new print with Company G and go through the pain of another gown conversion.

The idea of changing patient gowns again seems unfair and unnecessary. My reaction to being forced to switch was to inform Company F that I was moving all my business to another linen company. I regret that the person who really gets hurt in this change is the local representative for Company F who did not cause this problem.

Company F decided, after receiving my written intentions to discontinue purchasing from it, to reinvestigate the situation and rethink its decision; the process is ongoing. The final decision on the parts of both companies has yet to be rendered. My feelings are that once a bell has been rung, once a problem has been created, it is extremely difficult to pretend that it did not happen, that it was just a tragic mistake. 

I am attempting to use this situation as a teaching moment for my staff. We need to be more sensitive to the needs of our customers and try to make sure we do not put them in frustrating, no-win situations. Customers often are not forgiving of our communication missteps, so therefore we need to make sure we do things correctly on our first attempt.

Developing long-term business relationships requires sensitivity to the needs of your customers. Company F could have earned additional loyalty and respect had it initially decided to allow Company G to make the gowns exclusively for my laundry under a license agreement. Such an attitude would have protected their business and encouraged me to continue looking at them to meet additional needs.  

ROANOKE, Va. — A surefire way to improve the bottom line of your business or department is to increase the life of your linen. Increasing the number of quality servings you get from each piece of linen will dramatically decrease your cost of operation.

I recommend that the first step to increasing your linen life is to review each linen item with end-users to make sure that it is the proper item for the intended use.

If a bath blanket is being used as a lift sheet, excessive tears will develop. Are bath blankets or thermal blankets being used in place of mattress pads? Linen users find creative ways to use our linen and unless we engage in regular discussions with them, we will be unaware of just how our items are being used.

Bargain patient gowns usually do not have the sweep and coverage necessary to properly maintain a patient’s modesty. Ambulatory patients often use two patient gowns—one covering the front and the other covering the back—to make up for this shortfall. By purchasing a larger patient gown that provides greater coverage, you can decrease uses of the item by 30-35% and thereby increase its effective life.

I also recommend that you meet with your chemical vendor and review your wash formulas to make sure you are obtaining proper levels of cleanliness without excessively washing the linen.

Mechanical action and chemical action cause most fabric degradation. Wash each classification in such a manner to keep rewash below 3% of total volume produced. Some laundries sort all heavily soiled linen together and give it a special wash. High levels of alkalinity attack the cotton fiber and the finish on reusable barrier linen as well as the soil. One key to longer linen life is to reduce the alkaline concentration of the wash formula. Using enzyme detergents instead of traditional detergents can be an effective alternative.

Management should review the procedures for determining the proper size of each wash load. Overloading will cause poor quality wash and excessive stains. I have seen laundries that maintained excellent written procedures for weighing loads but their daily practice did not mirror what was on the page.

Carefully review all damaged linen to see if a pattern of abuse or product failure is evident. Once a trend is discovered, corrective action can be taken to adjust product quality or construction or to provide in-service education for personnel working in use areas.

We recently had a problem with small holes appearing in the barrier backing of our incontinent pads. We were unsure of the source but wanted to first eliminate the laundry. While brainstorming the problems, we figured that it could be happening in one of a number of locations: the soil-sort belt, tunnel washers, tunnel press, tunnel dryers, or one of the small-piece folders.

We determined to test our system by using brand-new pads. Our first step was to avoid the sorting belt and put the new pads directly into a sling. We ran a load through our No. 1 tunnel, its press and one of its dryers. The test load contained a number of damaged pads. We also ran a load through our No. 2 tunnel, press and one of its dryers and did not find any damaged pads.

We then ran a load through the No. 1 tunnel and press. Upon inspection, again we found damaged pads. Finally, we ran pads through the No. 1 tunnel and bypassed the press. This procedure still resulted in a number of pads being damaged. (It is interesting that we have not noticed damage to any other linen items going through this tunnel.)

Our short-term solution was to move all the incontinent pads from the No. 1 tunnel, where they had always been processed, to the No. 2 tunnel. This required us to make other changes in our pick lists to balance out the demand for the tunnel dryers. After a visual inspection of the interior of No. 1 tunnel, we found several possible causes for the linen damage. Today, we are still running pads through the other tunnel.

Check all dryers to make sure they are operating correctly. Excessive heat can damage linen and cause it to have a harsh hand. Inspect door seals and interior air-deflection blades to make sure everything is working properly. Dryers with poor seals that allow room air to enter the dryer without going through the burner area can cause artificially low outlet-temperature readings. These readings will cause the linen to be subjected to higher-than-programmed temperatures.

Thermal fluid ironers should not be operated at temperatures above 375 F. Ironing at higher temperatures will result in the loss of size stability in polyester fibers. Once the heat-set polyester fiber is no longer size-stable, the laundry will experience higher-than-normal shrinkage. I have seen contour sheets that started at 88 inches in length shrink to 76 inches. Resist the temptation to iron at higher temperatures to increase productivity, because you’ll be creating linen shrinkage problems.

These ideas do not represent an all-inclusive list, but they give you a good starting point. Determining ways to extend linen life is a never-ending task but one well worth the time and effort.

ROANOKE, Va. — We have nearly completed the first quarter of 2012 and it is time to take stock of where we are and where we want to go. It is time to develop a plan for the future.

It has often been said that failing to plan is planning to fail. In many ways, our happiness is dependent upon how effectively we manage our time and resources. In this column, I will discuss the need to keep our lives in balance, avoiding overemphasizing one part of our life at the cost of another.

We should be making goals and developing plans to improve some key areas in our lives: employment, finances, physical health, education, and social and emotional strength. Winning your future depends upon your ability to deal with all these areas at the same time.

Most of us spend a large amount of our time working on the employment portion of our life. I am blessed to have found laundry management, a vocation that I truly enjoy. But this is not the case for everyone.

I once knew a Milwaukee bus driver who hated driving a bus. He made sure that all his friends knew how much he hated it and how anxious he was to get his 20 years in so he could retire. Unfortunately, he only counted down the days to his early retirement and failed to develop other marketable skills that would help him find a job later. Consequently, after he had retired and moved to another state, he ended up once again driving a bus because it was his only marketable skill.

We should have a plan in place that will improve our marketable skills and help us get a better job in our field or in a new one. The laundry industry is facing many challenges, and we need to stay abreast of the skills and knowledge needed to meet them.

We also need to improve how we manage our finances. My mother told me that our needs, wants and desires always expand faster than our paycheck. A key to winning your future is to effectively live within your means.

Your happiness is not based on how much you make but on how effectively you manage your expenses. Our society encourages people to buy now and pay later, so it is easy for people to accumulate too much debt. The housing crisis is a stark reminder of what happens when we overreach our income.

Physical health is also important. It is certainly something that younger people do not spend a lot of time worrying about. When we are young, we believe we will live forever and there is no direct cause and effect between our choices and our health. As we get older, the realization that certain choices do affect our health is a hard pill to swallow.

I have put myself on a fairly vigorous exercise and diet program. My goal is to trim down and improve my muscle tone so my choices in my retirement (4 years, 10 months away) will not be limited. Many health insurance programs are now giving incentives for people to make healthy choices and improve their lifestyles. The trend is moving in that direction. I encourage you to get ahead of the trend and start now instead of later.

We all have untapped abilities, and we should look for opportunities to expand our knowledge in areas that we find interesting. We often think of education as something we only did when we were young and went to school, or those things we must learn for work. Education can enrich our lives and expand our horizons. There is so much to learn, and numerous opportunities await us online, at local colleges, and in our neighborhood bookstore.

The need to develop social and emotional strength recognizes that none of us are an island unto ourselves. We need the touch and companionship of other people. We need to be able to deal with rejection or criticism. We need to develop strong bands of fellowship and love.

Winning your future depends upon developing realistic goals in each of these areas and, most importantly, trying to keep your life in balance. If we emphasize one area of our life for too long, it will negatively affect other key areas. The person who is always at work may find that both his health and his social life are suffering. Many a marriage has ended in divorce because a person failed to keep an appropriate balance in his or her life.

Take charge of your life. By developing a plan for winning your future, your reward will be happiness and peace.

ROANOKE, Va. — I once wrote about having an opportunity to use reusable barrier isolation gowns in all the hospitals that comprise the Carilion Clinic. The ability to start such a program was rewarding after having failed to gain approval over the previous seven years.

Product Packaging and Distribution Design

The key to success is to develop a packaging system for the reusable gowns that will work in the same manner as the disposable gowns.

The disposable barrier gowns were packaged in a bundle of 10 and then heat-sealed in plastic wrap. Some units used over-the-door caddies that held the gowns and various sizes of gloves, caps and masks. Large users used small isolation carts similar to a toolbox where the same items were stored in drawers.

We discovered the packaging for the disposable gowns didn’t work well in an over-the-door caddy; once the wrap was torn open, the gowns tended to fall on the floor. So, we tried a 14x16 zip-lock bag. We needed to make some small adjustments to the fold to get 10 gowns into a bag. Once a bag was filled, we were able to squeeze out all the air and create a nice-looking package. The 10 reusable barrier isolation gowns actually took up less space than the 10 disposable gowns.

The mini-distribution department and offsite warehouse handled distribution of disposable isolation gowns. When units needed an isolation cart or caddy, they called mini-distribution, which delivered one to the proper location. Once on location, the nursing unit was responsible for replacing any supplies. Nursing ordered replacements from the offsite warehouse.

Items for each unit were delivered weekly, so this meant a number of cases of disposable isolation gowns had to be stocked on each unit. Limited storage on the nursing units made this a real problem during peak flu season.

We designed a system in which the reusable isolation gowns were stocked on the units in predetermined quantities and delivered by the linen room staff. The staff inventoried the gowns each day and restocked as needed, greatly reducing storage space needs.

Quality Control

If you are going to handle reusable barrier linen, you must do it to the highest standards. Your presentation and quality must be above reproach.

No matter how carefully I washed the barrier linen, some degradation was unavoidable. I could slow repellency loss by limiting the amount of alkali, using a solvent-based detergent, and eliminating all bleach and softener, but slowing it was not good enough.

We added a small amount of a barrier retreatment product to the final rinse. Sutter testing showed not only that the loss was eliminated, the barrier on some items actually improved. There are basically three product types on the market: wax-based, fluoropolymer-based, and a mixture. I prefer the fluoropolymer, because it adheres to the fibers only, has no effect on the fabric’s air permeability, and will not cause yellowing.

We wash reusable barrier isolation gowns in our conventional washer-extractors so we can strictly control the wash chemistry. We have reduced the weight per load by 65-70% of stated capacity due to the gown’s weight.

We inspect and fold the gowns in our surgical pack room. Each gown is inspected for holes or tears, and checked to make sure all ties are in place and are the appropriate length.

A gown is marked on the quality-control grid with a number or letter assigned to only one employee. It allows us to track a quality-control problem back to a specific employee.

We also built in random inspections by our supervisor. This allows us to check the finished work for problems and adjust our training program or take appropriate disciplinary action.

Wednesday: Initial user training and product rollout...
Click here for Part 1.

ROANOKE, Va. — I met with my production and maintenance staff recently to prepare for taking on a new account. We needed to move some of the work we were processing in our 275-pound open-pocket washers to one of our tunnel washers because of the continual growth of our reusable-isolation-gown business. It’s grown from 1,200 gowns a month to 92,000 per month! (Watch for more details about that in next month’s column.)

One of my maintenance men asked a question that shocked me. He wanted to know why we believed we could make money processing this type of product when the general consensus in the trade journals was that it was unprofitable. I decided not to argue with him about what the various trade journals may or may not have reported but instead to tackle the issue head-on.

Reusable barrier gowns and drapes made of 100% polyester are lightweight and therefore don’t work well with a system that charges by the pound, I explained. We had chosen to charge by the piece since our system allowed us to charge either by the piece or the pound. Charging by the piece also allowed our customers to make a quick and easy comparison to the various disposable alternatives on the market.

I also explained that, over the years, I had developed a special wash formula for processing these gowns that minimizes degradation to the fabric and increases their useful life. We also add a barrier re-treatment product in every wash load to ensure the fabric retains its fluid-repellent properties.

By using a Sutter Hydrostatic tester, I’ve proven on a number of products that the fluid repellency after 75 uses was actually greater than when they were new.

Consumer education is a vital part of making the system economically viable. Reusable barrier items must be used properly and returned to the laundry in order for them to get the expected number of uses. A key component is the manner in which they are packaged. The better the products appear upon delivery, the more likely the end-user will treat them with respect. I’ve seen a number of delivery methods that simply don’t encourage this.

The feel and “drapeability” of a 100% polyester fluid-repellent isolation gown is preferred over any disposable alternative, in my experience. We got our opportunity to introduce reusable barrier isolation gowns during the initial stages of the H1N1 flu pandemic. Front-line caregivers were disturbed at the number of gowns that were being thrown into the trash and the effect it was having on the environment. They asked us to develop a more ecologically friendly system.

My staff recognized quickly that we had done a number of things to ensure that we could actually make money on the product. They also came to realize that the largest piece of the puzzle was in how we charged for the items. Cost per piece is a universal term used across all disciplines and relates well to how our competitors market their disposable products.

The end-user or hospital administrator will want answers to these questions:

• Will the reusable product properly protect my staff and patients?

• Is it comfortable?

• How does it compare with the cost of the product we’re using now?

• Can I get a dependable supply of the reusable product?

• Can it be delivered and used in the same manner and system as the rival disposable product?

Designing a system that positively answers all these questions will allow you to get and keep the business while making a profit.

ROANOKE, Va. — We hear about global financial problems every day. We have seen the economic downturn and how the new healthcare law puts economic pressure on our facility’s bottom line. Several friends of mine have lost their jobs or been demoted in the latest round of cost cutting. While administrators make the tough decisions they believe will keep their facilities afloat, it is painful to watch the suffering of dedicated department managers.

In 1980, The Wall Street Journal reported that the Harvard Business School was devoting a segment of its MBA program to the topic of changing jobs. The article stated that one professor would begin the course by telling his class, “I will guarantee you that each and every one of the graduates of this program will be fired sometime during your career.” That is quite a statement considering that they are considered the best in the country. Therefore, it is logical that laundry/linen managers should assume that we are going to get fired at some point.

When you lose a job, there is a series of things that should be done immediately. And unless you prepare, unless you are proactive, you are not going to know what to do in that situation. Each experience is unique, but these steps should prove helpful.

Step 1: Establish That You Are Fired

Let’s start with my first point—establishing that you are fired. That doesn’t sound difficult, yet what happens is the boss will say, “You have been a good employee, but I have to let you go. But I don’t want it to look bad on your records, so you can either resign or I’m going to fire you.” What would you do in that situation?

While the end result is the same, there is a big difference between resigning by choice and resigning under duress. In Utah, where I lost my job, if you resign, you are not eligible for unemployment compensation. You are eligible for compensation if you are fired. I suggest familiarizing yourself with the laws of your state.

So, if you are fired, accept it. It’s not going to look any better on your résumé that you resigned a good job than if you were fired.

The first thing that you want to be able to do is to say to the boss, “I have two weeks vacation that I’ve earned and I expect it on my severance check.” In most companies, this is a vested right. The big question is whether to ask for severance pay. Most companies will give either a set amount or one week’s pay per year based on seniority. But unless you ask for it, your company may not offer it.

Realize that the person sitting behind the desk who has to tell you that you are fired is probably feeling bad, too, because he or she doesn’t know how to handle the situation any better than you. As far as I know, no one has made an in-depth effort to teach people how to fire top management people. We are told to make it short, don’t try to make it sweet, don’t try to cover it up, don’t try to be nice about it, just bring the employee in and tell him that he or she is fired.

When dealing with top management people, it’s a whole different story. Managers receive severance pay and vacation pay. They could be in a position to hurt the company down the road, therefore the company doesn’t want to alienate them. So ask for severance pay, and about any vested rights you might have in a profit-sharing program or pension plan. Many of our allied trades companies have excellent profit-sharing programs. You need to know about your rights prior to such a meeting.

Step 2: Determine If Your Boss is Suitable Reference

The next step is to find out what kind of a reference you are going to get from your boss. Get the story straight immediately. If your boss says, “Look, you have caused me more headaches than you were worth,” don’t use him or her as a reference. If there is any doubt in your mind, ask for a letter of reference.

Take responsibility for your own life. When it happened to me, I was crushed. That evening, after surprising my wife by coming home at noon, I attended a Boy Scout Troop meeting. We were showing a film called Wilderness Survival. That may not seem to have anything to do with surviving a job change, but it was exactly what I needed.

The first segment was on the psychology of being lost in the woods. The film emphasized that if you are lost in the woods and you decide that you are going to be found the next day, you’ll do absolutely nothing to support your life. You are not going to build shelter, find food or water, or start a fire! When the next day comes and you have not been found, you are a day hungrier, colder and thirstier. People have died in the woods waiting to be found “tomorrow.”

The main point was if you are lost in the woods, plan on being lost for seven days. I applied that to my unemployment situation; I decided that I was on a national job search and planned on it taking three to four months to find a job; today, I recommend planning on six to nine months between jobs.

This is important because it is going to make you sit down and take inventory of your finances, your energies, your skills, and the people you know. Tell yourself you are going to have to survive for six months on what you have received in severance pay and what you have in the bank. This will immediately relieve a great deal of pressure. If you say, “I’m going to find a job next week,” you are not going to plan, you are not going to prepare, and you are not going to budget your resources.

With this in mind, you may well want to take advantage of COBRA to maintain your health insurance. You don’t want to be without insurance for six to nine months. The most disastrous thing that can happen to you during unemployment is to have to go to the hospital for a major operation without having coverage.

Wednesday: Protect your vested rights…
Click here for Part 1.

ROANOKE, Va. — In discussions with my fellow laundry managers, no topic creates the deer-in-the-headlights look more than talking about standard operating procedures. Everyone knows we should have them and that they are an essential part of a good policy and procedure manual, but most managers put off creating them at all costs.

Creating a standard procedure is much like planning a trip from Myrtle Beach, S.C., to Seattle. There are an infinite number of routes that can be taken to make the trip. The planner needs to make a choice based on several options: speed of travel, historic sites, national parks, traffic, type of vehicle, weather, and interesting tourist traps. After all, everyone should experience Wall (Drug), S.D., once in his or her life.

Creating a standard procedure on how to do a job in your laundry is just like planning a trip. Your procedure needs to be designed around your laundry facility and your operational goals. The most common mistake that inexperienced managers make is to assume there should be a “nationally” correct way to do a job. They struggle with creating the procedure, because they do not want to set it up the wrong way. They fail to understand that the purpose of the standard operating procedures is to supply a uniform way of doing things in their laundry.

Why should we spend the time and effort to develop standard operating procedures? A manager can argue that they can operate their laundry without them. The best reason to develop standard operating procedures in your laundry is the knowledge you gain by reviewing the way linen is handled in your laundry.

I guarantee that, as you follow the flow of linen through your laundry and develop an understanding of how each step is completed, you will find ways to improve the workflow, reduce labor and lower your costs. Standard procedures should be developed with the entire laundry in mind, not just a single department or process.

For example, if you are operating a pre-sort laundry, the categories that you sort into are dependent upon the volume of linen processed, the way it is dried or conditioned, and the way the item is finished. There are times when the needs of the cart makeup area may override the needs of production.

Sorting washcloths and bath towels into separate categories will speed up the operator on the towel folder, but it will also slow down the processing of washcloths because it will take longer to get a load to wash. The key question: Will the laundry benefit from a constant flow of both bath towels and washcloths entering the cart makeup area, or can it handle washcloths in the feast-and-famine mode?

The laundry manager could overcome the problem of feast or famine on washcloths by increasing his inventory on that item, provided there is enough money in the linen budget. Both procedures will supply clean towels and washcloths to the cart makeup area. Each possible procedure has its pluses and minuses; neither one is perfect. The final answer may hinge on how other items are processed. If there is not much space to sort soiled linen, there may be an overriding need to keep sorting classifications to a minimum.

The standard operating procedures for your laundry reflect the unique challenges you face in receiving and handling soiled linen and processing it into clean linen. Procedures need to be reviewed and updated on a regular basis as changes are made to the equipment or linen items. Improving the overall performance of the laundry is a constant, never-ending process.

ROANOKE, Va. — I spent a lot of time at the Clean Show looking at improvements in productivity monitoring systems. I find the benefits of using one worth the time and hassle of collecting and entering the data.

I talked to numerous vendors that had developed systems to provide instantaneous productivity monitoring of each workstation and employee. The more frequent and accurate the feedback, the better the results.

The ideal system would allow for tracking of both group and individual production data.

I have always tracked three areas in my soil-sort department. The most obvious is the five employees who sort the linen off a belt from an elevated platform into various slings. This has always been a group effort, and their production is based on how well they work together as a team.

My second is the two “dumpers” who place linen onto the incline conveyor feeding the elevated sorting platform. Their performance has a major bearing on the soil-sort group’s efficiency.

Finally, I track the employee responsible for unloading the trucks, weighing the soiled linen and placing the carts in the cart dumper.

I want a system that can instantaneously track the performance of all three areas with a minimum of data entry. The ideal system, in my mind, would be one where the carts are weighed into the system by scanning the bar code. When the cart is placed into the cart dumper, it is scanned again and the next poundage is credited to all three tracking areas.

I want a system that visually gives the employees or the group a graphic measure of how they are doing vs. standard. The simple system of a red, yellow or green light does not provide the type of detailed information I want my employees to see.

The preferred system will also be capable of supporting large screens that can be placed in the break room and the supervisors’ work areas. The break-room screen would provide peer review of the workers’ or group efforts, while the other screens would provide feedback to these key groups as to where their efforts need to be focused.

An employee or group that is not meeting production standards could be lagging due to several conditions. It might be the result of poorly sorted or improperly washed linen; pillowcases that are not properly conditioned cannot go through the ironer as fast as those that have the right amount of moisture, for example. The supervisor can investigate and take the steps necessary to correct this problem.

Poor production may be the result of improper or incomplete training. It might be a problem with a piece of equipment; the supervisor can work with maintenance and get it corrected as soon as possible.

An employee may simply need a little added motivation. Knowing that the system is there, and that someone is actually paying attention to it, can provide the needed encouragement.

The ideal system would allow for tracking productivity of each employee, each piece of equipment, the number of pieces of each type of linen produced, and the production rate for each piece of linen. It would track downtime by piece of equipment and be able to provide laundry management with actual productivity by area.

Labor is our single largest cost, and real-time productivity monitoring promises the ability to improve the use of this resource. I would expect that my laundry could improve productivity by 10-20%. With that kind of labor savings, it would not take long to justify the purchase of such a system.