THREADS

Thread count by the numbers

Choosing IP products to stop superbugs

How to streamline scrubs organization

Innovation for healthcare textiles & EVS

2020: ISSUE 10

A FRESH STARTPennsylvania laundry finds a unique new source of reliable workers

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Learn more. Contact your Medline Representative to schedule an ERASE Pathogens assessment at your facility.

CLEANINGBY THE BOOK.

Clean by Sequence®—ERASE Pathogens. ™The CDC recognized 17 different high-touch surfaces that are most vulnerable to the spread of pathogens. Our clean by sequence process uses a numbered microfiber booklet, a “hot spot” map and a disinfectant, making it easy to train, implement and follow.

© 2019 Medline Industries, Inc. Medline is a registered trademark of Medline Industries, Inc. MKT19117571 / 23

Is your room really clean? Use ATP for monitoring and documenting the cleanliness of your facility,

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Innovation is not only exciting but necessary. Due to new regulations and payment models, consolidation, demographic shifts, and new products and technology, the healthcare industry is evolving at a faster rate than ever before. It sometimes seems as though the market changes overnight.

But innovation rarely happens overnight. It takes imagination, persistence and confidence to see the world the way it could be, not how it is today. At Medline, we have a history of looking at the challenges created by our changing industry and finding opportunities to innovate.

Ask better questionsInnovation starts by asking the right questions: “What, exactly, is the problem that needs to be solved?” If you don’t accurately articulate the problem, the solution you develop may not address the problem you originally intended to solve.

Be boldIt’s easy to get comfortable with the old way of doing things. For innovation to happen, you have to be confident enough to believe you can create a better way and bold enough to rock the status quo.

Engage stakeholdersUnderstanding the perspectives of all stakeholders is critical. In some situations, naysayers may even have financial incentives to protect the status quo. The sooner these perspectives are understood, the higher the likelihood an innovation will be successfully adopted.

Jeremy Fogel

welcomeInnovation rarely happens by accident

Issue 10 3

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Learn more. Contact your Medline Representative to schedule an ERASE Pathogens assessment at your facility.

CLEANINGBY THE BOOK.

Clean by Sequence®—ERASE Pathogens. ™The CDC recognized 17 different high-touch surfaces that are most vulnerable to the spread of pathogens. Our clean by sequence process uses a numbered microfiber booklet, a “hot spot” map and a disinfectant, making it easy to train, implement and follow.

© 2019 Medline Industries, Inc. Medline is a registered trademark of Medline Industries, Inc. MKT19117571 / 23

Is your room really clean? Use ATP for monitoring and documenting the cleanliness of your facility,

Change your perspectiveDoing the same thing day after day will not lead to innovation, and a change of perspective can help. Engage with others outside of your team, company and industry. A change of scenery can lead to a change of perspective — and unexpected new ideas.

Redefine innovationEven a small change or update can make a big difference — and a bigger impact. Sometimes the best innovations are the ones where people reflect, “That’s so simple. How did I not think of it?”

Embrace failureFailure is the road to innovation. You have to experiment, learn and keep trying. The only time you truly fail is when you give up.

For this issue, we talked with people about innovative approaches to patient experience training and infection prevention. And that’s another great way to inspire innovation — surround yourself with other innovative thinkers. It’s one of the best perks of working at Medline and in the healthcare industry.

Jeremy FogelDivision Vice President, Textiles, Interiors, and Environmental Services Medline Industries Inc.

4 THREADS 2020

What’s in your pockets?

Empty your pockets before dropping your

scrubs into the hamper.

Attention Nurses and providers: Add this quick task to your laundry routine.Make sure your pockets are empty before adding your scrubs to the laundry hamper to protect laundry personnel from needlesticks and sharps injuries.

©2019 Medline Industries, Inc. All rights reserved. Medline is a registered trademark of Medline Industries, Inc. MKT19W227173 / e19430 / 72

Need scrubs? Contact your Medline representative or call 1-800-MEDLINE.

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Medline Industries, Inc. Three Lakes Drive

Northfield, IL 600931-800-MEDLINE (1-800-633-5463)

www.medline.com

Published by Convero

835 Sharon Drive, Suite 200 Westlake, OH 44145

(844) 428-8844 www.converoinc.com

Medline Editor: Kelly Martinucci KMartinucci@medline.com

Medline Assistant Editor: Hannah Zielinski HZielinski@medline.com

Project Manager: Amy WardArt Director: Wendy Armon

Cover Photography: Chandler Crowell

©2020 Medline Industries, Inc. All rights reserved.Medline is a registered trademark of Medline Industries, Inc.

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CONTENTSspotlightLessons LearnedUntapping creative thinking as a clinician . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

A multifaceted approach to combating superbugs . . . . . . . . . . . . . . . . . . . . 7

News You Can UseChoosing IP products and programs that stop superbugs . . . . . . . . . . . . . . . . . . . . .8

Our pledge to the CDC antimicrobial resistance challenge . . . . . . . . . . . . . . . . . . . .10

featuresEfficiencyApplying Lean Six Sigma to laundry operations . . . . . . . . . . . . . . . . . . . . 12

Plastic microfiber regulation . . . . . . . . . . . . 14

Patient ExperienceThread count by the numbers . . . . . . . . . . . 16

Telling tales to create a voice for your brand . . . . . . . . . . . . . . . . . . . . . . . . . 18

Linen UtilizationStreamlined scrubs organization . . . . . . . 20

A reminder to empty scrubs pockets . . . . 21

Cover StoryA fresh start: Pennsylvania laundry facility finds a unique new source of reliable workers . . . . . . . . . . . . . . . . . . . . .24

Infection Prevention UV technology to boost disinfection effectiveness. . . . . . . . . . . . . . 28

Feature How to jump-start team creativity . . . . . 30

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LESSONS LEARNEDUNTAPPING CREATIVE THINKING AS A CLINICIANLisa PetrilliSenior Director of Strategic Marketing and Customer ExperienceMedline Industries Inc.

Clinicians may feel their days are shaped by routine, but creative thinking can unlock opportunities for new, effective ways to address the everyday challenges of healthcare.

FRESH PERSPECTIVE. “The challenges that healthcare leaders face grow in complexity on a daily basis. Solutions they’ve used in the past may not work for problems they face today. By allowing themselves to apply a creative lens to their challenges, they free themselves up to ask more provocative questions such as ‘What if?’ and ‘Why not?’”

CREATIVE SPARKS FLY. “It’s important that sharing creative ideas be a part of the culture to encourage successful ideas to spread. At a Hospital Quality Institute conference, a med/surg unit nursing director presented a genuinely creative competition her unit created to improve hand hygiene compliance among nurses and physicians. Before the competition, which took place in the fall and centered on football, their unit’s hand hygiene compliance was only 50 percent. After the competition, it was above 90 percent, including physicians. The competition became so fierce and fun that other units heard about it and wanted to get involved. The creative spark enabled the idea to spread and resulted in a greater impact to the entire hospital than had ever been anticipated.”

OUTSIDE INSPIRATION. “Ask other units what they’re doing to raise their performance and see if that insight can be applied creatively to the challenges you face. Additionally, look to other industries facing complex problems and the solutions they’ve created. How might those solutions apply to your area of expertise? We do this as part of Medline’s Institute for Healthcare Excellence. We take our customers on a ‘field trip’ to learn about experience design in another industry. It helps our customers shift their mindset and think about patient, caregiver and family experiences in an entirely new light.”

SPOTLIGHT

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LESSONS LEARNEDA MULTIFACETED APPROACH TO COMBATING SUPERBUGSRosie D. Lyles, MD, MHA, MScDirector of Clinical AffairsMedline Industries Inc.

In 2018, the U.S. Department of Health and Human Services and the Centers for Disease Control and Prevention launched the yearlong Antimicrobial Resistance (AMR) Challenge at a meeting of the United Nations General Assembly. Medline pledged support to this global call to action, aimed at addressing the growing worldwide risk of AMR pathogens.

FRONTLINE PERSPECTIVE. “As a physician and clinical researcher at Cook County Hospital, my firsthand knowledge of emerging pathogens affecting Chicago communities ignited my passion to prevent AMR infections. With patients frequently transitioning between acute and post-acute care facilities, the need for consistent infection control remains the same.”

NEED FOR SYSTEMWIDE EDUCATION. “Effective infection control protocols require that all stakeholders are aligned to optimal standards. It’s vital to educate not only patients and family members but also the entire healthcare team, including administrators, healthcare providers and environmental services personnel.”

A COMPREHENSIVE APPROACH. “Strategies to eliminate pathogens in the healthcare environment are effective only in concert. Bundling infection control interventions – such as hand hygiene, decolonization, wearing a gown and gloves, appropriate antibiotic stewardship, and cleaning and disinfecting the environment – provides a seamless safety net for patients and healthcare staff.”

BACK TO BASICS. “Each year, we face emerging pathogens that test the limits of our current antibiotics and infection control strategies. However, the basic principles remain unchanged. The rules we learned as children still apply: Proper hand hygiene, a clean and disinfected environment, and appropriate vaccinations are at the foundation of best practices.”

CONTINUING THE FIGHT. “Through investments in research and development, investigative clinical studies and our comprehensive ERASE programs that help our clients standardize infection control protocols, Medline is at the forefront of the fight against AMR. Drawing on my clinical perspective, I’m privileged to be a voice at the table.”

8 THREADS 2020

NEWS YOU CAN USE

Candida auris (C. auris) is the latest and greatest global superbug keeping hospitals and healthcare staff on their feet. With a case count just shy of 800 in the United States as of September 2019, this often multidrug-resistant fungus has been tough to tackle, leading to a 35 percent mortality rate among those infected.1, 2

With C. auris and other emerging pathogens alike, healthcare professionals know what’s on the line – patient lives. That’s why healthcare staff responsible for environmental services (EVS) and infection prevention and control (IPC) work tirelessly to perfect facility plans meant to prevent infectious threats. A strong IPC plan is important, but that’s only half the battle. It’s just as important to provide the staff with consistent training and the right cleaning and disinfecting products to ensure the best outcomes.

What to look forAccording to Centers for Disease Control and Prevention (CDC) guidelines, healthcare professionals should consider the following when choosing products for environmental disinfection in the instance of HAIs:3

1 It’s in the details. Follow manufacturers’ instructions for proper use of disinfectant (or general cleaning) products – such as recommended use-dilution, material compatibility, storage, shelf life, and safe use and disposal. By law, the user must follow all applicable label instructions on Environmental Protection Agency (EPA)-registered products. Off-label use means the user assumes liability for any injuries resulting from off-label use, and is potentially subject to enforcement action under FIFRA.4

2 Timing is everything. EPA-registered hospital disinfectants will vary on label contact times, anywhere from one to 10 minutes, so make sure you and your staff know the contact times for all the products in use. [Pro tip: Select products with lower times so you don’t have to worry about having to reapply the product to meet the required contact times.] Disinfect noncritical surfaces with an EPA-registered hospital disinfectant according to the label’s safety precautions and use directions.4

Take a preventive approach to infection prevention When the next emerging bug threatens your IPC plan, will you know which products to choose? Though manufacturer labels might speak to pathogens that made headlines in the past, what can your facility do to choose products that allow you to take a proactive approach to stopping threats immediately?

Assembling a cross-functional team of clinical, manufacturing and environmental services experts will help you prepare for the unexpected. At Medline, while scientists invest time researching emerging threats, product management teams work tirelessly to identify the right products and recommendations to effectively fight pathogens on facility front lines.5

All members of cross-functional infection prevention teams should leverage best-in-class industry standards to inform their strategy. Healthcare facilities looking to take a proactive rather than reactive approach to IPC follow the APIC guideline for descending order of resistance to germicidal chemicals.3 While the guideline was developed to

superbugsSTOPTips for choosing IP products and programs that support the halt of bugs like Candida auris

Issue 10 9

help end users make product decisions to kill the pathogens affecting their facility today, it can also be used in a proactive manner. For instance, using products that kill pathogens at the top of the list means that you’re covered for anything from bacterial spores like Clostridioides difficile (C. diff) down to the easiest to kill enveloped and medium-sized non-enveloped viruses like HIV and herpes. This rule of thumb helps EVS and IPC staff prioritize a range of threats in times when no one knows what it’ll take to kill the next pathogen.

The role of healthcare suppliersSuppliers should work closely with healthcare providers to educate staff on emerging threats, industry best practices and products before they make the news. That’s why the infection prevention squad at Medline started studying C. auris over a year ago.5 Their efforts helped launch Micro-Kill Germicidal Bleach wipes as the first product to be cleared by the EPA to kill Candida auris.* They have also identified cutting-edge disinfectant technologies, like the Solaris Lybot, so you can rest easy knowing you’ve given those superbugs everything you’ve got.

In addition to selecting the right products, educating staff on effective cleaning and disinfecting processes is critical to rounding out your IPC plan. Medline provides healthcare partners with both the products and programs to support your team’s comprehensive IPC efforts. The ERASE PathogensTM program holistically combines all of the important elements (facility assessments, cleaning process guidelines, evidence-based products,

staff education and outcomes reporting) and helps reduce costly, dangerous hospital-associated and surgical-site infections.

Learn more about how Medline is working to reduce the human and financial tolls of infection at https://www.medline.com/pages/clinical-expertise/infection-prevention/.

* First to market claim substantiated through confirmation that no other products on the EPA’s K list, which they recommend for disinfection of C. auris, have an EPA-approved claim against C. auris. https://www.cdc.gov/fungal/candida-auris/c-auris-infection-control.html#disinfection

REFERENCES

1. Tracking Candida auris. Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/fungal/candida-auris/tracking-c-auris.html. Accessed December 13, 2019.

2. “Medline Announces First Infection Control Product EPA-registered to Kill Emerging Pathogen.” Medline newsroom staff. June 14, 2019. https://newsroom.medline.com/releases/medline-announces-first-infection-control-product-epa-registered-to-kill-emerging-pathogen.

3. “APIC Guideline for Selection and Use of Disinfectants.” AJIC (American Journal of Infection Control). http://www.ospedalesicuro.eu/storia/materiali/doc/Selection%20and%20Use%20Disinfectants.pdf.

4. Disinfection and Sterilization. Centers for Disease Control and Prevention. Sept. 23, 2019. https://www.cdc.gov/infectioncontrol/guidelines/disinfection/index.html.

5. “How an Infection Prevention Squad Tackles Superbugs.” Medline newsroom staff. June 17, 2019. https://newsroom.medline.com/infection-prevention/how-an-infection-prevention-squad-tackles-superbugs.

APIC GUIDELINE FOR DESCENDING ORDER OF RESISTANCE

Bacterial sporesBacillus subtilis

MycrobacteriaMycobacterium tuberculosis

Non-lipid or small non-enveloped viruses

Polio virus

FungiTrichophyton spp.

Vegetative bacteriaPseudomonas aeruginosa,

Staphylococcus aureus

Lipid or medium-sized enveloped virusesHerpes Simplex virus; Hepatitis B virus; HIV

10 THREADS 2020

Making the pledge

Antimicrobial resistance (AMR) continues to threaten infection prevention strategies put in place by healthcare workers across the globe. According to the Centers for Disease Control and Prevention (CDC), each year in the United States, at least 2 million people get an antibiotic-resistant infection, and at least 23,000 people die.1 Medline and SilvaClean® partner Applied Silver have committed to the CDC’s yearlong AMR Challenge to fight antimicrobial resistance in hospitals globally. The AMR Challenge is a way for governments, private companies and nongovernmental organizations worldwide to make formal commitments that further the progress against antimicrobial resistance.2

Here’s how we pledged:

Medline Industries Inc. Medline Industries Inc. – manufacturer and distributor of medical products in more than 90 countries – commits to raising awareness of antibiotic resistance and combating emerging pathogens by supporting research and development aimed at reducing

the spread of resistant pathogens. Medline will work with public health departments and academic centers across the United States to support industry and federal-funded clinical studies. This research will focus on preventing infections caused by multi-drug-resistant organisms in high-risk patients in facilities such as intensive care units, wound infections with biofilm complications, post-discharge methicillin-resistant Staphylococcus aureus patients, and impact of environmental cleaning protocols.

Applied Silver Inc. Applied Silver, a health technology company, commits to sharing findings on the importance of hygiene in soft surfaces (e.g., fabrics and linens) in the healthcare environment at the American Society of Microbiology annual conference in June 2019. By spreading awareness of cleanliness in soft surfaces in hospitals, Applied Silver will reduce the spread of resistant pathogens. Applied Silver will advance efforts – including continuing education courses, webinars, workshops and distribution of educational materials – to educate hospital staff, patients, regulatory agencies and the community on the importance of incorporating soft surfaces interventions in standard infection control protocols in healthcare.

For more information on the CDC’s AMR Challenge, visit https://www.cdc.gov/drugresistance/intl-activities/amr-challenge.html.

REFERENCES

1. Antibiotic/Antimicrobial Resistance (AR/AMR). Centers for Disease Control and Prevention. https://www.cdc.gov/drugresistance/index.html.

2. The AMR Challenge. Centers for Disease Control and Prevention. https://www.cdc.gov/drugresistance/intl-activities/amr-challenge.html#m.

We’ve got what it takes to fight antimicrobial resistance

NEWS YOU CAN USE

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Taping blankets is tacky.

Taping blankets means more work and waste.Medline offers a wide range of patient positioners in a variety of shapes, sizes and materials. And while they’re the ideal choice to effectively aid patients, they’re not always available when you need them.

Rolling up a blanket is a great alternative in a pinch. Taping the roll, however, can create a lot of extra work and waste. The sticky residue left behind can be difficult to remove, costing facilities extra time, labor and cleaning products—and, sometimes, even the blanket itself.

©2019 Medline Industries, Inc. All rights reserved. Medline is a registered trademark of Medline Industries, Inc. MKT19W106090 / 3

Please think twice before taping blanket rolls. Talk to your Medline Representative about our full line of patient positioners.

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EFFICIENCY

What can healthcare laundries learn from manufacturing companies like Toyota, Coca-Cola and Hewlett-Packard? They can learn how to operate “lean.”

In this case, lean doesn’t mean trimming staff. It means reducing operational and process inefficiencies using Lean Six Sigma principles. By implementing Lean Six Sigma methodologies, businesses can reduce waste, lower cost and improve quality. Because Lean Six Sigma takes a team-based approach, it also can improve employee morale and engagement.

What is Lean Six Sigma?Lean Six Sigma is a systemic method that relies on collaborative team effort to reduce waste and variation and boost performance. It combines lean manufacturing principles from the Japanese manufacturing industry with Six Sigma, a set of process improvement techniques introduced by Motorola engineer Bill Smith.

Lean Six Sigma focuses on removing seven types of waste:• Inventory• Waiting • Defects• Overproduction• Motion • Transportation• Overprocessing

Applications for healthcare laundriesAlthough all seven wastes impact laundry operations, “the largest

expense driver, after product cost, in a laundry facility is unnecessary overprocessing of product, utilities and chemistry,” says former Medline vice president of manufacturing Oscar Chavarria, who holds a Lean Manufacturer Certification. “If you can reduce overprocessing, you can generate savings.”

Overprocessing happens when employees perform unnecessary work or use the wrong tool for the job. For example, a healthcare laundry may choose the wrong wash formula, which necessitates rewashing. Workers may not segregate products correctly, which leads to resorting. These types of inefficiencies cause delays – waste – which increases cost.

Take a walkTo reduce overprocessing using Lean Six Sigma methodologies,

Applying Lean Six Sigma fundamentals to laundry operationsReduce inefficiencies with a team effort to cut waste and boost performance

first examine each source of waste by going to the Gemba. Gemba is a Japanese term that means “workplace where day-to-day activities are performed,” according to iSixSigma.com.

Managers and engineers take a “Gemba walk” through the facility to look for sources of overproduction. “Observe operations through the lens of the seven wastes,” says Chavarria. “When you see overproduction, you’ll see dollar signs.”

Ask before you actNext, ask your employees why they do things a certain way. Why do towels end up in the same bin as sheets? Why is that cart 10 feet away? “Have the humility to ask and listen,” says Chavarria. “Often the best solution will come from your operators.”

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According to Lean Six Sigma philosophy, the people doing the work every day are your experts. If you come from a learning mindset, asking questions and staying open to input, you’re more likely to receive solutions that work for everyone.

As an added benefit, taking a lean, team-based approach leads to improved employee morale. This boost in employee engagement results in what iSixSigma calls “soft savings.” Soft savings are less directly measured but yield cost benefits.

According to a Gallup report analyzing publicly traded companies, businesses that followed employee engagement best practices experienced 115 percent growth in earnings per share during two different two-year periods. Businesses without those practices experienced 27 percent EPS growth.1

“With the lean approach, you’re teaching workers how to solve problems,” says Chavarria. “A team-based problem-solving approach leads to a diversity of wisdom. It also increases a sense of belonging. People want to belong to something and make a difference. Lean operations tap into that.”

REFERENCES

1. “State of the American Workplace.” Gallup. 2017. https://www.gallup.com/workplace/238085/state-american-workplace-report-2017.aspx.

HOW TO ‘LEAN OUT’ YOUR LAUNDRYLarge companies often provide Lean Six Sigma training on site. Others may hire a consulting or training firm. Individual staff members who are interested in learning the methodology can choose from many online, classroom and hybrid programs.

Absent formal training, here are the key points to keep in mind to create a leaner laundry operation:

• Develop and maintain a learning mindset. This is fundamental to Lean Six Sigma.

• Define your value stream. Value stream refers to all the processes, actions and activities that lead to your final product – clean, sterile linens. Once you define the value stream, determine how your laundry does or does not deliver that value.

• Become familiar with the seven types of waste, and define those seven wastes specific to your business. When everyone knows what is considered overproduction, for example, they can more easily identify and eliminate it.

• Take Gemba walks of your facility. Look for areas of overproduction, overprocessing, transportation and other wastes. How many did you find?

• Follow a plan-do-check-act (PDCA) process. Once you identify a source of waste, develop a plan to improve (plan), implement the plan and measure the results (do), compare it with past results (check), and decide as a team whether adjustments need to be made (act). Repeat as necessary.

• Consider designing a “visual factory.” A visual factory means using signs, charts and other visuals throughout your facility to communicate processes and information. Signs to identify where to store supplies, how to operate a piece of equipment or even where to hang personal items are elements of a visual factory.

• Look for “Kaizen quick wins.” Kaizen is Japanese for continuous improvement. The purpose of Kaizen under Lean Six Sigma is to focus on continuous improvement every day. Quick wins boost morale; over time, they lead to dramatic improvement.“With Lean Six Sigma, you’re building a culture where there is

continuous improvement through continual learning,” says former Medline vice president of manufacturing Oscar Chavarria. “It’s a journey, and it involves everyone. Continuous improvement never stops.”

Oscar Chavarria is vice president of Latin America field sales at Medline Industries Inc. As the former vice president of manufacturing, he led Textiles’ manufacturing and distribution operations in the Western Hemisphere to ensure the supply chain constantly evolved to meet ever-changing customer demands. He now oversees Medline’s sales and operations for Latin America and Puerto Rico.

“With Lean Six Sigma, you’re building a culture

where there is continuous improvement through

continual learning.”

– Oscar Chavarria, former vice president of manufacturing

at Medline Industries Inc.

14 THREADS 2020

Plastic microfiber

Assembly. However, its creation suggests a trend of similar bills to follow.

“Our first concern is, it’s bad for our California members,” Schwalb says of TRSA’s decision to fight AB-129. “TRSA has invested heavily in California and New York because it seems if either of those states start an initiative, it migrates to others.”

This isn’t the first microfiber legislation, and it likely won’t be the last. Another Bloom bill, AB-2379, required clothing manufacturers to affix a label onto all clothing made of 50 percent or more polyester.

EFFICIENCY

Increased attention and potential regulatory initiatives could impact healthcare laundries

REGULATION

To help reduce chemical and water use, many healthcare organizations have switched from cotton to a variety of microfiber textiles. But the commercial laundries that process large quantities of synthetic linens are becoming a target for legislation aimed at reducing plastic microfiber pollution — about 35 percent of which stems from synthetic textiles.1

All textiles, whether organic cotton or polyester (a type of plastic), release tiny strands of fiber less than 5 millimeters in length when they’re tossed around in the washing machine. Legislation argues that the laundering process releases the microfibers into the drain and then on to rivers and oceans, where cotton microfibers eventually degrade but synthetic microfibers do not.

California’s leading-edge legislationIn December 2018, California assembly member Richard Bloom, D-Santa Monica, introduced Assembly Bill 129 (AB-129). The bill stipulated that “any public entity that uses a laundry system,” and private entities that contract with state agencies for laundry services, would have to

install a filtration system to capture microfibers shed during washing. The rule would take effect Jan. 1, 2020. Laundries that do not have government contracts would have until Jan. 1, 2021 to comply.2

Kevin Schwalb, vice president of government relations and certifications for Textile Rental Services Association (TRSA), says this type of filtration system does exist, but most healthcare laundries would require a custom system built from the ground up. TRSA says the minimum cost would be about $250,000. Add additional equipment, construction and installation costs, and a commercial microfiber filtration system could reach close to $1 million.

TRSA helped get the bill pulled from consideration before it reached the Environmental Safety and Toxic Materials Committee in the California

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The label would warn users of plastic microfiber shedding and recommend handwashing. The bill easily could have applied to scrubs, uniforms, sheets and other healthcare linens.

AB-2379 also was pulled from consideration. But California’s initiatives and other pushes indicate microfibers is an evolving issue that’s not going away anytime soon.

Synthetic material benefitsAt present, healthcare laundries aren’t required to invest in an expensive filtration system. And healthcare environmental services (EVS) managers don’t need to stop using synthetic materials including microfibers. Even the Environmental Protection Agency (EPA) promotes microfiber material’s benefits.3 The material positively charges fibers and allows them to more effectively pick up soil from a surface, directly impacting the cleanliness and safety of the healthcare environment.

Maximizing product life cycleTo keep synthetic products performing their best, it’s important to follow the manufacturer’s specific laundering instructions. Use the correct water temperature and the recommended chemistry to help preserve the integrity of the product.

Specific to microfiber, EVS managers may consider adding an electrostatic sprayer to their routine for disinfection. This technology electrically charges disinfectant

by commercial laundries remains ongoing. “Our industry is a de minimis PFAS contributor,” says Schwalb. “We’re working with government-owned sewage treatment plants to gain a better understanding of the issue.”

REFERENCES

1. “Primary Microplastics in the Oceans: a Global Evaluation of Sources.” International Union for Conservation of Nature. https://portals.iucn.org/library/sites/library/files/documents/2017-002.pdf.

2. AB-129 Microfiber pollution. California Legislative Information. https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200AB129.

3. What’s so great about microfiber? Environmental Protection Agency Fact Sheet. Available at: https://www.epa.gov/schools/green-cleaning-sanitizing-and-disinfecting-toolkit-early-care-and-education. Accessed December 13, 2019.

Kevin Schwalb serves Textile Rental Services Association (TRSA) as the vice president of government relations and certifications. He has worked with top trade associations in Washington, D.C., for more than 19 years, nine of them with TRSA. Schwalb’s extensive experience in the legislative and regulatory arena includes such issues as tax relief and reduced enforcement actions from the Occupational Health and Safety Administration (OSHA) and environmental authorities.

solutions, which allows them to “wrap” conductive surfaces, providing more even coverage than other sprayers.

An electrostatic sprayer is suitable for cleaning beds, chairs, wheelchairs and similar equipment. However, it shouldn’t replace microfibers because the sprayer doesn’t clean surfaces in the way that the mechanical action of wiping with a microfiber cloth does — an important step.

EPA focus areasMicrofibers is one of two issues that TRSA is currently discussing with the EPA’s Office of Science and Technology. The EPA wants to gain a greater understanding of the risks of microfibers before it addresses risk management.

Per- and polyfluoroalkyl substances (PFAS), a collection of toxins that enter the water system, are a higher priority for the EPA right now. Discussion between TRSA and EPA to reduce risks associated with PFAS discharge produced

16 THREADS 2020

Peruse the bedding aisle at your local home goods store, and you’ll find sheets with thread counts ranging from under 200 to 1,000 or more. Consumers increasingly are placing a premium on thread count as a value indicator, but do those higher numbers translate to a better quality product for healthcare organizations? The answer might be found in a dryer lint trap.

Thread count measures the number of warp (horizontal) and weft (vertical) fibers woven together in a single square inch: 100 warp threads + 100 weft threads = 200 thread count sheet.

“One square inch is an unchanging variable,” says Syed Binali, vice president of textile sourcing for Medline Industries Inc. “In order to fit more threads, you need to invest in finer, long staple cotton. However, to avoid the increased raw material costs, some manufacturers twist strands of lower-grade, short staple cotton into 2- or 3-ply yarns. Oftentimes, sheets labeled 400 to 600 thread count are the result of counting each individual fiber in the twisted strands.”

The test? Wash a 300 thread count sheet constructed of long staple cotton and then a 300 thread count

Higher doesn’t always mean better

sheet made from inferior multiple-ply yarns and check your dryer’s lint trap. The short ply fibers will quickly break down and shed. Over time, the sheet will start to look and feel like a scrim.

“When you construct a sheet using ply yarns of cheaper grade, you are advertising a high thread count without providing any of the advantages it should offer,” says Binali. “If you manufacture a product that is initially comfortable but does not launder well, loses color or comes apart in the wash process, it is not a good product because it is not sustainable.”

When a sheet is properly milled using high-grade, cotton-rich fibers, the result is a tight, balanced weave that offers lasting strength, a crisp appearance and a smooth, cool feel. Additional factors that contribute to a quality sheet are breathability,

pill resistance and superior finishing techniques.

Healthcare demands for bed linensSheets and pillowcases play a significant role in care delivery because beds are the places where patients rest, heal and receive care. As the healthcare service experience becomes increasingly consumer-focused, materials management stakeholders are exploring options for the ideal bed setting. However, healthcare textiles must withstand rigorous usage and wash conditions not found in the home environment, including: • large batch industrial tunnel

washers• increased washer, dryer and

ironing temperatures• advanced laundry chemistry

necessary to ensure proper cleaning and stain removalHow do manufacturers strike

a balance between softness and strength? “Durability and comfort tend to be inversely proportional,” says Binali. “Our goal is to find that sweet spot where we are offering a commercially viable product without jeopardizing its ultimate utility, which is the patient experience.”

Thread count BY THE NUMBERS

PATIENT EXPERIENCE

Issue 10 17

Generations of research and development, along with ongoing customer feedback, have enabled Medline to validate textiles that consistently perform well. However, innovation never stops — because the healthcare environment is always changing.

“When a change occurs, such as laundries switching to a different bleaching agent, we make adjustments to accommodate the market,” says Binali. “We continue to offer our legacy products, but we’re always evolving, along with our clients.”

MATERIAL FACTSCarded cotton: the process of lengthening and cleaning raw cotton to prepare it for spinning into yarn.

Combed cotton: a straightening process to remove short fibers, producing a more uniform, luxurious yarn.

Extra-long staple cotton (ELS): harvested from cotton species cultivated to produce the long staple fibers associated with the highest quality cotton cloth. The smooth, fine fibers allow for higher thread count and exceptional softness. ELS cottons include pima and Egyptian cotton.

Mercerized cotton: a wet finishing process that results in stronger, more luxurious yarns that also absorb dyes more evenly.

Muslin: a durable plain-weave sheet with a thread count of 130, offering breathability and softness at an affordable price point. It is milled with combed cotton or a blend of cotton and polyester threads.

Percale: the feel of a crisp cotton shirt with excellent breathability. Woven in a tight grid pattern, percale has a matte finish and can be blended with polyester to enhance performance and reduce wrinkling.

Sateen: a weave pattern that places more fibers on the sheet’s exterior to provide a shinier finish and buttery softness. Compared with percale, the heavier fibers are less prone to wrinkling but offer reduced breathability.

Syed Binali is vice president of global sourcing at Medline Textiles. He received his undergraduate degree from Clemson University and completed his master’s at NC State University. He has been involved in global sourcing for the past 14 years.

THE CASE FOR A SOFTER PILLOWCASELooking to elevate the patient experience without deflating your bottom line? Start with your pillowcase. Investing in more luxurious pillowcases is a touchpoint that offers the greatest impact from a customer perspective.

Additionally, individual hospital units, such as mother and baby or VIP floors, often have unique sheeting requirements. Collaborating with a trusted vendor can help laundries and healthcare providers navigate the multitude of options available in the marketplace.

Contact Medline’s specialists to help you tailor a portfolio of textile options that offers the right fit for your facility.

18 THREADS 2020

Here’s how you can use storytelling to create a voice for your brand

The days of the passive patient are gone. Instead, people are doing their own research and proactively voting with their dollars when it comes to healthcare. Hospitals need to evolve strategies to connect with this new class of conscious consumers.

Branding is a big part of making that connection, but all healthcare facilities are hard at work building their own brands. How can your facility show consumers what makes you unique?

Stand out from the crowd Your brand is the embodiment of your facility’s mission and values. When crafting a brand, hospital teams can collectively decide what they want to accomplish. Once you know

your facility’s mission, ask why that matters for the community and why people should care.

When you have that vision, the next step is finding an effective way to share what your brand means. For example, your facility might stand out for heart health or labor and delivery, both key service lines vital to communities. Statistics about lives saved and babies born are an important part of the story – yet hard facts are not necessarily the best way to communicate with the people you serve. We are constantly bombarded with new facts, each one slipping through our minds seemingly faster than the last one. But stories stick with us.

Stories can illustrate the human side of medicine, and the human side is one of the richest opportunities for consumer connection. Find something your facility is passionate about, and find a team member to show it. Passion translates into better patient care, and you want consumers to see that.

Discovering goldFinding those stories might seem like a daunting prospect. Clinicians are busy out on the floor every day. You can certainly find doctors and nurses ready to share how they are making a difference, but patient care isn’t delivered just at the bedside. You can

PATIENT EXPERIENCE

talesTelling

Issue 10 19

find stories anywhere. Look at EVS, food service and supply chain. The patient is still at the center of what every one of these teams does.

Although hospital leadership might have a few story ideas prepared, opening the door to the entire facility can lead to surprising opportunities. Give employees and patients the chance to submit story ideas about those who go above and beyond the ordinary.

You might be surprised how quickly the ideas come flooding in, but hospitals always need to keep in mind the larger goal. These stories are meant to support and communicate your brand. If your facility is rolling out a new initiative, tie storytelling opportunities to different project milestones that show how your hospital is living and breathing its brand promise.

Craft your narrativeWhen you set out to tell these stories, think about how they will be disseminated. Are they destined for public-facing social media or internal channels? The platform for sharing will help shape how you tell the story.

A five-minute video, for instance, may struggle to gain traction on social media, where people are inundated with content. Instead, consider creating a short teaser for social media with an option to click through

MERGING TWO BRAND STORIESBuilding a brand is an extensive labor of love unique to each hospital. What becomes of that brand and its stories when a facility is acquired by or merges with another hospital? The answer lies in close communication and alignment.

Ensure that people from both organizations have a voice in determining how to tell consumers the evolving story. When two facilities merge, you want employees to be informed and feel positive about the change. If they believe in what the combined organizations can achieve, they can become brand ambassadors who tell and share stories with one another and with consumers.

Vivika Panagiotakakos is director of public relations at Medline, where she leads external communications. She is passionate about bringing stories to life and finding new ways to connect audiences across platforms and mediums. Before coming in-house to help companies drive greater collaboration and uncover deeper storytelling opportunities to elevate impact and expertise, she was out in the field as an award-winning broadcast journalist for nearly a decade.

and learn more. Always make it easy for people to find and access your message.

Telling a compelling story also takes a multidisciplinary approach. Ensure all of the teams involved are on the same page, and engage the compliance team from the beginning. Learn the guidelines for talking to consumers so you understand if and how you can share a story.

If you are thinking about storytelling, you need to connect, you need to make it memorable, and you need to make it matter. Don’t be afraid to talk about solutions to problems at your facility. It’s no secret that healthcare has challenges. Instead of pretending otherwise, show how your hospital proactively recognized a problem and did something about it. There is power in that kind of story.

Telling a compelling story takes a multidisciplinary approach. Ensure all of the teams involved are on the same page, and engage the compliance team from the beginning.

20 THREADS 2020

Scrubs are an essential part of healthcare. Doctors, nurses, techs and other staff members are so used to wearing these garments that they may feel like a second skin. But trying to keep scrubs organized can result in wasted time and money if not managed properly.

Maintaining orderA simple cart is one of the most common and basic management tools for scrubs. Healthcare staff can come in to find their sizes for the top and bottom pieces before heading out onto the floor or into the operating room. That cart can quickly become disorganized, however. Each person wants to find his or her specific size but might also be searching for a newer pair of scrubs. As workers rush to find the right pieces, the cart gets increasingly messy throughout the day.

Although disorganized scrubs may seem like a minor issue, it can cost healthcare staff valuable time. “It can be a major problem if people can’t get a scrub and are late to a procedure,” says Emily Fischer, national sales manager at Des Moines, Iowa-based IDS/The Wittern Group, which manufactures integrated smart vending machines and supply lockers.

Benefits of effective scrub management Rather than struggling to reorganize scrub carts throughout the day, hospitals can invest in a solution that gets rid of the messy scrub cart entirely. Scrub dispensing solutions like ScrubTrak automate the process, saving hospitals both time and money. Instead of manually sorting through stacks of scrubs, a healthcare staff member can simply swipe his or her badge, press a button, grab the scrubs and move on to the next destination. The entire process is quicker than brushing your teeth in the morning, according to Fischer.

Efficiency is the most obvious benefit of a scrub dispensing machine, but effective scrub management helps hospitals in other ways too.

Restocking. Scrub carts need to be restocked so they’re ready for people to grab the sizes they need. When scrub carts are messy, restocking staff have to manually sort through and count sizes. A scrub dispensing machine eliminates this process. “When EVS or their laundry service comes to restock, they don’t have to first sort the cart to figure out what they have and what needs to be restocked,” says Fischer. “They know instantly online what they need to restock the machine.”

Staff members who regularly use scrubs, such as nurses, no longer have to waste their time sorting through a messy pile of scrubs either. They can spend more time caring for patients, which helps improve both staff morale and patient care.

Dispensing solutions can save both time and money

Streamlining scrubs organization

LINEN UTILIZATION

Scrub dispensing solutions like ScrubTrak can eliminate messy scrub carts.

Issue 10 21

Infection control. Hospital staff may accidentally walk off site in scrubs and wash the garments at home, but a home laundry unit can’t reproduce the proper laundry chemistry and high temperature of industrial washers. Standard scrub carts have no way to track how often this happens; a scrub dispensing machine has built-in accountability and traceability. Staff members receive a prompt to return scrubs to the facility when they swipe their badges, and they must also swipe their badges to return their scrubs. The system can track all returned scrubs, which can then be laundered according to the necessary standards.

Cost savings. Accountability can also help hospitals cut down on costs related to lost scrubs. “The less money that is spent on items that are just walking out the door, the more money the hospital has to put back into those items that affect patient care,” says Fischer. “Cost savings are measured in the overall reduction of scrub replacement, because now scrubs are being replaced because they wear out, not because of shrink. We see 98 percent return rates.”

Hospitals are constantly looking for new ways to improve efficiency and cut costs, and those opportunities do not have to be hard to find. Something as simple as scrub management can have a measurable impact on the bottom line.

ELIMINATING SCRUB SHRINK After a long day in the operating room or on the floor, staff members may simply go home wearing their scrubs. Sometimes those scrubs then vanish from the hospital’s rotation – and scrub shrink adds up over time. “If they [facilities] have a contracted laundry service that they are paying per pound of laundry, as scrubs disappear, they are charged replacement costs for new scrubs,” says Emily Fischer, national sales manager at IDS/The Wittern Group.

A scrub dispensing system helps improve employee accountability because staff scan their badges to return scrubs, and hospital management can also set specific limits on the number of sets that staff members can have out at one time. For example, operating room personnel may be able to have two to three sets of scrubs checked out at once, while someone in radiology may be allowed to have only one set out at once, according to Fischer. If the allotted number of scrubs isn’t returned, that staff member cannot check out another pair.

Most laundry providers have an agreement to process hospital linens, including scrubs, by the pound. If scrubs are lost and disappear from rotation, the laundry must account for the missing weight, which translates into additional costs for the hospital. Without scrub shrink, laundry providers can determine when scrubs are officially worn out. Instead of constantly replacing lost scrubs, hospitals need to get new scrubs only when the old ones are worn out.

Eliminating shrink also improves transparency between the hospital and its laundry provider. “With a solution such as ScrubTrak, hospitals are able to specifically know who has taken what, when it is returned, and what is the overall inventory and quantity on hand,” says Fischer.

“With a solution such as ScrubTrak, hospitals are able to specifically

know who has taken what and when it is returned.”

– Emily Fischer, national sales managerat IDS/The Wittern Group

22 THREADS 2020

LINEN UTILIZATION

Clinicians know what to do. Every hour of their day is packed with more tasks than time allows. What is getting in the way? Alarms, distractions, tending to patients — it comes as no surprise that emptying their pockets is often forgotten. For the laundry, having to capture the items left behind means an extra step that can hamper sorting efficiency and staff safety, in addition to contributing to linen damage.

Empty your pocketsThe soiled laundry area can present a number of possible hazards to laundry employees. They must quickly separate soiled items, exposing employees to everything that went into the hamper — electrodes, remote controls, disposable items and dangerous contaminated sharps, such as used needles.

Scrubs are one of the biggest contributors due to their deep pockets. According to a review by the nonprofit organization Safe in Common, sharps injuries in the United States generate more than $1 billion in preventable healthcare costs each year, with an estimated per-incident outlay of more than $3,000 for laboratory testing, counseling and follow-up examinations.1

Family heirloomsBeyond hospital supplies, items from home intended for patient comfort — like beloved teddy bears, wedding rings, watches and cell phones — also find their way to the tunnel. With a slim likelihood of returning these items to the original owner, an added sweep at patient discharge can make all the difference.

Today, with things busier than ever, we all could use a reminder. Post a prompt for staff as a daily reminder to help ensure nothing is left behind. For more linen tips, ask your Medline representative.

Left

REFERENCES

1. “Prevention of Needlestick Injuries Can Save U.S. Healthcare System More Than $1 Billion Annually.” Infection Control Today. Aug. 22, 2013. https://www.infectioncontroltoday.com/sharps-safety/prevention-needlestick-injuries-can-save-us-healthcaresystem-more-1-billion-annually.

BEHINDEmpty your scrubs pockets before putting them in the laundry hamper

Issue 10 23

What’s in your pockets?

Empty your pockets before dropping your

scrubs into the hamper.

Attention Nurses and providers: Add this quick task to your laundry routine.Make sure your pockets are empty before adding your scrubs to the laundry hamper to protect laundry personnel from needlesticks and sharps injuries.

©2019 Medline Industries, Inc. All rights reserved. Medline is a registered trademark of Medline Industries, Inc. MKT19W227173 / e19430 / 72

Need scrubs? Contact your Medline representative or call 1-800-MEDLINE.

24 THREADS 2020

COVER STORY

With a population just shy of 8,000 people, DuBois, Pennsylvania, is the largest city in Clearfield County. Combined with surrounding areas, the region is home to around 18,000 people.

DuBois linen services company Paris Healthcare, a business unit of Paris Companies, competes with Pennsylvania farms, a glassware manufacturer and a cabinet door maker for the rural area’s hourly workers. Factor in a low unemployment rate, and it’s no surprise that labor shortages are a serious issue here. Paris Healthcare has struggled for years to find enough people to process more than 900,000 pounds of laundry per week, serving 400 locations in four states.

To keep the facility operating efficiently, Paris Healthcare general manager Chris Earle turned to a small but untapped labor source – the Jefferson County work release program. Run by the Jefferson County Adult Probation Department, the program allows a sentenced individual who received jail time to work while serving his or her sentence. It’s also an opportunity for inmates to lay the groundwork for success after they’re released, thanks to Paris Healthcare’s commitment to connecting them with needed resources throughout the program and after they re-enter the community.

A win-win situationLaundry work can be hard physical labor, especially compared with other jobs paying similar wages, such as fast food. When Earle joined Paris Healthcare in 2017, the facility had a 120 percent turnover rate. “I knew if we continued this pattern, it would be unsustainable,” Earle says. “It was very clear I had to not only hire employees, I had to keep them here.”

Earle met with the work release program director, Lenny Calhoun, in early 2018, and saw that the program could be a win for everyone: Inmates would be able to do purposeful work while earning money

A FRESH START

continued on page 26 >

Pennsylvania laundry facility finds a unique new source of

reliable workers

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JEFFERSON COUNTY WORK RELEASE PROGRAM: HOW IT WORKSLaunched in 2014, the Jefferson County work release program allows sentenced individuals to work outside the jail while serving their sentences. About 90 percent of Jefferson County inmates are eligible for the program.

The combined efforts of Paris Healthcare and probation officer/program coordinator Lenny Calhoun have made the program a rare success in central Pennsylvania. A work release program attempt in nearby Brookville fell apart due to transportation issues, Clarion County shut down its program, and Clearfield County has only one or two inmates working, Calhoun says. Meanwhile, Calhoun oversees a couple dozen workers each year in Jefferson County.

“We put time and energy into finding jobs for workers and getting them started,” says Calhoun. “When Paris teamed with ATA [Area Transportation Authority], that solved the biggest challenge.”

Although about half the inmates continue to work upon release, half of them don’t. Some can’t get a ride to work, while others simply don’t want to work. For those who do keep working, it’s life changing. A Department of Justice report states that employment programming, including both prison labor and work release programs, reduces prison misconduct and lowers recidivism.1

Jefferson County inmates are nonviolent offenders facing minor drug convictions. The work release program gives them jobs upon release, which means they’re less tempted to return to dealing and/or using drugs. Calhoun says a few inmates who lived outside the county stayed local to keep working at Paris Healthcare.

“They uprooted their lives for the work,” he says. “This program gives them a chance and creates a safer community for everyone.”

26 THREADS 2020

LEADING WITH EMPATHYParis Healthcare general manager Chris Earle operates on the principle of empathetic leadership, which is associated with higher employee morale, loyalty and engagement. A study from the Center for Creative Leadership found managers who show more empathy toward employees are viewed as having higher job performance by their bosses than transaction-focused leaders.2

Although 60 percent of leaders lack sufficient empathy, research suggests they can learn.3 Earle introduced empathetic leadership to his management team. They took emotional intelligence training and met with counselors to find out how to better understand the challenges workers face.

Earle explains empathetic leadership this way: If his car got a flat tire, he could secure the spare and still get to work on time. If one of his employees got a flat, would he have a spare? Would he have someone to call? Would he have a phone? Or would a flat tire mean days off work due to lack of transportation and money to pay for repairs? Empathetic managers understand that what they consider minor irritations may be major events to others. “You have to understand employees at their level,” Earle says.

Management got an opportunity to practice empathy when 22 inmates showed up for work last year through the Jefferson County work release program. Although some supervisors resisted the idea at first, their perceptions shifted. “After a couple weeks, my managers said, ‘These people are really hard workers and do a really good job,’” says Earle.

to put toward a fresh start upon their release. Paris Healthcare could rely on a motivated work force. And the county would save money on incarceration costs.

“Employing these individuals during incarceration allows them to pay down fines, pay room and board costs, and save what’s left for when they are released,” says Earle. “When we committed to the program, county commissioners were pleased to see revenues that offset operating costs, and I was excited to have a labor force that came to work every day.”

Moving forwardEarle agreed to take on up to 20 workers from the county program, but getting them to the job site was initially a challenge. The Jefferson County Jail is about 20 miles from Paris Healthcare and does not provide transportation for the work release program. The inmates don’t even have driver’s licenses, much less cars. In fact, Earle says about 20 percent of his regular employees walk to work due to lack of any other transportation.

He contacted the local transit agency, Area Transportation Authority (ATA), to propose a bus route from the jail to Paris Healthcare. ATA responded with stipulations, regulations and fare structures, and the required government approvals would take months.

Earle didn’t have that kind of time. To make do until a better transportation option surfaced, he rented an 11-passenger van and asked two of his drivers to handle work release transport – one for the first shift, one for the second. “Paris absorbed the cost until the bus

COVER STORY

Issue 10 27

and group homes that accept people in their positions,” says Earle. “But even these shelters are full at times, and we exhaust our search for something as simple as a place to sleep.”

Paris Healthcare offers this assistance to its traditional employees as well. “We created our own network,” Earle says. “We know many of our employees need help with transportation, housing, babysitting, healthcare…we connect them to those resources. We want to bring light to the programs available because the system is so hard to understand.”

Hunger can be another issue. In some cases, says Earle, workers have to decide whether to pay the cellphone bill or eat lunch this month – or they may not have the money to pay either.

Earle responded by providing lunch every Friday and every other Monday. He also keeps snacks available in the breakroom. If a barrier stands between employees’ lives and their jobs, Paris Healthcare does its best to remove it, he says.

Lower turnover rateSince fully implementing the work release program, Paris Healthcare’s turnover rate has dropped to 64 percent. Earle hopes to reduce it to 50 percent by 2020. “In our industry, that’s phenomenal,” he says. “These programs work, and we proved it.”

Of the 27 work release workers released from jail, 10 still work at Paris Healthcare. One who had previous industrial electric experience tested into a maintenance tech position and has excelled, says Earle.

route was in place,” says Earle. “But the expense of a van rental was far outweighed by having 20 employees show up every day, on time.”

In the meantime, Earle kept working on the bus route. He contacted county commissioners, who helped expedite the process. Three months later, ATA had a new route from the county jail to Paris Healthcare, with one stop in-between. It’s now part of the public bus system.

Solving problemsThe first group of inmates arrived on site last year ready to begin a new chapter of their lives, but they lacked necessary items to do the job. Many showed up in flip-flops or worn-out shoes. Paris Healthcare bought them socks and close-toed shoes and supplied uniforms. It did the same for this year’s workers.

Paris Healthcare also helps the inmates get the valid IDs and Social Security cards they need to work. “We’ve tracked down family members for Social Security numbers so they could go to work,” says Earle. “Some don’t have family members, so we try to set them up with other government agencies to get proper ID.”

The assistance doesn’t stop when inmates finish their sentences. Workers who can’t stay with family or partners upon release have a hard time finding a place to live, and many former inmates have wound up homeless because they couldn’t secure housing. Paris Healthcare helps them navigate the maze of social services to access the basic necessities.

“We assist in finding local temporary housing, making calls to homeless shelters, halfway houses

Paris Healthcare plans to participate in the work release program in 2020 and beyond. Over time, Earle says he hopes to expand the company’s involvement from about 20 workers to more than 30. He’s asking ATA for a bigger bus.

“Our commitment is to facilitate – by any means possible – their lives, so they can re-enter the community with a stable job, housing and transportation,” says Earle. “It’s changed their lives. They can’t believe we are giving them a chance and saying, ‘You’re just like everyone else. The only difference between you and the production worker beside you is your home address.’”

References

1. The Use and Impact of Correctional Programming for Inmates on Pre-and Post-Release Outcomes. National Institute of Justice. June 2017. https://nicic.gov/use-and-impact-correctional-programming-inmates-pre-and-post-release-outcomes-2017

2. Empathy in the Workplace: A Tool for Effective Leadership. Center for Creative Leadership. April 2007. https://www.ccl.org/articles/white-papers/empathy-in-the-workplace-a-tool-for-effective-leadership.

3. What’s the Number 1 Leadership Skill for Overall Success? Development Dimensions International. February 23, 2016. https://www.ddiworld.com/global-offices/united-states/press-room/what-is-the-1-leadership-skill-for-overall-success

Of the 27 work release workers released from jail, 10 still work at

Paris Healthcare. In fact, one who had previous industrial

electric experience tested into a maintenance tech

position and has excelled.

28 THREADS 2020

INFECTION PREVENTION

Hospital rooms are an essential piece of the patient experience. Patients will spend most of their stay in their rooms, and hospitals are responsible for ensuring those spaces are safe and clean. Environmental services have an array of cleaning tools to ensure surfaces are effectively and efficiently disinfected, but there is more to achieving a clean hospital environment than meets the eye.

Hidden hazardsSome of healthcare’s most challenging infections are caused by pathogens like C. diff, MRSA (methicillin-resistant Staphylococcus aureus), and VRE (vancomycin-resistant enterococci). These pathogens – made more challenging by antibiotic resistance – can escape even a thorough cleaning, and they cannot be seen lurking on surfaces touched and used by every patient.

In a perfect world, every hospital surface would be wiped down and properly cleaned every single time, but this level of precision is an unrealistic expectation. “Up to 75 percent of surfaces in a hospital room might not be properly disinfected when humans are doing it,” says Adam Steinhoff, chief operating officer of Toronto, Ontario, Canada-based Solaris Disinfection Inc.

Staffing challenges and the pressure to maintain swift turnover times are two of the underlying issues that lead to human error. “We are getting smarter about the disinfectants that are being used. We are getting more strategic about the training that goes into onboarding housekeepers,” says Tess Feeney, senior product manager with Medline Industries Inc. “But the truth of the matter is at the end of the day, there are still a lot of challenges that the housekeeper is up against.”

Missed surfaces can have a ripple effect for hospitals, known as prior occupancy room risk. If one patient has a particular infection, some pathogens may survive in the environment long enough to infect the room’s next occupant, even if each surface is properly disinfected.

In the face of inevitable human

What you don’t see

error and recalcitrant pathogens, hospitals increasingly are finding ways to augment the power of their environmental services teams.

Traditional UV disinfection UV disinfection, one such additional strategy, employs germicidal light to aid hospitals in the room cleaning process. Traditional UV technology, typically a mercury- or low pressure-based system, uses light to penetrate the cell walls of pathogens. This process leads to the deactivation of the cell.

But deactivation may be only temporary. “Pathogens are actually able to repair their DNA and go back to what they were doing,” says Feeney. These potentially reactivated pathogens leave patients vulnerable to infection.

How UV technology can boost disinfection effectiveness

Issue 10 29

Pulsed UV technology Pulsed UV technology works differently than its traditional predecessors. Instead of deactivating pathogenic cells, pulsed technology emits a broader spectrum of light that heats up the cells. As a result, the cell walls rupture. “That is a permanent physical change, and there is no coming back from that,” says Steinhoff.

Systems that use pulsed UV technology, such as Solaris, operate in quick, 3- to 5-minute cycles. After cleaning the room manually, the environmental services technician steps outside to allow the machine to do its work.

“Blasting the surfaces with UV light after they have been cleaned in a traditional fashion has been shown to dramatically knock down the load of pathogens that are left in the room,” says Steinhoff.

Updating disinfection strategyPathogens do not stop evolving. New, antibiotic-resistant strains are emerging, and hospitals need to ensure that their disinfection strategies keep up. But finding effective ways to update cleaning protocols can be difficult.

Investing in new technology always necessitates a cost-benefit analysis, particularly as hospitals’ margins shrink and managing costs becomes even more challenging. When considering the value of a pulsed UV system, evaluate the costs of just a single infection. “For example, a case of C. diff or MRSA can cost anywhere from $25,000 to $35,000 to treat,” says Steinhoff.

The cost of treatment can vary from hospital to hospital, and treatment accounts for only the direct costs. Infections come with a battery of indirect costs related to HCAHPS scores, potential penalties on Medicare and Medicaid reimbursement, and more. The numbers add up quickly.

“Adding a system that costs under $60,000 as an investment or under $2,000 a month on a subscription is easily paid back when you prevent

just one or two infections,” says Steinhoff. The Solaris system, which uses pulsed UV technology, achieves approximately a 2.5 log reduction of C. diff spores on surfaces throughout the patient room, according to Steinhoff.

The footprint of the technology is rapidly growing throughout the country with new hospitals adopting advanced disinfection solutions each month.

“At the end of the day it’s a pretty simple litmus test,” adds Steinhoff. “If you or a loved one were the patient, would you rather go into a room that was UV disinfected or one that wasn’t? For most people the answer is pretty clear.”

Effectively updating your dis-infection strategy can add an extra, powerful layer of protection to make the hospital safer for patients.

Tess Feeney is a senior product manager with Medline Industries Inc. She has managed a variety of products, including traditional wound care and compression therapy. Currently she leads the Infection Prevention Product Team within Medline’s EVS Division.

Adam Steinhoff is chief operating officer of Solaris Disinfection Inc. in Toronto, Ontario, Canada. He is also a co-founder. With over 10 years of experience in medical devices and healthcare, he is a proven leader who has worked in numerous capacities from sales and marketing to research and development.

Systems that use pulse UV technology, such as Solaris, operate in quick, 3- to 5-minute cycles. After cleaning the room manually, the environmental services technician steps outside to allow the machine to do its work.

Creative thinking is often an underutilized tool in healthcare. Inspiring a team to adopt fresh perspectives on old problems requires going beyond the traditional meeting routine to create collaboration opportunities, but it can yield rewarding results. When all team members on a unit are involved in developing a new approach or solution to a problem, they’re much more likely to take ownership of the results and to become passionate about the program or solution being successful.

How can team leaders start to encourage creative thinking? A few simple icebreakers at the beginning of each regular meeting can help teams shed old habits and build new ways of thinking. Here are a few activities to try:

Team building. Have everyone on the team write down an unusual fact about themselves. Pick the thoughts from a hat at random, and ask the team to guess whom it describes. Team members who know one another feel more comfortable working together and expressing new ideas.

Increasing participation. Select a topic for discussion. Instead of leaving the floor open to anyone, divide the team into smaller groups. Ask each small group to choose one word that describes the topic. Each group then shares the word with the entire team. Smaller groups help more people actively participate.

Focusing attention. Ask team members a series of prepared questions about the work environment to see how everyone perceives their surroundings. Making the activity a competition can be a fun way to engage team members. Attention to detail is a vital ability in healthcare, but routine can dull it.

Jump-starting

These icebreakers may sound simple, but they can have powerful effects. Fostering an environment that welcomes people to share their ideas and openly communicate can create a stronger, more engaged team.

Being creative can be great for business too. Studies show a direct correlation between the level of staff engagement and overall measures of patient experience. And higher levels of patient experience mean an increase in value-based payments to those facilities.

Reach out to threadsmagazine@medline.com to share how your team has used these activities or to offer your own ideas for creative thinking.

team creativityMeeting icebreakers can help staff members collaborate with new ways of thinking

FEATURE

30 THREADS 2020

Issue 10 31

Keep your pillows in

top shape.

©2019 Medline Industries, Inc. All rights reserved. Medline is a registered trademark of Medline Industries, Inc. MKT19W123512 / 3

Make sure everyone practices proper pillow care—share these tips with your team.

Keep ‘em clean—wipe down and disinfect pillows at bedside

Practice proper pillow care.Pillows don’t need much—just a bit of attention and consideration. Here are the top three tips for making the most of your facility’s pillows:

Pillows are made for propping patients—don’t

use towels or blankets

Don’t toss pillows in with soiled linens

THANK YOU FOR YOUR SUPPORT AT THE CLEAN SHOW – COME SEE US IN 2021!

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