Hospital targets scrubs and saves $185,000
Color-coded reusable scrubs replaced disposables
Brookdale University Medical Center in Brooklyn, NY, saved an estimated $185,000 in a one-year period by eliminating the purchase of most disposable scrubs, adding a limited number of color-coded reusable scrubs, and implementing an optional home laundering policy for surgical scrubs.
The approximate savings were:
- $60,000 from changes to different colors of scrub suits;
- $50,000 from home laundering;
- $20,000 from basically eliminating disposable scrub suits.
The remaining savings were from changes to cover gowns, shoe covers, etc.
"We went from originally nine scrub suits per person in different colors to five, because they didn’t have to change as often," says Robert Garcia, MT(ASCP), CIC, assistant director of infection control. "We went from 12 kinds of gowns to three basic gowns."
Garcia and others determined that the hospital’s infection control policies weren’t in line with the scientific literature, he says.
"If you look at what the literature shows us over the last several years of studies, there is quite a bit of support of literature that indicates that scrub suits have either minimum additional colonization of bacteria for individuals who wear scrub suits outside OR, as opposed to people who change when they leave or who wear a cover gown over scrub suits," Garcia says. "Even in those studies, no study has shown doing a regimental policy has had the benefit of reducing surgical wound infection, which is ultimately what you want to do."
The hospital decided to allow staff to leave the OR and return in the same scrub suit to perform another procedure, as long as the scrub suit isn’t visibly soiled with blood or other body fluids. However, staff members still are required to wear personal protective equipment when, for example, they leave the OR to perform a procedure in another area of the hospital, particularly if the procedure is invasive, Garcia says.
Some employees wearing disposable scrub suits didn’t need them, such as housekeepers who were wearing them over their uniforms. "But we’re already paying uniform costs, so we eliminated that," Garcia says.
Disposable scrubs were kept for medical students because of their short rotations, he says.
The hospital studied any potential benefits of wearing cover gowns outside the OR. Because some staff preferred to wear them for professional appearance, they were designated as optional.
When making changes to surgical scrubs and gowns, be aware that many employees have a strong preference, particularly if they’re involved in performing longer procedures, Garcia says.
To make the right selection of gowns, obtain outside expertise, such as clinical specialists who work for manufacturers, he suggests. Consider fluid penetration, the weight of the material, and the costs when making a selection, Garcia advises. "You need safety, comfort, and [low] cost," he says.
To avoid discord, approach physicians directly, he suggests. "Say, we’re looking to make changes. I understand you like this gown. Would you be willing to try that one?’"
More than 99% are cooperative, and nine of 10 will change gowns, he says. At Brookdale, "they simply weren’t aware of more modern material that gowns are being made of," he says. "Now they’re much lighter weight, offer great protection, and costs are generally very good."
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