The team attempted to solve the following problems:
| 1. | The existing bed sheets were fitted with garters. These garters would loose their elasticity after several washing cycles due to high washing temperatures. Once the garters became loose, the fitted bed sheets would not be able to hold and remain tucked under the mattresses especially when patients move around the bed. The fitted bed sheets will roll up to the center of the beds and look untidy and not presentable. The fitted bed sheets will also come out from the mattresses when the beds are raised and propped up. Thus the mattress is visible |
| 2. | The fitted bed sheets crease even after ironing due to the gathers around the garters |
| 3. | Changing of loose garthers is a tedious process and takes up a lot of linen attendants time. |
Using the fish bone method of analysis, the problems were a result of the following root causes:
| 1. | Poor quality garters |
| 2. | High washing temperature leads to the garters loosing their elasticity faster. |
| 3. | Due to the different sizes of mattresses being used in the wards, the fitted bed sheets are not able to fit properly. |
| 4. | SCORE, the laundry operator uses industrial flattener to iron the bed sheets. This flattener is more suited for flat sheets/linen. |
Several alternative solutions were considered to solve the problems. They include:
| 1. | Convert to envelope bed sheets |
| 2. | Tailor the bed sheet like pillowcase |
| 3. | Reverting to flat sheets |
| 4. | Giving bigger material allowance to be tugged under the mattress |
The first solution: “Convert to envelope bed sheets” was chosen because it would enhance the Hospital’s image, ease of implementation, user-friendly and effective method and easy availability of prototype. The total cost amounted to $47,600 (S$8.50 per unit; 5600 units).
A fourteen-day trial implementation was conducted to test the new envelope bed sheets at wards 45 to 49 with the following results:
| | Before | After |
| 1 | Fitted sheet come off from mattress when patient moves around too much or when the bed is raised | Envelope bed sheets do not come off the mattress easily as the flap of the bed sheet is deep and holds the mattress well |
| 2 | Appearance of bed sheet is creased as the ironing cannot be done properly due to the gathers | Bed sheet looks more presentable and well pressed as the envelope bed sheets are flat and ironing is made easier |
| 3 | Garters elasticity loosen and requires regular changing | No more garters being used |
| 4 | Cleaned bed sheets cannot be folded and packed neatly due to the gathers around the garters. This further contributes to the creases | Envelope bed sheets are flat, therefore folding and packing is easier and neater. Thus minimizing creases on bed sheets. |
This innovation will result in standardization such as the development of a Training manual and documentation.
Despite the success of the new envelope bed sheets, other areas for improvement were highlighted below:
| 1. | To ease changing of bed sheets for bed ridden patients |
| 2. | Differentiating from other bed sheets currently in use |
| 3. | Minimize tearing at the corner of envelope |
The team presenting the “Convert to envelope bed sheets” at the Changi General Hospital QC In-House Forum 2003 - 'Just Do It!'