title: Hospitals learn their collective power: an isolation gown success story.
abstract: BACKGROUND
  We describe an investigation and improvement project designed to provide comfortable, affordable, fluid-resistant isolation gowns in response to inadequate compliance with gown use.
  
  
  METHODS
  Infection control and purchasing departments determined number of gowns used, cost/gown, and contract information for our laundry service. We investigated disposable gown options. During a conference call for a multihospital project, we learned that 4 local hospitals all used the same laundry service and that all were dissatisfied with the quality of the reusable gowns. The 4 hospitals resolved to meet with the hospital laundry service to negotiate as a group. In preparation, we both investigated laundry services in neighboring cities and reviewed Centers for Disease Control and Prevention and Occupational Safety and Health Administration isolation gown requirements.
  
  
  RESULTS
  Confronted with its major customers acting collectively, the laundry service agreed to identify gowns by age, bring gowns to Occupational Safety and Health Administration compliance, mark grids so gowns could be removed after 75 washes, add 6,000 new gowns, and remove 6,000 old gowns. The cost increase was 3.75¢/gown. After the changeover was complete, reports of fluid leaking through gowns stopped. We saved $187,000 by keeping reusable gowns.
  
  
  CONCLUSIONS
  When we tried to provide comfortable, affordable, fluid-resistant isolation gowns, we encountered 2 barriers: our city had only 1 hospital laundry service, and disposable gowns were costly. We solved the problem through unusual collaboration: internal (Infection Control and Purchasing) and external (with otherwise competing hospitals). Collaboration and knowledge sharing led to accountability: the hospital to its staff and budget and the laundry service to the hospitals.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Indiana University School of Medicine, 535 Barnhill Drive, Indianapolis, IN 46202, USA. abkresse@iupui.edu
authors.forename: Amy B
authors.initials: AB
authors.lastname: Kressel
authors.forename: Jennie L
authors.initials: JL
authors.lastname: McVey
authors.forename: Joan M
authors.initials: JM
authors.lastname: Miller
authors.forename: Lauren L
authors.initials: LL
authors.lastname: Fish
mesh_terms: D003428:Cross Infection / Q000517:prevention & control*; D006761:Hospitals; D006801:Humans; D007847:Laundry Service, Hospital; D010356:Patient Isolation / Q000379:methods*; D011481:Protective Clothing