A Cleaner, Greener Future

Booth Centennial

When it comes to healthcare, Canadians put their trust in the quality of everything from surgical staff to meals provided to patients. Operating like miniature cities, hospitals, nursing homes, and long-term care facilities have many things in common, especially the massive amounts of laundry generated daily, including bedding, surgical gowns, operating room sheets, personal patient clothing, and much more…

Servicing everything from mammoth metropolitan hospitals with hundreds of beds to smaller clinics, Booth Centennial Healthcare Linen Services (BCHLS) has earned accolades in Canada and worldwide for its superior quality service, dependability, technological innovation, and numerous energy and water-saving initiatives.

Serving the Greater Toronto Area (GTA) in Ontario for over four decades, Booth Centennial is owned by 23 member hospitals that serve as customers for the company. Providing a range of laundry services to healthcare organizations, Booth continues to remain not-for-profit, a focus that appealed to Maria Ash when she joined Booth in 2005 as Director of Human Resources. Having worked in hospitals in the past, Ms. Ash was familiar with the need for laundry services; when she interviewed for the position, she soon realized how essential the service is to countless facilities across the GTA. “If you don’t have your linen supplies in hospitals – much like if you don’t have food – you can’t take care of patients. If there are no linens for the beds, patients cannot be admitted,” she says. “If you don’t have surgical gowns for the surgeon, the surgery’s not happening.”

Moving up to the position of Executive Vice President two years ago, Ms. Ash is proud of Booth Centennial’s many accomplishments, especially its countless environmental initiatives. Located in the Regional Municipality of Peel, Booth is one North America’s foremost healthcare solutions enterprises. The company’s proven track record in delivering services and an industry-wide reputation for quality began when it was created in 1969 by 12 Toronto-area hospitals. Instead of operating a dozen separate laundry facilities in individual hospitals – each with its own employees, machines, boilers and other equipment – the decision was made to build a large offsite laundry. The effort, made in the spirit of collaboration, saw equipment relocated from existing hospital laundry areas, all existing linen pooled, and every hospital contributing funds toward the purchase of additional machines. Existing staff were re-deployed to the new site, and areas in hospitals which were originally used for laundry facilities were freed up for other purposes.

Growing from 12 to 23 members, Booth Centennial is today the largest single-site healthcare laundry in Canada. At a massive 300,000 square feet, the facility – which serves both members and non-members – remains committed to delivering innovative and cost-effective linen and laundry services. “Booth was formed in the spirit that hospitals were not specialists in laundry, they were specialists in patient care,” says Ms. Ash.

Serving a diverse range of clients, ranging from hospitals to nursing homes, private laboratory clinics, surgical centres, hospital satellite offices, hospices and more, Booth Centennial has almost 500 dedicated employees. Some are from the industrial / manufacturing side, and many are newly arrived Canadians living in and around the Mississauga / Brampton border. “We take a lot of pride in that Booth is a very multicultural environment,” comments Ms. Ash. Highly organized and incorporating the latest state of the art equipment and systems, Booth has 12 shifts per week, with the capacity for up to 14 shifts.

Delivering to over 150 separate facilities daily, Booth cleans a staggering 80 million pounds of laundry every year. Its main services include rental and customer-owned goods. All linens are expertly laundered, and may go back to the hospital they originated from or a different hospital. The other laundry service Booth provides centres on customer-owned goods which belong to specific hospitals, and may include embossed items, specialty wear, named lab coats, uniforms, patient slings, warm-up jackets, and even personal clothing for residents of long-term care homes. These items are laundered through a different process – a smaller facility within the larger laundry – where each item is tagged with the originating hospital and returned within 48 hours.

“It is often more economical to get your lab coats from Booth Centennial rather than having to buy your own,” says Ms. Ash of the organization which, as a non-profit, works directly with vendors to negotiate better, at-cost pricing for its members.

When we think of laundry, the first thing that comes to mind may be the noisy laundromats of yesteryear, with carts crashing into one another and piles of linens everywhere. At Booth Centennial, the opposite is true. Booth is miles ahead of traditional facilities when it comes to technology, water and energy use, cleaning products, and making Ontario a cleaner, greener, and healthier place to be.

Unlike old-fashioned facilities, Booth Centennial has made considerable investments of time, money and research into every aspect of the business. From the moment laundry arrives at the massive plant to the time it is laundered and delivered to designated hospitals, clinics, aged care residences and other institutions, items are carefully tracked at every stage. Last year, Booth enhanced its IT infrastructure, and operates under Canadian Standards Association (CSA) guidelines. To further enhance its processes, Booth has installed a new line of sophisticated business software to manage live time performance throughout the plant, and provide an end-to-end tracking system plant-wide. With this solution in place, Booth customers now use a web based application to place daily orders or to access account specific financial and usage reports.

“It is very much a state of the art environment in our plant,” says Ms. Ash. “We do everything electronically, starting right from the point in time when the linens are received.” As soon as trucks pull up to the receiving dock, every cart of soiled linen is scanned, informing Booth staff which facility it came from. All carts are weighed, which tells the company what is incoming versus what is outgoing. In an average eight hour shift, about 60,000 kilograms of laundry is carefully sorted. In addition to counters, scanners, scales, photocells, bar codes and other technologies and equipment, there are large, 70-inch TV screens everywhere to give live-time production details, and the soil room has a screen measuring six by six feet which measures projected amounts of laundry versus actual amounts. All items are precisely tracked and scanned, and the company is investigating the use of wireless RFIP microchips embedded into linen, which would allow Booth to track items with even greater precision. “It is all statistics,” explains Ms. Ash. “Everything we do is completely metric driven.”

Technological innovation, a high degree of staff training, and a commitment to quality have made Booth an extremely efficient industrial laundering service. Following initial sorting into categories, employees do not handle linens again they are automatically transferred by rail system, clean, dried and ready to be folded on the other side of the plant. This high degree of automation enables less staff contact and far greater employee safety.

Booth Centennial is firmly committed to the ongoing practice of water conservation and reuse, and to using products specifically designed to be kinder to Mother Nature. Every stage of the laundering process is carefully monitored, including water flow, energy, and chemical consumption. Using the latest energy-efficient equipment and environmentally friendly detergents, Kilowatt hours (kWh) are precisely measured, and heat and water is recovered. All waste water is pre-treated and reused, and different chemical compositions and washing actions are used depending on the item. The building itself has ‘smart’ features, including lighting and temperature decreasing between shifts to conserve energy in a world where every kilowatt counts.

Earlier this year, Booth received Clean Green Certification – one of the first laundries in Canada to receive the accreditation. Committed to increasing the safety of water and the reduction of waste, Booth uses non-chlorine bleach alternative, phosphate-free products, and constantly tests chemicals and water usage. To qualify for Certification, Booth went through a labour-intensive process which required the organization to demonstrate specific best practices for energy, water, transportation, and chemical use. Data, including KwH and the number of litres of water used for laundry, were painstakingly measured and recorded.

“It is a great program to be a part of because laundries deal with a lot of water and a lot of chemicals, and if it is not run properly, it can really have a significant footprint on the environment,” states Ms. Ash. From using low-temperature detergents to optimizing its fleet of vehicles, Booth is not only saving precious resources like water, electricity, heat and gas, but is operating in an extremely cost-efficient fashion. With Clean Green recently becoming an international standard, Booth Centennial is recognized as one of the most innovative laundries in the industry, and is regularly visited by tours from Ireland, the Middle East, and even the Dubai Health Authority, who formally requested a consulting engagement with Booth. “Benchmarking on the international level is a big part of our business,” says Ms. Ash of Booth, which sees representatives from hospitals looking to outsource their in-house laundries, and owner / operators across North American and Europe looking for the latest, leading edge laundry solutions.

Additionally, Booth ensures all water is thoroughly cleaned, sterilized, and pH balanced through oxidizers, specialty products, and filters before it is introduced into sewer systems. Saving hundreds of thousands of litres per year, water is reused after the fourth or fifth rinse, where it is treated, and used again in the pre-wash for soiled linen just beginning its wash. The system was costly to implement, “but when you’re running a green laundry, you’re running a very cost-efficient laundry.”

Along with benefitting the environment through water and energy-saving initiatives, Booth Centennial is helping Ontario operating rooms by presenting a viable, green alternative to costly and environmentally unfriendly disposables: reusable sterile packs.

Unlike pricey paper gowns used in operating rooms which end up in the trash, Booth processes over 1,250,000 reusable sterile packs annually for operating rooms across Ontario. Containing sterilized operating room essentials, packs can be customized for different types of surgeries, and include multiple barrier level surgical gowns, surgical drapes and linens, towels and more. The packs are made and sterilized under ISO1345 Certification in a separate area of Booth’s plant which emulates a clean room in a hospital. Laundered using special formulas, surgical linens are scrutinized by 55 highly trained inspectors, pack-makers and sterilizers, with every single piece analyzed over high-tech light tables. “Even a tiny piece of lint, or a single hair, if found on a piece on linen in an operating room will result in shutting down the OR, and having to redo it,” explains Ms. Ash. “It can be very costly.”

The packs are heated to 275 degrees Celsius for 45 to 60 minutes in an autoclave, then transferred to a sterile cool-down room for up to two hours; Booth creates over 140 different sterile surgical packs for heart surgery, C-sections, arthroscopic procedures, and more. Every pack has a sterilizer indicator tab to ensure sterilization of the entire pack was successful; if not, the entire load is disassembled and goes through the entire process again – a very rare occurrence. “We take a very high standard of care with these packs,” says Ms. Ash.

She explains that the packs have skyrocketed in popularity, especially with more and more hospitals supporting green initiatives and cost-cutting measures. “We are dispelling the myth that disposable equals sterile – it is quite the opposite. Textiles have non-absorbency properties, repel fluids, and provide the highest level of protection. They are cheaper and green, and much more comfortable for operating room staff than paper gowns.”

As Executive Vice President, Ms. Ash is excited about the future of Booth Centennial, and proud of its many initiatives. Several years ago, the company launched green awards for hospitals choosing reusable products over disposable items, and she feels that – as a laundry industry leader and the largest single-site laundry in Canada – Booth has the responsibility of continuing to educate and elevate the entire health care laundry business in the country. In the end, it is all about the best interests of healthcare in the province.

“Since we are not-for-profit, it’s not about making more sales; it’s about doing good, and doing what is right for hospitals.”