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On The Mend In the Hospital Laundry

While hospitals may be skilled at getting their patients to mend, down in the laundry it’s a different story. Industry experts estimate eight-out-of-10 healthcare (and textile rental/COG) laundries do not mend or patch. Many hospitals do not have the resources, knowledge, or skills in-house. Others outsource mending / patching to simplify management activities and responsibilities spanning procurement, sterilization, use, recovery, and treatment after use (laundering, mending, inspection, folding and packing) for managing sterile linen.

Still other laundries see mending/patching as a business within the business and strive to develop best practices, mechanical skills and knowledge to:

  • Prolong the life of merchandise.
  • Control putting new merchandise into circulation.
  • Ensure that merchandise is recovered quickly and returned to circulation to generate income.
  • Ensure that ragged items are kept to a minimum, and that items once ragged, command the best possible prices.
  • Create a best practices environment to control merchandise costs, and develop trending data to manage and control new merchandise and its life cycle so profitability is maximized.

Laundries practicing these steps feel it is worth the effort, counteracts low margins, and increases their bottom line.

Mendable items include: surgical apparel: pant suits, scrub dresses, scrub suits, surgeon and nurses gowns, surgical linen, and wrappers. Professional and employee apparel include: lab coats, Doctor suits, intern shirts, and warm-up jackets. In addition, there is: patient apparel, flat goods (sheets, pillowcases, and blankets).

Linen used to protect the sterile field are inspected for pinholes and tears on a light table. Holes are marked, passed to the repair department and mended by applying a heat seal or iron on patch. Patches are classified as either rounds, squares, and rectangles and are available in a variety of sizes.

To prolong the life of merchandise, one must understand how to use and maintain the heat seal equipment used in its recovery. The top Teflon® iron cover should be wiped off every hour with iron cleaner to prevent adhesive buildup. The rubber pads on the heat seal equipment are essential to equipment operation. If they are cracked or worn, this will prevent the machine from doing its job.

It is also important to monitor platen temperatures with either a pyrometer or temperature tape so equipment works properly. The top Teflon plate is typically set at 405°, and the bottom plate at from 375° to 405°. Dwell time (heat applied to the patch) is from 8 – 12 seconds depending on the heat seal machine used.

Garment finishes that use soil release, stain repellant, permanent press, fire retardant or any other finish may require special care when bonding. One tip is to reduce temperature and slightly increase dwell time.

Mending Guidelines
It is important to develop guidelines and a Quality Control Plan enabling laundry personnel to determine how to inspect and evaluate linen items to be classified as “mend” or “rag.”

Guidelines for inspection and mending of patient linen – knit contour sheets may have the following requirements:

  • Two dime-size medium or dark stains are acceptable but no hard residual. (i.e. foreign matter such as gum can be attached to the item)
  • Patching is acceptable on holes up to 2” in diameter. No more than four patches per sheet.
  • Elastic on knit contour sheets must be intact.

Guidelines for inspection of patient linen-thermal spreads and shadow-striped bedspreads may have these requirements:

  • Visible stains and visible 1” holes are unacceptable unless they appear within 12” from the foot of the bed where tucked.
  • Neat mending or self-material patching is acceptable. Holes up to 3” may be patched. No more than three repairs allowed per item, but not concentrated in one area.
  • Sew all ripped hems and selvages.
  • On crinkle bedspreads, holes up to 2” can be darned.
  • Spreads can be downsized to 65”x85” for use as ER blankets.

Guidelines for inspection of incontinent pads, adult diapers, and adult bibs may say:

  • Light stain and medium stains, chux stains, or light scorching is acceptable, but no hard residual.
  • Dime-size dark stain is acceptable, but no hard residual.
  • Holes and tears in barrier fabric should be patched, or barrier fabric should be replaced.
  • Snaps and Velcro should be functional.
  • Fraying or binding and edges is acceptable.
  • Thin, worn items are unacceptable.
  • Debris (attached foreign matter) is unacceptable.
  • No mending of holes or rips on Birdseye cloth; should be replaced.

Additionally, it is important to know if an item has a maximum of 40 turns but is currently at 10. That information is considered when deciding whether to patch/mend or rag. Another factor is the item’s type. Washcloths and towels may make more sense to automatically rag versus other items.

Tracking and Trending
Developing and maintaining a Mending Production Report is an essential tool to track and control variables in mending. This includes overall costs, poundage, mending versus ragging pounds and costs, and also labor costs. Conducted monthly this becomes a valuable tool in statistical analysis to pinpoint and correct variances and improve efficiencies and profitability.

A Weekly Mending Production Report gathers valuable data that includes “pounds to plant” (i.e. items that are salvaged, repaired and returned into service), revenues associated with patching/mending, total pounds of rags sold and associated revenues, labor hours, wages and benefits, pounds per hour processed, and cost as a percent of revenues.

Variables that can be tracked and analyzed based on spikes upward or downward over time include:

  • How many pounds are being repaired and returned into service.

Key questions are:

  • is there a spike downward in repairs meaning that expensive new merchandise must be brought into service and plant costs increase.
  • Why is ragging increasing, (or decreasing?)

The data might show an upward ragging spike, leading you to discover an increase in lab coat ragging, versus patched / mended. Investigation could produce causes such as a defective shipment from the manufacturer, or defective laundry machinery causing tears and rips.

  • Why are pounds per hour decreasing while labor hours are increasing? E.g. Abnormal laundry machine downtime due to maintenance problems?
  • Why are wages and benefits increasing versus decrease in pounds processed?

Mending / patching is an essential part of the laundry which makes sense when trying to control expenses. Cost-effective laundries utilize these practices to maximize profits. According to industry experts around eight out of 10 laundries do not do mending.

Quick Rinse - News From Around The World

Ecolab Receives Environmental Stewardship Award

AUSTRIA - An environmental stewardship award was recently given to Ecolab Inc. in Austria in recognition of the their efforts to reduce the carbon footprint of a local hospital laundry. The award is for implementing their PERformance SMART low-temperature at an Austrian hospital. The laundry program is said to reduce water and energy usage, in addition to shortening wash time.