CHICAGO — Linen loss.
It’s a constant struggle in the industrial/institutional laundry industry, but it can be more challenging at healthcare and long-term care institutions.
At facilities that provide patient care, there are multiple ways that linen can “disappear,” which can make it difficult to have the necessary linen on hand for users and adds to healthcare linen costs.
The solution? Utilization data gathered through a linen management system. This information provides both the healthcare provider and the laundry a clear picture of how goods are being used and where loss consistently takes place so that linen loss, and cost, can be curtailed.
INVENTORY TRACKING
Ralph Hidalgo is system linen director at Adventist Health West headquartered in Roseville, California, specializing in environmental services and linen management. During the recent Association for Linen Management (ALM) webinar “Unveiling the Impact of Optimized Linen Management,” he shared that healthcare facilities and laundry operators need to create a partnership to counter linen loss and its related costs.
“Not only at the level of the account manager but you want the co-owner, somebody needs to sit in the room and have a real honest discussion about what pain you’re experiencing with your linen management and your losses and also understand what the losses and what the problems the linen company may be experiencing,” he says.
“You’ll be very surprised to find out that there’s a commonality between what you’re suffering and what they’re suffering.”
Hidalgo says that his system’s linen efforts were losing up to $1 million a year. The program it initiated has reduced that loss to around $600,000 a year for the past three years.
The importance of linen in a healthcare system needs to be elevated, he says.
“Linen itself is a medical instrument under CMS (Centers for Medicare and Medicaid Services), a very low level, but I’ll bet it’s the first medical instrument that’s going to touch your patient, but we don’t treat it that way.”
Hidalgo says the first level of “attack” to improve linen management is at the macro level.
This involves identifying real losses from two databases—internal poundage data or reports from the laundry and census data from the healthcare facility to pinpoint where linen loss is happening.
“You really need to avoid those losses, and in many cases, the linen management systems in place do not do that,” Hidalgo points out. “All they are reporting about is, guess what? ‘You had a $14,000 bill for the month of September,’ and you’re going, where did that come from?
“You then have to attack your linen loss at a micro level. You’re going to have to start drilling down. You’re going to have to reevaluate every reporting piece of paper, the way you’re managing or tracking down where your losses are located.
“In other words, you need to have the ability, for instance, to know that you should have 400 towels on a floor. The reality is that there were 200, and now you’re finding out there is zero. Why did that happen? Why doesn’t my system let me manage this and be able to work this out?”
A facility must understand the dynamics of the relationship between the daily census in a 24-hour period and the linen for a linen inventory system to function, Hidalgo adds.
“If you’re not able to interpret that, you’re going to constantly be in a situation where you’re getting on the phone next morning and saying the fourth floor needs 150 bath towels, and then you’re scrambling, running around floor to floor,” he says. “In a panic, you call the linen company, and you say I need not only the 150 that I usually get, I need 300.
“Your interpretation is that you’re short when you do have them. You just don’t have the data to tell you that, and that’s the reality that’s happening every day.”
Hidalgo stresses that healthcare and long-term facilities must have the metrics to measure where their linen is every hour.
“You have to see a picture from 24 to 48 hours, no longer than 72 if you have a real small operation, to be able to understand the numbers that are needed so you know exactly where you need to move around your linen, without calling a linen company for more, and supply the needs to that floor for your patients,” he says.
There are three departments that typically experience linen loss, shares Hidalgo, who worked with his linen provider to RFID (radio frequency identification) chip and track the linen in his system for 18 months.
Emergency rooms often send patients home in hospital pajamas or wrapped in bath blankets. EMS leaves the E.R. with a set of linens for the next patient they pick up.
Maternity wards lose items such as baby blankets and shirts, bath blankets, and underpads. And when patients are transferred to an extended care facility/skilled nursing unit, EMS often takes linens from the rooms with the patients.
“It wasn’t anything new,” Hidalgo points out, “nothing we didn’t already know. In these three departments alone in one hospital, the average was about four to seven pieces of linen leaving with a patient. With the census, that turned out to be between a $2,000 and $3,000 loss per week.
“If you’re able to, start measuring these kinds of situations, log your losses by department. Capture it, and with your executive leadership, sit with your laundry partner and start discussing plans and how to mitigate those kinds of losses. Without RFID if you have to, but if you can have RFID, go for it. It’ll be able to give you all kinds of information that can help you track down your losses.”
He stresses that the reporting tools used must be able to provide a clear picture of linen usage, including pounds per patient, cost per patient, losses, and cost of goods.
“You need all that information in a timely manner, not more than a month,” says Hidalgo. “You need to have that story really clear as to what’s happening, and that is where you’re going to partner with your laundry.
“They need to work with you and create a database and feed it to you either weekly or monthly or whatever period you need to be able to identify what’s happening with your linen usage and your costs.”
He says the laundry provider should have all the poundage data on its linen management system, and the healthcare facility should have the patient census information.
“You need to merge that together in a partnership to be able to develop real data that will tell you something that is going well or wrong, in a timely manner,” Hildago reiterates.
Monique Walker, director of housekeeping for Vi at Grayhawk, a senior living community in Scottsdale, Arizona, says linen is tracked manually at Vi with spreadsheets for personal linen, dining room linen, care center linen and independent bedding.
“We typically have to do the description, the pounds, and unit or area number so we can track all items coming into the laundry and the weight and washer it goes into,” she says.
“We have a labeling system … that we use to label fabrics. We also use a three-part ticketing system so that we can jot down what has come to laundry and what goes back to residents.”
Walker says the system used at Vi has been effective for years with little lost linen.
“When residents transfer to other units or apartments is when items can get lost,” she points out, “but communication through e-mail letting us know what movement happens and when allows us time to communicate with the laundry staff about changes before laundry is collected from the units.
“I think all the systems we have in place have been working for years, and we have not had many hiccups. I would share our program in its entirety and share forms and processes so that others could have their own program similar to ours.”
FINAL THOUGHTS
While linen loss can’t be fully eliminated, it can be controlled with linen management and accounted for in a healthcare facility or system’s budget.
“If you can get your facility to where you have what I call ‘easy losses’ under control, you can now budget for those losses,” Hidalgo says. “That’s part of doing business.
“If you’re not budgeting some part of your losses into your budget every year, you’re going to be sitting in front of your executives and them saying, ‘Why are you guys out of variance every month?’ This is really key, and I hope that triggers an opportunity for you to get back and look at that real close.”
He stresses that utilization data is key for healthcare/long-term care facilities and their laundry providers to understand how to reduce linen loss.
“This is the kind of data that you need to be able to talk the language within your hospital and with your linen laundry partner,” Hidalgo says. “Your laundry partners are hungry to understand what’s happening on your end. If you’re not talking to them, they can only assume what’s going on based on what they see on their end and so forth.
“By creating (utilization data) charts, you can have a better relationship with your linen partner and a better relationship within the internal organization of your hospital.
“Your linen laundry management teams would like to see, as they’re sweating to make this work, some type of results of what they’re pulling off. It really pays off.”
Miss Part 1 about causes of linen loss and the related costs? Click HERE to read it.
Have a question or comment? E-mail our editor Matt Poe at [email protected].
