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Whether your facility processes laundry on premise, uses a shared laundry, works with an outsourcing firm or some other method, smart textile management can lead to sizeable savings, both in processing and replacement costs.

Medline offers a full line of textile products - Shown: contour sheet & reusable underpad

Through its TexCap program, Medline Industries guarantees savings on textile utilization, based on total savings from textile processing and replacement costs per adjusted patient day. The program begins with a walk-through tour and assessment of all of the textile use areas in the facility and a subsequent "impact study" performed by Medline’s textile specialists who include nurses and former laundry and linen supply managers. 

"We go to each department that uses textiles – outpatient and inpatient, onsite, offsite – and we look at how the textiles are utilized," said Mark Whitaker, senior vice president, textile sales, Medline (Mundelein, IL). "We’re looking everywhere to see, ‘what’s the practice?’"

He explained, "we start by making very strong recommendations about the [textile] product mix. When the textiles utilized in a facility are engineered correctly to do the job they were designed to do, that is a huge first step. That’s what we can do first and foremost to help lower their costs." He added, "even if they have the right product – if they use it incorrectly, it can be very costly."

In addition to its professional laundry services, ARAMARK offers a comprehensive selection of textile products through rent, lease or direct sale – including scrubs, labcoats, patient apparel, work apparel (business casual and maintenance), flat goods, towels, microfiber, hygiene solutions and mats. The company offers several products to service multiple departments within one location. "For instance, we supply Environmental Services with microfiber mops, Facility Services with workwear, towels, mats, and linens, and Nursing and Surgery with scrubs and surgical gowns," said Dan Perry, senior vice president of sales, ARAMARK Uniform Services (Burbank, CA). "One solution for several needs helps save costs and allows the facility to manage a consolidated program."

Perry noted, "most customers prefer customized agreements with rental and direct sale flexibility. Depending on the facility, whether a hospital or small clinic, employee turnover, job requirements, and product usage varies. Some employees may not be in contact with bloodborne pathogens; therefore a different solution at a different price is necessary. Other employees are held accountable to OSHA requirements and are reliant on a consistent, sterile product. Having a product that lives up to its expectations is of the utmost importance."

Just some of the things flagged as wasteful practice by Medline textile specialists: Rolling up blankets to prop or position patients instead of using pillows (a blanket costs at least twice as much as a pillowcase just to launder); double-gowning patients to compensate for poorly designed apparel; using thermal blankets that don’t retain heat well – leading to the use of more blankets; using full-sized towels when a hand towel would do.

Small changes in practice can quickly add up to big savings when you consider that "for every dollar that a hospital spends on its textiles, 75 cents of that dollar is usually to process it or wash it; 25 cents is for replacement, said Whitaker.

Healthcare linen carts stocked and ready thanks to ARAMARK route sales representative.

Reducing the number of bed changes is one sure-fire way to lower laundry processing costs. According to Whitaker, twenty years ago Medline helped to introduce a contour sheet to the hospital bed that was made from a soft knitted fabric, fit different size mattresses, went on quick and easy and stayed put – as opposed to traditional woven contour sheets or flat sheets that were always popping off and led to nurses remaking the bed with fresh bedding. "That was very expensive," said Whitaker. "These contour sheets because they stayed on better, cut the bed changes down and made everything quicker. So we saved tons of money. Every time you save a bed change you may be saving 7 or 8 pounds that you’re not sending to the laundry again." Medline has also had success in reducing bed changes by introducing reusable incontinent pads to replace disposable underpads that are likely to leak through.

Another problem occurs when time-strapped caregivers routinely bring a stack of textiles into the patient room rather than first assessing what’s truly needed, said Whitaker. "In most states when you bring clean textiles into a patient room, they’re automatically considered soiled after that. Those [textiles] are already dedicated now to that patient."

Whitaker reminds facilities to "be conscious that nobody is deliberately wasteful in a healthcare environment. The caregivers are there to care for the patients and they’re going to do whatever they think they need to do most quickly to get that done. The caregivers are pressed just to do the routine things that they have to do for patient care – managing a textile supply isn’t part of that list."

Co-op laundry runs clean and lean with updated, high-tech equipment Opening their doors 15 years ago, Bay Linen, a hospital owned laundry in Clearwater, FL, processes and supplies all hospital textiles from medical and bio hazard materials to specialty items. Bay Linen was formed out of a need for a co-operative hospital laundry in the Tampa, FL, area. At the time, four hospitals in the area concluded that they would be far more productive if they joined forces rather than duplicating efforts and competing with one another. The customer base has now expanded from four hospitals to include 17 area hospitals. While Bay Linen originally had competitive laundry equipment when they began operation in 1992, by 2001 the facility was experiencing set-backs from the now outdated equipment that did not allow them to achieve necessary productivity levels. As they continued to grow, their equipment simply could not keep up. After running a failing operating schedule of 5 days per week and two years of losing money and not operating efficiently, Bay Linen decided they needed to purchase more reliable laundry equipment and increase their operating schedule to 7 days per week in order to be most productive. After conducting research, the laundry found that some of their most productive competitors were using a Milnor CBW tunnel washer with a 2 stage press. "The creation of a co-operative hospital laundry in Florida that was self-sufficient, reliable and capable of producing a high quality product for our customers was our number one goal," said Bay Linen CEO Mark Hoenemeyer. "Labor and utility savings were key factors in our decision making process in choosing an equipment supplier. In our redesign, we chose Steiner Atlantic Corporation because they offered the best solutions to our needs and had the most proven experience with Automated CBW Systems. Their flexibility and willingness to work around the operations of our existing laundry was paramount. They were able to design, install, and start up each new phase, while the current equipment continued full operation." Bay Linen began working with Steiner Atlantic Corporation in 2003 in redesigning the equipment for their 75,000-sq. ft. state-of-the-art hospital laundry. In 2004, Steiner installed the first of three Milnor CBW tunnel washers with the second two following shortly. "In designing a laundry, our goal is to offer the best solution to the customer’s needs," said Rich McKevitt of Steiner Atlantic. "Labor and utility costs were key concerns of Bay Linen. The fully automated laundry now boasts labor and utility savings in excess of $1,000,000." The Bay Linen laundry consists of three Milnor CBW tunnel washers each with a 150 lb. capacity, three 2 stage presses, 18 Milnor dryers, Milnor washer-extractors of varying capacities and two Milnor dryers with shuttle; as well as three Chicago Powerhouse Ironers and five Chicago Feeder and Folders. Milnor Mildata Production Management System is also used daily to generate reports and provide the facility with a wealth of information. Hoenemeyer commented, "Rich McKevitt with Steiner Atlantic has been a huge help with coordinating and facilitating any corrections that we may have needed in their laundry." Bay Linen is centrally located and their entire customer base is within 150 miles of their facility. Through the installation of the Milnor CBW washer system, Bay Linen is operating extremely efficiently while also experiencing outstanding savings in the laundry. They are currently operating with 150 FTEs. At the old plant, they had up to 300+ FTEs. Employee retention and morale has improved with the increased automation. Before the installation of the CBW tunnel washers, the laundry was in operation 84 hrs. each week operating seven 12 hr. shifts. Now, the laundry is operating 70 hrs. each week, with seven 10 hr. shifts, representing a 20% decrease in operation. The laundry has expanded steadily through the years and is now averaging 36 million lbs. per year. Energy consumption was greatly reduced from 0.27-0.32 to .2-.25 BTUs per lb., their current level of gas consumption. Chemical consumption is performed in-house and is reported to be less than 80 cents per clean 100 weight goods out of the door. With the national average of rewash rates being 4-6%, Bay Linen is ahead of the curve with a rewash rate of 2-3%. They use about 1.5 gallons of water per pound of goods which includes the whole laundry not just their tunnels. The water used in the washing process went from about 2.5 gal/ lb. to 1.5 gal/ lb. — a 40% savings in water consumption. The CBW tunnel washer provides a high-quality finished product, and the reliability of the equipment allows Bay Linen to service their customers well with 100% on-time delivery, which is imperative to the success of the hospital. Hoenemeyer stated, "We are a manufacturer, we’re not a laundry. We pick up soiled linen, wash it, iron and fold it, bring it back to the customer thus provided a quality manufactured product for the next patient." Bay Linen processes 7 days of hospital linen with 5 days of actual linen in system, with $1 million saved (each day $475,000). This is a huge factor to medical professionals that may only work on a 3% margin. The hospital laundry is 2% of their total operating budget. Bay Linen is able to sustain costs and have not had a price increase on their linen services in over 15 years which still remains at (34 cents/lb.) "Our success is a result of our dedicated staff and the reliability of the laundry equipment that we have installed in our laundry. We owe Mike Kortas, Bay Linen director of engineering, Steiner Atlantic, and Milnor for making us what we’ve become today," said Hoenemeyer.

After completing the walk-through, the Medline textile specialists review the information to assess the facility’s costs for both textile replacement costs and laundering costs and make their recommendations for improvement. "We find that we almost always can identify savings as large as 20 percent," said Whitaker. But what ultimately determines the cost savings that can be achieved depends on the commitment from the facility. "We try to understand the culture within each individual hospital so that we identify the procedures that can be modified. We discuss with them what’s practical and what’s not and then we come up with what we think the savings potential are."

Whitaker acknowledged, "there are many facilities where the patient care staff is so tied down with their daily routine that virtually any change can be a problem. Even so, there are usually suggestions we make with regard to the way textiles are distributed that could reduce costs with an improvement in staff efficiency."

He continued, "First we’ll make the recommendations and then we go the next step of a guarantee. Realistically, the guaranteed savings come in somewhere between 5 and 8 percent."

Whitaker noted that while regular meetings among key hospital staff are integral to driving the guaranteed savings program, administrative support is what really sets a program in motion. "If administration is really committed to cost savings we can deliver it."

Another reason Medline is able to offer guaranteed savings with TexCap is that the program’s sales representatives are compensated based on meeting the cost savings goals set with the hospital. "It’s not the traditional ‘pay by commission’, where the more a hospital buys, the more the rep makes," said Whitaker.

One longtime TexCap customer, the University of Arkansas Medical Center, Little Rock, has taken full advantage of the program, realizing savings of more than $100,000 every year. The program began as somewhat of an experiment, explained Whitaker. "We first put in the linen room manager as a Medline employee. Eventually we took the entire linen distribution staff and put them on our payroll. We put pay incentives in place for the linen distribution manager – the better we did on the costs savings, the better his bonus."

He added, "The nursing staff rightly said that ‘reducing textile costs can’t negatively influence our patient care. We can agree to do all of these things, but if you don’t deliver the linen clean, on time, where we need it, when we need it – it really doesn’t matter what the costs are.’ In this scenario we said, ‘no problem, we control it’, it was really strong. It continues to drive that savings year after year."

Letting an outsourcing firm handle laundry headaches is becoming an attractive option for many facilities.

"Aramark Uniform Services institutes a streamlined process for orders of every size to ensure the customer always has product on-hand," said Perry. "Our quality control check helps alleviate loss and ruin occurrences. We incur the initial capital investment of equipment, distribution, and labor. Therefore, cost savings is passed on to the customer. By allowing Aramark representatives to pick up, launder, and maintain inventory, the customer improves efficiency and worker productivity at their location."

Medline also offers textile management software that helps facilities to analyze distribution and utilization patterns. The company’s textile specialists can help facilities
to craft policy and procedure manuals, as well as host Linen Awareness Days. They have also created programs for hospitals that want their staff to purchase their own scrub garments through Medline-hosted scrub shows on-site, web-based ordering systems, or through a partnership with retail uniform store Scrubs & Beyond.