CNO Leads $1M Charge for New Scrubs, Uniforms

The CNO of a Florida health system calls the organization's switch to new uniforms for 6,000 employees 'change management at its finest.'

Change can be tough for anyone, whether it's starting a new job or moving to a new city. But a $1 million, industry-first change that involves more than 6,000 employees requires exceptional leadership. That's where Diane Raines, DNP, RN, NEA-BC, senior vice president and CNO for Jacksonville, Florida-based Baptist Health comes in.

Raines, along with Baptist Health COO John Wilbanks, FACHE, was the executive champion for an initiative to adopt new work garments made from antimicrobial, fluid-repelling, moisture-wicking fabric. Baptist Health was the first health system to widely adopt the Vestex uniforms from Vestagen Technical Textiles.

But the adoption of the new uniforms didn't happen overnight; and it also didn't happen without a lot of staff help and input.

"This has been three years in the making," Raines says. The process started with physicians and nurse epidemiologists watching and waiting for a couple of years as data started to show that the fabric was able to do things like reduce MRSA on apparel.

"From a medical standpoint, you want to make sure if you're going to make a change like this there is evidence behind it," Raines says. "We really looked at this not as uniforms but as technology that could help protect our staff and patients."

Once the health system decided to adopt the new apparel, it didn't simply order 30,000 new sets of scrubs, lab coats, and uniforms. Instead, hospital leaders assembled an interdisciplinary implementation team of 100 employees to participate in a day-long session about fabrics, styles, and colors. Among those 100 volunteers were people who weren't initially sold on the idea of new uniforms.

"We also asked our leaders to put some of the skeptics in there. You could tell people thought, 'This is ridiculous, I'm not doing this,'" Raines says. But, "the more information you can give people the more likely they are to adapt. Those 100 people became champions themselves, and that was one of their duties: to go among their peers and talk this up."

Once the 100-person team chose some initial designs, "we took their decisions on the road," Raines says. "We called it a trunk show."

The "trunk show" took the uniform options to all of Baptist Health's locations—including five hospitals, a home health agency, and a free-standing emergency department—and let everyone who passed through the shows to vote on the colors and designs that they liked best. Raines says about 1,000 people came through the trunk shows, giving the employees a chance to see, touch, and have a say in the new uniforms.

Altogether, about 6,000 of the system's 9,000-person staff will be wearing the new technology, including nurses, physicians, aids, housekeepers, imaging staff, and others who go in and out of patient rooms and have repeated contact with patients.

The organization purchased initial sets for existing employees, giving three sets to full-time employees, and two sets to part-timers. Staff members started wearing the new uniforms about a month ago, and the health system's official "go live" date for everyone to be in the new apparel is September 1.

"As units get their uniforms, people send me text messages with pictures," Raines says. They'll write things like, "Here's out pediatric intensive care unit in our new uniforms… here's how great we look."

Next up is new patient apparel, too, which was designed by a team of caregivers (mostly nurses) to provide more dignity to patients, as well as add functionality with elements like pockets and slits for drainage tubes.

The patient apparel includes a wrap gown with double-back panel, as well as shorts and shirts for patients who don't need to be in gowns. Raines says the production on the new patient apparel is wrapping up and implementation will begin at the end of September.

Raines says the process of designing and implementing the new apparel has been interesting, calling it "change management at its finest." Although she says the vast majority of the staff were thrilled that they were getting an extra level of infection protection, there are still have a handful of people who complain that they don't like the colors or don't want to wear the technology.

"As more and more people adopt and adapt that kind of goes away," Raines says. And although leadership requires strong decision making—9,000 people can't be involved in every decision—when appropriate, staff involvement is crucial.

"We felt like we had a lot of buy-in going into it," she says. "The more we can involve staff in decision making the better we can be. We search and hire independent critical thinkers to take care of our patients, and you can't ignore that when it comes to decisions."