Operating Room (OR) nurse Bonnie Humiston knew the OR was spending too much money on linens. So when she enrolled in the hospital’s A3 program, she decided to tackle these expenses for her eight-week project.
Her goal: Reduce per patient linen expense by 40 percent.
A3 results: Trimmed OR linen expenses by 56 percent, equaling a yearly savings of $33,360 in patient linen costs and a direct hospital savings of $10,800. Here’s how Humiston did it.
Humiston met with Linen manager, Anne Manuel, and learned that departments are billed for excess linens stocked on the floor, but not for items returned to the linen cart.
“We established baseline linen orders to avoid excess inventory,” said Humiston. “Anne then re-evaluates our order based on what gets sent back on the cart and adjusts linen quantities as needed.”
Flat sheets in the OR were routinely overstocked. “We didn’t have any standard work instructions for linens and it was easy to pack the sheets into the cupboard,” said Humiston.
She worked with OR Environmental Services aide, Doug Dinkins, to fix the problem.
“It didn’t make sense for Doug to count out the number of sheets to go in the OR cupboard,” said Humiston.
“We decided to put a piece of orange electrical tape on the inside of the linen cupboard as a visual indicator to show how high to stock the shelf.”
Humiston also started weekly linen discussions during staff meetings to gain input on how to better use linens.
Using linens wisely
“Oftentimes, we put a warm blanket on a patient bed before the patient is in the room. If there’s a delay getting the patient, the blanket gets cold and we have to get another one,” said Humiston. “Now we wait to get the blanket until the patient arrives in the room.”
In addition, every bed in the OR is covered with a flat sheet, and then another flat sheet is draped on top to use as a draw sheet to transfer the patient from the bed.
“We don’t need a draw sheet for infants and toddlers. It’s easier to just pick them up,” Humiston said.
“We eliminated the draw sheet for patients weighing 12 kilograms (26 lbs.) or less.”
Humiston also worked with OR and Outpatient Surgery staff to reduce an overstock of patient pajamas.
“Pajamas are challenging because we’re dealing with sizes from infants to adults so we have a large quantity. However, we had an overabundance of pajamas,” said Humiston. “We discovered that if we run out of pajamas, Linen has extra readily available.”
Humiston and her team have since eliminated the pajama overstock on the floor.
Blue towel savings
The OR staff used to clean beds between patients with a green towel, until Humiston discovered that switching to a blue disposable towel would save 8 cents per towel.
“Eight cents doesn’t sound like much until you realize the OR averages 50 surgical procedures a day, and we use a towel to clean the room after each procedure,” Humiston said.
Word soon spread about Humiston’s A3 project and other departments quickly followed suit and switched to the disposable blue towels.
Humiston’s most complex issue focused on how some linens were charged to the OR. “The OR’s monthly budget showed that we were using an average of 1,300 packages of two-pack sterile towels,” Humiston said. “But the OR uses the four-pack sterile towels and not the two-packs.”
The OR was mistakenly being billed for towels that were used throughout the hospital. Humiston met with her manager, Mary Kline, RN, and Linda Hetson of Nursing Administration to reallocate the expenses to the appropriate departments.
“In our department, we all think twice about how we use towels, blankets and sheets now,” Humiston said.
For information about A3 training, call 330-543-4771.