Facilitator:
Terri Stoner

1. Review and draft a list of standard linen supplies to make up patient beds. Supplies to be evaluated include: Bath Blanket, Blanket Thermal Bedspread, Bottom Sheet (review alternative product knitted fitted sheet), Lifter sheet, Mattress Pad, Pillow case, Reusable pillow and Disposable, Top Sheet, Towels, and Washcloths
2. Review and draft a standard procedure for use of appropriate and optimal product for use in lifting patients.
3. Draft a recommended standard procedure and process for making beds, preparing a room, storage of linens, and avoidance of waste.
4. Address Quality Control issues, how to keep adequate supplies for room set up, patient requirements, and provide quality products with a mechanism for replacement of worn or unsuitable linens.
5. Document staff and product savings.

Our team began its work by requesting information from all users on what linens were needed and what changes might be provided as an improvement for patients and our staff. It became clear, that although we have spent lots of money on linen and laundry, we did not have the right mix of products. With that in mind, we began from the beginning, we totally evaluated each item of linen for appropriate use and once found, we then drafted a standard bed linen makeup. This standard was tested using a PIG to purchase linen products. After a successful trial using the PIG, the team has concluded its work with the following recommendations:

1. The team is recommending acceptance of a new standard list of supplies to make up a patient bed. Posters and inservices will begin in April and conclude in May with full implementation of the new bed standard.
2. We are requesting a new standing committee be established- the Linen Management Committee. A list of potential members is attached along with draft goals and objectives. To begin its work, the team is requesting implementation of a linen database using Standard Textile Control Tex system. This committee will be charged review of linen utilization and continue the teams work with the review of products using for patient lifting.
3. The team is recommending that linen be pulled for patient beds in the morning, prior to making the bed, rather than pulling linen for the cart and leaving it at the patient bedside the night before. This change of procedure will eliminate the waste of washing clean linen that cannot be used it the current patient leaves the hospital in the early part of the day.
4. The team addressed many quality issues. One final recommendation is that users can easily remove linen that is unusable from the system. There are plastic bags provided on each linen cart for this purpose, the linen room gathers this linen, evaluates it for reuse, and if appropriate replaces this inventory with new linens that can be added to the total inventory.
5. The team projected savings has been documented for multiple departments, attachments with specifics have been shared with areas so that changes would be included into the budget for next fiscal year.

The total mix of linens has been changed to more accurately reflect the needs of our patients and the variety of bed, mattress sizes. The Linen staff is helping to review all linen carts and suggest quota changes, which more accurately reflect the needs of the area.

See attachment I, "What you need to know about Bed Linen Usage at UI Hospitals and Clinics".

The team has identified multiple barriers they are all being addressed in the inservice training programs, via Informm broadcasts, and through direct mailings.

The barriers are:

1. Resistance to change….We have always done it this way…..Our patients needs are different….Who gets charged?….
2. Unit Differences- We have a standard that can be applied to every nursing area that uses adult size mattresses. The team is working to evaluate and provide a similar standard for pediatric areas.
3. To facilitate this change, we needed to change the approval process for requesting linen products. For instance, we are asking areas that want disposable pillows to justify their request to the linen team. Once the linen team has reviewed the request, they can 1. Deny the request and work with them to find a way to make the reusable work, or 2. They approve the request and are provided with the disposable pillow.

Action Plan:

1. Purchase new linens for implement new bed standard. Funds will come from current disposable savings and from changes in linen and laundry use.
2. Inservice Nursing, Housekeeping, and Linen and Laundry areas on new standards. Change quotas on linen carts to meet current needs.
3. Implement the Standard textile Control Tex inventory Management system to provide ongoing data to the new committee.
4. Charge a new Hospital standing committee to further investigate and resolve Linen issues.
5. Modify current and future area budgets to reflect savings as appropriate.

Significant savings have been reported by Nursing, Material Services Linen, Laundry, and Housekeeping.