From waiting rooms to surgical suites and beyond, hospital purchasers look for fabrics to keep hospitals clean.
By Katherine Carlson
At North Memorial Medical Center, a Level 1 trauma center in Robbinsdale, Minn., value analysis teams meet routinely to evaluate new health-care products suggested by clinicians or distributors. Project administrator Ann Roberge, who purchases textiles, lists firm criteria for fabrics used in the hospital’s furnishings.
“We want to create a home-like environment for patients, and first impressions are important,” she says. “We want fabrics that are cleanable, durable and fire retardant. Lately, we’re interested in environmental aspects of products. When products are fire retardant or antimicrobial, we want those qualities not applied, but integrated into the fabric.”
North Memorial uses no fabric window treatments or wall coverings, since cleaning them can be problematic and time-intensive. Roberge prefers upholstery fabrics that exceed the base durability level (60,000 double-rubs) at 100,000 double-rubs. Because renovation of the 518-bed facility takes place in stages, textile colors, patterns and styles must be consistently available.
Different hospital settings require different fabric properties. In waiting areas, preoccupied families spill coffee or soda, and stain resistance is key. In patient rooms, soothing colors and textures, cleanability and antimicrobial properties rise to the top of the list. In a surgical suite, stringent infection control, one-use disposable products and comfortable staff work wear might be the priorities.
“Price is only one factor we take into account,” says Richard Mencel, director of materials management at North Memorial. Mencel suggests that in institutions like hospitals that never close, durable is beautiful. “In offices, people use furnishings eight hours a day,” he says. “In a hospital, we use them 24 hours a day.”
Cutting a swath
Competition among health-care providers, whether hospitals, managed-care clinics, specialty offices or long-term care facilities, stimulates an ongoing search for innovation: high-tech equipment, new drugs and treatments, stylish interiors and products that speed healing, hurt less, protect more or just feel better.
Fabric innovations could trigger a quiet revolution in health-related products and furnishings. Imagine, for example, linens that prevent infection, eliminate odors or reduce pressure sores; staff wearing masks that resist viral infection and durable uniforms that don’t irritate skin; furnishings that welcome visitors but not their germs or spills; and disposable plastics created, used and incinerated without toxic chemical emissions.
This healthy vision can’t occur too soon: In 2004, the most recent year for which the U.S. Centers for Disease Control and Prevention (CDC) has figures, 16% of the United States’ Gross Domestic Product was spent on health care—$1.9 trillion or $6,280 per person.
Fabric products aren’t a big-ticket item in the whopping health-care budget; still, health facilities are a consistent and lucrative market. Novation, an Irving, Texas, contracting company with 11,500 members in health-related group purchasing organizations (GPOs), helped buy a record $31.6 billion in supplies, devices, drugs and services in 2006.
New textile products could both succeed in the marketplace and leverage big health-care savings by helping to reduce costs associated with hospital-acquired infections, furnishing replacement, waste management and housekeeping.
Every surface in a hospital, clinic or long-term care facility gets cleaned—over and over again. Walls, carpets, floors, linens, scrubs, towels, chairs and surfaces collect germs, and patients already depleted, stressed or fragile can’t fight off infection. According to the CDC, 20–30% of those admitted to hospitals already have an infection. Two million patients each year get a hospital-acquired infection (HAI), costing the health-care system an estimated $30.5 billion. It gets worse. The CDC estimates that 70% of HAI bacteria are resistant to one or more of the drugs used to treat them. That’s a good reason why material distributors selling to health care voice “a recurring demand for products that provide antimicrobial protection,” according to Fred Schecter, vice president of Sommers Plastic Products, Clifton, N.J.
In the antimicrobial fabric world, it’s good to be silver. Silver is a naturally occurring element with three impacts on microbes: disrupting cell metabolism, respiration and reproduction. Bacteria, mold and mildew aren’t happy in the presence of silver, so fabrics with applied or integrated silver resist odors, breakdown and bacteria growth. The only open question is whether bacteria can become resistant to silver and develop into untreatable “super-bugs.”
Sommers has partnered with AgION® Technologies Inc., Wakefield, Mass., to introduce AgUARDIAN™ interior design materials with silver-based antimicrobial compounds incorporated into vinyl, plastic and polyurethane fabrics. “We are excited that [Sommers has] incorporated our antimicrobial technology into the products and materials used to furnish and decorate doctors’ offices and waiting rooms, nursing homes, ambulatory and acute-care facilities,” says Ladd Greeno, president and CEO of AgION.
Other manufacturers of silver-based fabric or products include SmartSilver™ from NanoHorizons Inc., State College, Pa.; Silvertec, a fabric application, from AccuMED Technologies, Buffalo, N.Y.; Silverlon® wound dressings, Cardwell Medical Inc., Marietta, Ga.; and Silver3 mattress coverings, Gaymar Industries Inc., Orchard Park, N.Y.
Silver isn’t the only antimicrobial option. Milliken & Company, LaGrange, Ga., recently introduced BioSmart™, antimicrobial technology based upon chlorine bleach. Other fabrics earn points for being resistant to bleach fading and discoloration, allowing health-care facilities to use this cheap and plentiful disinfectant.
Creating an environment
A fabric’s environmental impact—during production, throughout its life and after its disposal—is increasingly important to architects and designers, according to Cliff Goldman, president of Carnegie Fabrics Inc., Rockville Centre, N.Y. Carnegie develops fabrics for wall coverings, upholstery, cubicles, windows and custom applications.
Design considerations still dominate Carnegie’s fabrics, and Goldman never forgets that good looks and functionality rule. “Health-care end users are looking to create a style and ambience, much like the hospitality industry,” Goldman says. “In health settings, textiles have to meet certain basic criteria. They must be flame retardant, durable, cleanable, stain resistant and able to stand up to high-temperature washing and bleach.” Designers creating a great look for healthy spaces want functional, attractive and, increasingly, “green” fabrics.
“The health-care industry has really woken up to the fact that products made with toxic components aren’t always good for patients,” Goldman says. He cites a growing trend among hospitals moving away from vinyl manufactured with polyvinyl chlorides (PVCs). When incinerated, PVCs can produce dioxins, a group of known cancer-causing chemicals, but disposal isn’t the only problem. Manufacture of fabrics with hazardous chemicals can expose already sick patients as the chemicals migrate into the air.
Carnegie’s Surface iQ wall coverings are PVC-free, use only water-based inks and coatings, exceed Type II vinyl performance criteria, and earn Leadership in Energy and Environmental Design (LEED) points. Surface iQ was one of Building Magazine’s “Editor’s Choice: Top Product Picks” in 2007. The company’s Xorel wall covering is rugged, cleanable, fade resistant, stain resistant, certified as in compliance with air-quality emission limits and won’t support the growth of mold or bacteria.
This isn’t the same as being antimicrobial. Goldman is wary of fabrics with antimicrobial claims, and he isn’t alone. Kaiser Permanente, Oakland, Calif., the largest not-for-profit health plan with 8.7 million members, issued a December 2006 memo with this bottom line: “Review of current scientific literature reveals no evidence that environmental surface finishes or fabrics containing antimicrobials assist in preventing infections.”
“I’d beware of inflated claims,” Goldman says. Good staff hygiene and effective housekeeping are proven methods of reducing infection. Goldman predicts that health-care facilities will be exploring green fabrics and cleaning solutions, rather than germ-killing furnishings, in the future.
Getting covered and comfy
When a fabric’s main function is to protect an emergency room nurse from exposure to blood or body fluids, meeting safety standards is job one. “Performance is critical in our products,” says Fernando Marin, senior global director of medical business for Polymer Group Inc. (PGI), Charlotte, N.C.
The wide range of single-use products developed from PGI fabrics includes drapes, gowns, protective wear and wound-care fabrics. Along with performance, PGI focuses on comfort. “Often, single-use garments are worn for an extended period,” Marin says. “The fabric needs to allow users to perform their duties in comfort. Our fabrics are soft, flexible and breathable, even those synthetics that usually feel stiff. We make fabrics that are rugged without losing the benefit of comfort.”
PGI’s newest fabric, MediSoft® Ultra™, possesses all the comfort features, while exceeding the Association of the Advancement of Medical Instrumentation gown and drape industry standards. The fabric is produced at PGI’s plant in Suzhou, China, a new state-of-the-art facility with meticulous standards of cleanliness, according to Marin. PGI has seen steady growth in both the health-care and industrial markets, and Marin sees potential for the fabric in other applications: homeland security, law enforcement and industries where a single-use garment sees many hours of use.
“We’re looking at ways to improve our fabrics, seeking advances in existing raw materials and exploring biodegradable materials,” Marin says. “We’re also trying to reduce the weight, so products are more comfortable”—and can be shipped and stored economically.
For patient-care products, comfort may dictate how compliant people are—and how well they heal. AccuMED Technologies Inc., Buffalo, N.Y., offers a patented material, Breathe-O-Prene®, used in orthopedic braces, sleep apnea head gear, leg bags, back supports, fetal monitoring and other applications. According to AccuMED marketing manager Julie Sentiff, Breathe-O-Prene supports the user with superior moisture wicking and breathability, but is also latex- and adhesive-free, reducing skin irritation.
The European Pressure Ulcer Advisory Panel estimated that pressure sores affect approximately 7% of adult hospital patients and 17% of long-term care residents. Pressure sores are related to immobility, diet and skin irritation. Fabric products that breathe, wick moisture or prevent irritation could be a growth market as the U.S. population ages.
Back at North Memorial, the value analysis teams assess new products for purchase. Scientists (and medicine is a science) want data, and claims of health benefits for innovative fabrics must be backed up with credible studies.
Other health-care trends that offer opportunities for fabric innovation include:
- Increased focus on hospital-acquired infections, which now must be reported in 15 states and soon may be mandated in more. Fabrics and products that are attractive, easy to clean, non-irritating and resist microbes, as well as single-use items that are protective and comfortable, could become more interesting to health purchasers.
- Competition among health-care providers, spurring redesign of facilities to make them more comfortable, stylish and functional.
- Demographic changes in the population and the proliferation of senior-care services, such as long-term care, assisted living, senior day care and home health care. Fabric products for these markets with features comparable to those for hospitals and clinics make sense for elder-care facilities.
- Environmental awareness, with more purchasers examining product life cycles, regulatory burdens, impacts on patients and waste disposal costs. For example, Hospitals for a Healthy Environment, a partnership between the American Hospital Association and the EPA, set a goal of 50% waste reduction by 2010.
- Attention to the disabled, who are living longer because of improvements in health care, including veterans with severe injuries returning from Iraq and Afghanistan. Clean, comfortable, single-use and non-irritating fabrics and products are used daily by the disabled.
- More complex and sophisticated purchasing, including improved data management, procurement “playbooks” that guide staff looking for products and teams like North Memorial’s scrutinizing the benefits of new products.
North Memorial’s Roberge predicts another trend for fabrics that look great and perform well in hard-use health-care environments. “People will be using these fabrics in their own homes,” she says. “They’re designed to make people feel better.”