Seminar Objectives. Defining Linen Loss. Now You See It Now You Don t! A Campaign to Stop Linen Loss. Janice Larson CLLM & Heidi Ayala RN, CLLM

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1 Now You See It Now You Don t! A Campaign to Stop Linen Loss Janice Larson CLLM & Heidi Ayala RN, CLLM Seminar Objectives To provide the participant with tools to: Define linen loss Identify which items are being lost Begin a program to prevent further losses Monitor progress Defining Linen Loss True Loss Losses that are not retrievable Includes deliberate and inadvertent theft Linen thrown in trash instead of linen hamper Misused linen that must be taken out of inventory prematurely 1

2 Defining Linen Loss (cont.) Theft - a major contributor to losses and replacement costs Deliberate Items taken for personal gain or use Scrubs, blankets, towels, pillows Inadvertent Taken by patients who think it s acceptable Baby Linen Defining Linen Loss (cont.) Artificial Loss Linen that is retrievable Linen not in circulation due to: Overstocking of carts & closets Hoarding by staff Scrubs not yet returned Reasons to Suspect Loss Questions Are losses occurring? Where might losses be occurring? Which items are being lost? Observations Increases in replacement cost Shortage of products Relationship of replacement cost to total linen budget 2

3 Who s Responsible Patients Employees Others Identifying Potential Losses Methods of detection Clean to Soil Ratio Linen Loss Survey Replacement Factor Analysis Physical Inventory Clean to Soiled Ratio Industry average 8% clean to soiled ratio Verify poundage through billing invoice Assess if hospital is experiencing loss from clean to soiled linen Document incoming and outgoing weights daily Determine replacement cost per pound 3

4 Daily Weights Form Daily Weights Daily Weights Month: January Clean Soiled Clean Soiled WEEK 1 SUN 3,082 3, % WEEK 3 SUN 3,096 3, % MON 3,175 3, % MON 3,160 3, % TUE 3,156 3, % TUE 3,202 3, % WED 3,147 3, % WED 3,147 3, % THU 3,129 3, % THU 3,156 3, % FRI 3,102 3, % FRI 3,025 3, % SAT 3,129 3, % SAT 3,130 3, % TOTALS 21,920 23, % TOTALS 21,916 23, % WEEK 2 SUN 3,096 3, % WEEK 4 SUN 3,082 3, % MON 3,160 3, % MON 3,082 3, % TUE 3,202 3, % TUE 3,156 3, % WED 3,125 3, % WED 3,147 3, % THU 3,138 3, % THU 3,160 3, % FRI 3,200 3, % FRI 3,102 3, % SAT 3,088 3, % SAT 3,129 3, % TOTALS 22,009 23, % TOTALS 21,858 23, % Clean to Soiled Ratio Form WEEK ENDING CLEAN to SOILED RATIOS CLEAN POUNDS SOIL POUNDS CLEAN to SOILED % $$ SPENT FOR NEW LINEN REPL. COST/LB. January 7, ,920 23, % $0.00 January 14, ,009 23, % $0.00 January 21, ,978 23, % $0.00 January 28, ,843 23, % $0.00 Monthly Total 87,750 94, % $11, $0.13 February 4, ,871 23, % $0.00 February 11, ,858 23, % $0.00 February 18, ,984 23, % $0.00 February 25, ,920 23, % $0.00 Monthly Total 87,633 94, % $11, $0.14 Linen Loss Survey Provides insight into potential loss Provides opportunity to Interface with end user Observe linen practices Addresses Product usage Discharges / Transfers Security Distribution Apparel 4

5 Survey Form Survey For Potential Linen Losses Name: (Optional) Department: Please return to by via hospital mail system. Product Use 1. Does the quality of the linen affect how you use it and/or how much of it you use? Please explain: 2. Is there a hospital protocol to remove these items from service? 3. What do you do with linen rejects (stained, torn, etc.)? 4. Have you ever written on or seen other people write on linen? 5. Do you unsnap and untie gowns before placing them in the soiled linen hamper? 6. Do you use disposable washcloths? If yes, when (i.e., AM care, all the time, incontinent care, etc.)? 7. Do you routinely or occasionally throw away linen contaminated with feces? Are you aware of other employees who do this? 8. Do you routinely or occasionally red bag linen that is contaminated with feces or used for patients in isolation? Are you aware of other employees who do this? 9. What color are the cleaning rags that housekeeping uses? Are they cloth disposable? 10. What do you do if there is a spill that may cause a patient or visitor to fall? Replacement Factor Analysis Uses Phillips and Associates Factors Provides data on gross replacement factor per individual item per 100 uses Provides data that allows Calculation of expected losses Determination of linen loss rate Used most often by laundries Replacement Factor Analysis Gross Replacement Factors provided by Phillips & Associates, Inc ITEM DESCRIPTION Total Usage for 3 Months* Gross Replacement Factor per 100 Uses Expected Losses for 3 Months Linen Purchases for 3 Months* DELTA Unexpected Monthly Losses Unexpected Daily Losses Cost to Lose Estimated Cost of Unexpected Daily Loss Estimated Cost of Unexpected Annual Loss Flat Sheet 15, x 2.19 = $4.35 $7.99 $2, Knitted Fitted 4, x 1.74 = $3.00 $1.28 $ Sheet Underpad 5, x 1.97 = $4.44 $17.68 $6, Bath Blanket 9, x 3.57 = $3.34 $2.52 $ Thermal Blanket 1, x 2.67 = $9.90 $0.28 $ IV Gown 4, x 2.97 = $4.87 $3.23 $1, Bath Towel 17, x 4.88 = 859 1, $1.42 $8.54 $3, Washcloth 18, x = 2,113 2, $0.19 $0.82 $

6 Physical Inventory Most effective if conducted annually Provides data that will Help identify unexplained losses Quantify amount of circulating inventory Help locate dead linen stock Inventory Reconciliation Worksheet Inventory Reconciliation Products Catalog # First Inventory Purchases Ragouts Second Inventory Losses Flat Sheet Knitted Fitted Sheet Underpad Bath Blanket Thermal Blanket WHI IV Gown TEL Bath Towel Washcloth X Prevention Develop an action plan that addresses losses and reasons for the losses Prioritize initiatives based on findings Include as key tools Education of staff Development of linen utilization policies 6

7 Action Plan Goal: Zero Linen Losses Action Items Beginning Responsible Expected Date of Completion Progress/Comments Distribution Date Person (or Ongoing) (Briefly Describe How Implemented) Weigh Linen Linen Management Software Avoid Overstocking Action Items Discharges/Transfers EMS Access to Linen Beginning Responsible Expected Date of Completion Progress/Comments Date Person (or Ongoing) (Briefly Describe How Implemented) Patient/Visitor Access Discharge Protocol Linen Education Educate the end user on rational consumption of product usage Benign abuse is preventable Include in staff orientation Continue on an ongoing prevention Cost to Use/Cost to Lose Analysis Product Weight Predicted Life (expected number of uses) Processing Cost Replacement Cost 7

8 Cost to Use versus Cost to Lose Analysis Products Lbs./Each Cost to Process Unit Price Use/Item* Cost to Use Cost to Lose Flat Sheet 1.20 $ 0.36 $ $ 0.48 $ 7.31 Knitted Fitted Sheet 1.31 $ 0.24 $ $ 0.35 $ 5.97 Underpad 1.40 $ 0.42 $ $ 0.59 $ 8.42 Bath Blanket 1.92 $ 0.58 $ $ 0.90 $ 8.01 Thermal Blanket 4.00 $ 1.20 $ $ 1.56 $ IV Gown 0.66 $ 0.20 $ $ 0.37 $ 7.14 Bath Towel 0.46 $ 0.14 $ $ 0.22 $ 1.88 Washcloth 0.08 $ 0.02 $ $ 0.05 $ 0.26 *Use per item data from Laundry Plant Textile Replacement Factors report published by Phillips and Associates, Inc. Linen Utilization Policies Manage linen usage through established policies and procedures Key policies are Scrub or Garment Control Rag-Out or Discard Linen Change Standard Track usage and costs with linen software system Progress Tracking Worksheet Goal: Clean/Soiled Ratio = 8% Goal: Replacement Cost = $0.12/lb. JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC C/S Ratio (%) Replacement Cost /lb. 1. Weighs clean & soiled linen 2. Set par levels 3. Installed Executor Actively enters data 5. Prints and distributes monthly reports 6. Conduct Linen Task Force meetings 7. Implementing Action Plan 8. Has EMS Controls 9. Using Indep. Study Materials 10. Using Video 11. Scrub Amnesty Day 12. Linen Awareness Day 8

9 Conclusion Linen is a valuable asset essential for patient care Linen losses should not be an accepted practice Losses impact the financial health of the hospital All staff have a responsibility to use linen wisely Summary Define linen loss Identify which items are being lost Begin a program to prevent further losses Monitor progress Avoidable Losses = Stealing Linen is a valuable asset essential for patient care 9

10 Janice Larson, CLLM Director Cost Management Services Encompass Textiles & Interiors Heidi Ayala, RN, CLLM Cost Management Consultant Encompass Textiles & Interiors 10

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