Support Services: Doing More with Less

Today’s current healthcare delivery landscape demands that hospital support service operators do more with less; otherwise hospitals will face significant financial consequences. As the industry is evolving to keep up with rapid market changes, we as healthcare service providers are faced with the question, “Where do we cut support service spending, and how much do we cut?”

Perhaps we do without necessary capital equipment investments by in large because of the uber competitive capital request environment. Hospitals today are more focused on spending dollars on revenue producing needs, not on non-revenue producing necessities. Odds are we have squeezed our support services departments of every dollar available and cannot cut anymore without significantly impacting quality. Simply looking at these drivers of the perceived inefficiencies are not enough anymore as they have been summarily exhausted, and for this reason, we are digging deeper and hunting down inefficiency in every facet of our day-to-day activities.

Linen Utilization

One area where this is apparent is in linen utilization. In fact, most of the readily available conduits for savings in healthcare support services can be found within examining the linen utilization process.

In talking with several hospital and supply chain executives, it became apparent that there is a comfort with linen processing expenditures because linen costs are in line with industry averages.

Determining Usage

The metric used to establish the standard comfort level with linen processing expenditures is Pounds per Adjusted Patient Day (PAPD). The industry average is 15.5 PAPD. While performing at levels below the industry average is commendable, utilizing the PAPD metric to determine efficiency can create a false sense of success.

PAPD uses in-patient and out-patient data to determine usage. Outpatient visits use and require significantly less linen than in-patient stays. If enough outpatient visits occur, the subsequent patient activity data can dilute linen usage metrics to the point that they mislead the evaluator into thinking that the in-patient usage is performing at or below industry averages. I find far more veracity in evaluating linen usage efficiency by looking at Pounds per Patient Day (PPD). This metric is far more telling if linen resources are being consumed at efficient levels as the majority of the linen usage comes from in-patient stays. Looking at linen usage through this lens lends itself to an even greater question, “How do we drive greater efficiency through in-patient linen usage without impacting patient service?”

The answer is quite simple. We cannot afford to approach linen via the status quo. We have to innovate how we utilize linen and minimize waste. If we eliminate the waste associated with linen usage and as a by-product reduce the weight of the linen being processed, we can reduce amount we spend on linen. The penultimate way of accomplishing this goal is to change the hearts and minds of the main users of linen in the hospital. This will require hospitals to foment a linen usage culture that views linen as precious commodity and not an expendable supply or just a cost of doing business.

Consider this: One gallon of gasoline weighs approximately six pounds and costs $2.40 per gallon. Therefore one pound of gasoline costs $0.40. Now consider that it costs, on average, between $0.65 and $0.75 to process one pound of linen. As consumers of gasoline, we make it a point to stretch every penny’s worth of gasoline as far as we can. Why not do the same for linen?