Hospital Laundry Services | In-House | A Complete Guide

Importance of Hospital Laundry | In-House | A Complete Guide

Hospital Laundry Services

Hospital Laundry Services in the hospital industry is prime important as the protection of the patient’s health is the main priority. The industry is growing on the faith of patients.

Especially to gain the faith of the patients' many factors are important, like attending to the patients on time, proper identification of the pain, and proper remedy suggested by the doctors. Apart from the personal attended service provided to the patients in the hospital, hygiene plays a vital role in this industry. 

Once the patient is admitted to the hospital, he must get a homely feeling. Cleanliness maintained in the hospital plays a main role in generating the popularity of the hospital. Apart from the technologically updated equipment used in the hospital, hygiene plays the main role here. In this article, we will be discussing the types of hospital laundry and the linens used, their importance, adequate, clean, and constant supply of these linens.

Challenges Faced by hospital Laundry Services: 

Maintaining a regular supply of disinfected and clean clothes on a regular basis is also a main task of the housekeeping section. A reliable laundry service is one of the most important services in the hospital laundry. 

In today’s medical aid facilities, patients expect linen to be changed daily. An adequate supply of clean and disinfected linen is important for the comfort and safety of the patient; thus it becomes essential to know what is the fabric used in the hospital linen? 

It should be noted that the textiles used within the hospital like Mattress Covers, Blankets, Bed Sheets, Towels, Napkins, Pillow Covers, Curtains, doctor Aprons, Operation Theater cloth, Chair, and Cushion Covers, table cloths, hand gloves, and masks are the main linen used in hospitals on a regular basis. There is a hospital linen and laundry service management system which helps the house keeping department manage the hospital linen. 

Operations of Hospital Laundry Management:

The hospital collects these materials from different sections like Operation Theatre, Special and General wards, OPD-Out Patient Departments, and office areas. OT linen materials need special care since they are to be washed and sterilized carefully. 

To fulfill this requirements, hospitals either outsource this linen to the laundrymen or they have an in-house laundry department. To clean the Operation theater linen a special treatment is given to those linens as they are mostly bearing the stains of blood and the special chemicals used in the OT section.

Outsourcing this linen to the local laundrymen is not feasible and economical to the hospitals. So also it depends on the size of the hospital such that the number of beds and wards in the hospital. 

Now to carry out a regular washing, delivering the daily requirement, and maintaining the surplus washed, cleanly folded stacked linen activity is carried out by the housekeeping or hospitality department in the hospital. 

What activities were carried out? What care is being taken to maintain hygiene? What equipment or machines are required? What is the manpower required? What is the consumption of Electricity, Water, Steam, or Gas? Where should the Laundry department be located in the hospital building? We will all be discussing in the following article.


Responsibilities of Hospital Housekeeping Services:

The responsibility of the hospital housekeeping services department starts right from procurement to managing the technical and non-technical operations carried out in the hospital on a daily basis which includes:

1. Determining the types of linen to be purchased,

2. The quantity of the necessary linen to be kept in stock, as per the quantity required at different departments.

3.The operations of the laundry services. The following process is to be followed:

a) Collect soiled linen from various sections.

b) Sorting the linen and processing them

c) Inspecting and repairing or replacing damaged linens.

d) Assembling and packaging of specialty Items and Linen pack for sterilization and

distributing clean linen to the respective departments.

e) Maintaining different types of records.


Space and other Utilities Required for Laundry Service:

Generally, the hospital laundry is located in the basement of the hospital, to avoid interference with the movement of patients and medical officers. Ideally, it should be located on the ground floor of the hospital building connected near to the water and power plant resource.

Proper space for the provision of heavy equipment like Washer Extractor, Tumble Dryer, Flat-work ironer, Ironing table, Sorting Table has to be done

Provision for Water, Power, and Compressed air supply to be provided.

Space required to store the cleaning chemicals.

Space required to keep the sorting table to segregate the soiled linen

Spotting facilities to wash manually OT stained uniforms and clean other soiled linen.

A place for sewing and repairing damaged linens. The place for ironing.

Require desk to tag the linen, registers and files to maintain the records.


Movement of Linen and the functions of the Laundry Department:

In addition to this the lines are collected from different wards and different sections in the hospital using the dry linen collecting trolleys and it comes to the laundry department.


Once the linen is collected from the different sections for laundry, it is sorted as per the treatment required depending upon the dirt and stains on the linen. Mostly, as cotton textiles are used in the hospitals it need not be sorted as per the fabric of the linen. Linens that require a normal wash are separated, and linen which requires stain spots to be cleaned is separated. Accordingly, the linens are divided first.


It is a process where the stained spots are identified and cleaned using special chemicals on the spotting table. Usually, we find the stains of the medicine spilled on the linen and the bloodstains in the OT section. Once the spotting is done, linen goes for the dry cleaning process. Where it is washed using solvents or chemical-based detergents.

Dry Cleaning:

In short, it is a process of washing the garments or linen to clean the left out stains after spotting, which otherwise cannot be removed in a normal wash.

PERC is the main chemical solvent ie. Tetrachloroethylene is used to clean the linen. As linens are washed only using this solvent and water is not used in this process it is termed as dry cleaning.

Washing and Extracting:

Washer-Extractor is used to wash the lines. It is called washer extractor and not a washer because after washing the linen maximum moisture in the clothes is extracted. In the previous year washers and hydro extractors were used separately as the washer manufactured were of low drum spin capacities. In high spin washer-extractors, both the washing and extraction are done, hence called washer-extractors. This is the process where more use of water takes place compared to the other processes.


After the linens are washed it comes to drying. It is generally called a tumble dryer where the clothes are dried.

Here the different types of linens are dried at different temperatures, drying at higher temperatures can damage the linen.

General clothes are dried in a tumble dryer and linens are dried and ironed in a flat-work ironer.


The control desk is the nerve center of the whole department and its efficiency determines the graceful operation and effectiveness of the department. RFID has been used to track linens and garments in the laundry department. It is considered as a focal point for the dissemination of data and communication at various points within the department.


Optimizing workflow may be a fundamental component of any successful laundry design. The manner in which you calculate the capacities of your laundry equipment is critical for the particular success of your laundry operations.

The workflow in production is simply as important as the performance of the equipment itself. You must prevent the creation of bottlenecks in your production due to improper equipment sizing and placement, or the shortage of in the valuable automation required in the equipment where ever needed.


1 Pre calculate the volume and type of linens to be washed per day.

2 The time required for the linen at each process inside the Laundry.

3 Design of the laundry trolleys to match the opening of the doors of the washer-extractors and the dryers for easy movement inside the allotted space.

4 Positioning the Washer Extractors and Dryers relative to the Water, Steam, and Air supply.

5 Locating the washer-extractor and dryers to ease the sorting process.

6 Positioning of all the equipment properly, to ease the entire laundry process.

7. Placing the Washer Extractors and Dryers near the drainage to remove the drain water.

List of Equipment used for Laundry:

The following is the list of commonly used laundry equipment,

1 Washer-Extractor:

Capacities and sizes of washer extractors depend upon the linen required to be washed daily. Washer-extractors are available in different sizes from 8kg to 120kg of linen to wash per cycle. One Cycle time is from 40 to 55 minutes depending upon the manufacturer to the manufacturer.

2 Tumble Dryer:

Capacities and sizes of Tumble Dryer depend upon the garments required to be dried daily. Tumble Dryers are available in different sizes from 13kg to 60kg of the garment to be dried per cycle. One Cycle time is from 30 to 45 minutes depending upon the manufacturer to the manufacturer.

3. Flat Work Ironer:

As per the name, we understand that all the flat and thin linens like bed sheets, pillow covers, etc. are dried and ironed in the flat work ironer. After taking out from the washer extractor, the linens like bed sheets and pillows are directly ironed in the flat-work ironer.

4. Vacuum Finishing Table:

The ironing table or vacuum finishing table is the table where garments are ironed using steam, vacuum, and iron.

5. Automatic folding machine (Folder):

The automatic folding machine is fixed immediately after the flat-work ironer, which folds the linen and stacks it properly. Which saves the time and labor required at the end?

Modifications in Washing System:

On the other hand due to the spread of pandemic diseases like swine flu, corona virus, and similar other viral diseases, the use of a disinfected laundry system has started developing.

The use of Barrier washers has come into practice. In barrier washers, the clothes are loaded from one end and are unloaded from the other end.

This Barrier Washer has two doors, one is at the back end and another door from where the linens are taken for ironing. This is used to minimize the handling of the linen from the same side to avoid contamination.

As a consequence nowadays as so many viral diseases popping up, it feels that compulsory disinfected linen washing will come into the process very soon.

Wash the garments with ozonized water and disinfect the linens in the washing process itself, to avoid the spread of viral infection.

The long-term development of the laundry service will include the utilization of bar-coding and/or RFID. This will enable the hospital to track the movement of linen from one department to another department. It has been observed that the linens are misplaced in transit when the linen is given to laundrymen outside or outsourced. It is envisaged that this technique will assist in linen control, stock levels, identifying where linen losses are happening, management systems, etc.

It will not be cost-effective to bar-code all items of linen and a guide is going to be the value of the article and loss rate. Ancillary Facilities, Laundry Managers Office, Tailoring Area, Workers toilet, Boiler room space, Stores.


Physical Location of Laundry facilities:

Laundry machines should be located near the Mechanical and Electrical department, with a facility of electricity, proper ventilation, water, air, and steam. It can also be in close proximity to CSSD (Central Sterile Services Department) and Dietary system. Ground floor locations with the least disturbance to patients.

Laundry design should be in such a way that most of the processes like sorting, washing, extraction, drying, ironing, calendaring, folding, and packaging. It is always advisable to separate the laundry area into two parts i.e Washing and Hydro Extraction in one part and sorting the clean linen in the other part.

OT laundry should be processed separately.

Laundry flooring and ceiling:

The floor should be rustproof, non-slippery, washable, sufficient gradient to supply easy flow of water. The ceiling should be smooth, washable, moisture-proof, soundproof, with a minimum height of 3.5 meters, to accommodate the equipment. Walls should be washable and free from crevices, corners, edges, or projection with light color as they contribute good reflection of sunshine.

Importantly, the design of doors and windows should be such that it should be wide enough to take heavy machinery and trolleys in and out. Proper space required for maintenance of the equipment. Proper light and natural ventilation should be available from the window. 

Ventilation: Air change per hour is suggested. 

Lightening: Daylight should be used if possible which helps to extend productivity and improve the efficiency of the labor. 

Power supply: 3 KW hour to do 45 KG of laundry per hour. The distribution panel (Electric- panel) should be easily accessible and should be far away from the direct path kept for venting hot water and water vapor. 

There should be a stand by a generator in case of a power cut or emergency. Water: There should be proper storage of water. Approximately 10 liters of hot water and 15 liters of cold water required per 0.5 kg of linen processed. Steam Supply: A temperature of 170 degrees Centigrade is obtained from steam at 45 kg per 6 sq. cm pressure. All steam pipes should be properly insulated using glass wool and covered with aluminium cladding.

Fire safety: The provision of fire extinguishers should be located throughout the laundry with a fire detection system and alarm. Workers should not be allowed to smoke in the laundry while on duty. They should be trained on how to use fire extinguishers. No electrical equipment should be left on after use. Sewing room: It should be located near the sorting and packing room, to avoid contact with the unpolluted linens. Laundry manager’s room: It should be located centrally in order for the manager to properly supervise the whole laundry operation. The doors and walls should include an outdoor vision panel to permit a full view of the area.

Hospital Linen Classification: -

a) General Purpose linen: curtains, drapes, table cloths, and similar items commonly utilized in all parts of the hospital come under this category. This linen is not used for patient care. b) Patient linen: This consists of patient clothing like patient pajamas, shirts, gown, coats, etc. worn by patients. c) Ward Linen: This consists of patient bedclothes like bed sheets, pillow covers, blankets used by the patient. d) OT, Labour room, Procedure room linen: This includes items like pajamas, kurtas, gowns, coats, shirts, etc. worn by anesthetists, surgeons, OT personnel’s and also surgical gowns, masks caps, trolley covers, OT towels, etc. required in OT, labor room and procedure room. e) Ward Linen: These linens are always white in color f) Operation Theater Linen: This is always green in color including doctor’s gown g) Patient Linen: This is blue in color. h) Minimum sets of Hospital Linen: Hospitals should have a minimum of 6 sets of linen per bed. It is calculated as per following:One already in use (on a bed)One able to use (in sub store)One en- route to laundryOne in a washing cycle in laundryTwo available (in central store).

Planning Considerations:

The provision of a replacement laundry or the main upgrade of an existing one involves a considerable investment. Revenue expenditure over the life of the project will be in the order of 20 times the capital cost. It is essential, therefore, that at an early stage within the planning the project team should consider the rationalization of laundry services across a neighborhood or the likelihood of obtaining laundry services from an adjoining district.


The following should even be considered while planning for a Hospital Linen and Laundry services.

i. Size of the Hospital. ii. Types of Hospital. iii. Availability of new Linen and Laundry services in those areas. iv. Type of Clientele. v. Weather Conditions. vi. Physical Layout. vii. Functional flow of administered in Linen and Laundry services. As is usually followed in designing of all other health care services, the design of hospital laundry should also follow the functional flow.

The laundry will only function effectively if the building is planned in strict accordance with the assembly sequence. Separate areas should be allotted for receiving, storing, or processing soiled textiles from areas that process, handle, or store clean fabric.

Design Considerations:

Plans for linen and laundry services may follow local site considerations. In the case of high rise buildings, gravitational sort of layout is often considered. However, the decision is always being left to the project planning department. Structural and Engineering Space Requirements: For establishing space for linen and Laundry Services for a hospital depends on the parameters mentioned within the planning considerations. 

However, minimum space requirements are 10 square feet per bed or 10 square feet per 2.5kg of linen. The floor should be smooth, washable, non-slippery and water impervious. The walls should be hard, smooth, washable, and lightweight reflecting with no dust collection projections. The ceiling height shouldn't be about 3.35 meters from the finished floor level to include the varied ducting.

As a thumb rule, 100 litres/bed/day of water is the requirement for the smooth functioning of laundry services. A boiler supplying steam at 170-180 degrees Centigrade at 100-125 Psi should be collocated to attenuated distribution losses.

A water softening plant consistent with the local water system is desirable. A 400 Volt three-phase reference to a standby backup supply with adequate provisioning of 15 Ampere Sockets should even be considered during the initial drawing board.

Location and Interdepartmental relationship:

The laundry should generally be sited within the cartilage of a hospital and can be located as close as possible to the boiler house to attenuated distribution losses. Linen and laundry services are often collocated. Other facilities requiring services include boiler e.g. Garage, Central Sterile Supply Department, Dietary Services and Maintenance Shop. 

There should be quick access to the principal hospital service roads and to public roads; and sufficient space to form sure that vehicles can maneuver, turn around and park easily at reception and dispatch bays. Where the laundry is an offsite facility, it should be sited with convenient access to the principal main and trunk routes which serve those hospitals that aren't having great access to the laundry.


Types of Laundry Operations:


Contractual system:

In this contractual system, the hospital owns the linen but has no provision to wash it. It hires a contractor whose job is to gather linen and after laundering delivers to the hospital. Sometimes the hospital also provides space and facilities for laundering. The disadvantage for the rental system is that it results in the mixing of linen and the chance of non-social infection are more.

Rental system:

Especially for a hospital with a small size where it will not be economical to possess their own laundry. In the rental system, the hospital hires linen from the contractor on a rental basis. The system is advisable for a small hospital with up to 50 beds.

In-House system:

During this system, the hospital has its own laundry plant. It is one of the simplest methods for laundry hospital linen. This type of laundry is more suitable for a hospital of larger size. Advantages are Reduction in the Loss and damage of linen.

Cooperative system:

During this system, one laundromat caters to the number of hospitals. This system is the most economic. This system is suitable for the hospital of small size and nursing homes. Disadvantage: Chance of upper non-social infection, also if there is a strike in one laundromat, it affects the functioning of the many hospitals.

Features of Different Machines used:

Washer-Extractor Features:

1.Large door opening and Safe Door interlock. 2.Powerful Advanced Computer Control Center. 3.Freestanding Construction and an unsurpassed Suspension System. 4.Supply Dispenser and External Liquid Connection. 5.Robust Energy Efficient Drive. 6.Freestanding Construction. 7.Solid Bearing Housing.

Features of Tumble Dryer:

Stainless steel inner cylinders, painted or galvanized outer bodies, digital temperature-controlled interfaces, anti-wrinkle safety tumble, the drum is usually belt driven, all-welded constructions.

Dry Cleaning Washing/dyeing and processing machine:

Set of equipment required for dry cleaning:

The main dry cleaning machine has front loading, one Pocket, Heavy Duty All chrome steel, Inner and outer, these value Oriented units are suitable for all processes i.e. Washing, Dyeing, Processing, Enzyme, Bleaching, etc. Available in different heating systems: Steam, electric and Thermic Fluid Heating. Fitted with an auto temperature and solvent level controller, it runs through electric, steam and water solenoid valves and precisely calibrated sight gauge glass. Auto Reverse, Manual PH port with a powerful gearbox drive. These machines are available in the following capacity. 8kg, 15 kg, 25kg, 50kg, 65kg, 100kg, 150kg, 200kg & 400kg.

Laundry folding machine:

3.3Meters x 3.3Meters Laundry folding machine fully automated. Properly folded linen up to a length of 3.3m. It can function properly for a minimum of 10 years. It has a strong alarming system that alerts us if any linen is stuck in between the process.

Steam Finishing Machine:

A large Flat Top padded with imported high porosity and heat resistant silicone padding. Strong welded construction. Thermostatically controlled table heater. Extended exhaust duct with lightning device. Swiveling-type arms are all kinds of greenbacks with instant interchangeability. Dry padding for the least amount of time and top quality steam ironing. 

Powerful suction through vacuum generator, centrifugal blower activated by spring-loaded full-length pedal working in conjunction with sturdy micro switches. Silence and fewer vibrations are the main features. Motor overload protection switch. All electricity is easily accessible from the front. Operator's Convenience and Safety.

Flat Work Ironer:

Hollow roller internally heated. A large diameter with moving ironing chest. Large diameter ensuring an extended contact surface, flexibility for addition of another roll, powerful suction for fast drying, Child lock safety, which helps for the safety of operators.

Policy and Procedures:

Types of laundry. Types of linen. Control of pilferage and theft. System for distribution of linen to user units. Planned preventive maintenance programs for laundry equipment. Training of operators and other staff for universal precautions and operations of machines. Inventory control. Condemnation and disposal. Maintenance of history sheet of types of equipment.


An efficient and effective Linen and hospital Laundry services can enhance patient experience and reduce the danger of cross-contamination. Laundry products should preserve. the patients’ dignity, promote the patients’ care and should not discriminate the patient group like gender, clinical status, religion, and status. Quality inspectors might need to know how the laundry process impacts above and style a framework to spot necessary quality requirements within the organization. 

Thus, laundry and linen service plays a really important role in maintaining and safeguarding the health and hygiene of both the patients and medical staff. The quality and standard of this service determine during a large measure, the standard of any health care system.