The Critical Role of Linen Management in Patient Care

When patients think about healthcare, their minds typically turn to the skill of the physician, the sophistication of medical technology, or the cleanliness of a facility. Rarely do they consider the importance of linens—hospital gowns, sheets, towels, and more. However, as explored in a recent episode of the CX Matters podcast (hosted by Cole Lyons of the American Journal of Healthcare Strategy), linen and laundry services are a crucial yet often overlooked aspect of patient care. In conversation with guest Jason Isherwood, CEO and founder of LinSights Health and ClearVu-IQ, the discussion revealed how proper linen management can dramatically influence patient experience, hospital operations, and even public health.

Reframing Linen’s Role in Patient Care

A hospital gown might seem inconsequential when compared to advanced surgical equipment or new pharmaceuticals. Yet as Isherwood explains:

“Besides the clinician; that gown, that sheet, that pillowcase—whatever that product is—may be one of the only things that intimately touch a patient.”

When a patient arrives at a hospital, they may be anxious, in pain, or uncertain about what lies ahead. Slipping into a freshly laundered, comfortable gown can enhance feelings of safety and trust, whereas stained or torn linens can do the opposite, raising concerns about quality of care or cleanliness. The patient’s impression extends beyond that single piece of fabric, shaping how they perceive the institution as a whole. It’s one more layer of an experience that can make or break patient satisfaction and influence HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores.

The Expanding Linen Industry and Its Challenges

The linen and laundry service sector is currently valued at around 5 to 6 billion dollars in the United States, and it’s projected to grow to 8 billionin the coming years. That growth mirrors the increasing scale and complexity of the healthcare industry itself. Yet, despite its size, linen management is extraordinarily fragmented. According to Isherwood,

“It’s a very regionalized approach,” meaning that most linen providers operate in distinct geographic pockets. Only one or two organizations have the breadth to cover multiple states or national markets.

For large health systems that straddle different regions—think Jefferson or Penn Medicine in the Philadelphia area—this decentralized model poses significant problems. A single health system may rely on multiple providers with varying supply routes, different quality assurance processes, and inconsistent products. Standardization of linens—so critical to patient experience—is nearly impossible in this fractured environment.

Quality Control Hurdles

The complexity of linen supply can lead to lapses in quality. Ripped seams, faint stains that never quite washed out, or missing pieces like pillowcases or bed sheets all negatively impact patient perceptions. A “clean” item that still bears visible discoloration can be unsettling, even if the product has been properly sanitized.

“When you follow the product through the actual processing facility,” Isherwood notes, “that’s where you see issues you may never notice in a mere spreadsheet analysis.” This underscores the gap between data and reality. While hospitals often track usage numbers to control costs, many lack the time or personnel to audit laundry facilities, inspect linens on arrival, or investigate process inefficiencies at each step—particularly on an ongoing basis.

Linen’s Impact on the Patient and Staff Experience

Beyond simple aesthetics, linen management can influence clinical operations and patient flow. “It’s not just about one gown that costs 40 cents to wash; in aggregate, it’s huge,” Isherwood says. Consider these scenarios:

1. Shortages: If patients have to wait for a clean gown or if operating rooms lack enough clean towels for surgeries, clinical care is directly affected. In some instances, overzealous cost-cutting (reducing linen inventory without planning) can lead to public relations crises. Hospitals have faced staff protests and union involvement when gown or sheet shortages disrupted normal care.
2. Infection Control: Healthcare-associated infections (HAIs) remain a major concern for patient safety. Linen processed without adherence to rigorous standards can introduce or fail to eliminate pathogens. Organizations like the Healthcare Laundry Accreditation Council (HLAC) exist to certify that laundries maintain high standards, yet many hospitals do not systematically verify whether their suppliers are accredited.
3. Staff Workflow: Nurses and other staff spend valuable time managing linens—time that could be used for direct patient care. Missing or damaged items force clinicians to scramble for replacements, adding stress and interrupting routines.
4. Patient Comfort and Confidence: Perhaps the most immediate effect is on the patient’s emotional well-being. Slipping into a ripped gown or lying on a stained sheet can heighten stress. Conversely, a well-stocked linen supply featuring comfortable gowns and the right product sizes can help patients feel more at ease and dignified.

Data and Real-Time Analytics: The Missing Link

Modern healthcare runs on data. Yet for linen management, much of the data remains lagging, usually reviewed in arrears at quarterly business reviews. By the time a health system identifies over- or under-utilization trends, 13 weeks—or more—have passed. This delay means the system struggles to adjust inventory properly. If administrators cut linen supply based on data that’s already outdated and then flu season arrives, they can quickly end up with shortages.

Isherwood points out that “People tend to focus on the data piece, and data does tell you a story, but the issue is there’s not enough people power. There’s not enough staff to dive into that data to follow through.” Supply chain managers oversee countless purchase-service categories, so linen often receives only cursory attention—a quick fix or cost cut, not a holistic solution.

Enter Real-Time Data and AI

The new frontier is a software platform that leverages artificial intelligence and real-time analytics to continuously track linen flow, such as ClearVu-IQ. By treating hospitals like hotels—analyzing rooms, patient admissions, discharges, and historical usage—this system can predict, almost immediately, whether a floor needs more gowns or fewer towels. Isherwood envisions automated alerts pinpointing anomalies, enabling hospital staff to focus on specific problem areas, such as a single floor whose blanket usage skyrockets, rather than investigating the entire facility.

“Changing behavior is tough,” says Isherwood. “Especially across large systems. So if we can automate these insights, if we can make it so you can see issues in near real-time, you can move quickly to solve them.”

By integrating supply chain software with patient flow data, the platform can forecast linen needs during high-acuity moments or high-volume seasons (e.g., flu season). Instead of always reacting to shortfalls, hospitals could proactively position linens where they are most needed.

Bringing Transparency to a Regionalized Industry

One of the most compelling aspects of a real-time software solution is the ability to share benchmarking data across a market. Isherwood cites the example of Chicago, where major systems like Northwestern, Loyola, and Rush Health depend on one or two major providers. With enough participation, each health system could compare its linen usage and quality control metrics against other institutions—anonymously or with specific performance indicators.

This benchmarking has value beyond cost savings. It offers public health insights, too. Linen usage might correlate with changing levels of acuity, seasonal illness patterns, or efficiency improvements. Though it would be an oversimplification to call linen usage a reliable leading indicator for disease outbreaks, having near real-time data on a major consumable could provide helpful signals to hospital administrators and public health officials alike.

A Call for Greater Awareness and Action

Hospitals place enormous emphasis on infection control, yet many healthcare professionals and even quality teams rarely consider linen a top priority. As Isherwood notes, “Linen can be so commoditized, people forget the impact it has on infection prevention or patient comfort.” Though infection prevention professionals are well-versed in the importance of properly laundered textiles, routine decision-makers often assume linen is “just there” and thus fail to see its deeper ramifications.

Practical Next Steps

1. Demand Supplier Accreditation: Ensure that any laundry service meets accreditation standards, such as those set by the Healthcare Laundry Accreditation Council (HLAC).
2. Perform Facility Visits: Conduct “Gemba walks” (a term from Lean Six Sigma) at laundry facilities to verify quality processes. Ask how stains and tears are caught, what type of disinfectants are used, and how frequently equipment is audited.
3. Leverage Data Beyond Quarterly Reviews: If real-time data solutions are not yet available, push for more frequent reporting—at least monthly or biweekly—to better align linen supply with patient census fluctuations.
4. Engage Infection Prevention Teams: Collaborate with infection prevention staff early in the linen contract negotiation process. Their perspective can highlight what quality controls matter most and help enforce standards.
5. Educate Clinical Staff: Nurses and physicians who understand the importance of the right product at the right time—and how to avoid wasting linens—can collectively reduce the strain on inventory and eliminate unnecessary costs.

Why This Matters Now

The conversation between Cole Lyons and Jason Isherwood drives home a crucial point: Healthcare is a vast ecosystem, and small-seeming elements can have an outsized impact. In a complex setting of rising costs, staffing challenges, and growing patient expectations, streamlined linen management is no longer a “nice-to-have”—it’s a “must-have.”

As new technologies emerge to track and optimize linen supply in near real-time, hospitals can reduce waste, minimize patient risk, and improve the overall care experience. By achieving greater consistency and transparency in how textiles are supplied, laundered, and distributed, health systems can bolster both patient and staff satisfaction.

Conclusion

Linen may be an unseen backbone of patient care, but its impact is far from trivial. The experience of slipping into a clean, well-fitting gown can set a reassuring tone for patients—just as encountering a stained or inadequate supply of linens can erode trust and confidence in care. Proper linen management also touches infection control, hospital workflows, and operational costs in powerful ways.

Forward-thinking innovators like Jason Isherwood with LinSights Health and ClearVu-IQ are paving the way for smarter, data-driven solutions. By pairing on-the-ground expertise with artificial intelligence and real-time analytics, these emerging models promise a major leap forward in how hospitals handle everything from surgical drapes to everyday bed sheets.

In the end, linen is more than just fabric—it symbolizes comfort, dignity, and safety. When managed well, it becomes a seamless part of the healing process, fulfilling its role so effectively that patients barely notice it. Yet behind the scenes, that single sheet is backed by a complex system of suppliers, staff, and technology. Hospitals that grasp this complexity—and treat linen as a strategic asset, not a commodity—stand to enhance both their bottom line and the well-being of their patients.