When it comes to hospital budgets, linen and laundry costs sometimes get ignored. After all, laundry and linen expenses only account for 2 to 3 percent of a hospital’s budget, according to the American Reusable Textile Association. Although typically a tiny slice of a budget, without appropriate oversight linen expenses can rise to six or seven digits very quickly, stretching a hospital’s budget. David Harris, senior consultant, advisory solutions for Vizient, noted some large hospitals could spend more than $1 million annually on linen. Because of this, Harris urges providers to pay attention to their laundry and linen expenses.

“I think that sometimes linen is just not managed as closely as other supplies or services, and [hospitals] don’t necessarily realize the expenses associated with either purchasing linen or having the laundry done,” Harris said.

Possible factors that drive up linen and laundry expenses include linen leaving the hospital either with a patient at discharge or with a medical transporter, and medical facilities lacking a linen utilization program. To get control of linen expenses, Harris offers the following suggestions.

Choose between owning and renting laundry

In a hospital setting, some opt to either purchase their linens or rent them through a laundry service. Regardless of their choice, Harris encourages providers to determine which is more cost effective for their facilities, to rent or to own. A good way to determine this is to set benchmarks for assessing linen and laundry costs. One benchmark he suggests hospitals use is pounds of clean linen delivered divided by the adjusted patient days. According to the November 2015 Becker’s Hospital CFO Report, total pounds (clean linen) divided by patient days should be less than 15 pounds, and total pounds divided by adjusted patient days should be less than 12. The optimal cost per pound of laundry and linen rental should be less than $0.44 per pound.

Prevent the loss of linen

Linen can disappear from a facility through waste disposal, exchange with ambulance crews or discharged patients. Harris said providers must keep a watchful eye on their linen inventory and he offers this advice when dealing with misplaced blankets and other bedding:

  • Educate staff on the proper placement of soiled and bloody linen. According to OSHA, staff should place contaminated laundry in bags that are either labeled or color coded per OSHA’s Universal Precautions policy.
  • Devise a plan where a facility’s linen is accounted for when it leaves the hospital and is in the possession of an ambulance crew 
  • To reduce the loss of linen at the time of discharge, consider asking families to provide the patients with their personal blankets or outerwear

Other instances of loss may occur as a result of staff or patients thinking that the cost of linen is insignificant or is factored into the overall patient bill. Hospitals should make staff aware of the cost of linen to emphasize the need to retain it just as they would other reusable, patient care products or resources. 

Create a linen utilization program

To tackle cost issues associated with losing linen, Harris said hospitals must establish a linen utilization program.

“We sometimes find that we come to a hospital and we ask to see their linen utilization policy. More often than not, they can’t find it,” Harris said. “If they’ve got one, they need to review it regularly and make sure it’s working. If they don’t have one, then they need to develop one.”

To help develop a policy that meets the needs of patients and caregivers, Harris suggests that health systems form a linen utilization team that crosses various departments within a hospital. This group should include nursing, supply chain, environmental services, staff from the facility’s procedural areas, linen department, infection prevention division, patient care experience area and the hospital’s linen supplier. Within this group of stakeholders, he recommends they determine if the current program is not only meeting the needs of the hospital’s bottom line but also the needs of the patients and the caregivers The linen utilization team should be responsible for writing or revising a linen policy that will clearly state:

  • The frequency of bed changes
  • Standard bed make-up that is consistent from one floor to another
  • Proper handling of stained, torn or soiled linen
  • Appropriate use of linen and by whom
  • Amount of linen on hand in the patient’s room
  • Exchange protocol with ambulance crews for the emergency department and any patient care areas where transfers of patients occur

Harris suggests the team meet every two weeks until the linen utilization policy is fully implemented and operational then adjust to quarterly meetings for ongoing review of data and usage.

“Remember that linen and laundry are something that warrant attention. They can be easily overlooked because they don’t catch the eye like a lot of things can in the hospital,” Harris said.

Want to learn more? See how a Vizient clinical cost management solution can help you manage your services more efficiently.

Published: November 13, 2018