Textile rental focus

Setting standards to improve service for all

1 August 2008

The Best Practice Guide published by the Society of Hospital Linen Services and Laundry Managers aims to set standards and goals that will encourage a good, uniform level of service from suppliers and help customers gain maximum benefit from it by applying some of the principles in their organisation, Ian Hargreaves explains

In today’s “value for money society” we continuously refer to quality – quality food, quality service, quality goods. But for those phrases to have any real meaning, the term needs to be defined for each scenario.

One dictionary defines quality as “degree of excellence, high rank or social standing, class or grade of thing determined by this.” But even this definition can be subject to different interpretations, according

to personal preference.

The laundry industry often refers to an item’s “fitness for purpose”. If a sheet is clean and free of creases, then it must be “fit for purpose”. Is this necessarily the case? If we start to compare results by a particular criterion, such as whiteness, that aspect will take on special significance.

Further, some criteria will be ignored because they are not easy to judge.

Bacteria contamination is seldom considered as microscopic bugs cannot be seen by the naked eye.

When the Society of Hospital Linen Services and Laundry Managers set out to establish “linen standards”, it reasoned that such benchmarks would lead to textile items that had been laundered and finished under hygienically controlled conditions and

that the system would ensure all UK healthcare establishments would have a linen service that aimed to meet at least the same minimum acceptable standard. Benchmarks would also allow comparisons

of service providers to be made on equal grounds.

There would always be customers that would insist on a 100% perfect service, but, being realistic, how many would be prepared to pay for this level of perfection?

Instead, by using this standard as a measuring stick, those whose services were defined as poor would be able to identify the areas where they needed to improve, and then implement the changes necessary to achieve the minimum standard or even a higher target standard.

Healthcare linen is often taken for granted, and it

is only when an individual takes exception to the standard of linen found in a particular hospital and writes to the local press that areas such as staining, tears and deficiencies reach the agenda at Trust board meetings.

No one should have to sleep on a sheet that is stained with another person’s body fluids, and provided there

is a sufficient stock of linen, this will not happen.

However, if linen supplies are inadequate, and/or levels of staining excessive, then there will be cases where a stained sheet will be accepted because the only alternative would be to manage without any sheets.

The linen standards or benchmarks that SHLSLM has set are applicable to several areas of the linen service including:

• hygiene and the prevention of infection through linen;

• levels and degree of staining;

• acceptable levels of repairs/holes and tears;

• quality of finish in relation to creases and presentation; and

• whiteness retention.

When considering acceptable levels of hygiene,

the industry needs to look at more than the levels

of cleanliness and bacteria counts.

It needs to bear in mind that there are “foreign objects” that may be clean and bug free, but which can still harm or damage people and/or linen, for example, ground particles of glass caused by a careless operator bringing a bottle into the workplace.

For these reasons the guide includes a sector that promotes good practices. Many of these are already followed by launderers processing garments for use within the food or pharmaceutical industry.

All minimum and target levels have been set following extensive discussions throughout the industry.

Many of the suppliers who were approached, were already exceeding the minimum standard set, some however, were not. The Society did not seek to set standards that were so high that only the elite could achieve them. Instead it wanted to bring everyone to

a minimum level that was acceptable, and then encourage further improvement from that point. Hence in the guide we give both a minimum standard and a higher target that will give goals to achieve to provide a better service.

One thought for the future is that by the use of a carefully structured monitoring system, based upon, clearly defined standards, a system, similar to the Guild’s “Star” award could be developed.

This would denote all launderers operating to or above the minimum standard, thereby saving time and resources that are currently being employed by linen and garment users to satisfy their own customers that they are achieveing good quality control.

Instead, service providers would be regularly monitored and provided with a detailed report and customers would be able to see this on request.

The NHS was quick to realise the advantages brought about by having clearly defined specifications when tendering its work.

Without such specification, monitoring was more of an arbitrary processs, which often failed to produce improvements or satisfy either the customer or the supplier.

The idea of a standard is not, of course, restricted to Healthcare establishments. The system could easily be adapted to cover garment rental users, such as food industry customers, engineering establishments and others, who rely on launderers to supply a “quality” service at an affordable price.

The Society’s Best Practice Guide has attracted interest from nursing homes including both those that have their own laundry service on site, and others that rely upon services provided by launderettes, and commercial launderers.

Many have been unaware of requirements such as thermal disinfection or of the precautions required when handling and processing potentially infectious linen.

The guide has been written in a style that will ensure it can be understood by all. It attempts to remove some of the jargon and buzz words that have crept into every day discussions between user and service provider, and provides an easy to follow document

that ensures both parties can communicate with one another, successfully.

Until now, discussions about the linen service standards have been focussed on the laundry. But now SHLSLM is urging Trusts to look at the wider picture and see the effect that their own work practices have on the service.

How many times has soiled linen been allowed to accumulate outside a ward entrance that is used by both patients and staff? Has anyone checked to ensure that all soiled linen is removed at regular intervals and that any spillages have been satisfactorily dealt with?

The way laundered sheets are transported is another important consideration. Standards of cleanliness and hygiene must also be applied to the trucks and trolleys used to carry linen.

It’s a waste of effort if sheets that have been laundered and packed in a well managed environment, are then transported through the hospital in a wooden truck that is never or rarely cleaned/disinfected even though it has as been used for waste, soiled and possibly infected linen, or any of the other numerous, undesirable items generated by a hospital.

While SHLSLM was trialling its recommendations, it quickly became apparent that a laundry’s quality could often be pre-determined without the need for lengthy and time consuming checking procedures.

Initially, the society decided to check 100 sheets, at random, looking for stains, tears, holes and inappropriate creasing. This was done by opening up each sheet, inspecting, and then refolding the sheet, after noting any variance from the accepted level.

Interestingly, those laundries that had a well documented system for dealing with quality problems, and whose staff had been trained and instructed in its use, had the best results.

The ones with the highest number of deviations from the “standard” were plants where there was little or no visible sign that quality control was being applied.

Staff were unaware of any criteria, such as stains, holes, or tears, for judging results neither did they

know at which stage linen should be checked.

This finding adds support to the suggestions that

all healthcare processing plants should be EN14065 compliant.

The Society of Hospital Linen Services and Laundry Managers’ sole aim has been to promote healthcare linen services in a professional manner.

By promoting the use of good practices and linen standards it has gained members from all corners of

the industry.

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