Plant Inspections Offer Opportunities to Shine (Part 2 of 2)

I know that my laundry operation is due to be inspected sometime this year, but I'm not sure how to get ready for it. Where do I start? Where should my focus be? In what areas am I most likely to face criticism or sanction if our plant is deemed substandard?CHEMICALS SUPPLY: Steven Tinker, the director of research and development for Gurtler Industries, South Holland, Ill., has more than 30 years of experience in laundry chemistry research, development and marketing. He’s secretary/treasurer of the Healthcare Laundry Accreditation Council.
First, a disclaimer: I’m one of the original members of an independent industry effort to establish the Healthcare Laundry Accreditation Council (HLAC), and I serve on its board of directors.
The HLAC Accreditation Standards, available online at, can help guide you through all the areas of concern in your facility that will be important in an inspection.
The best way to prepare is to run your own pre-inspection or mock inspection, perhaps with your department heads. There are four key areas to focus on:Occupational safety and hygiene – Make sure that all the appropriate signage and warning information are up to date. Walk through the laundry and look for “unsafe” conditions. Make sure it’s clean and that excess clutter is properly stowed.
Employees dressed in neat, clean uniforms, and floors, walls and ceilings that are clean make a good impression. Take time to repaint your yellow or red safety or caution lines on the floor, handrails and other guards. Check your fire control systems, extinguishers and sprinklers, and make sure your disaster and fire evacuation plan is well posted and easily understood.
Make sure the maintenance department has all the equipment operating properly, and that all equipment guards and safety shields are installed and working properly. Check the eye-wash stations to make sure they are openly accessible, and see that employees use the hand-washing stations.Employee development and training – Hiring, developing and training your employees is one of your most important duties. Training programs for things such as bloodborne pathogens exposure should be well documented.
Proper use of ironers, small-piece folders, washers and sortation systems should also be documented. If your operation has drivers, their training records should have dates, training objectives and an indication that they meet minimum levels of competency.Quality control and process monitoring – The laundry is just like a factory that transforms raw materials, components, parts and more into a usable product. Process control and quality management are important to assure your customers that your clean textiles are consistent and of the highest quality.
Make sure that all of your employees understand how you rate quality, and the proper procedures for handling quality issues. Identify key factors in your process that affect quality, and make sure that these are checked and records are kept of the values.
These can be as simple as the final pH of fabric coming out of the washer, load weights and the titrations prepared by your chemical representative. Water quality tests, softener regenerations, boiler treatments, preventive maintenance, rewash rates and test swatch results are all quality-assurance records you could maintain.The overall textile processing cycle – After you make sure that all your record-keeping is up to specification, I recommend you walk through the laundry, from the back to the front, and observe the entire textile processing cycle.
First are collection, handling, transportation and sorting of soiled textiles. Watch to make sure they are properly bagged, labeled, handled, weighed and sorted by your standards. Confirm that universal precautions are being observed, if applicable. Make sure you have a procedure for handling sharps.
Next, watch the wash aisle. Make sure the washers are loaded properly, water temperatures and levels are in control, wash times are proper, chemical injection systems are operating correctly, and the extraction process is in control.
Watch the dryers to make sure the temperatures and drying times are set properly. Observe the ironers for proper handling of textiles and safe use of the equipment.
Next, observe the packaging and/or storage of clean textiles. Make sure the storage area is clean, neat and secure. Do you have a posted cleaning schedule for various areas within the laundry?
Next is delivery of the clean textiles. Make sure they’re separated from the soiled textiles when delivery and pick-up are handled in the same vehicle. See that the vehicle is clean, and a schedule to clean is set.
When the inspection of your process is complete, you may have a list of several items that need to be improved, upgraded or changed. Implementing these improvements should help you run a smoother, safer, higher-quality operation, and help assure you that your facility will pass its upcoming inspection.LONG-TERM CARE LAUNDERING: Vicki Elliott is environmental services manager for Kendal at Ithaca (N.Y.), a continuing care retirement community housing 300 residents (independent living, adult home/assisted living, and skilled care).
At Kendal at Ithaca, the New York State Department of Health (NYSDOH) conducts surveys annually without notification, so we must always be prepared.
I was given a 3-inch binder of rules and regulations when I became the environmental services manager that I was to review and use to make sure that the laundry remained in compliance. Most related to basic, common-sense issues such as providing sufficient and clean linen, infection control procedures, proper transportation of clean and soiled linen, and maintenance of the laundry area.
I worked closely with the director of facilities, who pointed out areas that were potential problems and suggested I contact other facilities that had already been surveyed.
I also joined the local National Assn. of Institutional Linen Management (NAILM) chapter and contacted other laundry managers with similar operations in upstate New York about their inspections.
Another way to prepare is to ask your local Department of Labor representative to conduct a mock Occupational Safety and Health Administration (OSHA) survey. The New York inspector looked at our training records, use of personal protective equipment (PPE), fire safety and lint buildup, and suggested a way to identify laundry chemicals by using a color coding system. He gave me a comprehensive report on how to make improvements.
Kendal at Ithaca is committed to promoting high-quality life and healthcare for the aging, and we strive to stay in compliance with mandated rules and regulations.
If the NYSDOH survey team should find any deficiencies, the administrator receives a plan of correction. This report is sent to the NYSDOH offices in Syracuse and Albany, to the federal government office, and to Kendal’s Corporate Compliance office.
It’s also posted on the New York state and federal Web sites, and it must be posted on bulletin boards throughout our Health Center.HEALTHCARE LAUNDERING: Sue Klein is the marketing manager for Shared Service Systems, Omaha, Neb., a central healthcare laundry that serves customers ranging from large urban health systems to small rural hospitals. She’s been active in the International Association of Healthcare Textile Managers (IAHTM).
Inspection is something we anticipate every day. Patient lives are influenced by the cleanliness and handling of our linen, and we encourage our customers to inspect us at any time.
As an exclusive processor of healthcare linen, we follow guidelines issued by OSHA, the Centers for Disease Control (CDC) and JCAHO. These organizations mandate practices in the handling and processing of healthcare linen, and serve as good areas in which to concentrate. Focus on:Air flow – The CDC requires that the receiving area for contaminated textiles be maintained at negative pressure compared with the clean areas of the laundry. Routinely check that this pressure is properly operating to ensure that any contamination from soiled linen is not passed to an area where cleaned linen is located.Handling of soiled linen – Following the OSHA guidelines for handling bloodborne pathogens begins with the healthcare facility itself. The laundry may take an active role in educating the facilities about the condition of soiled linen being received.Wash formulas – Periodic testing and checking the resulting clean linen is important to cleanliness, as well as customer satisfaction. Proper wash times and water temperature are also key elements.Handling of clean linen – Workers may be tempted to pick up linen from the floor, or continue to process unsatisfactory linen as if it were clean. Paying workers by the piece needs to be tempered with quality measures. Stored clean linen must be protected from contamination or re-soiling before it’s sent for delivery.Transportation – If soiled and clean linen are transported in the same vehicle, the soiled must be sealed and impervious. We disinfect our trucks and the laundry carts every time they return to us. A focus on cleanliness cannot stop at the door.Worker health – Bloodborne pathogens, chemotherapy drug residue and bodily fluids found in soiled linen pose a risk to the workforce. Strict hand washing and use of gowns and masks are valuable tools in protection. Clearly, the worker who is handling clean linen must be free of disease to ensure no contaminants are introduced to the clean linen.
Inspection is a word which can induce stress and anxiety, but if your daily operations reflect these areas, your practices can become a true competitive advantage.


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