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TRSA Dismisses ALM’s Healthcare Linen Research Proposal

ALEXANDRIA, Va., and RICHMOND, Ky. — The Hygienically Clean Healthcare Advisory Board and Healthcare Committee of TRSA, the association for linen, uniform and facility services, have rejected the Association for Linen Management’s (ALM) assertion that it has taken “the first step to identify microbial levels present on healthcare textiles in the U.S. today” and its self-characterization as “the textile industry’s best resource.”

ALM says it is underwriting the development of an independent scientific research entity called the Textile Research Council (TRC). The intent is to form a collaborative organization with insightful representatives from all of the associations involved in textile care services and other experts who will, as a team, provide oversight and guidance for evidence-based research.

TRSA President and CEO Joseph Ricci, CAE, says that ALM’s plans to conduct research on microbial testing ignore well-established internationally developed and recognized standards and measurements.

“ALM appears to be highlighting and solving a problem that doesn’t exist, while committing resources to develop measurements that already exist,” Ricci says. “U.S. hospital patients’ risk of obtaining HAIs from healthcare textiles over the past 43 years is less than 0.000007%, conservatively.” 

ALM’s research plans are grounded in its study published in the May 2019 edition of American Journal of Infection Control (AJIC). ALM says it launched and implemented the work in conjunction with the laundry, the infection preventionist or designated clinician at the hospital, and the linen manager at the hospital for each of the participating laundry/hospital pairs in the study. And the association hired an academic librarian to complete the literature search.

TRSA points out that the study begins with nearly 800 words tying linen to healthcare-associated infections (HAIs), although noting there have only been 12 cases of HAIs indirectly linked to linens worldwide (including three in the United States) over the past 43 years.

ALM says it appreciates TRSA’s comments related to the recently published, vetted study in AJIC, adding that “they are an example of the discussions we could have as a collaborative organization.” 

TRSA points out that it has supplemented robust inspection protocols with a quantifiable healthcare textile (HCT) performance level through its Hygienically Clean Healthcare Certification program. In addition, it says its long-standing Healthcare Committee has developed dozens of resources to educate the linen, uniform and facility services industry and healthcare professionals.

“Resources would be better spent focusing on real issues, such as the hygiene of washing healthcare textiles at home that endangers patients and others, as well as the more than $1 billion in linen loss created by mismanagement and misuse of linens and scrubs,” says Ricci.

The anticipated outcome of further research is unclear, according to TRSA. References in the AJIC research indicate there is no U.S. “standard,” when voluntary industry guidelines have been in effect for nearly a decade, which TRSA says implies that ALM intends to pursue government regulation and prescriptive processing formulas. 

TRSA says the AJIC report contends that further U.S. research is required to validate global protocols in the United States. International standards apply just as well to the United States as anywhere else in the world; essentially the same microbial tests and laundering techniques are used everywhere, observes Ricci. 

TRSA says it will not participate in ALM’s new research council and will encourage its association members not to participate. 

“I’ve not spoken directly with anyone from their organization, but based on their comments I don’t believe they understand the intent of the new organization,” says Linda Fairbanks, ALM’s executive director. “However, if they choose not to participate, that’s their prerogative and we will respect that decision.”

In lieu of the council’s formation, TRSA has proposed inviting Judy Reino, as the operator of a Hygienically Clean Healthcare Certified and HLAC Accredited laundry, and the president of ALM, to serve on the Hygienically Clean Advisory Board.

This would “foster ALM’s understanding of already established standards of hygienically clean linens as a starting point to research instead of starting from zero,” Ricci says.

ALM says that the purpose of conducting research is to generate new knowledge or to validate existing knowledge based on a theory, stating that research studies involve systematic, scientific inquiry to answer specific questions or test hypotheses using disciplined, rigorous methods—the type of research that is readily accepted by healthcare providers and administration. 

“Our goal with the Textile Research Council is to unite those within the industry,not divide,” says TRC chairperson Cindy Molko, CLLM, RLLD.

To read the original May 27 article about ALM’s effort, followed by a TRSA letter to the editor in response, click HERE.

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