Putting Patient Comfort, Safety First


Patients are key in healthcare textiles and linen management. (Photo: Encompass Group) 

Janice Larson |

Consultant talks impacting patient outcomes, satisfaction through textile management

LOS ANGELES — Healthcare linens and other textiles are important to patient safety and comfort. 

That’s what Melanie Miller RN, CNOR, a consultant with Silver Lining Apparel, a Certified Value Analysis Healthcare Professional (CVAHP) and an active member of AHVAP, the Association of Healthcare Value Analysis Professionals, believes.

Miller is a team-oriented nursing professional, experienced in direct patient care, perioperative care management, and materials management with strong focus on value analysis, linen management, sterile processing and supply-chain management.

She is an advocate for quality healthcare textiles and linen management processes that focus on the patient. Miller believes that by working together, healthcare providers and healthcare product developers and distributors can achieve their common goal of increasing positive patient outcomes and satisfaction scores, and I spoke with her about this.

Larson: What key textile products do you believe impact patient outcomes and experience in healthcare settings?

Miller: Linens are very important. Ensuring that the linen thread counts support quality patient care is important for ensuring patient safety and comfort. 


Melanie Miller

Melanie Miller

Fitted sheets should fit the bed properly, which is easy to say, but not always easy to do. When making patient beds, staff members should ensure that the fitted sheet doesn’t create a bow in the bed (due to being too tight) and isn’t saggy when wrapped around the mattress (due to being too loose). Proper fitting sheets should not be wrinkled or create pockets that the patient could roll into while resting, increasing the risk for additional pressure on areas of the body already vulnerable to pressure sore development.

In regard to patient experience, gowns play a big role. Making sure patient apparel is sized appropriately and has a wrap full enough to cover the patient as they move around helps preserve patient dignity. Patients are the most important member of the care team. As the key team member, their gown communicates that the organization respects their dignity and need for modesty as they travel throughout the facility. 

Gowns are also important in regard to patient safety. When patients are in the bed, gowns should be sized appropriately so that they drape over patients without adding unnecessary layers. The standard rule of three indicates that there should not be more than three layers under the patient while they rest in bed. Gowns should also be soft, breathable and moisture-wicking to ensure that the patient’s skin is protected and they are comfortable in whichever position they need or choose to rest in. 

A patient gown should also provide caregivers with easy access to the areas of the patient’s body that they need to access to provide necessary care, especially in the case of wound care. Physical body checks are an important step in proper wound care, and the right gown allows them to be completed with minimal discomfort to the patient.

Larson: Do you think underpads influence patient outcomes and experiences in healthcare settings?

Miller: I do. Underpads are an important part of care, and more and more healthcare organizations are moving away from disposable underpads and are reverting back to using reusable underpads, which were once the industry standard. 

A quality underpad should wick moisture away from the patient’s skin to ensure dryness. It protects both the patient and the surfaces they are resting on and provides a safe way for staff to properly position patients.

One important aspect to consider is this: Underpads should only be used when necessary. Not every patient needs an underpad while resting in bed or in a chair. Providing appropriate levels of care is based on patient needs. This idea goes back to the three layers concept, and adding an unnecessary layer under a patient is not advisable.

Larson: What about laundry and linen distribution processes impacting patient outcomes?

Miller: The goal of a laundry process is to ensure that linen is hygienically clean and that each piece has been assessed for stains, discoloration, defects or damage. Linens washed according to state and federal laundering guidelines keep patients safe from the threat of cross-contamination.

Sorting is an integral part of the linen process on both the healthcare facility’s end and laundry facility’s end; it’s a shared responsibility. Soiled laundry should be appropriately sorted by the healthcare staff and then sorting should be checked again when the soiled linens arrive at the laundry facilities. Assessing and sorting the laundry provides an opportunity to remove any contraband left in pockets or folds of linens that could be dangerous, or to dispose of any disposable items that may have been mixed into the reusable laundry in error.

Patients are underserved when excess waste is created. Adding more than three layers under them and generating unnecessary costs related to excess linen and bedding usage is an expense to all stakeholders. 

A well-designed linen process reduces waste. Not only does it allow for each piece to be laundered appropriately, properly sorted and assessed, efficient laundry processing also provides plenty of opportunity to remove stained or damaged linens before they arrive back at the healthcare facility, avoiding an accidental re-wash. Bed-making plans reduce waste by only using the items in the patient beds that are needed.

Larson: What aspect of the laundry and linen distribution process impacts patient satisfaction?

Miller: I know from personal experience that when you are a patient, you recognize from the moment you are admitted to a room that a hospital has a hotel feel. Patients consider themselves more than a patient; they consider themselves as a client or consumer. They want to see a towel and washcloth that are in good condition, are soft and are of the size they need.

Patients want bed linens to be soft, fit the bed, be in good condition, be wrinkle-free and be comfortable. They like flat sheets that are long enough to cover them when they lie down, and they want a thermal blanket that is warm. However, they don’t want too many extra linens. Patients just want the correct amount of linens to keep them comfortable while they rest and heal.

Larson: How can the healthcare textile industry tie their goals and business processes more closely to Triple Aim (population health, experience of care, per capita cost)? What can we do to keep Triple Aim arms top-of-mind when working with hospital clients?

Miller: I think what is most important is making sure that every team understands the importance of their role in the healthcare textile creation, purchasing and handling process. Relationships need to be built between the linen consultant team, laundry processing team, supply-chain team, value-analysis team and nursing governance. If all come together to identify which items they believe are most important to patient care, they can have an open conversation. 

Responsibility for quality healthcare textiles needs to be accepted on all ends of the textile management process in order to meet patient needs. Healthcare workers who take the time to consider their role in the process can be part of the solution.

Larson: What type of education do you think is needed for value-analysis professionals to understand the healthcare textile industry?

Miller: It’s important to develop value-analysis professionals through the Certified Laundry and Linen Manager (CLLM) Program, connecting them with information shared by the Association of Linen Management (ALM), and educating them with TRSA, the association for linen, uniform and facility services, training. 

It’s also important to learn through experiences such as visiting the laundry facilities they work with, attending health educational classes, and ensuring they are up-to-date on infection control industry standards and all other standards needed to be confident when responding to their local Departments of Health, Centers for Medicare and Medicaid Services (CMS) and The Joint Commission.

Larson: Is there anything else you’d like to share?

Miller: I know I mentioned it before but in terms of patient satisfaction, patient self-esteem and patient modesty, it’s always important to remember that the patient is the primary member of the care team. Their opinions should be sought out and responded to quickly. Patient experience should always be top-of-mind. 

If you don’t think the patient experience matters, you’re not paying attention to the industry trends. Consider the relationship between healthcare and hospitality when it comes to patient experience and satisfaction. It’s a score that is compared and documented and people respond to them in public reporting environments.

About the author

Janice Larson

Encompass Group LLC

Vice President, Clinical Resources and Consulting

Janice Larson is vice president of Clinical Resources and Consulting at ‎Encompass Group LLC.


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