Linen efficiency strategies: Containing costs and reducing waste

Troy Taylor, Chair- Distribution, Sally Lee, Co-Chair- Value Analysis Program, Ann Bennett, RN- Emergency Department, Joanne Brasch, M.S.- Dept of Textiles, Frances Hollinseed, RN- Perioperative Services, Gloria Hurd- Environmental Services, Tristan Kable, RN- Transplant/Metabolic, Jeff Mobley- PCS Administration, Patti McCabe, RN- Pediatrics, Bill Montalvo-

Infection Control and Prevention, Paula Paivo- Angelica Laundry, Phoebe Penalver, RN- Women’s Health, John Danby- Occupational Safety: Sustainability

Objectives:The Linen Committee was charged to establish and enforce linen management policies to improve efficiencies and reduce waste, and to incorporate sustainability principles, while maintaining patient-focused quality of care and safety.

Methods:Baseline data was collected to understand linen categories (e.g., bed linens, towels, gowns, scrubs, etc.), and their replacement and laundering costs. Unit site visits were performed, and staff were surveyed to assess their understanding of linen management practices. Departmental policies on bedmaking and linen management were reviewed.

Results:Cost and weight analyses for bed linen composition showed that two major items for potential reduction were incontinent pads and thermal blankets. Combined, those two items comprised almost60% of total bed linen weight and 25% of the linen replacement budget.

Staff from 15 nursing units participated in a linen survey. Survey results indicatedknowledge gaps in staff practices and that they would benefit from further educational outreach.

Action:The Linen Committee recommended the following changes to improve linenefficiencies, which were included in the staff education campaign:

(1) eliminate daily linen change requirements; (2) reduce use of incontinent pads and thermal blankets; (3) refrain from bringing extra linen into patient rooms; (4) promote linen reject bag usage to reduce linen waste.

Early Outcomes:With implementation starting in July 2012, early results have demonstrated reduced linen replacement and laundering costs for bed linens. The education campaign has raised awareness on staffs ability to support sustainability efforts without compromising the quality of patient care.

Questions? Ideas? email: Sustainability@ucdmc.ucdavis.edu

Eliminate daily bed linen change: The revised bed linen change policy eliminated mandatory daily bed changes, and focused on bed linen change as needed, or upon patient request. Staff education focused on highlighting the benefits from saving nursing time and the hospital’s reduced environmental footprint. Patient education included tent cards provided at bedside, and verbal notification at unit admission.

Reduce use of incontinent pads:Incontinent pad practices were changed to focus on using them only after clinical assessment of patient need. Along with the recent introduction of disposable incontinent pads, overall costs of purchasing and laundering incontinent pads has decreased.

Reduce use of thermal blankets:New bed making procedures reduce the use of thermal blankets which had been replaced upon each bed linen change. The blanket gets changed only if soiled or upon room cleaning, after patient discharge.This has reduced laundering costs for thermal blankets.

Eliminate unnecessary extra linen storage in patient rooms:Staff education campaign focused on deterring extra linen being stored in patient rooms. This prevents unnecesssary risk of contamination for linen that might not get used, as well as reduces the need for additional linen inventory.

Promote proper hamper use:Clearly defined and labelled hampers facilitate efficient linen sorting of soiled and rejected linen, ensuring that no linen should be discarded as red bag waste.

Additional Areas of Oppotunity:Future projects to support linen cost reduction and sustainability goals, include:- Washable surgical linens and warm-up jackets - Reusable pillows- Scrub dispensers to reduce loss of scrubs - “Walking” linen reduction - Reject linen diversion from landfill

Staff Education Campaign:

Linen Bed Changes

2012

Reusable Pillows

Incontinent Pads and Thermal Blankets

» If linens for all hospital beds were changed daily, this would result in $620,000 in laundering costs annually.

» In 2009, it was estimated that $164K of linens were thrown out instead of washed

New reusable pillows potentially coming to patient beds. . .

New bed change practices reduce usage of incontinent pads and thermal blankets by only using them to make beds for patients in need.

Questions? Concerns? Ideas? email: Sustainability@ucdmc.ucdavis.edu

To ensure your comfort and protect our environment, we will change your bed linens as needed or upon request.

Together we can help to conserve millions of gallons of water, save energy, reduce air pollution and minimize the release of detergents into our ecosystem.

HEAL TH IER PLANE , HEAL TH IER PEO P le.

» In 2011, UCDMC threw away 134,045 disposable pillows (costing over $200K)

» In 2012, the Linen Task Force wants to reduce cost and environmental impact by switching to reusable pillows that o�er more patient comfort

To ensure your comfort and protect our environment, we will change your bed linens as needed or upon request.

Together we can help to conserve millions of gallons of water, save energy, reduce air pollution and minimize the release of detergents into our ecosystem.

HEALTH IER PLANET, HEALTH IER PEOPLE.

Reminder: ALL soiled linens should go in the soiled linen hamper

Reminder: Thermal blanket might not need to be changed everytime Not every bed change requires an Incontinent Pad

» Reducing Incontinent Pad purchasing and processing by 50% would lead to over $110K cost-savings, along with reduced water and energy consumption

» Reduces hospital environmental footprint

New bed change processes save hours of nurse time and laborPediatrics

Linen Survey Results:

Questions? Concerns? Ideas? email: Sustainability@ucdmc.ucdavis.edu

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68% of repondants from this department claimed that extra linen is being stored in the patient rooms.

Can you �nd all the extra linen in this picture?

Linen should be put in only the soiled linen or reject hamper .

Respondants from this department claimedthat linen is being disposed in the trash.

Promoting a culture of resource conservation saves money and time for everyone

Reminder: Incontinent pads are to be used on beds of patients in need76% of respondants from this department claim that incontinent pads are still being usedon most or all beds. Reducing incontinent pad purchasing and processing by 50% would

lead to over $110K cost-savings, along with reduced water and energy consumption

n= 19

Educational posters and inservices were provided for each nursing unit that participated in the linen survey. Individual unit results were sharedwith staff and posted in staff areas. New policy revisions and productswere clearly outlined along with evidence to support each initiative. The campaign emphasized the financial, environmental, and safety reasonsfor the changes.

Lessons learned:- Multi-disciplinary participation is key for an effective committee.- Updates with nursing management council and senior leadership helped to refine recommendations and gain support.- Vendor and product changes during process hindered data collection and assessment (i.e. changing laundry vendors).- Staff surveys helped gauge needs in training for the education campaign.- Time and resource commitments are required for successful policy roll-out.

General poster outlining the revisedlinen policies and practices

Department specific poster summarizing survey results

To ensure your comfort and protect our environment, we will change your bed linens as needed or upon request.

Together we can help to conserve millions of gallons of water, save energy, reduce air pollution and minimize the release of detergents into our ecosystem.

HEALTHIER PLANET, HEALTHIER PEOPLE.