CHICAGO — Randy Bartsch, president and CEO of Ecotex Healthcare Linen Service, which has operations in Seattle, Vancouver and Toronto, sees many challenges in the healthcare laundry industry.
An overriding challenge he points to is the rapid consolidation of the customer base.
“In December alone, we saw four of the top 10 health systems pair up in mergers,” he says. “First San Francisco-based Dignity Health, the fifth-largest health system in the nation, announced that it was merging with Colorado-based Catholic Health Initiatives (CHI) to form an even larger health system with 139 hospitals.
“Then, in the same week, St. Louis-based Ascension, the largest nonprofit health system in the United States and the world’s largest Catholic health system, announced it was combining with Providence St. Joseph Health, based in Renton, Wash., to create, according to The Wall Street Journal, the nation’s largest hospital operator. The Ascension-Providence deal would have 191 hospitals, and would dethrone the nation’s largest pure hospital operator, the Hospital Corporation of America (HCA), which has 177 hospitals.
“These big-three hospital systems combined will operate 507 hospitals across the country.”
Bartsch says this consolidation puts growing pressure on providers of non-clinical support services like laundry and linen.
“Ours is an industry where ‘no news is good news,’” says Bradley J. Bushman, president of the Healthcare Laundry Accreditation Council (HLAC). “When things are going great for the hospital, they’re going great for us. On the other hand, if there are quality or infection issues, we hear about them quickly. Of course, there’s an upfront cost to quality and infection prevention, and this isn’t always apparent to the customer. We have made progress here, but we tell an even better story when we can educate about the standards we follow and the steps we take to ensure quality assurance and infection.
“Arguably, the larger message to keep in mind is the cost of not taking these steps.”
That means healthcare laundries have to keep an eye on the bottom line while maintaining clean, quality linen.
According to Bartsch, the best way to meet challenges on the business side of healthcare laundry is to continue to focus on the business, striving to lower costs, or at least keep them in check, to be efficient. That way, healthcare laundries can offer a cost-effective choice for customers.
“We have become increasingly more focused over the past five years,” he says. “Size and scale allows us to provide more and better services and innovations for our customers, as we can spread our costs over a larger base.”
The business challenge isn’t just on the laundry side. Healthcare facilities, such as hospitals and long-term care operations, have to consider the bottom line when choosing to either outsource its laundry service or create a centralized service or maintain an on-premises laundry (OPL).
“Control over product quality and service seem to be the primary concern,” says Linda Fairbanks, executive director of the Association for Linen Management (ALM). “This may give central, cooperative and on-premises operations the edge; however, if they can’t manage the cost issue, they lose to the commercial plants that provide good customer service (listening to their customers vs. telling them why they can’t do something) and quality products. The hospitals/health systems that beat up on a good laundry processor over pennies will regret it by failing to realize that quality has a cost.”
For Joseph Ricci, president and CEO of TRSA, the association for the linen, uniform and facility services industry, the choice between OPL/centralized or outsourcing should be based on identifying expertise, such as certified laundries and laundry professionals, which allow healthcare facilities to focus on patient care and not laundry.
“They should also consider opportunity cost-of-space utilization for laundry equipment and inventory that could be used to better serve patients for testing and treatment,” he says.
Bushman says OPLs have been fighting an uphill battle as the “value” of the space they occupy has, in many cases, become coveted by healthcare management.
“Of course, OPLs can make the case that they provide a higher level of service by being on-site, but in many cases, it’s just not enough to overcome this core obstacle,” he says.
In addition to service level, the price/quality proposition will need to be balanced, according to Bushman. He says establishing a committee of stakeholders is usually the best and most common way to make the best possible decision.
While healthcare facilities and laundries must continually look at the bottom line, the primary concern when it comes to linen has to be cleanliness. And that ultimately means infection control.
The industry continues to make strides to assure that the goods processed are hygienically clean.
“The linen, uniform and facility services industry continues to innovate and automate, by partnering with its customers and vendors to improve chemicals, fabrics and handling,” Ricci says. “We are also making it a priority to better educate the healthcare and laundry communities.”
Fairbanks says that laundry personnel, on both soiled and clean sides of operations, are aware of the importance of hand washing, the chain of infection, textile handling, airflow, appropriate wash process, storage, residual moisture and transportation. Also, infection preventionists and laundries are communicating more and focusing on sound, evidence-based practices and ensuring those practices are adhered to.
“Healthcare providers are learning that checks and balances need to be in place for accountability to sound, proven practice, including proper separation/storage of clean and contaminated textile products through all stages of the process, hand hygiene in textile handling, and first-in/first-out linen rotation,” she says.
Bushman agrees that there has been significant headway made in increasing awareness among management and operational personnel.
“That is, there’s much greater understanding among all relevant stakeholders of the dangers posed by contaminated healthcare textiles (HCT),” he says. “This includes laundry plant personnel at all levels, environmental services (EVS), infection practitioners (IPs), those in the hospital C-suite, patients and even the public.”
Bushman says the industry has also made advancements in both the functional and aesthetic aspects of HCTs.
“Just like the hospitality industry’s improvements regarding overnight guests, hospitals are starting to understand that the quality and comfort of HCTs has an impact on a patient’s overall satisfaction,” he says. “As a result, we’re seeing higher-quality, more durable, more comfortable and more functional textiles.”
Check back Thursday for the conclusion on the service/management relationship and future challenges.