Victor Mitry is called a “hero” because, thanks to his forethought, health care workers at University of California Los Angeles Health did not experience a shortage of isolation gowns during the pandemic. Now his innovative strategy is continuing to pay off over the long term with cost savings and environmental benefits.
“In the old days they used to call me cheap, but now I am — I guess — a hero in sustainability.”
— Victor Mitry, UCLA Health
As UCLA assistant director of logistics and materials, Mitry implemented a program to switch UCLA Health to reusable isolation gowns in 2014. Making these changes before the pandemic hit meant UCLA Health did not experience shortages. UCLA Health staff had the gowns they needed to address the pandemic, and caregivers were grateful. At other organizations, health care workers faced severely limited supplies of disposable gowns, and in some notable cases, staff wore plastic bags for protection.
According to the American Hospital Association, the pandemic has created a $202 billion loss in the health care sector, forcing worker layoffs and other extreme efforts to minimize supply chain costs. Switching from disposable to reusable gowns offers an opportunity to lower health care costs, address climate change, and improve resilience while preserving the safety of health care workers.
Economic and environmental savings
UCLA Health was purchasing 2.6 million disposable isolation gowns prior to implementation — and that number was projected to increase. The disposable gowns were susceptible to snags and rips and created 234 tons of landfill waste each year.
UCLA is among several health systems who found cost savings from the switch, over $450,000 each year. Beyond the cost benefits, studies (including a recent pandemic-focused study from Stanford University) have found reusable isolation gowns outperform disposable gowns, use 200% less energy and water, generate less waste, and have a smaller carbon-footprint than disposable textiles. They provide all of these benefits while meeting OSHA and Association for the Advancement of Medical Instrumentation standards.
Given price increases (up to 2000%) in isolation gowns during COVID-19, reusable gown use has the potential to build long-term resilience within the health sector while protecting against price fluctuation and supply chain disruptions.
Trial by fire — and pandemic
“What we learned during the pandemic is that we have to look at resiliency. Our supply chain kind of dropped on us and we were left with a lot of PPEs that weren’t available. The good thing was that we started our isolation gown program back in 2012 and so we were ahead of the game and that helped us a lot.”
— Victor Mitry
Much like UCLA, Carilion Clinic, a seven-hospital system serving more than 1 million people in Southwest Virginia, had switched to reusable gowns during the 2009–2010 H1N1 outbreak after experiencing limits to their supplies and seeking a less-waste intensive solution.
“We didn’t not have a single PPE service failure at our hospitals during the pandemic.”
— Jim Buchbinder, Carilion Clinic director of laundry services
Before the COVID-19 pandemic, the system was going through 14,000 gowns per a week. Demand tripled during the pandemic to 45,000 gowns per week. Ultimately demand grew to 70,000 gowns per week. In order to meet pandemic demand, Carilian increased the speed of its laundry services. As a result of their efforts, including a streamlined process involving four laundy-pickups per day, priority laundry service, and color-coded laundry bags, they didn’t experience PPE service failure at any of their hospitals during the pandemic.
In addition, because they were already using reusable linen for other applications such as wrapping surgical instruments in the OR, this averted the need to cancel procedures during the shortages of wrapage from China during the pandemic.
The transition from disposable to reusable
UCLA started with a pilot at its busiest unit, then expanded to more units as the gowns were proven to be effective. The pilot process addressed considerations for day-to-day use and caregiver feedback. Sustainability, nursing, and infection prevention staff were among those who assisted and provided perspective to the process.
For example, caregivers informed Vitry and his team that they preferred snaps instead of string ties for ease of removal, and that some of the test materials were hot to wear or slippery.
Using what they learned, the organization selected a custom gown made from 99% polyester and 1% carbon with short cuffs to allow for double gloves, longer sleeves, and reversibility so that it wouldn’t matter which way the gown was put on. Each gown lasts 75–100 washes.
During the transition, UCLA discovered there was some confusion about calling the gowns “reusable,” so they changed how gowns were described, calling them “single-use washables.” This both cleared up the confusion and increased acceptance among staff.
A triple win
For UCLA Health, cost savings was among the drivers for switching to reusables. The projected cost for disposable isolation gowns was expected to increase to $2 million while the costs for reusables over four years would be half that amount, including all processing costs.
However, transitioning to reusable isolation gowns resulted in a triple win: cost savings averaging $450,000 each year — a total of $3.5 million in savings since the project began; user satisfaction among caregivers who are grateful for the protection; and resiliency.
Carilion Clinic is also experiencing savings; spending only $0.39 per use of reusable isolation gowns, compared to the $0.76 they were spending for disposable gowns.
Both health systems now have an inventory of reusable gowns to face any future supply chain disruptions.
Preparing for the next pandemic
Hospitals across the country are looking to implement reusable isolation gowns and textiles. The Stanford Medical Student Association’s Climate and Health, for example, is working with Stanford hospitals, researching and gauging receptivity to safe, cost effective, reusable gowns and piloting them at their facilities.
Based on the 2020 Sustainability Benchmark data, dozens of hospitals in the Practice Greenhealth network are already using reusable isolation and surgical gowns; 68% of hospitals that use reusable supplies are also using reusable patient linens (such as patient gowns and linens).
Practice Greenhealth is the leading membership and networking organization for sustainable health care, delivering environmental solutions to more than 1,100 U.S. hospitals and health systems.