LINEN & LAUNDRY SERVICES

LINEN & LAUNDRY SERVICES

Overview

•          Previously, people (dhobi) used to be hired, or all washing activities used to be on Contract Basis based on Tender.

•          Due to various drawbacks of “Dhobi” system, it was changed and self-regulated by hospital.

•          It is a department responsible for providing adequate, safe and timely supply of linen items when and where needed.

•          It is a good public relation tool and marketing tool for hospital because of high visibility.

•          It contributes in providing overall good quality patient care.

•          It is also a department, which faces maximum criticism in a hospital.

•          It has great importance justified in two ways;

•          For safety of patient

•          For good appearance

•          The term hospital linen covers all textiles of the hospital including mattresses, pillows, blankets, sheets, towels and so on most frequently used materials.

•          Laundry is such department which is responsible for providing adequate, safe and timely supply of linen to user departments.

•          Laundry is also very vulnerable to the cross-infection so infection control mechanisms should be properly considered in this department..

•          It has been found that a breakdown in linen supply causes 3%- 4% cancellation of operation schedules.

•          Similarly 3%-4% infections spread due to mishandling of infected linen in the hospital.

Classification of Hospital Linen

•          Patient Linen

•          Bed Linen,

•          Body Linen,

•          OT Linen

•          Staff Linen,

•          Department Linen

•          Laundry Linen

•          Contaminated infected Linen

•          Soiled linen,

•          Foul Linen

Linen Requirement

1. OTs & Labor room are calculated on actual consumption.
2. General & private wards are estimated at the rate of 2-3.5 Kg. Of dry linen per patient per day.

4 sets of linen per bed is needed

# One set to be in use.

#1 set at the laundry.

 # 1 set for available for immediate used.

 # 1 set for stand by and emergency purpose

5 sets of linen should be planned as active inventory;

–         A soiled one in use on the patient’s bed.

–         A clean one in the linen closet in the nursing unit

–         A soiled one in the dirty linen collection area

–         One piece being processed in the laundry

–         A clean one in the linen store or back-up store for replacing active store

–         Preferably in the ground floor of an isolated building connected or adjacent to the power plant. Because laundry is the largest user of power, steam, and water.

–         It should be so located as to have ample daylight and natural ventilation.

–         It should be accessible to inpatient ward.

–         Close to service elevators.

–         It should be so located that allows movement of linen by the shortest route.

Location

•          Preferably in the ground floor of an isolated building connected or adjacent to the power plant. Because laundry is the largest user of power, steam, and water.

•          It should be so located as to have ample daylight and natural ventilation.

•          It should be accessible to inpatient ward.

•          Close to service elevators.

•          It should be so located that allows movement of linen by the shortest route.

FUNCTION Linen & Laundry Services

•          Collection or receiving soiled and infected linen

•          Processing soiled linen

•          Inspection and repair of damaged articles, their condemnation and replacement.

•          Assembling and packing of linen.

•          Distributing finished linen.

•          Maintenance and control of inventories and processed linen.

Organization

•          The efficient operation of the laundry depends upon trained and skilled manpower.

•          The operational chief of the laundry is a laundry manager who may have been trained in laundry operation or adequate experience in the field.

•          Reports to the associate administrators.

•          Most of the hospitals are recruiting trained personnel to head their in house laundries.

•          Others technical as well as general will work.

Manpower requirement of the laundry

To success & efficient operation of the laundry select technically trained, experienced laundry manager.

Estimated average numbers, by size of hospital

No. Bed                                                  No. of employees

50                                                                                                           2

100                                                                                         6

200                                                                                         11

300                                                                                         20

400                                                                                         27

500                                                                                         32

Types of laundry Services

1. Contract System: Demerits:

# Mixing of linen.

# More chances of loss in transit.   

 # Chances of cross infection.

2. Rental system- More expensive & only short period recommended. small <50 beds ideal.

3. Cooperative system – Caters number of hospital.Merits:

# Cheaper costs of production 

# Less investments

# Convenient for smaller hospitals.

4 In-plant system: Run owns and its own mechanical laundry services.

Advantages:

# Reduced loss and damage

# Assure regular supply within limited inventory

# Safe handling of infected linens

# Control on washing formula.

Methods of Supply

•          Clean for dirty exchange: Clean linen is provided in place of dirty linen.

•          Topping up system: 24 hrs. supplied.

•          Requisitioning system

•          Daily quota system

Linen Work flow

Facilities requirement

•          Reception area with facilities for receiving,

•          storing & washer-loading of soiled linen,

•          central disinfections area, clean linen processing room,

•          laundry manager’s office, sewing, inspection & mending area,

•          light table, supply storage room, lockable store,

•          provision for supply of water, power, stream,

•          cart-washing and cart storage area,

•          clean linen storage room and issuing counter.

•          In off site: A clean linen storage & issuing room, lockable storage in nursing unit/user department, separate rooms for receiving and holding soiled linen from the wards.

Floors

•          Dust free, smooth (chips), concrete

•          Having drainage

•          Should not be slippery or water remaining on the surface

•          Preferably, lattice-type wood mats should be placed at each workstation.

Equipment use in Linen & laundry

•          Washer extractor sluicing machine,

•           Double door washing machine,

•          Hydro extractor (combining washing, rinsing and extraction), Flat work iron,

•          Tumble dryer, table trolley,

•          ironing table, hand iron,

•          dry linen trolley, Linen hanger,

•          distribution trolley,

•          motorized sewing machine etc.

Duties of Linen & laundry Manager

•          Buying linen,

•          warehousing,

•          issuing new linen,

•          delivering,

•          collecting and some times repairing linen.

•          Managing people and equipment.

•          Manage large quantities of supplies.

•          Check timely shortages and linen abuse .

Control of Theft of linen

•          Use of lock and keys

•          No duplication of keys

•          Prohibiting unauthorized entrance

•          Color codes and stamps

•          Inventory checks and counting

•          Keeping linen supply level low as far as possible

Conclusion

•          Linen carts should be kept facing to nursing station

•          Main objective of providing better medical care to the patients in a clean, conducive environment.

•          The efficiency and effectiveness of nursing care can increase with a better organized this Linen services.

Housekeeping Management in Hospitals

G. Krishna Veni

Overview on Housekeeping Department
Historical Perspective
 Under direction of ward nurse
 The concept of Housekeeping was not clear
Modern Perspective
 Psychological Impact of patients
 Improved hygienic practices and better sanitary conditions have a direct relationship to the post operative complications.
 Under direction of Housekeeping department
 Members of HK department are experts in cleaning and organizing in house activities
 The housekeeping departments work has advanced rapidly in recent years and requires not only knowledge of technical skills but also an understanding of the ‘Tools’ of management
 Principles of management
 Plan, organize, coordinate, control and monitor all the housekeeping activities in hand for effective utilization of resources
 Housekeeping – Definition
 Housekeeping is defined as the provision of a clean, comfortable and safe environment for the patients and public in a hospital setup
 The concept of housekeeping is simplistic
 butWhen one considers maintaining a ‘house’ of several hundreds of rooms and numerous public areas, the task becomes gigantic.
 Aims of housekeeping department

 Achieve the maximum efficiency possible in the care and comfort of the patients and in the smooth running of the hospital.
 Establish a welcoming atmosphere and a courteous, reliable service from staff of all departments.
 Ensure a high standard of cleanliness and general upkeep in all areas.
 Train, control and supervise the staff of housekeeping department.
 Establish a good working relationship with other department.
 Ensure that safety and security regulations are made known to all staff of the hospital

 Responsibilities of Housekeeping Department
 Daily cleaning
 Periodic cleaning
 Trash and garbage removal including proper hospital waste disposal
 Discharge cleaning
 Exterminating bugs and pests
 Preventing spread of infection
 Safety and security of the hospital
 Creating healing environment
 Gardening
 Interior decoration
 Organization Chart

 Organizing Housekeeping Department

 Location
 Facility & space requirement
 Storage areas (e.g. under staircase)
 Cupboards with locks
 Notice boards
 Management information system
 Registers (attendance, asset,...)
 Forms (Indent, requisitions,…)
 Asset list (equipment, materials..)

 Checklist (Quality, Maintenance..)

 Recruitment and staffing
 Tapping the right source
 Interview process
 Selection process
 Grooming
 Personal Hygiene
 Honesty
 Courtesy tact & diplomacy
 Orientation
 The organization and brief outline of the hospital
 Information regarding condition of service, pay, etc.
 Information regarding grooming, hygiene, courtesy, safety, security, etc.
 Rules like dress code, hours of work, leave policies and procedure, lunch hours, etc.
 Hospital tour
 Observing Equipments and supplies used in the housekeeping department
 Observing cleaning procedures done
 Training
 Methods of supervision
 Housekeeping procedures like sweeping, mopping, dusting work
 Equipments and supplies, when to use and how to use, amount to use and care of the equipment. (Attach equip.. usage)
 Refresher training
 During lean periods
 Newer techniques/methods
 Practical training under supervision for quality improvement
 Qualities of the housekeeper
 Basic knowledge of health care sanitation
 Ability to plan, administer, and develop all phases of a comprehensive housekeeping program
 Ability to assign, supervises, and evaluates the work of subordinates
 A pleasant personality
 An interest in people and tact in handling them
 Inter departmental relationship
 Maintenance department (electricity, plumbing, carpentry, civil)
 Stores
 Laundry
 Security
 Nursing
 Other departments
 Management Issues
 Effective communication
 Absent of responsible person
 Work Allocation
 Conflicts Management
 Time Management
 Housekeeping practices in key working areas in hospitals
 Out Patient Department and Clinical area
 Operation Theater
 Ward
 Laboratory
 Office area
 Sanitary area
 Outside area
 Common Housekeeping practices in key working areas
 Systematic cleaning operations – Year calendar
 Basic work procedures
 Control of odors, pests, rodent & animal control
 Waste disposal – methods and procedures
 Safety regulation – Accident, fire, electrical
 Care of furniture
 Interior decoration
 Storage procedure for used equipments
 Managing Sanitary Workers

 Workers under housekeepers
 work distribution for male and female workers
 Recruitment and selection procedure
 Nearby areas
 Different areas & families
 Physical appearance
 Age mix
 Effective supervision
 Handling the difficult worker
 Effective communication
 Performance evaluation


 Retaining Sanitary Workers

 Nutritious snacks
 Providing free lunch
 Free uniform
 Free medical facilities
 Recreation (tours, movies etc.)
 Sick leave
 Change their shifts if they have any acceptable reason
 Help them if they require money for Emergency
 Help them to educate their children
 Bonus for 100% attendance

 Challenges …..
 Routines need to be planned so that they do not inconvenience doctors, nurses, visitors
 Cleaning has to be consistent, suitable in conjecture with nursing procedures, e.g. bed making before vacuum cleaning
 A greater need for flexibility and the ability to adjust to interruptions
 Methods & equipment require special attention so as to prevent cross - infection
 The noise is of more importance than elsewhere.
 Greater variation in different work methods and standards in different areas, example - operating theatres, wards and visitor’s lounge
 ( standards of cleanliness)
 The need for check cleaning, that is the frequent re-doing of cleaning tasks, in heavy use areas e.g. Mopping of floors, cleaning of toilets and wash basins. (frequency of cleaning)
 Laundry Services
 It is a centralized function coming under the housekeeping department taking care of all activities from purchase to linen management to laundry to condemnation
 Linen Management will vary based on the climate, culture, systems and procedure of the individual organization
 Hospital can go for
 Inside laundry services - with adequate machineries
 Inside laundry services – Manual wash by dhobi
 Outside laundry services – On contract basis

 Functions of laundry department

 Collection or receiving soiled and infected linen
 Processing solid linen through laundry equipment. This includes sorting, sluicing and disinfecting, washing, extracting, drying, conditioning ironing, pressing and folding
 Inspection and repair of damaged articles, their contamination and replacement
 Distributing finished linen to the respective user departments
 Maintenance and control of active and back-up inventions and processed linen
 Maintaining all type of registers


 Organizing laundry department

 Manpower requirement
 Duties and responsibilities of linen in - charge housekeepers
 Recruitment and selection of dhobi
 Management information system
 Equipments – selection, care
 Linen – selection, care, stain removal procedure
 Work procedure
 Stain removal procedure
 Management issues
 Stock the linen materials in 1:3 ratio
 Each day the bed sheet is dusted and the side is changed when the bed is made. This way both sides of the sheet is used. On the third day the bed sheet is changed
 Use all faded and damaged fabrics for dusting and cleaning windows, furniture etc
 Stock the linen materials in 1:3 ratio
 Each day the bed sheet is dusted and the side is changed when the bed is made. This way both sides of the sheet is used. On the third day the bed sheet is changed
 Use all faded and damaged fabrics for dusting and cleaning windows, furniture etc

 Other housekeeping knowledge
 Innovative and decorative tasks like flower arrangements and pot decoration etc.
 Gardening
 Arranging dinner, tea for guests
 Arranging rooms for conferences, meetings
 Functional arrangements
 Conclusion
 The housekeeping department is a non-revenue-producing service department in the hospital. A poorly run department results in money needlessly spent and creates a negative impression on patients, visitors and staff, which will adversely affect their perception of the quality of care provided by the hospital.