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A Collective of Cooperation



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Interview with Deborah Lark, President of the International Association for Healthcare Textile Management

The International Association for Healthcare Textile Management (IAHTM) will spend 2014 celebrating its 45 years as a promoter and advocate of education for those in leadership roles at the large cooperative healthcare laundries that dot the landscape in the United States and Canada.

IAHTM’s President is Deborah Lark, who is Chief Operating Officer at the Portland Hospital Service Corporation located in Portland, Oregon. Lark was appointed the organization’s President at its 2013 annual meeting/education conference and will serve a two-year term through the 2015 conference.

And while some of the processes involved with a healthcare-laundry are similar to those in businesses working with hospitality or food and beverage textiles, there is plenty more that’s different, she says.

“We’re much more highly regulated by infection control standards,” Lark says. “For example, a non-healthcare laundry, say a hospitality laundry or maybe a Cintas that focuses on walk-off mats, does not have the chemistry, temperature, exposure time and the biohazard or infection control considerations that a healthcare laundry has to manage.

“There are processes all the way through the finish, the packaging, and transportation back to the hospital – in a fashion that facilitates the level of hygienically pure state that is required for healthcare.”

Business World contacted Lark as part of a continuing look at the healthcare industry and the many elements that operate within it. She discussed the history of her organization, some of the unique challenges of the sector and some things that may impact the future.

BUSINESS WORLD: Can you give a sense of your knowledge of what led to the creation of IAHTM, why people felt it was necessary and how it’s evolved since then?

DEBORAH LARK: Back in the 60s, it was really when large cooperative healthcare laundries started to form.  Prior to this time period, hospitals around the U.S. and Canada had what we called OPLs or on premise laundries that were very inefficient. Hospital groups decided to continue forming what they called cooperative laundries, so health systems in an area or region could take advantage of shared laundry and linen services in a cost effective and efficient manner.  In 1968 a piece of legislation was passed that authorized a 501 (C) 3 tax exemption for joint endeavors by non-profit hospitals with the exception of joint laundry services.  The very first cooperative healthcare laundry in Boston, MA subsequently lost its previous tax exempt status.  This legislation was the spark that kindled the idea for the first existing cooperative laundries to form an Association. Basically, the CEOs of those original cooperative laundriescommunicated with each other about operations, information that they could share to help each other and they decided to form an organization, which became IAHTM. The original cooperative laundry was located in Boston and thereafter Baltimore, Seattle, Madison and Los Angeles.  Numerous cooperative laundries have since been formed throughout North America.

Over the years, IAHTM grew in membership as more were formed throughout Canada, and the United States. In the beginning, the association really focused on its members relative to equipment, linen and production, natural resource use and driving down the cost of operations, so that continues today.  However, we’ve come to include really what we call, C-suite education, so we’ve got a high-profile version of education that we bring in for our membership to help us operate better as Presidents and CEO’s of the member organizations and it can have anything to do from working with Boards of Directors, negotiating with unions, benchmarking, upcoming legislation impacting the industry to leadership development. We’ve provided a lot of education on the Affordable Healthcare Act for example – it’s just a really a wide breadth of education that we bring to the membership, which is our main focus.

BW: You mentioned several factors that C-suite executives need to be kept abreast of and have their fingers on all the time. Has that always been the case? What has changed in the industry that makes education of that level executive your primary goal?

LARK: I think the growing demand that has been put on the hospitals and healthcare organizations in general to make sure that they are providing top-notch patient care. Obviously the economy affects their desire to have very efficient operations and to make sure that we’re in compliance with rules and regulations on a Federal, State and Local level.  Everything that has happened, from requiring independent financial audits to handling retirement accounts, to changes in Medicare Reimbursement rules – IAHTM has tried to keep pace with the changing environment and the pressures that have come to bear on hospitals. New technologies have come out with regard to both processing equipment and textiles, different technologies that have come out that help reduce our natural resource utilization, etc., ways to ensure that you have a good tone at the top of business and that you are working ethically and morally when it comes to the organization as a whole.

BW: So there’s a lot more to this than what meets the eye. This is a far more complex industry than those without knowledge of it might assume it is.

LARK: That would be correct. I think the everyday person doesn’t even know this industry exists. It’s a very niche industry, so to speak. I think when the average person looks at the hospital, they don’t think of the textiles and the linens, and what has to go to into the process of handling soiled linen, processing it and getting it back to the hospitals from an infection control and patient care perspective. There’s a lot of chemistry involved. There’s a lot of equipment involved in these large cooperative plants that the layman has no idea even exists. And certainly it’s a business, it’s a large business. These cooperatives, I’ll use mine as an example – I service 15 hospitals, I have 145 employees – there’s large revenue. These are organizations that can impact hospitals and patient care, so all of it is involved in these cooperative laundries.  Linen is like any other critical medical supply – hospitals cannot operate without it.

BW: So if you’re going to choose this industry, you chose the most complicated, most difficult portion of this industry?

LARK: That would be correct.

BW: Are there ever days where you roll your eyes and wonder why can’t I be doing this for a hotel chain or something like that, or do you enjoy that more importance is laid on yours?

LARK: I’ve been in this industry for 18 years and I had no idea, when I walked in the front door looking for a job, about this particular industry. It’s very interesting, it’s fascinating, it’s challenging. I guess for those A-Type personalities out there, which most of us in IAHTM are, we really enjoy that challenge. This particular organization is a great value for me personally and I think to all of our members, really, because we are such a niche industry, things are very specific and these challenges that we all face, we have the ability to seek each other’s counsel and advice.

BW: Do you think the fact that the industry is as complicated as it is and everyone shares a similar kind of burden as far as the regulations go and requirements, does that make it a more collective industry than maybe similar non-healthcare related industries might be? Is there more cooperation here than with the other ones?

LARK: Yes, I think within and particularly for cooperative healthcare laundries that are members of IAHTM, yes, I would say that’s very, very true.  A study of almost all preambles of formally organized associations will state that one of their primary objectives is the free exchange of ideas for the mutual benefit of the membership.  That exchange of ideas, advice and counsel is alive and well within the IAHTM membership.  Beyond the high level of education we provide to members, that exchange of ideas is one of the reasons we exist.

BW: What are some other advantages of the collectivity? Any association sells its value proposition on the idea that we’ll be a collective, we can bargain together, we can do this together or that together. But, in your opinion, what are some of the main reasons why being a part of this organization is better than going it alone?

LARK: Certainly, the group buying power that we have – we actually have a number of vendors in the industry who supply equipment, chemicals, linen, production management software and other related supplies.  Jointly, we’ll handle well over 750 million pounds of laundry per year.  This gives us a great deal of volume purchasing power.

I think one of the greatest benefits that I’ve seen, is what we call a peer review.  This is a program wherein two or three of our counterparts will travel to your plant and do an optional audit and make suggestions about how you can make changes or maybe handle some issues you’re having.  Given the wide range of expertise and talent our members have, these peer reviews are invaluable.  I think there’s a trust, there’s a code of conduct that engenders trust. It’s networking, too. We’re spread all over North America, but there’s a great deal of networking that takes place on a daily basis in addition to our educational conferences twice a year.

BW: What is the format of the next conference, in Memphis?

LARK: That is actually our “Spring” conference which focuses on growing our junior management staff into stronger leaders and providing opportunity for their personal and professional growth. For example, our plant supervisors, HR managers, and engineers have attended some of these conferences when the specific subject matter relates to their specific organizational role.  The larger conference, which is the executive educational conference, will be held in Salt Lake City this coming September. That’s a longer five-day conference and that’s really where the C-suite education comes in.

BW: Talk to me about the current membership. How have numbers been trending? You mentioned the 750 million pounds figure, but in terms of how many entities you have as members, where has that been going in the past couple of years?

LARK: We’re really focused on growing our membership. It has grown slightly over the past five years. We’ve brought in several new members – I think we are about 45 members at this point in time. And again, there are some very specific criteria and requirements in order to qualify as a member of IAHTM.

BW: What is the typical entity that’s a member? Or is there a typical?

LARK: Yes. Membership is limited to those organizations that are formed and operated for the purpose of providing shared laundry and textile services to two or more hospitals or healthcare institutions; are owned by governed by or under the control of one or more hospitals or healthcare institutions recognized by the IAHTM Board as qualifying hospitals or healthcare institutions; and which have a management, ownership and control arrangement which is consistent with other members and is not a broad based contract management arrangement for independent or unrelated customers. The management must report directly to a Board of Directors and be independent of any contract management company.

BW: Are there a lot of entities that would fit your membership, but aren’t part of it? Do you have a pretty good share of what’s out there or are you still scratching the surface?

LARK: We have a pretty good share. There are still some entities out there, and that’s one of our goals, certainly to reach out to those qualifying organizations. As president of IAHTM and certainly the past presidents of IAHTM and our executives, that’s one of our on-going goals – to make sure that we are identifying any cooperative healthcare laundries out there that would qualify for membership, that are not members, because we want to make them aware and certainly let them hear the advantages of membership. Part of our philosophy is that cooperative laundries are much better run in the interest of the hospitals if there’s a person that reports directly to the board of directors. As opposed to being managed by a management company, where linen and service is not their main priority.

BW: What sorts of things are on your agenda going forward that you want to accomplish? What factors are out there that people in your position need to be aware of?

LARK: No. 1, I want to grow the organization. I want to make sure that we are connecting with those qualifying healthcare cooperatives that are out there, and making ourselves known to them, so that they have the ability to take advantage of what our organization offers. I want to continue to elevate the level of education to our members, making sure we’re keeping up with trends in the industry and changes in laws. Another thing I want to do is start having more and more collaboration with the vendors in the industry, whether it be equipment, textiles, chemical vendors or service providers that are specific to our industry, so that their research and development is addressing what we’re concerned about.

BW: How will the industry look different five years from now?

LARK: I think there’s going to be a lot of downward pressure to continue to reduce costs, gain efficiencies.  Again certainly with the healthcare act, it’s yet to be seen. We all know that’s going to bring some changes. More and more of the cooperatives are going to be certainly accredited by the HLAC – the Healthcare Laundry Accreditation Council. I think that’s a trend that we’re going to continue to see grow. I think it’s going to become more and more of a demand by the hospitals, that the cooperative doing their linen and laundry service be accredited. I think those are some trends we will see changing.

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