Reusable PPE in Healthcare (Conclusion)

CHICAGO — COVID-19 changed the world almost overnight, including the availability of personal protective equipment (PPE).

The pandemic created a worldwide shortage of PPE for front-line workers as they worked to save lives and eliminate spreading the coronavirus at healthcare operations (HCO).

“Supply chains throughout the world felt the pressures to make the highest quality PPE at rapid speeds,” says Jeff Courey, president and CEO of George Courey Inc. headquartered in Montreal. “Raw materials became immediately scarce and production capacity filled within weeks.

“Since most of the world uses single-use PPE, disposable inventory and raw materials were consumed first, opening the door for many hospital systems around the world to try reusable PPE for the first time.”

“Reusables gained much attention because of the ability to be processed multiple times and reused safely,” adds Dan Schwartz, vice president of Fashion Seal Healthcare, a healthcare linen supplier based in Seminole, Florida.

“Healthcare facilities are utilizing reusable PPE, including isolation gowns and barrier lab coats. Scrubs hygienically cleaned through industrial laundries also gained increased demand as healthcare providers keep patients, healthcare employees and their families safe by eliminating employees bringing contaminated scrubs home to be laundered and not hygienically cleaned.”

David Stern, chief executive officer of Novo Health Services in DuBois, Pennsylvania, says some hospitals switched to reusable textiles because they felt it was the sustainable option and the most reliable.

“Most of the hospitals bought reusable iso gowns and have had us launder them on an as-needed basis and will keep them in their inventory so that if it happens again they will be prepared,” he points out. “That work is slowly being reduced as COVID-19 patients in hospitals are being reduced.”

As the pandemic slows, how can laundry and linen services convince healthcare facilities about the benefits of reusable PPE and maintain use of these products?

Part 1 examined the current status of reusable PPE due to COVID-19 and how to maintain demand. The conclusion looks at processing changes and the future of reusable PPE.


“The laundry industry has adapted well,” Stern says. “Manufacturers are finding more efficient machinery for fold and process of these garments, and others have found ways to package the iso gowns so that there isn’t a lot of labor involved in the packaging and the end-user can take it from the packaging as they would a Kleenex tissue.

“Because Novo is committed to RFID technology, we have been able to not only help our customers manage their RFID enabled garment inventories, but we manage the amount of washings the garment is designed for to ensure the manufacturer’s guidelines on barrier effectiveness.”

Courey says that processing of PPE has not really changed. Healthcare laundries have already proven their methods in the fight against other issues like SARS, Ebola, etc.

“As long as healthcare laundries follow proper processing protocols as outlined by accreditation organizations like the Healthcare Laundry Accreditation Council (HLAC), there is no risk,” he says.

Some operators have seen an increase in hoarding reusables. Hospitals take rental gowns and keep them on-site and wash them in their washers, which in turn caused more linen to be put in service to keep circulating inventory levels healthy.

There are numerous problems from this practice for operators, ranging from causing gown shortages to nullifying AAMI level II inspection, which requires operators to only give these gowns 75 washes to guarantee 20cm of hydrostatic pressure for liquids repellency.

The practice forces operators to ragout all gowns that came back from these hospitals due to non-compliant issues with AAMI level II inspection process and to send the hospitals a bill for the purchase of all gowns that are on their premises.

And operators say this doesn’t even address the lost revenue from the hoarded gowns.

Because hospitals are mostly closed down during pandemics for on-site visits from vendors, operators say it’s been easy for them to “get away with hoarding gowns to wash on-premises.”  Laundry managers say the industry will have to find ways to combat hoarding with tighter contract language and penalties when it happens.

“Our healthcare clients are still in the midst of the pandemic,” points out Brendan O’Neill, chief operating officer of London Hospital Linen Service in Ontario. “Complaints are usually related to logistics challenges or specific product shortages—an item is not always in the right place at the right time.”


“I believe the pandemic has opened the eyes of many health systems that see a viable alternative to disposable PPE,” Stern says. “The reusable market, when considering all costs, is very competitive, more reliable and much friendlier to our environment.”

“Our recent launch of WonderWink INDYTM high-end scrub line and its success thus far demonstrates employers are interested in protecting their patients, protecting their employees and retaining employees with a uniform meeting all their requirements,” Schwartz shares. “We remain very optimistic about the future of the reusable space.”

“A big question now is what will governments do to prepare for the next pandemic,” says Courey. “What needs to happen is a rebuilding and expansion of our national stockpiles of PPE.

“When evaluating stockpiles, it is important to consider the space and cost involved with storing inventory for long periods of time. This reality favors the stockpiling of reusable textiles since on average, considering 60-75 turns versus one turn for a single-use product, it also takes between 1/60th to 1/75th of the space to keep in inventory. These savings can be quite significant long term.”

Some healthcare providers are planning to use a hybrid reusable/disposable model in the future, says Melanie A.  Miller, RN, CVAHP,  vice president/chief strategy officer for Silver Lining Apparel, a woman-owned healthcare apparel company lead by Joy Volk in Los Angeles.

“They like (reusables) very much, but they’re going to make sure that they always have an appropriate inventory of reusables and disposables,” she says.

Nursing and supply chain leaders will determine a model that incorporates both reusable and disposable wisely and appropriately, Miller says. Determining where the reusable and disposable gown distribution will be a collaborative process at each HCO. Supply-chain and nursing leaders will opt for the model that provides staff safety and best financial practice.

If  there is another huge surge, she says that, hopefully, with the knowledge gained by selecting dependable reusables and disposables (hybrid model), supply chain leaders  and linen management leaders will be in a better position to react and ensure available PPE for staff.

Jeremy Fogel, president of Medline’s Textiles Division headquartered in Northfield, Illinois, also sees hospitals and long-term care facilities moving to hybrid solutions to have adequate stock levels to protect staff and patients during emergencies.

“We will continue to take measures to he
lp healthcare run better, as we have done throughout the pandemic, and to strengthen the nation’s healthcare supply chain,” he says.

O’Neill says that as the pandemic subsides, healthcare laundries will need to continue the battle for reusable products (PPE gowns, surgical gowns, microfiber cleaning products).

“We all are very aware the large single-use companies will be back with a strong message as to why they believe they have a better option,” he points out.

“As an industry, we need to band together to ensure the awareness of reusable textiles stays at the forefront. Whether it is healthcare, institutional, commercial or specialty linens, we…

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