2024 laundry columns – Healthcare Hygiene magazine

The Critical Role of Processing Specialty Healthcare Textiles: Introducing “Textdevices"

By Gregory Gicewicz

This article orginally appeared in the December 2024 issue of Healthcare Hygiene magazine.

Imagine you’re a surgeon mid-operation, working on a complex, high-risk case. Suddenly, the surgical gown meant to shield you begins to fail, exposing you to potential infection risks. Though hypothetical, this unsettling scenario underscores a real issue: the essential need for proper processing of specialty healthcare textiles. These textiles—more accurately called "textdevices"—are not just fabrics; they are regulated medical devices requiring precise handling to ensure both staff and patient safety.

Over the years, I’ve grappled with the challenges of managing these specialized items in healthcare settings. Realizing the need for clarity, I coined the term “textdevices” to describe healthcare textiles that straddle the line between fabric and medical device. Textdevices require unique handling due to their regulatory, functional, or structural complexity. By understanding their distinct needs, hospitals and laundries can reduce risk, protect patients and staff, and control costs.

What are Textdevices?
To better grasp the concept, let’s distinguish textdevices from general healthcare textiles. While standard items like sheets, towels, and gowns fall under “bulk textiles,” textdevices include specialty items with unique processing requirements. These can range from surgical drapes to antimicrobial curtains, each requiring careful handling to maintain functionality and safety.

Here are some common types of textdevices:
1. Operating Room (OR) Textiles:
Items such as sterile gown packs, towel packs, and surgical drapes. These are critical for maintaining sterile fields during surgeries.
2. Isolation Gowns:
Personal protective equipment (PPE) designed to prevent the spread of infections among healthcare workers and patients.
3. Cubicle Curtains:
Privacy dividers often overlooked in infection control protocols. These must be regularly cleaned and properly tracked to ensure safety.
4. Microfiber Cleaning Devices:
Mops, cloths, and dusters used for environmental cleaning. They require special laundering to maintain their effectiveness.
5. Patient Lift Slings:
Devices for transferring patients with limited mobility. These often feature fabric and mesh components, making them prone to damage in standard laundry cycles.
6. Patient Positioning Devices:
Used to stabilize patients during procedures or routine care, these may include foam inserts, straps, or other components requiring careful handling.
7. NICU Textiles:
Linens and clothing used for newborns in neonatal intensive care units, requiring soft materials and hygienically clean processing.
8. Antimicrobial Textiles:
Items treated with substances to reduce microbial growth. Improper laundering can degrade their antimicrobial properties.
9. Hyperbaric Textiles:
Linens used in hyperbaric chambers, often made of flame-retardant materials that require low-heat drying and special handling.
10. Gait Belts and Patient Restraints:
These combine fabric with metal components, creating challenges in washing and drying cycles.
11. Blood Pressure Cuffs:
A hybrid of textiles and medical equipment, these require cleaning protocols that balance hygiene with device integrity.
By recognizing these as textdevices, hospitals and laundries can better address their unique needs and processing requirements.

The Challenges of Managing Textdevices
Textdevices present logistical and operational challenges that go beyond standard textiles. Many are regulated as Class II medical devices, requiring specific cleaning, labeling, and sterilization processes. Mixing these with bulk textiles can result in damage or contamination, while improper handling can lead to compliance failures and increased infection risks.

For example, cubicle curtains, often touched by numerous people, are notorious for being overlooked in infection control. Without proper laundering and tracking, these can become vectors for disease transmission, as seen in hypothetical cases of highly contagious conditions like Meningococcal Meningitis. This underscores the importance of rigorous protocols for all textdevices.

Lessons From the Laundry Industry
In my early days as the CEO of a healthcare laundry, I encountered a costly incident involving damaged textdevices. A load containing improperly sorted cubicle curtains, OR towels, and gait belts led to over $2,000 in losses. The root cause? Inadequate training of a wash deck employee.
From this experience, we revamped our processes, prioritizing employee education and detailed protocols. The result was a significant reduction in errors and improved trust with hospital partners. This experience taught me that proper management of textdevices is not just about compliance—it’s about accountability and partnership.

How to Effectively Manage Textdevices
Managing textdevices requires a structured approach:
1. Create an Inventory
Hospitals must maintain a detailed inventory of all textiles, categorized by location and ownership. This helps identify textdevices and their specific needs.
2. Understand Processing Requirements
Textdevices often require special handling, such as low-temperature drying or chemical treatments. Items classified as Class II medical devices, such as surgical gowns and patient slings, must meet stringent regulatory standards.
3. Evaluate Laundry Capabilities
Not all laundries can process all textdevices. Some may lack the equipment or certifications for tasks like sterilizing OR packs. Understanding your laundry provider’s limitations is critical.
4. Consider In-House Processing
For certain items, in-house processing offers greater control. However, hospitals must ensure they meet industry standards, avoiding the risks associated with inadequate equipment or training.
5. Specialized Outsourcing
Partnering with laundries that specialize in specific textdevices can be effective. However, this approach requires robust tracking systems to minimize loss and ensure accountability.
6. Assess Single-Use Alternatives
While reusable textiles are generally more economical and environmentally friendly, single-use items may be practical in emergencies or for facilities without access to proper processing capabilities.

Sterile vs. Hygienically Clean: Choosing the Right Standard
One key decision for hospitals is whether textdevices need to be sterile or simply hygienically clean. Sterile textiles, free of all microorganisms, are essential for surgeries and procedures involving immunocompromised patients. Hygienically clean items, while not sterile, suffice for general care.
Understanding these distinctions can prevent costly mistakes, ensuring that the right standards are applied in the right contexts.

Why Proper Management Matters
The stakes of textdevice mismanagement are high. From infection risks to financial losses, the consequences of improper handling can be severe. However, with careful planning and collaboration, hospitals can mitigate these risks. By recognizing the unique needs of textdevices and investing in the right processes and partnerships, healthcare facilities can safeguard patients, protect staff, and optimize operations.

Textdevices may not always receive the attention they deserve, but they play a vital role in healthcare safety and efficiency. As the environments in which we deliver care become increasingly complex, so too must our approach to managing the tools and textiles that support patient outcomes. By leading with knowledge and proactive solutions, we can ensure that textdevices fulfill their critical role in modern healthcare.

Gregory Gicewicz is the president and CEO of Compliance Shark, a business compliance platform, as well as past-president of the Healthcare Laundry Accreditation Council (HLAC). He may be reached at: gregory@complianceshark.com

Laundry Accreditation and Certification

By Gregory Gicewicz

This article originally appeared in the September 2024 issue of Healthcare Hygiene magazine.

In the mid-2000s, as the new owner of a small healthcare laundry in western Washington state, I faced a turning point that changed everything. Our facility, processing just 2.5 million pounds of linen annually, was outdated and barely functioning. I had convinced a large hospital to tour our plant, confident that my Harvard degree and Microsoft experience would win them over. Instead, the visit was a disaster.

Three infection prevention nurses inspected our facility, finding one issue after another. Dirty linen carts were touching clean ones. Employees were mishandling clean linen without washing their hands. The air in the soil room was blowing the wrong way, and the layout of our equipment was unsafe. We failed miserably and lost the account.

Humbled by the experience, I reached out to one of the nurses for help. She suggested we pursue accreditation to meet the necessary standards for processing healthcare textiles. That advice set us on a new path, one that would ultimately lead to our transformation.

Imagine a world where no standards govern healthcare textiles. Laundries would operate without guidelines for sorting, washing, or environmental hygiene. Staff training would be nonexistent, and no third-party inspections would ensure compliance. Would you want your hospital’s linen processed in such a place? Would you feel safe knowing your loved one’s linens were handled without any regulatory oversight?

Accreditation and certification are critical in maintaining high standards in healthcare laundry services. Without them, a hospital’s reputation—and patient safety—could be at risk. Just as a five-star restaurant can quickly lose its status if it’s discovered that its meat supplier isn’t certified, a hospital can suffer severe consequences if its laundry vendor is not accredited or certified.

Fortunately, there are independent bodies that set and audit standards in healthcare laundry. Two of the most reputable are the Healthcare Laundry Accreditation Council (HLAC) and the Textile Rental Services Association’s (TRSA) Hygienically Clean Healthcare program. I strongly recommend ensuring that your healthcare laundry is either accredited by HLAC or certified by TRSA.

HLAC, a non-profit organization established in 2005, accredits laundries that process healthcare textiles. Accreditation is voluntary, meaning hospitals can choose to work with laundries that are not accredited. HLAC’s standards are based on a thorough review of scientific literature, expert consensus, and real-world outcomes, ensuring they are both effective and reliable.

HLAC’s standards cover every aspect of laundry operations, from handling soiled textiles to delivering clean items. With more than 600 standards, the accreditation process is comprehensive and rigorous. The inspection process involves a detailed review of documentation, a physical tour of the facility, and interviews with staff. The findings are then reviewed by an HLAC subcommittee, which makes the final accreditation decision.

The TRSA Hygienically Clean Healthcare program, unlike HLAC, is a certification initiative focused on outcome-based standards. Developed by the Textile Rental Services Association, this program includes random microbiological testing of processed linens to ensure hygiene standards are met. TRSA’s approach combines process-based best practices with empirical testing to provide a clear measure of safety and effectiveness.

Laundries seeking TRSA certification undergo a similar process to HLAC accreditation, including a thorough inspection of the facility and an evaluation of staff training. However, TRSA’s certification emphasizes the outcome of the laundry process, verified through microbiological testing at certified labs.

When deciding between HLAC accreditation and TRSA certification, it depends on what you value more: process-based standards or outcome-based verification. Both programs offer strong credentials and ensure that healthcare textiles are processed safely. Some laundries choose to pursue both to demonstrate their commitment to the highest standards, though this can be expensive and resource-intensive.

Ultimately, the decision to choose HLAC, TRSA, or both depends on your facility’s needs and goals. While these programs are invaluable in maintaining high standards, they are not a substitute for ongoing vigilance and onsite inspections by your healthcare facility. Accreditation and certification provide a critical baseline, but it’s up to your facility to ensure that these standards are consistently met.

My journey from running a struggling laundry to operating a fully accredited facility underscores the importance of adhering to stringent guidelines and seeking external validation. Accreditation and certification are essential in ensuring that healthcare textiles are processed safely, protecting patient health and supporting a hospital’s reputation. By embracing these standards, laundries not only improve their operations but also contribute to the broader healthcare environment. The transformation of my facility through HLAC accreditation is a testament to the power of rigorous standards and the pursuit of excellence.

Hygiene Heroes: Finding the Perfect Healthcare Laundry Match

By Jason Isherwood

This article originally appeared in the June 2024 issue of Healthcare Hygiene magazine.

In the complex ecosystem of healthcare, maintaining the highest standards of hygiene is not just a goal but a necessity. Among the myriad components contributing to these standards, healthcare laundry services hold a critical yet often underappreciated role. With the wellbeing of patients and healthcare professionals at stake, selecting the right laundry partner becomes a decision of paramount importance.

The Importance of Specialization in Healthcare Laundry

Healthcare laundry is not just another load of washing—it's a sophisticated operation that demands adherence to stringent hygiene standards and regulations. Unlike regular laundry services, healthcare linens require specialized handling to prevent the spread of infections. This necessitates not only a deep understanding of industry standards but also a commitment to maintaining these standards rigorously.

The risks associated with improper handling of healthcare laundry can have serious implications. From the transmission of healthcare-acquired infections (HAIs) to the compromise of sterile environments, the stakes are high. Consequently, the choice of a laundry partner must be informed and deliberate, aimed at minimizing these risks while maintaining cost effectiveness.

Key Factors to Consider When Selecting a Laundry Partner

Quality and Compliance

A prospective laundry partner must demonstrate uncompromising adherence to health and safety regulations, including standards set forth by the Occupational Health and Safety Administration (OSHA) and the Centers for Disease Control and Prevention (CDC). Certifications such as from the HLAC (Healthcare Laundry Accreditation Council) and TRSA (Textile Rental Services Association) serve as endorsements of a facility's commitment to best practices in laundry processing and infection control.

Reliability and Efficiency

Effective healthcare operations require a seamless flow of clean, hygienic linens. Assessing the turnaround times for laundry services, along with contingency plans for emergency situations, will offer insights into a provider's ability to meet your facility's needs consistently and reliably.

Technology and Innovation

The role of technology in enhancing laundry processing and tracking cannot be overstated. Advancements in laundry equipment and methods not only improve the quality and hygiene of laundered items but also contribute to operational efficiencies. Innovations in laundry sanitation, including the use of ozone, UV light, or electrolyzed water, further signify a provider's dedication to superior hygiene standards.

Sustainability Practices

In an era where environmental concerns are increasingly coming to the fore, evaluating a laundry provider's sustainability practices is crucial. This encompasses water and energy conservation measures, as well as the use of eco-friendly detergents. Choosing a partner committed to green practices aligns with broader social responsibilities and can contribute to the facility's sustainability goals.

Evaluating Experience and Reputation

A provider's experience in the healthcare sector, evidenced by testimonials and references from existing clients, speaks volumes about their capabilities. The diversity of healthcare settings they service, from hospitals to clinics, and their track record in these environments offer insights into their reliability and adaptability.

Distinction Between Inpatient and Outpatient Laundry Services

When examining healthcare laundry providers, it's crucial to distinguish between those serving inpatient facilities, like hospitals and long-term care centers, versus outpatient settings, such as clinics and medical offices. Inpatient laundry needs are characterized by a higher volume of linens, encompassing everything from patient gowns and bed sheets to surgical drapes and staff apparel. This necessitates a laundry partner with the capacity to handle significant loads, often with a faster turnaround to ensure the constant availability of clean linens, crucial for patient care and infection control.

Outpatient facilities, on the other hand, might deal with a lower volume of laundry but still require the same high standards of cleanliness and infection prevention. The difference lies in the types of items laundered, such as specialized patient gowns or towels, and the frequency of service needed. Outpatient providers might benefit from more flexible laundry services compared to their inpatient counterparts, reflecting the difference in patient throughput and the nature of medical services rendered.

Understanding these nuances is essential when selecting a healthcare laundry partner that aligns with the specific needs and operational dynamics of inpatient versus outpatient facilities. This criterion ensures that the chosen laundry service provider can deliver the required level of service quality, compliance, and reliability, properly tailored to the unique context of the healthcare setting in question.

Cost Analysis and Budget Considerations

Understanding the comprehensive cost structure of healthcare laundry services is essential to evaluating a potential partner's affordability. However, it's important to weigh upfront costs against long-term benefits, such as savings derived from efficient operations and reduced risk of HAIs. Negotiating contracts with clear terms and transparent pricing will ensure alignment with budgetary considerations.

Communication and Customer Service

The backbone of any successful partnership is open, effective communication. A provider's responsiveness, the training, and support offered to healthcare staff, and the robustness of their account management and reporting systems are key indicators of their commitment to customer service excellence.

Conducting Site Visits and Audits

Nothing offers a more tangible sense of a laundry provider's operational realities than on-site visits. These excursions can reveal much about their day-to-day operations, adherence to hygiene and safety standards, and the condition of their facilities and equipment.

Partnership and Collaboration

Ultimately, the relationship with a healthcare laundry service provider should transcend the transactional aspect, fostering a sense of partnership and mutual growth. A provider's willingness to engage in collaborative problem-solving and to adapt to the evolving needs of the healthcare industry signals a readiness to be a true partner in achieving your healthcare facility’s goals.

In conclusion, the process of choosing the right healthcare laundry partner, while daunting, is critical to upholding the hygiene standards essential for patient care and safety. It demands a comprehensive evaluation of potential providers against a suite of criteria grounded in quality, reliability, innovation, sustainability, and mutual collaboration. Armed with thorough diligence and a strategic selection process, healthcare facilities can establish partnerships that not only meet but exceed their linen management needs, ensuring safe, efficient, and cost-effective operations. In the quest for hygiene excellence, finding the perfect match in a laundry partner is not just beneficial—it's imperative.

Jason Isherwood is the CEO/founder of LinSights Health, a Linen/Laundry optimization advisory firm, as well as currently is a member of the board of directors for the Southeastern Pennsylvania Chapter of AHRMM (SEPAC) and a member of the Association for Health Care Resource & Materials Management (AHRMM) National Chapter Relations Committee. He may be reached at: Jason.isherwood@linsightshealth.com

Transforming Healthcare Laundry: A Look at Some Emerging Laundry Technologies

By Gregory Gicewicz

This article originally appeared in the May 2024 issue of Healthcare Hygiene magazine.

In the ever-evolving landscape of healthcare, where patient safety and operational efficiency are paramount, emerging technologies are reshaping every aspect of the industry. One critical domain experiencing a profound transformation is healthcare laundry. From radio-frequency identification (RFID) technology and robotics in laundry automation to antimicrobial textiles, generative artificial intelligence (AI), utility-saving advances like water recyclers, and synthetic textiles offering enhanced efficiency and durability, a wave of innovations is revolutionizing how healthcare facilities manage their linens. This essay explores a few of the latest advancements in healthcare laundry technologies, highlighting their impact, benefits, and potential for the future.

RFID Technology: Revolutionizing Inventory Management
RFID technology has emerged as a cornerstone in healthcare laundry operations, offering real-time visibility and control over inventory. By utilizing RFID tags attached to each linen item, facilities can automate tracking throughout the laundering process, from collection to distribution. This technology eliminates manual counting errors, enhances inventory accuracy, and streamlines workflow efficiency.

RFID-enabled laundry management systems provide invaluable data insights, allowing facilities to optimize linen utilization, monitor inventory levels in real-time, and track item lifespan for timely replacements. Moreover, RFID facilitates rapid identification of lost or misplaced items, minimizing operational disruptions and reducing replacement costs. As healthcare facilities strive for leaner operations and cost savings, RFID technology proves instrumental in achieving these objectives.

Robotics in Laundry Automation: Efficiency Redefined
The integration of robotics into laundry automation represents a monumental leap forward in operational efficiency and productivity. Robotic systems, equipped with advanced sensors and algorithms, perform a myriad of tasks previously handled manually, such as sorting, feeding, folding, and packing linens. These robots operate with precision and speed, significantly reducing labor costs and improving turnaround times.

Robotic automation not only accelerates the laundry process but also ensures consistent quality and hygiene standards and enhanced worker safety. By minimizing human intervention, the risk of cross-contamination and infection transmission is mitigated, aligning with stringent healthcare regulations and standards. Furthermore, robotic systems are adaptable to fluctuating demand, enabling scalability and flexibility in laundry operations.

Antimicrobial Textiles: Enhancing Infection Control
In the ongoing battle against healthcare-associated infections (HAIs), antimicrobial textiles have emerged as a potent weapon, offering an additional layer of protection against pathogens. These textiles are embedded with antimicrobial agents, such as silver nanoparticles or copper ions, which inhibit the growth and spread of bacteria, viruses, and fungi on fabric surfaces.

By incorporating antimicrobial textiles into their linen inventory, healthcare facilities bolster infection control measures, reducing the risk of HAIs and promoting patient safety. These textiles are particularly beneficial in high-risk areas, such as operating rooms, intensive care units, and isolation wards, where stringent hygiene protocols are imperative. Additionally, antimicrobial textiles contribute to prolonging the lifespan of linens by minimizing microbial degradation, thereby optimizing resource utilization and cost-effectiveness.

Generative AI: Optimizing Process Efficiency
Generative artificial intelligence (AI) algorithms are revolutionizing healthcare laundry operations by optimizing process efficiency and resource allocation. These AI-driven systems analyze vast datasets related to linen utilization, demand patterns, and operational parameters to generate predictive models and actionable insights. By leveraging machine learning algorithms, generative AI platforms dynamically adjust inventory levels, scheduling priorities, and workflow optimization strategies to align with evolving demands and priorities.

Generative AI also facilitates predictive maintenance of laundry equipment, identifying potential issues before they escalate into costly breakdowns or disruptions. Moreover, AI-powered predictive analytics enable proactive decision-making, allowing healthcare facilities to anticipate fluctuations in linen demand, plan resource allocation accordingly, and optimize inventory management strategies. As a result, facilities can achieve higher levels of operational efficiency, cost savings, and customer satisfaction.

Utility-Saving Advances: Sustainability in Focus
In the era of environmental consciousness and sustainable practices, utility-saving advances play a pivotal role in healthcare laundry operations. Water recycling systems, for instance, enable facilities to reclaim and reuse wastewater from laundry processes, reducing freshwater consumption and wastewater disposal costs. These systems employ advanced filtration and purification technologies to ensure the quality and safety of recycled water, aligning with environmental regulations and sustainability goals.

Additionally, energy-efficient laundry equipment, such as high-efficiency washers and dryers, minimize energy consumption and greenhouse gas emissions, contributing to carbon footprint reduction and cost savings. Moreover, solar panels and renewable energy sources power laundry facilities, further reducing reliance on fossil fuels and mitigating environmental impact.

Synthetic Textiles: The Future of Linen Management
Synthetic textiles offer numerous benefits over traditional fabrics, including longer lifespan, enhanced efficiency, and superior resistance to contamination and staining. These textiles withstand frequent laundering without compromising quality, reducing replacement costs and extending linen lifespan. Their inherent resistance to contamination minimizes the risk of cross-contamination and infection transmission, ensuring hygienic linen management. Additionally, synthetic textiles process more efficiently, reducing energy and water consumption, and contribute to sustainability efforts.

In conclusion, the convergence of emerging technologies in healthcare laundry heralds a new era of efficiency, quality, and sustainability. From RFID-enabled inventory management to robotics in laundry automation, antimicrobial textiles, generative AI, utility-saving advances, and the adoption of synthetic textiles, these innovations drive progress toward safer, more efficient, and environmentally conscious practices. As healthcare facilities embrace these advancements, they pave the way for a future where patient safety and operational excellence go hand in hand.

Sustainable Strategies for Hospitals: Transforming Linen and Laundry Operations

By Gregory Gicewicz

This article originally appeared in the April 2024 issue of Healthcare Hygiene magazine.

In the rapidly evolving landscape of healthcare, sustainability has emerged as a critical consideration for hospitals worldwide. From reducing carbon emissions to minimizing waste generation, healthcare facilities are under increasing pressure to adopt environmentally responsible practices across all aspects of their operations. One area where hospitals can make significant strides toward sustainability is in their linen and laundry operations. By implementing sustainable practices in this crucial area, hospitals can not only reduce their environmental footprint but also improve operational efficiency and enhance patient care. In this article, we'll explore steps that hospitals can take to make their linen and laundry operations more sustainable.

We will discover that the most impactful sustainability measures, which yield significant results, are often the simplest ones. These "low-tech" solutions may lack the glamor of cutting-edge technologies that grab headlines, but their effectiveness speaks volumes.

Importance of Sustainability in Healthcare
Before delving into specific strategies for making linen and laundry operations more sustainable, it's essential to understand why sustainability matters in healthcare. Hospitals are significant consumers of resources, from energy and water to medical supplies and linens. As such, they have a profound impact on the environment and public health. By adopting sustainable practices, hospitals can reduce their environmental footprint, conserve resources, and contribute to a healthier planet for current and future generations. Additionally, sustainability initiatives can lead to cost savings, enhance the hospital's reputation, and improve patient and staff satisfaction. Overall, sustainability is not just a trend—it's a strategic imperative for hospitals looking to thrive in an increasingly environmentally conscious world.

Promoting Reusable Textiles
One of the most impactful steps hospitals can take toward sustainability in their linen and laundry operations is to promote the use of reusable textiles wherever possible. Instead of relying on disposable single-use items such as surgical gowns, isolation gowns, incontinent pads, drapes, towels, and environmental cleaning items (e.g., microfiber), hospitals can invest in high-quality reusable textiles made from durable materials such as cotton or polyester blends. Reusable textiles can withstand multiple cycles of sterilization and laundering, making them a cost-effective and environmentally sustainable alternative to disposable items.

In addition to reducing waste generation, reusable textiles offer several other benefits. They are often more comfortable for patients and healthcare workers, reducing the risk of skin irritation and allergic reactions. In the operating room, reusable surgical gowns and surgical towels normally perform better than their single use counterparts. In the environmental services theatre, reusable cleaning mops and wipers typically perform better and require fewer products per cleaning cycle. This enhances room turnaround times and saves money.
Reusable textiles also are ordinarily more durable and resistant to wear and tear, leading to longer service life and reduced replacement costs. They promote local jobs since they must be processed by local healthcare launderers and since local healthcare launderers process them, they can be delivered more frequently. Single use items use more valuable hospital stocking space since they are delivered less frequently. As a result, reusable textiles traditionally cost less per use than disposable items.

By transitioning to reusable textiles hospitals can demonstrate their commitment to sustainability while maintaining high standards of cleanliness and patient care.

Investing in Synthetic Textiles Versus Cotton Textiles
Another strategy for enhancing sustainability in linen and laundry operations is to incorporate synthetic textiles alongside traditional cotton textiles. While cotton has long been favored for its softness and breathability, synthetic fabrics such as polyester and polypropylene offer several environmental and functional advantages. Unlike cotton, which requires large amounts of water, pesticides, and land for cultivation, synthetic textiles can be produced using fewer resources and processed more efficiently.

Additionally, synthetic textiles are highly durable and resistant to wrinkles and shrinking, reducing the need for frequent replacements and prolonging their service life. They also have quick-drying properties, which can lead to energy savings during laundering and drying processes. For example, a dryer load of cotton gowns will take around 25 minutes to fully dry. Conversely, a dryer load of 100 percent synthetic gowns will dry in less than 10 minutes. Furthermore, synthetic textiles can be recycled and repurposed at the end of their life cycle, contributing to a circular economy and minimizing waste generation. By incorporating synthetic textiles into their linen inventory, hospitals can reduce their environmental impact while maintaining the quality and performance of their linens.

Steps for Making Linen and Laundry Operations More Sustainable
Now that we've discussed the importance of sustainability in healthcare and the environmental advantages of reusable and synthetic textiles, let's explore specific actions that hospitals can take to make their linen and laundry operations more sustainable:
1. Make Environmental Stewardship Part of Your Mission Statement: Demonstrate unwavering dedication to environmental awareness from top management. Ensure that both external and internal reports include a dedicated section highlighting sustainability efforts and achievements. Champion this commitment in all communication channels, fostering a clear understanding among employees and customers that sustainability is a fundamental principle of our organization.
2. Understand Your Laundry Environmental Footprint: Take steps to understand the top carbon-generating activities in your laundry. Some typical big contributors include water usage, natural gas usage, electrical consumption, chemical usage, truck fuel consumption, and solid waste generation. If necessary, solicit the help of a laundry/linen sustainability expert services firm.
3. Implement a Daily/Weekly/Monthly Sustainability Scorecard: Measure, track, and report daily/weekly/monthly key sustainability performance indicators. To ensure accuracy, make sure these are measured against a consistent volume metric such as pounds of linen produced. Some examples of sustainability performance indicators include:
• Gallons of water consumed per pound of linen processed
• Natural gas therms consumed per pound of linen processed
• Kilowatt-hours of electricity consumed per pound of linen processed
• Gallons of diesel fuel consumed per pound of linen processed
• Yards of solid waste produced per pound of linen processed
4. Measure #3 More Granularly: Determine the top contributors to the above indicators. For example, measure the natural gas usage of all gas-using devices including dryers, boilers, and ironers. This will help you understand where to focus your efficiency efforts. If your boiler is using 50 percent of your daily natural gas, then this is a good place to focus your optimizing efforts.
5. Invest in Energy-Efficient Equipment: Upgrade laundry equipment to energy-efficient models that consume less water, natural gas, and electricity, reducing operating costs and carbon emissions. Large energy efficient advancements have been made in washers, dryers, ironers, compressors, chemical dispensers, boilers, and more. Tunnel washers typically consume less than 30 percent of the resources, compared to conventional washers. Modern water recyclers can save more than 50 percent of water and 20 percent of heat and chemical usage. Cutting-edge heat recovery systems capture and reuse heat generated during the drying process, reducing the amount of energy needed to heat incoming air for drying or other uses.
6. Implement Wash Formula Conservation Measures: Maximize resource efficiency by optimizing washing formulas. Ensure wash cycles are not longer than required and minimize hot water usage. Utilize optimal chemistry with assistance from knowledgeable chemical company representatives. Maintain optimal loading of washers, avoiding both underloaded and overloaded conditions, which are major contributors to resource waste in laundry operations.
7. Choose Eco-Friendly Detergents and Chemicals: Use biodegradable and non-toxic detergents and cleaning chemicals to reduce environmental pollution and protect human health.

In conclusion, sustainability is a critical consideration for hospitals seeking to minimize their environmental footprint and enhance operational efficiency. By promoting the use of reusable and synthetic textiles in linen and laundry operations, hospitals can reduce waste, conserve resources, and contribute to a healthier planet for all.

Dry and Mighty: A Closer Look at the Crucial Role of Drying in Healthcare Textile Safety

By Gregory Gicewicz

This article originally appeared in the February 2024 issue of Healthcare Hygiene magazine.

In our world of healthcare laundry, we often say, "Getting healthcare textiles clean is a straightforward task, but the true test lies in ensuring they stay clean right up to the moment they reach the patient." We often focus on identifying and correcting some common sources of linen contamination including dirty air, unclean hands, soiled linen carts, inadequate tunnel washer processes, and contaminated surfaces. While these are all dangerous and prevalent, now let’s delve into an invisible threat whose consequences have been deadly. That is the threat of inadequately dried healthcare textiles.

This article delves into three crucial facets of healthcare textile drying, addressing key aspects:
1. The various methods employed in drying healthcare textiles.
2. The potential hazards associated with inadequately dried healthcare textiles.
3. Strategies to guarantee optimal drying of healthcare textiles.

Clean healthcare textiles are typically dried using one of five methods:
1. Tumble Drying: Utilizing hot air circulation, these dryers efficiently remove moisture from textiles. Commercial-grade dryers, often equipped with advanced features like moisture sensors, ensure thorough drying. They can be standalone or part of a larger tunnel washing system.
2. Air Drying: Some healthcare textiles undergo natural drying on lines or racks, an eco-friendly method suitable for delicate items. Though eco-conscious, air drying may extend drying times, and requires abundant extra space in the laundry.
3. Steam Drying: This method uses steam to remove moisture, proving effective and energy-efficient, especially in garment drying tunnels.
4. Flatwork Ironing: High-capacity systems like flatwork ironers are used for specific flatwork healthcare textiles, providing both drying and pressing in a single step.
5. Steam Pressing: Steam presses are employed to finish and dry specialty healthcare textiles like cubicle curtains and lab coats.

Achieving precision in the drying process requires meticulous attention to detail across all methods, considering factors such as textile type, initial moisture content, load size, drying device temperature, speed, desired finished product temperature, and drying time. Misalignment or oversight in addressing these variables can lead to undesirable outcomes, emphasizing the critical importance of precision in the drying process.

The consequences of over-drying include damaged linen, patient skin irritation, and increased environmental impact. On the other hand, under-drying can lead to damp textiles, fostering the growth of pathogens that cause Healthcare Associated Infections (HAIs). Various bacteria, fungi, and, to a lesser extent, viruses thrive in warm, moist conditions, posing risks to patient safety and contributing to an unsanitary healthcare environment.

Pathogens that may thrive on healthcare textiles:

Bacteria:
1. Clostridium difficile (C. difficile): Causes colitis and gastrointestinal issues.
2. Staphylococcus aureus: Associated with skin infections.
3. Pseudomonas aeruginosa: Known for thriving in moist environments.
4. Enterococcus faecalis: Commonly found in the gastrointestinal tract.

Fungi:
1. Mucormycosis: Caused by molds linked to contaminated linen.
2. Candida albicans: Causes candidiasis or yeast infections.
3. Aspergillus spp.: Certain species can grow in damp environments.

Viruses:
1. Adenovirus: May persist for a limited time in a moist environment.

Strategies for Optimal Drying:
1. Follow Manufacturer Guidelines: Adhere to laundering and drying guidelines for specific healthcare textiles, including recommended temperatures and drying times.
2. Sort Textiles Appropriately: Categorize textiles based on fabric type, color, and soil level to ensure an even and efficient drying process.
3. Control Load Sizes: Tight control of load sizes, especially for tumble dryers, is critical to prevent over-drying or under-drying.
4. Invest in Proper Drying Equipment: Commercial-grade equipment with features like moisture sensors ensures optimal drying conditions.
5. Monitor Drying Times: Set appropriate drying times based on textile type and load size to avoid fabric damage or microbial growth.
6. Perform Regular Maintenance: Schedule routine maintenance for drying equipment to ensure efficient functionality.
7. Meticulous Equipment Cleaning: Establish and enforce a robust equipment hygiene program to prevent lint and dust accumulation.
8. Measure, Monitor, and Tune Drying Results: Implement a process monitoring program to regularly check finished textiles, ironer chest temperatures, and drying equipment.

In conclusion, achieving optimal healthcare textile drying requires meticulous attention and a comprehensive strategy to mitigate risks and uphold patient safety. From cleaning to drying, understanding the consequences of inadequately dried linens is vital. By adhering to guidelines, sorting textiles judiciously, controlling load sizes, investing in proper equipment, monitoring drying times, conducting regular maintenance, and prioritizing equipment hygiene, healthcare facilities can master the art of optimal textile drying. This holistic approach ensures the efficiency of the drying process, maintains excellent hygiene standards, and safeguards the well-being of patients. It underscores the critical role of healthcare textiles in the broader landscape of patient care.

Tunnel Washers in Healthcare: Balancing Savings, Sustainability and Safety

By Gregory Gicewicz

This article originally appeared in the January 2024 issue of Healthcare Hygiene magazine.

A continuous batch washer, commonly known as a tunnel washer, is a type of industrial washer that offers enormous advantages to healthcare in sustainability, economy, and productivity. But these advantages come with profound safety risks, if not managed properly. Tunnel washers are designed to handle large volumes of laundry continuously. Unlike traditional batch washers where a set amount of laundry is loaded, washed, and then unloaded before the next batch, a tunnel washer allows for a continuous flow of laundry through the machine. These washers are commonly used in healthcare laundries, where a high volume of laundry needs to be processed efficiently. Tunnel washers typically consist of a series of compartments or modules through which the laundry progresses. Each compartment serves a specific purpose in the washing process, such as washing, rinsing, and extracting water.

The tunnel washer design offers enormous economic advantages such as increased productivity, reduced labor requirements, optimized water, chemical, and heat usage, and consistent wash results. While a conventional washer may use more than three gallons of water per pound of linen processed, a state-of-the-art tunnel washer can use less than half a gallon of water per pound of linen processed. Because tunnel washers efficiently reuse heat and chemistry, massive savings in natural gas and chemicals are another advantage. Tunnel washers are particularly useful for handling large quantities of linens, uniforms, and other textiles in a streamlined and efficient manner. In our current era, it is critical for hospitals to take measures to reduce their environmental footprint and promote sustainability. Given their revolutionary efficient use of water, heat, electricity, and chemistry, a tunnel washer, for healthcare textiles, can be a critical part of a healthcare facility’s sustainability strategy.

While the benefits for the laundry, of a well-designed and a well-run tunnel washer are immense, the risks and drawbacks of a poorly designed/run tunnel washer are just as vast.

Tunnel washers are capable of processing huge quantities of linen per hour and a laundry plant may depend on this throughput to complete their wash day. Therefore, extended tunnel washer downtime due to outages can be catastrophic, causing hospitals to not get all their linen processed.

Achieving the right balance of detergents, bleach, and other chemicals is crucial for effective cleaning. Inconsistent chemical dosing or improper pH levels can result in poor cleaning performance, damage to fabrics, or excessive wear on the machine.

For a chemical formula to work as designed, water levels in compartments must be precisely managed. Too much water means suboptimal chemical concentrations and inadequate mechanical action. Too little water means too high of chemical concentrations, inadequate dilution, and improper mechanical action.

Chemical formulas require precise temperatures to clean as designed. For example, most bleaches require a certain temperature threshold to activate and disinfect. Likewise, wash steps require a high enough temperature to optimally remove soil. Conversely, too extreme of temperature drops in the rinse zone may cause thermal shock and damage textiles.

Most tunnel washers are equipped with systems for recycling water and chemicals. While these systems offer economic and environmental benefits, managing these recycling systems and ensuring they operate effectively adds another layer of complexity. Malfunctions in these systems can impact both the environment and the cleaning performance.

Tunnel washers are constantly exposed to a perfect cocktail of heat, steam, water, and contaminated linen. Therefore, their parts, including surfaces, discharge areas, and tanks are perfect breeding grounds for pathogens that can contaminate clean linens.

Tunnel washers are complex machines with many critical components such as water pumps, chemical pumps, drain valves, temperature probes, water level probes, and more. Regular maintenance is essential to prevent breakdowns and ensure optimal performance. Failure to perform routine maintenance can lead to unexpected downtime and increased repair costs.

To mitigate these complexities and risks, it's important for healthcare laundries to invest in proper training for staff, adhere to recommended maintenance schedules, and stay informed about advancements in laundry technology to optimize performance and resource usage. Regular monitoring and quality control measures can also help identify and address issues promptly. Below are some specific:

1. Establish a regular tunnel washer process monitoring program. This should include chemical titrations, water testing, temperature probe calibration, water level probe calibration, chemical pump calibration, surface testing, and most of all final linen testing.
2. Build a robust training program for tunnel washer operators and maintenance technicians. Operators should be taught to pay special attention to load sizes and end-product quality.
3. Ensure tunnel washer critical parts are in stock in the plant. These include belts, valves, probes, wheels, press membranes, pumps, critical motors, and critical electrical parts. While it is expensive to keep spare parts onsite, the cost more than pays for itself when the parts are needed.
4. Create a rigorous tunnel washer maintenance schedule that includes critical part health checks and proper cleaning.
5. Build a strong relationship with your tunnel washer vendor as well as your chemical vendor. These vendors can provide additional levels of technical and operational expertise.
6. Have a disaster plan ready in case your tunnel washer goes down. This can include an additional tunnel washer (very expensive), several larger conventional washers (slower and more expensive), or even a backup laundry facility.

Gregory Gicewicz is the president and CEO of Compliance Shark, a business compliance platform, as well as past-president of the Healthcare Laundry Accreditation Council (HLAC).