Partnering with a quality healthcare laundry service became even more important 2 years ago when AORN condemned the home laundering of surgical scrubs. Whether you're shopping for a new service or reassessing your in-house launderer, here are the key questions you need answered.

1. Are they accredited?
The Healthcare Laundry Accreditation Council (www.hlacnet.org) is an independent, non-profit organization that inspects and accredits laundries that process surgical textiles. A laundry that has been inspected and accredited by HLAC meets the industry's highest standards for processing healthcare laundry. The accreditation should give you peace of mind in knowing your reusable textiles are handled and cleaned properly. In addition, the Textile Rental Services Association (www.trsa.org) certifies launderers that have practices in place to prevent laundered goods from becoming a source of bacterial infection and have mastered the fundamentals of processing healthcare linen.

Does that mean non-accredited or non-certified laundries aren't capable of doing the job? Not at all, but partnering with a service that lacks HLAC accreditation or TRSA certification will demand a little more homework. For example, ask to tour a laundry service's facility and download HLAC's standards (see "On the Web") so you know what to look for during the visit. Also take along your infection preventionist to gauge her perspectives. Make sure there's a barrier wall separating soiled linen from clean linen, that the air pressure is greater on the clean side than on the soiled side of the barrier, and that employees on the soil-sort line wear barrier gowns, face masks and gloves.

2. Do you have freedom of choice?
Your laundry service shouldn't limit you from using reusable isolation gowns, surgical drapes, scrubs and custom surgical packs. Reusable textiles and gowns can reduce your facility's waste disposal costs by 50% or more. A reusable textile program is often cheaper than buying disposables. In choosing custom reusable surgical packs, your ORs receive exactly what they need for each procedure, which eliminates the waste of disposable textiles included in standard packs that often end up in the trash.

3. Are existing customers happy?
Ask for references from the laundries you're considering and call them to be sure they provide clean textiles and exemplary service to the facilities they serve. Do the laundries always meet agreed-upon pickup and delivery times? Are the items they return adequately cleaned and in good condition? Some stains might remain even on properly cleaned textiles (there's a difference between acceptable and unacceptable stains), but the clean items you receive back shouldn't be soiled, discolored or contain large tears or holes.

4. Do they return surgical instruments?
Your facility can save thousands of dollars by having a service collect surgical instruments that inadvertently end up in the laundry. The healthcare sustainability advocacy group Practice Greenhealth estimates a hospital can conservatively save $20,000 a year in returned surgical instruments.

5. Do they help manage inventory?
While reusable healthcare linens can reduce waste and costs, savings can easily disappear if your textile inventory isn't properly managed. Ask if a laundry can help you track textile inventory and par levels — some laundries will even provide on-site staff for these purposes — as well as help prevent textile loss and abuse (as much as 30% of reusable healthcare textiles are thrown out or end up lost, according to national estimates). At the very least, expect to work with a dedicated customer service rep who's available whenever needed to answer questions or track where textiles are in the laundering process.