Content about Plant Operations

ROCKLEDGE, Fla. — Bill Carey has been in the laundry business his entire adult life. Six years ago, he took over the helm at Space Coast Hospital Services, a not-for-profit hospital cooperative laundry.

“Our mission is to help our hospitals reduce their cost of linen services,” Carey says. “If we don’t help them, somebody else will. We are operating in an extremely competitive environment right now, and we have to deliver.”

Education, Training Lead to Savings

Besides linen management, another area where Space Coast Hospital Services has reduced client linen costs is in isolation gowns. Carey credits Bobby Coble, territory manager, acute care, Encompass Group, with helping meet client needs.

“Traditional gowns tie in the back,” Coble says. “Ties in the back are more difficult for patients to untie. Disposables were reportedly preferred by many patients because they could just rip them off and throw the gown away.”

Encompass came up with a gown that ties on the side, enabling patients to more easily take it off and making the garment more acceptable for isolation applications, according to Coble.

Space Coast Hospital Services provides linen management support in each hospital in areas of linen utilization and educational programs. It also partners with Encompass, which provides customers with a linen-management tracking tool to pinpoint cost and usage by user area.

Pam Perdicaro, Carey’s service manager, reaches out to hospital clients to help them better understand laundry and linen operations, and how correct procedures can reduce their costs.

Quarterly hospital linen service director meetings and semi-annual on-site linen awareness programs emphasize training. “Nursing needs to understand that any additional linen left in a room has to be removed and sent back to the laundry for processing when the patient leaves,” Perdicaro says. “Storing additional items in a patient room just adds to their costs.”

There is improvement after the meetings and training, according to Perdicaro, but the laundry has found that regular reviews are needed to keep things fresh in everyone’s mind.

For example, the laundry learned that some certified nursing assistants were discarding soiled incontinent pads that could have been laundered. “They were throwing away the items that they thought were ‘too dirty,’” Perdicaro says.

“Another major area of linen cost that we manage is linen loss from transport,” Carey says. “We now provide specific EMT packs of linen for transporting patients leaving a hospital. The packs contain linen items needed, but they may have a small stain or tear that would keep them out of our standard linen inventory.”

It is an efficient way to utilize linen that would otherwise go to rag out, while in turn reducing clients’ linen losses, Carey says.

“Information and training saved one of our clients $350,000 over the last five years by reducing their pounds per adjusted patient day,” he says.

Staff is Key to Co-op Laundry’s Success

Carey credits his staff with initiatives to improve efficiency and reduce costs. Plant Operations Manager Ray Esche evaluated truck run and idle times to reduce diesel consumption.

“We used to have to keep our trucks idling during the unload process in order to power the lift gates,” Carey says. “We worked with our lift gate supplier to install remote lift-gate power outlets at the dock. Now, the lift gates work off electricity, allowing the diesel engines to shut down.”

Space Coast Hospital Services also installed governors on its delivery trucks to limit highway speeds to 68 mph. Fuel consumption reports show that transportation miles per gallon were increased by 14.5% for the truck fleet.

Kelley Desjardins, production manager, tracks daily plant processing production every day.

“We bonus our production employees for performance,” Desjardins says. “Once the plant performance threshold is met, the production employee needs to reach at least 98% of the production standard for any bonuses to kick in. Bonuses increase as pounds per operator hour increases for the entire plant.”

The plant, originally built in 1982, was expanded and upgraded with tunnel washer technology in the early ’90s. Two Milnor tunnel washers and four Chicago Dryer Co. finishing lines meet core production requirements.

Although designed for 15 million pounds per year on a single shift five days a week, economic conditions have reduced processing requirements.

“In order to reduce operating costs and still keep our people working, we went to four production days, eliminating Wednesday linen processing,” Carey says. “Office, maintenance, and delivery still operate five days per week.”

Thirty-one of 67 employees have worked at Space Coast for more than 10 years. “Our people are the key to our success, and employee retention is very important to us,” Carey says.

He remains positive about the future. “We are well positioned for additional business. We will continue to be a high-quality linen service and will always stay committed to our mission of providing the best service and quality product at the lowest possible cost.”

Click here for Part 1.

FAIRWAY, Kan. — In an effort to shed light on what hospitals want from their laundry providers (and, in doing so, provide intelligence to help providers meet healthcare client needs and expectations in 2012), a 360-degree review on the subject was in order.

In addition to interviews with environmental service (EVS) managers and nurses at a dozen hospitals across the country, about two dozen laundry operators were surveyed and interviewed.

While the nature of this review is anecdotal (i.e., not a scientific study), the feedback gathered resonates true.

What Laundry Operators Think They Want

Based on a survey of operators representing all sizes and types of laundry operations, they say hospitals want (in order of importance):

• On-time delivery and sufficient inventory
• Responsiveness to client needs and requests
• Good-quality products
• Competitive prices
• HLAC accreditation

While operators ranked HLAC accreditation low as a customer priority, most agree this is changing as more and more laundries become accredited.

The primary complaints received from clients are (in order of frequency):

• Costs too high
• Stains and tears on items
• Insufficient inventory
• Poor quality
• Lost or missing goods

There were many operator complaints about clients not taking the time to communicate needs, to understand pricing issues, or to participate in inventory control and loss programs.

Of those surveyed, 71% provide service on a rental basis, with the remaining 29% providing a combination of rental and customer-owned goods (COG). Ninety-three percent of all respondents provide clients education on linen use and control; 86% provide inventory management programs.

What Hospital EVS Managers Say

While some EVS managers might not rank having its laundry HLAC-accredited top of the list, it is a must-have criteria for others. “Our laundry provides excellent service and works closely with me and my administrator on any issues that arise,” says Kent Miller, CHESP, director of environmental services for Jackson Hospital & Clinic in Montgomery, Ala.

“I believe a healthcare laundry should be HLAC-accredited,” adds Miller, who is also president of the Association of the Healthcare Environment (AHE), an HLAC founder. “My laundry provider is accredited, and they made sure I received a copy of the accreditation certificate.”

When asked how their laundry provider could improve its service, EVS managers say they need:

• Better-quality goods/fewer stains
• Better communication on product changes and service options
• Help in enforcing appropriate linen usage among staff/controlling losses
• Training programs for staff in each unit (along with spot audits)

When asked what their laundry provider does right, EVS managers stated:

• On-time delivery
• Responsive to requests
• Good fill rates

Overall, the EVS managers interviewed were happy with their laundry providers. Those happiest with their service have a close relationship with a customer service representative from the laundry.

But one issue remains difficult to resolve.

“I have great laundry service, but the biggest gripe I get from staff is about stains on linen, especially on our knit sheets,” says Wes Thiss, CHESP, EVS director at St. Mary’s Hospital in Richmond, Va. “I realize that part of the stain issue is our fault. The iodine cleanser commonly used in hospitals stains terribly. But the perception among staff is that if there is a stain, it’s not clean.”

The Nursing Perspective

Nurses want the linen they need right now. “If it has hair or a stain on it, we put it straight in the soil bin,” says RN Copp.

In general, nurses say they need:

• Clean linen without stains, tears or holes
• Patient gowns with snaps that work
• An adequate supply of items
• A better understanding of their needs (listen to what they say and follow through!)
• An appointed hospital linen liaison or advocate for each unit

A survey taken of 42 nurses during a Practice Greenhealth webinar¹ in February 2011 revealed that 40% rated their laundry service as “good,” 30% rated it as “fair,” 20% rated it as “poor,” and only 10% rated their laundry service as “great.”

“In my 17 years as an RN and administrator, I have observed that most linen services do a decent job,” says Brenda Willis, RN, Tonganoxie, Kan. “But if there is no one appointed on the unit floor to oversee linen use and advocate on behalf of the laundry, there are more problems and greater linen losses.”

One nurse noted that staff hated getting patient gowns with snaps that didn’t snap. Because the perception was that gowns with broken snaps kept being returned to them, nurses started throwing them away.

“The most common mistake operators make in serving hospitals is not communicating sufficiently with hospital staff,” says Deborah Lark, COO of Portland Hospital Services Corp., Portland, Ore. “It’s critical to communicate with and educate end-users about linen and the laundry operation.

“Unless we educate the end-user, there is a tendency for clients to take linen for granted. Hospital staff can wind up making assumptions about the laundry operation that result in unrealistic expectations.”

The Challenge — Will You Meet It In 2012?

Does your laundry operation have customer service reps that regularly visit with the client contact and floor staff?

Do you provide training for staff on appropriate linen usage?

Do you insist that each hospital unit have an appointed linen advocate?

The successful execution of these tactics can make the difference between happy customers and your profitability in 2012.

But Thiss acknowledges that it’s hard to get nurses to participate in any type of linen committee. “We need help getting our nurses to want to participate in training and committee work.”

“The most important thing hospital staff can do is be open-minded and willing to form quality and linen committees that can then set realistic goals and par levels,” says Kelly Jefferson, vice president of customer support services for Reino Linen Service, Gibsonburg, Ohio. “We also need to coax staff to talk openly about fill rates and returns.

“Until you have a true relationship and partnership established between the laundry and end-users, there will always be questions of fill rates, quality, costs and customer satisfaction.”

Click here for Part 1.

ALEXANDRIA, Va. — The textile services industry has reached new heights in natural resources conservation, according to the latest Laundry Environmental Stewardship Program (LaundryESP®) survey released by the Textile Rental Services Association (TRSA).

Responses compiled from 500 U.S. TRSA member facilities indicated that their carbon footprint per pound of laundry is 11% smaller than in 2006, driven by a 14%-per-pound decline in energy use. Water consumption has dropped 6% in that time.

The results emerged on the heels of a study published by a European textile services coalition that concluded the production technology typically used by TRSA members “is the most sustainable way of doing laundry, almost without loss of quality and functionality.”

Such large-scale washing, drying and wrinkle removal is up to three times more sustainable than a domestic laundry process, the European group concluded.

It added that TRSA members’ techniques were also proven up to twice as effective in this respect as on-premise laundries (OPLs).

In terms of carbon footprint (carbon dioxide production), the metric most associated with sustainability, LaundryESP® determined that TRSA member laundries now generate 0.36 pounds of CO2 per pound of laundry washed. That’s a 24% decline since 1997, the first year of data tracking.

This prevents emission of 1.49 billion pounds of CO2 per year, which is the equivalent of taking 135,000 typical cars off the road. It would be necessary to plant roughly 30 million trees to achieve a similar reduction.

“LaundryESP® is a testimonial to TRSA members’ commitment to improving their efficiency, which enhances the environment and the economy,” says TRSA President Joseph Ricci. “Sustainability in commerce is not just about expending fewer resources, it means achieving those gains year after year because it’s profitable to do so.”

Businesses that patronize TRSA member facilities deserve much of the credit for the textile services industry’s greater efficiencies, according to Ricci.

“They understand that sending their uniforms, linens, floor mats, towels and other textile products to TRSA members is the most economical way to clean these,” he says. “LaundryESP® proves to our members’ customers that their patronage of TRSA companies is ‘greening’ their own businesses more than ever and enabling our members to continue to be vital corporate citizens in cities and towns across the nation.”

TRSA has prioritized promoting member companies’ services to facilities now using OPLs as well as businesses that could substitute durable, reusable cloth products for the non-launderable or paper equivalents they now buy.

The new research provides up-to-date confirmation that professional uniform service is a pro-environment choice that’s becoming more sustainable, Ricci notes.

The LaundryESP® findings indicate how TRSA members’ resource requirements have dwindled:

• 2.55 gallons of water per laundered pound, down 33% since 1997, a 9.9-billion-gallon annual differential, or enough to serve the residential purposes of 270,000 people in a year.
• 2,260 Btu of energy, down 27%, due to declines of 26% in natural gas, 9% in electricity, 81% in propane, 75% in fuel oils, and 30% in all hydrocarbon (production) fuels.

These combined reductions save energy at the rate of 11 trillion Btu per year, or enough to power 116,000 typical U.S. households.

Recent data comparing the sustainability of large-scale TRSA member laundering techniques to domestic and OPL processes were generated by TKT, the research arm of the Dutch national associations for textile services (FTN) and dry cleaning (Netex).

CINET, a council of mostly European national associations, published these studies.

KEYSTONE, Colo. — You might not expect a town of 825 permanent residents to have much need for production laundry services, but try adding 230 inches of annual snowfall, 19 ski lifts, 135 ski runs, cat skiing, night skiing, high-speed gondola rides, ice skating, and hockey.

Twenty-five thousand pounds of rooms linen each day adds up pretty quick for Richard Griffin, laundry manager for the Keystone Lodge and Spa.

Griffin, a veteran laundry manager and vice president of the Association for Linen Management, operates a tight but effective production hospitality plant at the Vail Resorts property. Service requirements include three different levels of linen quality serving 400 hotel rooms and 1,600 condo units.

He recently spoke to American Laundry News about the challenges of linen management and distribution at the seasonal resort laundry operation.

“The key to our linen management success is controlling the inventory,” Griffin says. “We provide linen services here at the Keystone Lodge and Spa, but also to a number of smaller properties in Keystone and over the mountain at Breckenridge, as well as for 1,600 condo units in the area.”

Q: How do you keep track of inventory at so many locations?

Griffin: We physically inventory the available linen at all of our major drop points three times per week. One of my employees, separate from the delivery person, visits each location and does an inventory. This gives us hands-on knowledge of what is needed in each area.

If we get a call requesting a linen delivery, I already know what they have and where it is. The goal is to keep linen from being stockpiled in dead inventory.

We have storage and staging in a building adjacent to the laundry. We build our orders in bulk carts with help from in-house linen management software, and with information provided by our physical inventories. Each cart is then tagged so the customer knows what they received.

Q: What about par levels?

Griffin: The transportation requirement for off-site clients increases the par level requirement. Most of our hotels maintain a par level of three to four. In addition to all the normal stuff you deal with in meeting deliveries, we have some special high-mountain conditions.

Q: Like what?

Griffin: Weather affects a lot of things out here. The skiing here is great due to the volume of snow that we get. Laundry carts don’t roll through snow very well.

Linen in transport from offsite locations back to the laundry can get frozen. “Thawing” is typically not in the standard ALM linen cycle process taught at ALLC (American Laundry & Linen College) back in Kentucky. There are times when linen arrives at the laundry frozen solid. We have to bring it inside for several hours before we can begin sorting.

Tomorrow: How operating a tunnel differs from a conventional wash aisle...

CHICAGO — Taking inventory is often cause for headaches at any laundry facility, and a recent webinar on linen inventorying addressed how to make the process work for each individual system.

Barbara Williams has more than 30 years of experience in the textile industry. As a consultant with Standard Textile Co., she frequently speaks about linen process improvements, linen management, and cost-reduction programs for healthcare operations.

During the webinar sponsored by the Association for Linen Management, Williams stressed the many rewards of taking a regular inventory and touched on a few challenges a laundry facility faces during the process.

Among the rewards, Williams says, are balancing supply with demand and assuring that an adequate supply is circulating. Too few linens causes shortages, which can lead to hoarding and a lack of confidence in the system. “Too much inventory can cause misuse and over-utilization of products,” she says.

An inventory also can help a laundry, whether it be on the premises or off site, determine effective allocation of linens, as well as replacement rates.

Determining those rates can lead to a planned purchasing program, thus helping to eliminate panic buying and rush orders. Administrative reporting is another advantage, she says, and allows a facility to have information on hand in the case of an insurance claim after a flood or fire. Budgeting is high priority during these economic times, and taking an accurate inventory can help determine future needs.

Other inventorying goals are ascertaining a facility’s loss rates, determining if a facility has a high rate of “mysterious disappearances” of linens, recirculating so-called “dead” inventory, and identifying locations that may be hoarding linens. As a result, facilities have the opportunity to implement security programs to reduce loss and are able to put some quantities of inventory back into circulation or reallocate supplies.

“As many of you know,” Williams says, “you end up with a lot more in circulating inventory right after a count is taken.”

She recommends taking a proactive approach to linen inventory to identify potential roadblocks or problems and take a closer look at shortages or overages.

Challenges Facing an Inventory

In today’s market, most facilities are being asked to do more with less, which can result in fewer staff resources available to help with an inventory. This can also result in a problem with time commitments and cooperation from a staff that already sees itself as overburdened.

Another challenge can be the large networks that many healthcare facilities are part of these days. “It takes a lot more cooperation and communication,” Williams says, “but many large networks are doing inventory successfully.”

Linen supplies are different from a product kept on a shelf; constant movement of the linens is a cause for concern when contemplating taking an inventory. A healthcare facility, for instance, cannot simply stop the movement of linen, so timing of an inventory is crucial. The number of locations where linen is stored and used, as well as the number of stock-keeping units in a healthcare facility, challenges an inventory manager.

Inventory accuracy often hinges on a cut-off point and a clear delineation between what is to be counted and what is not counted.

A commitment by management, as well as nursing management in a healthcare facility, is essential to an accurate inventory. If the results show a high return on the investment, this can help persuade management to cooperate. Determining what the actual ROI is important as well.

“Are you willing to act on the results of your inventory?” Williams asked participants. “If you aren’t willing to act, then there may be no return on investment. Acting on the results is crucial to making an inventory worthwhile.”

When to Take Inventory

“Today, most large laundries have gone to an annual inventory,” Williams says. “We recommend doing the inventory at the same time of the year so there is a consistency of inventory.”

Williams also recommends semi-annual inventories, more for on-premise laundries than large, shared or pooled laundries. Smaller operations, such as hospitality facilities, can do a quarterly or monthly inventory.

Another possibility is a cycle count. Williams says this works well if a facility doesn’t require a complete inventory, if the manpower is not available, or if there isn’t the level of cooperation required for a complete inventory. She suggests taking one or two of the highest use items and counting those. Then, the following month, select another two items and count those.

When the webinar participants were polled anonymously, 64% indicated they inventory once a year and 9% inventory on a semi-annual basis. Williams was slightly disappointed to hear the remaining 27% don’t take a linen inventory at all.

Also factoring into inventorying is choosing the best day and best time of day during which to act.

Base this on several elements, Williams says: staff availability, low-activity time, nursing practices, shift changes and linen delivery schedules. The important thing, she says, is to be consistent; take inventory at the same point each year, on the same day and at the same time of day.

Tomorrow: Your Inventory Involves What?

WINTER HAVEN, Fla. — Managing a laundry facility is a challenge, and when expensive equipment breaks down, the ability to repair it can hinge on knowing where to locate a single part.

During an Association for Linen Management webinar, Parts Are NOT Parts, David Chadsey, managing director of Capital Equipment Consulting (which recently changed its name to Laundry-Consulting.com), spoke about parts management and maintenance, focusing on the need for inventory and documentation.

Knowing what you have by way of inventory is the first step in documenting your machine maintenance, Chadsey says. At some point, every piece of equipment will need to be replaced. Understanding the process and planning for the inevitable will make the job easier to handle, he says.

Chadsey advocates documenting a machine’s usage and tracking inventory as means to understanding what equipment and parts a facility uses and needs. “Because if you don’t know what you use and don’t know what you need,” he says, “the day you need it, you’re probably not going to have it.”

Maintaining a parts inventory is important to keeping a facility up and running, he says.

When polled, every participant in the webinar indicated his or her “inventory system” was to simply look on the shelf when a part was needed.

Inventorying

Inventorying can be done in several different ways, Chadsey says.

“Establishing an inventory control and a systematic approach to documenting the parts you use is very important. It’s going to prevent extended downtime,” he says.

Inventorying can be done by machine, by part or by rate of replacement. Keeping track of parts and ordering on a regular basis can have other benefits. Many manufacturers and supply companies will offer discounts or no-charge freight, so, Chadsey says, there are some savings that go along with tracking parts and being able to order on a regular basis.

“There is nothing worse than having a piece of equipment fail on Wednesday before Thanksgiving,” Chadsey says, “and your distributor doesn’t have the part.”

Another benefit to inventorying is the data gained when analyzing a return on investment (ROI) for a particular piece of equipment. It also provides credibility to upper management when a facility manager suggests a change.

Warranties

Another key to parts management is knowing what warranty goes with a particular piece of equipment or part. Chadsey suggests knowing exactly when a warranty starts, as some manufacturers use “final approval” for the start date and that may not come until six months after the equipment was installed.

Another consideration is to determine what parts are covered. Some warranties cover general parts but not “wear” items, Chadsey says. Be sure to have those “wear” items defined. Keep in mind there may be special terms to the warranty; for instance, is freight covered in the warranty? Is significant lead time necessary to obtain the part?

Remember also, Chadsey says, that there is a difference between parts warranties and labor warranties. Check the timelines for parts and labor, as they often differ considerably.

Also, ask about extended warranties. This may be needed for new products or if there is a question about the equipment’s longevity. And if you need to activate a warranty, remind your provider that an extended warranty exists. Otherwise, Chadsey says, you may be paying for something you thought was covered.

Downtime costs also need to be considered when negotiating a warranty, and the cost of a warranty and services may be negotiated, particularly if on-site staff are more than capable of doing the needed work.

Monday: The most reliable source of parts...

ST. JOSEPH, Mich. — When striving toward a properly equipped hotel laundry facility, owners and operators have a number of factors to consider, including the right equipment mix, new technologies, types of machines and unique industry challenges.

The proper selection of commercial laundry equipment can have a significant impact on several key operational factors—namely time, money and utilities.

Before the Equipment, You Need A Distributor

Whether shopping for laundry equipment for a new hotel/motel or looking to upgrade an existing operation, it is important to connect with a reliable, established distributor for product guidance and future maintenance. The best laundry distributors are those that have a long history in the business and have received positive reviews for the customer service they provide — both before and after the sale.

It also is wise to look for a distributor with solid warranty and service agreements, factory-trained service technicians and a full parts inventory, so replacement parts can be obtained with minimal downtime. For example, if laundry equipment stops working on a busy Saturday, having a distributor that will send a service technician out promptly with the replacement parts needed for repairs is crucial to keep up with the flow of guest needs.

A reputable distributor will help ensure the laundry room is designed to efficiently meet the needs of the hotel staff and guests. The arrangement should accommodate a good workflow and have proper ventilation and enough space on all sides of the equipment for maintenance and operation. Distributors also can help owners calculate how many loads of laundry will be required to accommodate the average flow of guests.

Finding the Right Mix

To maximize a laundry operation’s efficiency, there are a few variables that need to be considered. For example, how many hours will the equipment operate per day? The answer to this question is dependent on the number of rooms, types of linens laundered, etc. and directly affects the variety and size of the equipment needed.

Another factor that needs to be addressed is the hotel’s target market. If hotel guests are generally business travelers, the type and the amount of linens vary greatly compared to a full-service resort where multiple towel types, robes, linens, etc., are required for daily guest use. Depending on the types of linens and the amount of laundry at the on-premise facility, a distributor can help determine where more or less equipment would ensure a smooth laundry operation.

A simple rule of thumb for preliminary discussions about the capacity of equipment needed to stay ahead of hotel/motel laundry needs is one pound of washer capacity for each guestroom. For instance, if a hotel has 100 rooms, it would need approximately 100 pounds of washer capacity. For dryers, hotel owners and operators would want to select equipment that provides approximately 30-50% additional capacity, in this example, around 150 pounds of dryer capacity.

Generally, owners and operators with more than 40 to 50 rooms opt for two smaller washers, which allow for laundry to be done continually throughout the day, instead of waiting to do all of the linens at one time. Also, in case the equipment breaks down, a second unit is there to keep up with the guests’ linen and towel needs.

Technologies Save Money, Time and Linens

The largest cost in a hotel laundry is labor, which can comprise 50-60% of every dollar spent. One of the best things a hotel owner can do is to upgrade the washers to models that have higher spin speeds, which remove more water from linens. This leads to a reduction in the amount of natural gas consumed in the drying process by shortening the dry times. Higher-extraction washers can cut drying times 20-40%.

Housekeeping operators stand to recoup the price difference between efficient and less-efficient on-premise laundry equipment in labor savings over a few years.

High-spin washers help hotels keep the cost of linen replacement down, as shorter dry times help increase linen life. Most of the damage to linens occurs in the dryers, when linens are tumbling in temperatures of 160-180 F for anywhere from 25 to 50 minutes.

Tomorrow: An additional challenge...

COMPTON, Calif. — Infection control might be on everyone’s radar, but it is just one factor in recent changes to healthcare apparel. Peter Menaker, regional sales manager for textile manufacturer, distributor and importer American Dawn, says there are other factors driving changes in the textile industry, too.

Menaker briefed laundry processors and linen distributors during an Association for Linen Management-sponsored webinar, Changes in Healthcare Apparel.

For healthcare workers and laundry managers, infection control can be a major concern.

“As of June 2010, Centers for Medicare & Medicaid Services stopped reimbursing for the costs of hospital-acquired infections,” he says, “so it became more important for healthcare facilities to make sure there are as few hospital-acquired infections as possible.”

Most of the concentration has been on hand-washing initiatives. “That’s been a big focus,” he says, “because most such infections are transferred on the hands of the healthcare worker. I’ve seen recently initiatives … (concerning) hospital-acquired infections that occur among catheter patients and in patients with central lines.”

Another point of interest to laundry personnel is the use of antimicrobials bonded with the fabric of patient garments.

“Antimicrobial treatments are certainly starting to show up on patient apparel, bedding, cubicle curtains, room curtains, scrubs, personal protective apparel and equipment, and certainly they’ve been found in surgical gowns for some time.”

Antimicrobial Treatments

Menaker went into depth on treatments that involve metallic ions being fused permanently onto a textile product. Silver, copper and even gold are used in these technologies.

“These metallic ions combine with a membrane that increases the surface tension of fabrics that can also make them fluid-repellent yet breathable,” he says.

The ions puncture a germ’s cell membrane, rendering it incapable of replicating. These types of antimicrobial treatments, according to Menaker, are nonleaching and permanently bonded to the fabric. He warned against using any type of treatment that works by allowing the chemical to leach from the fabric.

“If the antimicrobial is leaching out of the textile, eventually it will not be effective in killing the organisms we want it to kill,” Menaker says. “Also, it’s possible that the leaching chemical could disturb the skin (of the wearer) and cause an issue. And we don’t want to be causing an allergic reaction or any problem with their skin.”

Also, a leaching type of textile creates a zone of inhibition, which leads right to a zone in which the antimicrobial treatment is only partly effective in killing off germs.

That could lead to the microbe mutating and becoming resistant to the treatment, developing into a superbug, he says.

Antimicrobial treatments can present challenges for laundry managers.

“With any of these antimicrobial agents, we want to make sure we use a chemical and a process in our laundry that will not break the bond between this molecule and the product that we want it to stay on,” Menaker says. “And the provider of the antimicrobial textile or your laundry chemical provider should be able to let you know which processes might be necessary for use with these types of products.”

There is a staining test available that can determine if the antimicrobial treatment remains on the textile product, he says.

Another potentially problematic issue for laundries arises when items such as isolation gowns or cover gowns feature a coating that can be refreshed. Each garment has a grid stamped onto the fabric or a label attached that allows the laundry to keep track of the number of times the item has been laundered.

Most treatments can withstand a limited number of washings—usually around 75. The challenge arises when a garment has been chemically refreshed, or a treatment is reapplied to the garment. How laundry personnel communicate that the garment is once again fluid-repellent is an ongoing concern.

Reapplying the treatment could also be cost-prohibitive.

Menaker says textiles are usually not involved in hospital-acquired infections, and there is a question whether treating the textiles with an antimicrobial would truly be helpful in preventing infection.

“I don’t think there have been any studies on this, and the jury is definitely still out,” he says.

Patient Satisfaction

Patient satisfaction is growing as a change motivator in the industry, Menaker says. Many healthcare facilities are using Press Ganey and other survey tools to gauge how patients perceive that institution’s commitment to care.

“In fact, textiles come into patient satisfaction quite a bit,” Menaker says, “if you realize that patients have more interaction with their hospital gown and their bedding than they really have with doctors and nurses.

“They’re exposed to their textile products 24 hours a day for every day they’re in the hospital. So, like it or not, these do make an impact on how satisfied they are with their treatment at the hospital.

“Usually the laundry hears about it when a linen item is of subpar quality or in quantity. But it can also go the other way, too. If linens are upgraded, they can actually make a patient experience more positive.”

Patient dignity is another influence on healthcare apparel decisions. Religious considerations, physical size and patient mindset all go into determining how a hospital’s apparel offerings fare in a patient’s assessment of dignity issues.

Burkas and face veils have been in the press, and obesity is a concern on many different levels, Menaker says. Patients also are more involved in their own care, and patient comfort and allowing them to focus more on the care for their illness is important, too.

“We also have smaller and smaller people coming into the hospital, too, with more premature births, and there may be some issues with garments being too big or not properly sized for the little patients,” says Menaker.

And there are standardization issues to be considered, especially as they relate to supply/processing costs and effectiveness of the laundry service.

“With so many SKUs, particularly in patient gowns,” Menaker says, “there’s some cost implications in standardizing, stocking fewer different garments, and processing them properly and distributing them to the end-user.”

Tomorrow: Laundry processors need to play a role in policy changes…

ASHTABULA, Ohio — When laundry managers review their injury logs with inspectors from OSHA or from their workers’ compensation insurance carriers, back injuries frequently rank among the most commonly reported. On average, each back-injury claim represents a week of lost productivity, according to the Bureau of Labor Statistics, plus associated healthcare costs. The culprits triggering many of these back injuries are not difficult to fix.

By paying attention to ergonomics, work positioning and the elimination or minimization of repetitive bending, reaching and lifting, laundry managers may save their workers from needless pain and injury and save their companies from needless, burdensome costs.

Spring-Loaded Carts Prevent Back Strain

Spring loading refers to setting a platform of vinyl-covered wire frame, plastic or plywood atop or under a series of metal springs, all set within a laundry truck or cart.

When linens are placed on top, the platform gradually sinks into the bottom as the weight of the linens increases. As linens are removed during cart makeup or when fed into a flatwork ironer, for two examples, the platform gradually and automatically rises.

It is this rising action that directly reduces the lower back strain by maintaining the height of the work at or near the waist level of most workers. Reaching into the bottom of carts is eliminated.

Two Types of Spring Loading

From a review of utility trucks being used to hold clean linens for feeding a variety of machinery at the Clean Show, the majority of them were fitted with the hanging style of spring loading. In this style, one end of each spring is attached to the platform through grommets set within the perimeter of the platform while the other end of the spring is hooked over the rim of the laundry cart or truck, always at the corner and sometimes in the middle depending on the load.

The platform hangs within the container, and the load is borne from above. The springs are typically encased in a flexible sleeve to safeguard workers from contact with the springs and to prevent linens from getting caught or snagged.

The second style of spring loading hides the springs underneath the platform. This coiled style virtually eliminates the potential for the springs to come into contact with workers or linens. Either style may be sized to fit nearly any type of utility cart or truck commonly found in a laundry.

Which Is Better?

Both styles offer comparable performance and longevity with almost no maintenance requirements. Both styles may be removed to clean the inside of the cart without any tools. Their zinc-plated, rust-resistant springs rarely wear out from too many cycles and have been known to last for decades, as long as the weight of laundry placed on the platform is within the specified range.

The coiled style handles heavier loads than the hanging style, with load ratings of approximately 38 pounds per spring at full spring extension versus approximately 31 pounds per spring when hanging from the rim. Therefore, to handle 300 pounds of laundry, for example, the coiled style would require eight springs underneath while the hanging style would require 10 springs around the perimeter of the utility truck. The difference of only two springs may affect the price by as little as $20, but when applied over a fleet of 100 utility trucks the savings become substantial.

From a safety perspective, though both styles meet ergonomic needs, the coiled style earns points for hiding the spring mechanism under the platform. However, the hidden coil style requires space within the interior of the cart or truck. This means a 14-bushel laundry truck, for example, with the spring-loaded mechanism hidden inside, actually functions more as a 12-bushel laundry truck. To move 14-bushel loads, a larger laundry truck needs to be used at a slightly higher price. Again, when applied over a fleet of 100 utility trucks, the difference becomes substantial.

Monday: Specifying the right spring-loaded mechanism…

OAK CREEK, Wis. — When Crothall Laundry Services officially opened its new 83,000-square-foot plant during a June 27 ribbon-cutting ceremony, it marked a couple of important firsts for the Crothall Healthcare service line.

The $13 million state-of-the-art facility is the first that Crothall has built from the ground up, and it is reportedly the first laundry in the world to certify (its processing included) under certain LEED (Leadership in Energy and Environ-mental Design) standards. And Crothall managed to complete the construction project—aided by many industry vendors—in nine months.

A hundred dignitaries filed into a tent erected in the plant’s parking lot to listen to congratulatory remarks from Bobby Kutteh, CEO of parent company Compass Group; Steve Carpenter, president of Crothall Laundry Services; and others before touring the gleaming facility.

The plant can process approximately 25 million pounds of clean linen per year in one shift or up to 50 million pounds annually on two shifts. Crothall claims it is producing efficiencies exceeding 150 pounds per operator hour.

Crothall built the stand-alone plant south of Milwaukee after Aurora Health Care decided that its Crothall-run campus laundry in Milwaukee would be converted to another use. The facility processes 18 million pounds annually for 17 hospitals. Crothall has been processing linen for Aurora Health Care since 2000.

ARCO/Murray National Construction Co. was responsible for all construction phases. Various manufacturers and Pellerin Laundry Machinery Sales Co. provided design, installation, start-up and training services. Herb Fitzgerald Co. assisted locally.

Three PulseFlow® tunnel washers (150-pound modules) from Pellerin Milnor Corp. supply the needed washing capacity. Their patent-pending technology incorporates top-transfer batch processing. On average, the system is capable of laundering healthcare linen at a water-consumption rate of approximately 0.45 gal/lb, saving Crothall roughly 8.5 million gallons—or 39% compared to the traditional tunnel washing process—annually.

The E-Tech soil-sort area utilizes continuous sorting on rail, featuring LED-display sort windows and computerized tunnel-load sequencing.

A press-to-dry rail system automatically carries 300-pound bags of clean laundry on rails overhead to any available Milnor dryer, replacing the traditional shuttle.

Next page: The new plant processes laundry without using high-pressure steam boilers…

CHICAGO — Anyone who has ever been challenged to shoehorn a functional laundry into a tiny space knows that they can perform such a feat, but the sequel is making that laundry work properly.

Nowhere is this situation more profound than in the cruise line industry, where a square foot of space is like gold. And nowhere in the annals of commercial/industrial laundry design are there as many examples of laundries that do not work because they were designed by people not qualified nor practiced in process (work) flow. An example might help to illustrate the point:

During a recent cruise ship start-up operation, a machinery company had sold several hundred thousand dollars of equipment to a prominent, prestigious and well-known cruise line company. Upon entry into the laundry space, an individual could stand in the middle and turn around with outspread arms and touch two of the opposite walls.

Rather than placing the equipment along a wall so there would be room to work in front of the machines, the washers were placed in front of the dryers. The total space behind the washer-extractors was 2 feet, and the spacing between the washers and dryers was 3 feet. To make matters worse, the 34-inch-wide carts came in contact with the machines every time a dryer needed to be unloaded.

Another confounding issue was a flatwork ironer in the middle of the floor, right in front of a single door used for ingress and egress into the laundry processing area. Furthermore, this space had to be used for both laundry and guest drycleaning services. There was no soiled-linen storage area, and the laundry crew actually sorted the textiles into the washers as they were coming down from the guest floors.

Granted, this illustration highlights extreme conditions, but it is typical of what can happen when too little thought and experience is applied to a compact-laundry layout. There are specific guidelines that should be followed when a compact laundry is being planned.

Form Follows Function

The function and size of the laundry must be calculated first based on the work to be processed. It is not a cardinal sin to say to an owner, “There is not enough space to do what needs to be done,” but be prepared to offer some viable alternative.

So now, the thought process must be re-engineered. In some cases, it may be necessary to open up options and revisit the hours of operation. Instead of operating a compact laundry 8 hours a day, it may be necessary for that laundry to operate 16 hours a day in order to get all of the textiles processed within a specified block of time.

The functional task of every laundry is to process soiled textiles and convert those textiles into clean, usable textiles. Certain parameters must be followed:

• First and foremost, compact laundries must comply with all municipal, state and federal safety regulations.
• Workflow must follow a prescribed pathway without any cross traffic patterns.
• All equipment must be sized to meet the hourly production task. Do not install just one machine type. At the very least, install two machines: one smaller and one larger.
• Temporary storage of “in-process goods” must be provided.
• The laundry should be devoid of unnecessary items. It is not a storage closet.
• All laundry associates must understand the operational process.

Safety and Regulatory Considerations

Owners or general managers sometimes try to save money by skirting regulatory requirements. Don’t do it. Those regulations are in place for health and safety.

Some of the germane regulations that must be followed no matter the size of the laundry are:

• clearance requirements around all machines for maintenance and repairs
• fresh-air provisions for proper gas-fired equipment operation
• ventilation requirements for laundry and equipment to operate efficiently
• adequate water volume and temperatures to remove stains
• proper wastewater sewage elements; adequate line sizes for all machines dumping simultaneously; removable wastewater lint traps; sufficient sewer line clean-outs and vent lines
• electrical disconnects within 3 feet or line of sight for every machine using electricity
• water and natural gas valves within 3 feet of machines using those utilities
• a twin-compartment utility laundry sink for special laundry procedures
• fire sprinkler systems (even though not all municipalities mandate them, they are recommended)

Tomorrow in Part 2: Operational issues that should be considered and implemented during the planning and design process…