Operations Management

Textile Budget Considerations: A Laundry List

January 23, 2019 8:12 am

In the grand scheme of health system leader priorities, textiles aren’t usually the most pressing topic in health care. However, textiles can easily drain financial resources that would be better invested elsewhere, or at least better invested in a stronger textile program. Fortunately, there are a variety of steps hospital and health system leaders can take to ensure all textile dollars are well spent, while also conserving time and money for other essential efforts to optimize patient care.

Benefits of Moving Laundry Off-Site

For most facilities, working with an off-site laundry helps maximize resources in a variety of ways. From a direct-cost standpoint, doing so avoids the significant expenses of purchasing and maintaining laundry equipment and supplies. In addition, due to bulk buying power, laundry service providers can often offer high-quality products at lower prices. Transitioning to an off-site laundry also helps save money on licenses, permits, and inspections related to laundry facilities. As an example, obtaining Healthcare Laundry Accreditation Council (HLAC) accreditation costs $5,000 to $6,000—not including any investments necessary to meet HLAC requirements—and it can take up to a year to achieve.

Off-site laundry service providers also can help improve efficiency. By relieving staff of laundry responsibilities, hospital and health system leaders free up time for team members to devote greater attention to patient care. They also can repurpose space that had been devoted to laundry or other, more effective uses. And a knowledgeable laundry services provider can help manage a healthcare facility’s textile program to reduce waste, meet regulations on the amount of extra linens necessary to have on hand, and ensure textiles are always available when they are needed.

An off-site laundry’s expertise in safely handling linens also can improve patient health outcomes. Approximately 2 million patients in the United States suffer from healthcare-associated infections (HAIs) each year, and the overall annual direct cost of HAIs for U.S. hospitals ranges from $28 billion to $45 billion. a Linens that are cleaned thoroughly and handled correctly can help prevent these costs, while also preventing the development and spread of superbugs.

In many cases, healthcare facilities require availability of an off-site laundry provide as a contingency plan to ensure that they are not left without the necessary supplies if a problem occurs with their own laundry operations. However, working with a laundry provider in the first place obviates the need to devote time and resources to establishing this contingency plan. High-quality off-site laundry providers will have their own fully developed backup plans.

Reasons for Keeping Laundry In-House

Of course, there are a few exceptions to these recommendations. If it is logistically unrealistic for a facility to outsource, keeping laundry operations on premise might be more practical. For instance, if soiled linens are kept in a different area than the loading dock where a laundry provider would be able to pick them up, and personnel are unable to transport the linens to the dock, an on-premise laundry might be more effective. Another scenario where an on-premise laundry makes sense is if a healthcare facility has a large amount of specialty items, making it counterproductive for a rental company to serve the facility. A third reason to keep laundry operations on premise is if labor relations or union contracts create a barrier to outsourcing. However, such exceptions are rare, and on-premise laundries are becoming increasingly uncommon. In fact, fewer than a dozen remain in the state of California.

Choose the Right Provider

For organizations that opt to outsource laundry services, achieving all the potential benefits of such a partnership requires a careful and deliberative selection process. Before choosing a laundry services provider, the organization should conduct research to identify a reputable organization that will be able to meet the facility’s needs. Healthcare organizations should look for a company that has significant experience in the healthcare industry and can meet the stringent health and safety requirements necessary to protect patients from the spread of disease.

When evaluating potential providers, key questions that should be asked including the following:

  • What kind of experience do you have with the healthcare industry?
  • What accreditations do you have with respect to safe linen processing?
  • Do you have a program for helping healthcare facilities manage inventory?
  • How many accounts do each of your representatives manage? (The answer to this question will indicate how much time a representative has to devote to a new client.)
  • What is your on-time percentage for deliveries?
  • What is your backup plan if something goes wrong?

The healthcare organization also should consider the other products and services the laundry provider offers. In addition to linens, some laundries also offer a broad range of other healthcare-related items, such as scrubs, lab coats, cleaning supplies, exam gloves, restroom products, and sharps containers. The potential benefit of choosing a laundry provider that offers such a broad range of products and services is that is can serve as a one-stop shop for the facility’s other needs, thereby saving time through a streamlined ordering process. Further, the laundry’s bulk-buying capabilities could help secure better prices than would be available through individual vendors.

A Color-by-Discipline Program

Another way to maximize textile investments is to implement a color-by-discipline program in which staff are assigned color-coded uniforms or scrubs based on their roles. It’s no secret that patient satisfaction is vital to the bottom line, and these types of programs can make a significant difference in the patient experience at a given facility. When all employees within a given discipline wear the same color, patients and their families have an easy visual cue about whom to seek out for various needs. This consistency in appearance also adds to the facility’s aura of polish and professionalism, and the combination of reduced confusion and a more professional ambiance helps patients feel more confident in the care being provided. b

A color-by-discipline program also can help improve brand recognition. If patients and visitors have a positive experience and are aware of the facility’s brand name, they can share that experience and name with others. Standardized uniform colors that align with other branding efforts, including embroidered logos on each uniform, help differentiate an organization from the competition and ensure patients and visitors remember the organization’s name.

An additional benefit of color-by-discipline programs is a sense of unity among staff. Although an argument can be made in favor of allowing employees to express their individuality by selecting their own apparel, uniforms can contribute to team solidarity. For large facilities, color-coded attire also improves communication by making it easier for employees to identify each other by role and to direct patients and visitors to the appropriate team members throughout the organization. Uniforms also can help instill a sense of pride among the facility’s staff, particularly when employees are given the opportunity to participate in the decision-making process regarding their uniforms’ design. c

Management of a color-by-discipline program also is important to effective execution. Knowledgeable suppliers can help hospital and health system leaders make cost-effective, results-driven decisions by evaluating factors such as how many departments and employees the facility has as well as preferences on comfort, embroidery options, size ranges, styles, color selection, and garment longevity. They also can take responsibility for gathering input from employees, analyzing the responses, and providing recommendations on uniform options that incorporate staff feedback.

After determining the basics on what apparel to include in a color-by-discipline program, the next step is to determine an approach for placing orders that will give current employees and new hires access to the products they need on an ongoing basis while placing the least possible burden on the administration. An online order-management system is often an excellent way to address this.

In addition to working with a healthcare facility to develop a cohesive color-by-discipline program, a uniform supplier may be able to use web-based technology to set up a customized online store for the facility, where designated staff can easily manage and monitor the ordering process. These stores are built based on the facility’s unique program, so employees have access to only the items that have been chosen in advance, simplifying and expediting the ordering and reordering process.

Of course, not all customized web stores are created equal, and some suppliers’ platforms offer greater insight, control, and flexibility than others. If a facility wants employees to be able to purchase their own white coats, scrubs, or other apparel—which can help free up time for the administration, ensure staff members always have access to the proper apparel, and eliminate the need to waste space on an on-site stock of uniforms—it is important to find a supplier whose online ordering platform is built with this capability in mind.

With some web platforms, other options include establishing dollar allowances for individual employees and designating specific staff to make purchases on behalf of their teams. The latter option allows a healthcare facility to control costs while enabling team members to take responsibility for their own uniform needs. Depending on the supplier, it also may be possible to arrange for delivery of apparel directly to employees, further reducing administrative hassles.

Online ordering platforms also can include tools and capabilities that make it easier for administrators to manage programs over time. For instance, new hires can quickly be added to the system, and employees who leave the organization can easily be removed. Some suppliers’ platforms also allow administrators to monitor spends, view employees’ order histories, and track which items are purchased most frequently. With such capabilities, administrators have 24/7 access to consolidated data related to the color-by-discipline program and the resources necessary to make strategic adjustments over time.

Track, Monitor, and Adjust

To manage inventory effectively over time, organizations must thoroughly understand how linens are used, how a uniform program should be implemented, and how products come to be lost. Although it is possible to track and monitor these components independently, organizations also may find it beneficial to turn to a laundry services provider for support in this area so internal teams can focus on other priorities.

An outsourced service provider may be able to collaborate with staff onsite to gain insight into the facility’s operations and identify potential opportunities to improve cost-effectiveness. In addition, the laundry provider may be able to provide training for staff to help them understand the actions they can take to help keep the textile program operating smoothly.

However, as the program is monitored over time, it is important to resist the temptation to depend entirely on technology, such as scrubs-counting machines, to do the job alone. Although these types of technologies offer many benefits, malfunctions can derail progress. So adding a human element helps ensure the numbers are evaluated in context and outside factors are considered. For example, if a major event is happening in the local area, a healthcare facility may need to plan for additional patients and, therefore, additional textiles. Technology can help track what usage patterns have been, but it can’t always fully predict future needs.

Everyone knows that fresh, clean textiles are an essential part of providing a comfortable, positive experience for patients. But the steps for implementing a textile program in which every dollar produces the maximum ROI aren’t always as obvious. Although every provider has different needs and priorities, optimizing a healthcare organization’s textile budget can help the organization’s leaders keep this crucial aspect of their business running smoothly.

Mark Whitten is a vice president at Mission Linen Supply, Phoenix.

Phil Charlton is a project manager at Western State Design, Hayward, Calif.


a. Stone, P. W., “Economic Burden of Healthcare-Associated Infections: an American Perspective [Abstract],” Expert Review of Pharmacoeconomics & Outcomes Research, 2009.

b. Penn Medicine Department of Communications, “The Professional Image of Nursing,” News Blog, Oct. 13, 2015.

c. Owings, J., “The Colors of Carson Tahoe,” Threads, 2017.


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