Plant, Personnel, and Process
By Gregory Gicewicz
November 29, 2015 | Formats: Article | Content Areas: Textile Management Operations | Tags: Laundry and Textiles, Linen , Management, Process Improvement, Staffing Models
Health care professionals charged with assessing and selecting a textile service provider for their facility have a singular goal: To ensure the laundry provider follows the most rigorous of standards so clean textiles arrive at the facility free of contamination. Therefore, visiting a potential health care laundry is a must and should include relevant representatives from environmental services and infection prevention. During the visit, focus the evaluation on the Three Ps: the plant, the personnel, and the process. Here’s a topline look at those Three Ps (for thorough detail, see the current edition of the Healthcare Laundry Accreditation Council’s “Accreditation Standards for Processing Reusable Textiles for Use in Healthcare Facilities,” available at https://www.hlacnet.org/):
The Plant
1) How is the plant laid out? Ultimately, as you walk around the facility, you want to get a sense that you’re in a building that has been designed in a way that promotes efficient workflow without compromising the protection and integrity of the health care textiles. Look for circumstances where clean linen might become contaminated. Is there proper airflow from clean to dirty? Are there areas where clean linen may come into contact with dirty linen? There’s no room for shortcuts.
2) Does the laundry have policies and procedures for cleaning and maintaining the plant and its equipment? Does everything appear clean and free of lint? Look on the walls, tables, ceilings, and under equipment.
3) How does the laundry handle waste? Ask for an explanation of their policy for managing medical waste and hazardous substance-related wastes.
4) Is the provider in compliance with relevant regulations regarding air, water, wastewater, and chemicals?
5) What’s the backup plan for providing uninterrupted operations and services? Does the provider have reciprocal processing agreement in place in the event of a disaster?
6) Stuff shouldn’t happen: How does the provider ensure and maintain the proper functioning of the plant’s equipment? Ask to see the equipment maintenance log to ensure that maintenance is being followed.
The Personnel
7) Are the employees—at all levels—focused on patient safety and service quality? Speak to the laundry personnel to learn as much as you can about the plant culture.
8) Do you get a sense of professionalism? How does the provider ensure and document that personnel are qualified for their respective positions, and are job descriptions clearly defined?
9) What if someone comes to work sick? What are the health and hygiene policies and procedures to prevent textiles from being handled by or exposure to personnel with potential health issues?
10) Informational signage should be everywhere. For example, regarding the handling of chemicals, is safety information and signage readily accessible to personnel? Are contaminated linen areas clearly marked?
11) What are the procedures when personnel are exposed to hazards (e.g., biological, chemical, mechanical, etc.)? Ask employees for an explanation of those procedures.
12) What are the hand-washing and hand-hygiene procedures?
13) Are all personnel protected adequately? What are the provisions and procedures for personal protective equipment (PPE) and attire? Observe workers in areas exposed to soiled linen (washers, sorters, drivers). Are they wearing appropriate PPE?
14) Is there a program addressing occupational safety and health (e.g., exposure control plans, etc.)?
15) What about continued training? What programs exist for continued education regarding safety, laundry operations,
pack processes, and other processes, Bloodborne Pathogens Exposure Control Training, etc.?
16) Note: HLAC’s current standard’s manual devotes an entire section that addresses facility and process elements unique to the presence of surgical pack assembly.
The Process
17) What is the facility’s procedures and policies regarding the handling and collection of soiled health care textiles? Are these in accordance with relevant regulations?
18) Functional separation is key to the process: How does the provider maintain and ensure the separation of clean textiles from soiled textiles? This applies to carts, sort/wash/dry/finish areas and/or vehicles during handling, collection, and transportation of soiled textiles.
19) Likewise, what are the provider’s procedures regarding cleaning and disinfecting in the use of carts, containers, covers, and liners to collect and transport soiled textiles? Visually inspect their clean carts—are they free of visible soil on the outside and inside?
20) What are the precautions in place in the soiled sorting area?
21) Finding foreign objects in linens is a common occurrence. What are the provider’s policies regarding these (e.g., reusable surgical instruments, sharps, etc.)?
22) What are the provider’s processes regarding washing and extraction? Ask to see a titration report. Look for appropriate contact time, wash temperatures, and chemical concentrations
23) How does the provider ensure that washed health care textiles become hygienically clean?
24) Make sure you get a full understanding of the provider’s extracting and drying procedures to preserve the integrity of textiles, and to minimize microbial growth after washing and prepare for ironing and folding.
25) What are the processes in place regarding drying, finishing, folding, stacking, packaging, storage, and transport? Lastly, while not part of the Three Ps per se, it’s also smart to check references for a complete picture of how the provider performs on a continuing basis relative to its standards.