Over the last several years, two major economic trends have impacted the healthcare industry - budget impacts of controlled reimbursements from CMS and private insurers, and technological and market advancements allowing more healthcare delivery in less costly locations than hospitals.
As a result, the number of US hospitals and in-patient activity has decreased. Outpatient and home care activity has been skyrocketing for several years, with no apparent trend changes in the near term.
The acuity level of consumers that are still using in-patient care has risen dramatically, and hospitals are seeing a shrinking in-patient population that is still demanding better outcomes. Hospitals have been measured more holistically on patient outcomes than ever before, and have responded by trying to capture and control more of the healthcare delivery spectrum – from local physicians and clinics to senior living communities. As health systems vertically integrate and touch us at more and more points of care, more and more is expected of them to not make any missteps along the way.
How does this impact healthcare textiles? As healthcare systems up their efforts to raise patient satisfaction levels (to earn better reimbursement rates, in part), they see opportunities to use textiles and apparel to help them. One need not search much further than Eric Frederick’s recent first-person account of his hospitalization (American Laundry News, Oct 2018) to see that yesterday’s fabrics, designs and linen service can no longer be the norm. Just as cotton-fleece sweats no longer cut it as high-performing athletic apparel, healthcare bedding and apparel is becoming more performance-based on a daily basis.
Staff Apparel trends
Some of the measures of patient satisfaction on the government’s HCAHPS survey are communication levels and understanding between caregivers and the patient and their family. Well, if a patient has a difficult time telling who is a nurse or an aide or a lab tech because they are all wearing the same outfit, how are they going to respond to the survey questions around clear communication?
Our research has shown that at least two-thirds of all hospitals have employed a color-coded uniform program for their patient-facing staff in an effort to help patients and family clearly identify who is the nurse and who is the doctor. Nurses wear one color, doctors another, etc. Now that more and more employees are wearing uniforms, in many cases with the facility logo, they too are demanding more from their clothes. Synthetic-rich, home-wash performance fabrics are fast becoming the norm in retail scrubs, replacing the old 65/35 polyester-cotton and 50/50 cotton-polyester stalwart blends of the past. It is only a matter of time before operating room scrubs, still purchased and processed mostly by healthcare laundries, move to more performance-based fabrics and designs as well. Early attempts at 100% polyester efforts have fallen short, but improvements are coming. Institutional laundries may need to alter their processing methods to adapt to the new fabrics to meet their customer’s requirements. With their treated fabrics and delicate stretch components, these new scrubs will pose a laundering challenge, but offer opportunities for enriched customer relationships if they get it right.
Patient Apparel Trends
I don’t have enough hands and fingers to count all the recent instances of famous designers, design students, and individual doctors and nurses, among others, who have claimed they have come up with a new patient gown design that will make the “old open-butt gown” a thing of the past. They all failed. The old patient gown design is still alive and kicking (but is undergoing some evolution). The problem is none of those would-be inventors really understood the full use-cycle of the garment, and how it is used and cared for along its travels, and what facilities would be willing to pay. The requirements of inpatient and outpatient use, institutional laundering, and donning and doffing by anyone (without instruction) make the overly-simple current design enduring if not endearing.
However, the focus on patient satisfaction has raised the expectations of the simple gown to offer more comfort, dignity and performance than ever before. Synthetic blends, softer fabrics, brighter and more stain- and fade-resistant prints and designs, and better coverage (while still allowing for fast and easy clinical access) will be the new normal in patient apparel. This should add up to easier processing and less energy use for laundries. Synthetic knit gown usage is on the rise too.
Patient Bedding Trends
Just as uniform programs and better patient gowns are intended to increase patient satisfaction, the design and ambience of the patient rooms and the overall hospital environment is moving towards a hospitality and home-like feel. Research has shown that healing and recovery are faster and better in a more comfortable environment. (Just ask Eric.)
Performance-based fabrics are coming to the patient environment as well. Cotton will fade away for polyester that is designed to feel like cotton but enhance the microclimate around the patient’s skin. For all the high-tech medical devices and supplies used in healthcare, it is only textiles and apparel that are touching and surrounding every patient 100% of the time they are in care, other than a plastic ID band and the air that they breathe.
We now know that pressure and moisture are two of the major contributors to skin breakdown and decubitus ulcers. Sheets, incontinence products, blankets as well as gowns are now being designed to remove pressure and moisture away from the patient’s skin, and to work in conjunction with the new wave of pressure-reducing therapeutic beds and mattresses to help prevent skin breakdown.
The good news for laundries is that in many cases these are easier-to-care-for fabrics and articles that are more stain-resistant and faster-drying. The flip side is that the acquisition cost will increase, but the overall cost per use should be lower due to much longer life cycles if cared for properly.
Another wave coming with the preponderance of synthetic knits is the no-fold linen system. Knitted bottom and top sheets, pillowcases and patient gowns can be delivered in bags unfolded and unwrinkled, speeding up post-processing and redelivery times. Granted, old habits die hard in both the nursing unit and the laundry, and change is not for everyone. But for those have embraced the no-fold systems, especially in-house laundries, the benefits have far outweighed the cost of change.
In summary, as the healthcare-delivery landscape now offers more alternative points of care, patients are expecting more from acute care providers and other points of delivery across the spectrum. In systems looking to increase patient and resident satisfaction, high-performing synthetic fabrics as well as innovative garment and article design will make the traditional plain-weave cotton-blended apparel and textile items a thing of the past. Healthcare laundries will need to alter their systems and processes to adapt to the new synthetic performance world.