Carilion Clinic Case Study

Roanoke, Virginia-based Carilion Clinic saved 50% converting from disposable to reusable isolation gowns in 2011 after the Swine Flu pandemic, saving over $850,000 and eliminating 515,000 pounds of waste over the first 3 years. As a result, its nine hospitals avoided PPE failures during the COVID-19 pandemic and today its largest hospital, Roanoke Memorial, is re-using every product that can be laundered, including  operating room linen.

“In a hospital setting, it’s easier to just throw away all the mess that’s created – just put it into a plastic bag and send it to a landfill.

It’s harder to wash it, but it’s something we have the tehnology to do, and it benefits the environment and the hospital for us to do it.”

– Jim Buchbinder, Carilion Clinic Director Laundry Servies 


The Organization

The non-profit Carilion Clinic, based in Roanoke, Virginia, is composed of nine hospitals, a network of primary and specialty physician practices and complementary services, that serves more than 1 million people in Virginia and West Virginia.

Since its conversion to reusable isolation gowns a decade ago, the healthcare system has launched a number of strategies to address sustainability. They include minimizing and recycling waste with an emphasis on re-use and donation, lowering energy and water consumption, and sourcing food locally. Carilion Roanoke Memorial Hospital and Carilion New River Valley Medical Center both received the 2021 Environmental Excellence Award from Practice Greenhealth.

The Challenge  

Disposable isolation gown suppliers weren’t able to meet the demand during the global swine flu pandemic caused by the H1N1 virus in 2009-2010. Meanwhile, the nursing staff was unhappy with the amount of waste generated by disposable gowns, according to Julie Moyle of Practice Greenhealth (PGH). As a result, the healthcare system implemented its reusable isolation gown program in 2011.

Moyle and Kaeleigh Sheehan, both sustainability strategy managers at PGH, shared the conversion experience of Carilion and other hospital systems that PGH has helped with environmental programs during a recent ARTA Speakers Series presentation.


Jim Buchbinder, Director of Laundry Services Carilion Clinic

The Implementation

A 60-day pilot of reusable isolation gown program began in four high-use units. The staff was surveyed after 30 days and again when the trial was completed.

The study resulted in full approval from the Infection Control and the Nursing Product Standardization committees and Carilion proceeded with a systemwide conversion from disposable to reusable barrier isolation gowns, adding four units each six weeks.

Eric Frederick, then Carilion’s director of linen services, has said there were two initial concerns, ensuring that the gowns were returned to the laundry for reprocessing and that the nurses were properly trained on how to tie the reusable gowns.

Working with the nursing unit director and the training department, a staff training program was developed that covered the proper gown donning technique, the quality control system being used, and information about the environmental impact and the projected cost savings of the conversion.

The Learnings

A barrier retreatment product was added to the final rinse during the laundry process to reinforce the gown’s barrier properties.

Frederick has said he felt presentation and quality of the gowns was critical to the success of the program. So, each gown was inspected for holes and tears, and checked to make sure all ties were in place before re-packaging.  A packaging system similar to that of the disposable gowns was devised, Frederick has said. Reusable isolation gowns were packaged 10 gowns to a bag and looked similar to the packs of 10 disposable gowns the clinical staff was accustomed to, but they took up less space.  

Distribution and storage of the gowns was another issue that was addressed. In the past, disposable gowns had been delivered in bulky cases to nursing units on a weekly basis by the materials department. The implementation team designed a system in which the reusable gowns were stocked on isolation carts in predetermined quantities and delivered by the linen room staff. The staff inventoried the gowns each day and restocked as necessary, reducing the storage space required.

The Results

Carilion Clinic officials estimated a cost savings of 50% per gown use, based on $.79 for disposable gowns compared to $.39 per use for reusable gowns, in a pre-COVID world. “They saw the payback period, the ROI (return on investment), was less than 6 months and thereafter they were saving 50% per gown,” said Kaeleigh Sheehan, from PGH.

The Carilion Clinic healthcare system saved over $850,000 over the first 3 years, from fiscal year 2011 through 2013. Over the same period, the healthcare system eliminated nearly 515,000 pounds of waste, Moyle said.

Moyle added, “Notably the end users really appreciated the increased comfort of the reusable textiles as well as the barrier protection, the storage space and the decreased environmental impact. And perhaps most importantly, Carilion Clinic did not experience a supply disruption…during the COVID pandemic.”

More recently, Carilion saw its pre-pandemic gown use of 14,000 gowns per week triple to 45,000 during the COVID-19 pandemic. Eventually demand soared to 70,000 gowns weekly. To meet the demand, Carilion increased the speed of its laundry services with four laundry pickups a day, created a priority laundry service, and added color-coded laundry bags.

This time around, “We didn’t not have a single PPE service failure at our hospitals during the pandemic,” said Jim Buchbinder, Carilion Clinic director of laundry services.

Today Carilion’s largest hospital, Roanoke Memorial, has committed to reusing every product that can be laundered, including  operating room linen.

 “In a hospital setting, it’s easier just to throw away all the mess that’s created—just put it into a plastic bag and send it to a landfill,” said Buchbinder. “It’s harder to wash it, but it’s definitely something we have the technology to do, and it benefits the environment and the hospital for us to do it.”


By Dory Trinka. Trinka is a freelance writer and editor and provides content management services to businesses and nonprofits,