Combat HAI by Quantifying Linen Cleanliness

By Joseph Ricci

Healthcare-associated infections (HAI) are a significant source of anxiety for healthcare organizations and their patients. Though only deaths and large outbreaks make the news, one report is enough to erode the trust patients have for healthcare providers. And one infection is enough to end a patient’s life. Both healthcare professionals and those of us who provide services to healthcare organizations must do more to stem the spread of infections acquired in healthcare settings.

According to a CDC study, one in 25 hospital patients has a HAI on any given day. In 2011, there were about 722,000 such infections in US hospitals, including pneumonia, gastrointestinal illness, urinary tract infections, primary bloodstream infections and surgical site infections. About 75,000 of patients with HAIs died during hospitalization.

To prevent the spread of infection, all hospitals, surgery centers, medical offices, nursing homes and other medical facilities go through great lengths to gauge cleaning effectiveness to ensure hard, non-porous surfaces are thoroughly disinfected. We must pay equal attention to the handling of textiles containing blood and other potentially infectious materials to avoid tragic results.

Outsourcing to a commercial laundry that specializes in healthcare offers a hygienic yet cost-effective option. In fact, most US healthcare organizations have realized this. According to a September 2012 Modern Healthcare survey, laundry is hospitals’ most outsourced function. It is widely accepted that high-quality laundries produce safe, reusable textiles through rigorous implementation of commercial laundering formulas, which carefully calibrate time, temperature, chemistry and mechanical action.

But it is not enough to simply have safety processes and procedures in place that purport to work towards hygienically clean healthcare textiles. To be truly safe, a laundry must quantify and verify textile hygiene. Simply put, a laundering procedure is not effective unless it is producing documented hygienic outcomes.

Laundering can reduce the presence of pathogens to levels that pose no threat to human health. But how do healthcare organizations know if their laundry is accurately measuring outcomes? The laundry industry has widely accepted, outcomes-focused hygienic standards and safety certifications programs. These can help organizations choose a safe laundry with which to work. Healthcare providers can be confident they receive hygienically clean linen by using a certified laundry and enforcing certification in their contract provisions.

An example of such a certification is the Hygienically Clean program. Developed to address growing concern about controlling HAIs, this scientifically based program is working towards complete elimination of harmful levels of microbial content.

HAIs worry patients, threaten lives and cast a shadow over a hospital’s reputation. At the same time, healthcare providers are under financial and compliance pressure to cost-effectively deliver services. Healthcare organizations cannot afford to speculate about whether or not its textiles are hygienically clean. They must demand accountability from laundries, whether in-house or outsourced. Certification is an essential tool for holding laundries accountable and being accountable to patients.

We urge hospitals and the laundries that serve them to stop measuring process and start measuring outcomes, for the sake of their patients, their staff and the longevity of their organizations.

Joseph Ricci is President & CEO of TRSA (, which represents the laundered textiles industry.