ROANOKE, Va. — Textile replacement costs are the second largest cost in operating a laundry, trailing only the cost of labor.
I have been in the healthcare laundry business since 1972 and have had the opportunity to see a number of different management philosophies in dealing with this expense. To me, the key factors that must be considered are customer needs, quality of textiles versus expected life (cost per use), and the need to have a consistent product presentation.
I belong to and work with a number of different groups that support the laundry/linen industry. Each one defines its goal in a different way.
Provider-owned laundries more often than not see themselves as a part of the patient care team and look for textiles that will enhance the patient experience and look good. They want to do this at a reasonable cost, but cost is not the overriding factor. Many providers are willing to purchase higher-end textile products in order to present a visible difference between them and their healthcare competitors.
The greater the competition between healthcare providers in a geographical area, the greater the desire to differentiate themselves.
A good example of a textile product in this area is the purchase of a 100% polyester thermal spread that holds its size and color during its lifetime, and the color is selected specifically because it blends well with the interior designs in the hospital. Because the product takes less energy to process and has a longer useful life, a facility can even justify a custom color if needed.
The second general type of laundry is the large co-op-type laundry. The overriding management concern in this type of laundry is to keep the cost as low as possible. Sometimes, all the hospitals in an area belong to the same co-op, so another major concern is to prevent the abuse of textiles from one facility to raise the cost to all the facilities. The concerns of the nursing staff at the member hospitals are subordinated to the need to keep the costs down.
A good example here is where one co-op I know removed all pockets from scrub apparel to prevent sharp objects from puncturing the press cushion on the tunnel washers. My scrubs are completely reversible, and each top has three pockets per side. Yes, what the textile manufacturer calls a fully reversible six-pocket scrub does cost more but it fits the needs of all male and female staff. One scrub style fits all.
Traditionally, co-op laundries use white poly-cotton blend thermal spreads because they are the least expensive to buy. These white thermal spreads perpetuate the traditional bland, sterile-looking hospital environments most hospitals are trying to get away from.
The commercial laundries’ major focus is making sure they maintain a certain bottom-line profit margin. This can be accomplished by tightly controlling how much linen is delivered to each facility. Their major emphasis in textiles is making sure they can allocate linen loss to each customer.
One laundry in my area is putting RFID identification chips into their linen so they can accurately track how much is sent and returned. These systems will allow the laundry to more accurately charge out linen loss. Often, the commercial laundry will buy a less expensive gown while still charging replacement costs based on the better-quality gown offered previously.
A marketing ploy that has become popular over the last five to 10 years is treating surgical scrubs like a uniform rental program. The vendor places exchange lockers into the healthcare facility and restocks these lockers on a weekly basis. Each employee is given a certain number of scrubs in his/her particular size.
The healthcare facility is responsible for all lost scrubs and pays a weekly rental fee. This program was developed as a possible answer to the problem of scrub losses but does not reduce cost or increase user satisfaction.
Problems arise with scrubs not coming back from the laundry, employee changing sizes, and increases in shifts an employee may work. Often, employees end up taking the soiled scrubs home to process. This self-protection move by the employees only increases the laundry vendor’s profit margin.
To summarize my opinions based on more than 45 years in the business:
Healthcare laundries owned by a single provider or network — Textiles are a functional part of the effort to provide good healthcare. Emphasis on cost per use and how the textile product enhances the patient experience. Textile costs are to be kept at a reasonable level, and laundry management works closely with hospital staff to increase the functionality of the textile products. Laundry management works cooperatively with medical staff to explore new medical textiles as they become available.
Co-op laundries — Emphasis on purchasing textile products at the lowest acquisition costs. All member hospitals must use the same products. Generally, less likely to test or recommend testing any advanced medical textile product. Management time spent on containing costs and making sure textile products are appropriately allocated between owners. Co-op laundry management will get involved with innovative products when they are purchased by the interested facility and all they have to do is process it. Any extra costs for processing the linen will be directly allocated back to that facility.
Commercial laundries — Emphasis is on the bottom line. Textile products are purchased at a low cost and systems developed to enhance revenue by charging for lost linen. Program development is driven by appearing to address customer issues but actually improve bottom-line revenue. Commercial laundries are willing to process and work with new, innovative textile products when the hospitals insist, and they can find a way to make it highly profitable.
There are a number of excellent healthcare linen providers in this country, but the type and quality of linen they purchase is based on their textile philosophy.
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