Linen Management

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

Linen Loss Management

• Soil to clean comparison compliance

  Meets established benchmark

  Below established benchmark

• Enter results for recent period

• Enter date results reflect

  Date

• Is a process in place to manage EMS access to Linen?

  Yes

  No

  N/A

• Rejected Linen process in place and clearly labeled

  Yes

  No

  N/A

• Scrubs stored in a secure location

  Yes

  No

  N/A

• FIFO (First In First Out) followed

  Yes

  No

  N/A

Clean Linen Processes

• Par level established in linen room?

  Yes

  No

  N/A

• Usage based ordering system in use?

  Yes

  No

  N/A

• Departmental item par levels reviewed and adjusted?

  Yes

  No

  N/A

• Linen distribution documented and entered into data management systems (AngelLink)

  Yes

  No

  N/A

• Enter last review date.

  Date

• Adjusted Patient Days reported monthly.

  Yes

  No

  N/A

• Documented departmental delivery schedule?

  Yes

  No

  N/A

• Linen committee formed and meeting at an established frequency.

  Yes

  No

  N/A

• Business Review Completed

  Yes

  No

  N/A

• Written linen utilization policy / guideline established and documented?

  Yes

  No

  N/A

• Linen charged back to departments.<br>

  Yes

  No

  N/A

Linen Room Inventory (Document Excess)

• Document items in excess and quantites

Additional Comments

• Floor Tours

Department

• Unit Name

• Area / Unit Type

  Select Med Surg PACU Emergency Department Rehab Radiology ICU/CCU Outpatient Clinic Pediatrics / L&D

  • Med Surg
  • PACU
  • Emergency Department
  • Rehab
  • Radiology
  • ICU/CCU
  • Outpatient Clinic
  • Pediatrics / L&D

Clean Linen Storage

• Department linen storage covered and secured?

  Yes

  No

  N/A

• Par levels are followed (Compare current level to posted par levels)

  Yes

  No

  N/A

• Standard bed makeup contain only necessary items?<br>(Pillowcase, fitted sheet, flat sheet, blanket)

  Yes

  No

  N/A

• Is the patient room free of excessive linen items (observation)?

  Yes

  No

  N/A

• Are bedside tables and cabinets free of linen?

  Yes

  No

  N/A

Soiled Linen Storage

• Are medical waste containers free of linen? Inspect soiled utility room)

  Yes

  No

  N/A

• Are trash containers free of linen? (Inspect soiled utility room)

  Yes

  No

  N/A

Quality

• Are white linens bright and of consistent shading?

  Yes

  No

  N/A

• Are folds neat and of the correct width?

  Yes

  No

  N/A

Additional Comments

• My level of satisfaction with the service received is

• Much worse than expected

• Worse than expected

• As expected

• Better than expected

• Much better than expected

• Delivery Rating

• Much worse than expected

• Worse than expected

• As expected

• Better than expected

• Much better than expected

• Quantity Rating

• Much worse than expected

• Worse than expected

• As expected

• Better than expected

• Much better than expected

• Quality Rating

• Overall Service Rating

• Much worse than expected

• Worse than expected

• As expected

• Better than expected

• Much better than expected

Customer Comments

• I have reviewed and understand the contents of this report.

  Sign