CHICAGO — For David Balliet, senior director, customer relations, for Hospital Central Services Cooperative Inc. (HCSC) in Allentown, Pennsylvania, linen committees bring awareness to a commodity that may not be obvious to those who manage linen or work in the healthcare industry.
“There are things that hospital employees do with linen every single day, and they may not even realize that their actions could actually be linen abuse and are contributing to unnecessary replacements due to linen loss and damage,” he says. “Patient linen is to be used for patient care only; it’s as simple as that.”
Linen committees, Balliet continues, are also the forum to help develop an education and communication plan that can be impactful in controlling linen loss and abuse.
“Linen is often taken for granted, and as long as nursing has the right products, in the right quantity, at the right time, and of good quality, it can often be an afterthought,” he points out. “Hospital employees don’t always realize the importance of how they utilize this valuable commodity, and the impact and role that they have on the quality and longevity of the hospital linen.”
“An effective linen committee serves as a conduit connecting the laundry and linen services with the customer or end-user,” says Linda Fairbanks, executive director for the Association for Linen Management (ALM). “An active linen committee creates win-win for both the laundry and the hospital and drives success as it controls costs and improves efficiencies for both sides.”
Balliet says two types of policies or guidelines should be revised or adopted in the initial states of a hospital’s linen committee.
The first guideline to establish is a bed change/linen usage policy.
“Within the bed change guidelines, the committee will not only look at what linen items will be used on the patient admission/discharge beds, but also establish the frequency, and what specific items will be changed on the bed and patient,” explains Balliet. “The communication method to patients and family members must also be created through the linen committee after those guidelines are established.”
Other procedures he recommends be included in this guideline are external patient transports (to control linen utilization and loss through EMS) and rejected linen, so a facility knows what to do with pieces of linen that are not deemed acceptable for patient care.
“The second policy that the committee must adopt would be a scrub suit or employee-wearing apparel policy,” shares Balliet. “It is very important to revise or create this policy, as it has an impact on infection prevention as well as scrub utilization/cost and loss.”
Fairbanks adds, “Developing a policy is only the beginning of a process improvement approach that would measure the effectiveness of the policy toward achieving the goals, analyze the outcomes compared to the predictions and make changes as needed.”
Monitoring fiscal, regulatory, infection prevention and patient satisfaction data will aid greatly to identify potential policy needs, she says. Utilization data, such as pounds per adjusted patient day (PPAD) and loss rates that are outside of industry norms will indicate need for change.
“The committee should analyze each policy consideration with the following three questions: What will the policy accomplish, what will it cost, and will it consistently produce the desired outcomes?” shares Fairbanks.
Before policies/guidelines can be created, the linen committee needs to be formed. But who should be on the committee? Balliet recommends including several key members, such as the linen manager or supervisor, environmental services management, infection prevention, CFO or executive director of finance, security, clinical resource director, and end users and transport services.
Other key committee members include public relations and education department members—plus the linen provider.
When a healthcare facility’s linen committee first starts, Balliet recommends that it meet on a monthly basis.
“The first meeting should be a kick-off meeting in which the goals of the committee are determined,” he says. “After the kick-off meeting, they should meet on a monthly basis until all policies/guidelines have been completed.”
After that, the committee can reduce the frequency of the meetings to every other month and then eventually meet once every quarter.
Education and communication are key when it’s time to train and enforce the guidelines and policies to the hospital employees, says Balliet. There are many ways this can be accomplished.
“Linen awareness day in-services are probably one of the more popular and effective ways to educate hospital staff,” he shares.
“The in-services can be done in many ways, including ‘taking the show on the road,’ where the nursing staff can be gathered within their own department for a brief five- to seven-minute in-service using a trifold poster board and eight to nine different talking points.”
These talking points can include proper blanket usage, procedure for rejecting linen, linen abuse including employee actions that may damage linen, excess linen and patient rooms, proper gown wearing, discharge bed make up, linen loss through EMS transports, and loss by throwing linen in the trash.
“Learning is a repetitive process and reminders of policy/practice are effective at the point and time of use,” Fairbanks says. “Utilizing visual cues, posters, and reminders near the linen products point of use are an excellent approach. Including linen utilization practices and policies in hospital new employee orientation can help to set the stage for proper linen practices that may differ from their previous employers.
“Including instruction on linen utilization, avoiding linen abuses, and adherence to facility policies in annual employee training programs will help keep linen practice on their mind.”
By having the laundry service provider partnering with the hospital, Balliet says both entities will have a better understanding of the effect each other has on the hospital’s linen program.
“The linen provider is the resource expert to help the committee work toward their goals, and also has product knowledge,” he points out. “The facility and the linen provider both feel the crunch of linen loss and abuse. If the hospital can become more efficient with their use of linen, the laundry provider will also become more efficient.”
Balliet believes it’s important for all linen committee members to have a “homework assignment” to stay engaged between meetings.
“Effective laundry managers note that if a committee approach is utilized, it is important to have staff that are engaged and not assigned,” adds Fairbanks. “If they are only there because a manager instructed them to be there, the committee will fail.”