HLAC Begins Review of 2023 Standards
AUGUST 13, 2026
Standards are only valuable if they continue to reflect current science, industry practices, and the realities of healthcare laundry operations. That’s why this year, HLAC has officially begun reviewing and updating its 2023 Standards.
This effort brings together a multidisciplinary committee with experience from across the healthcare textile industry. The committee includes Infection Preventionists, laundry owners and operators, a microbiologist, and a Director of Research & Development. Each member reviews the Standards from a different perspective, helping ensure that any revisions are both scientifically sound and practical to implement in day-to-day operations.
The review builds on the work completed during previous revisions. One of the most significant additions to the 2023 Standards was Certified Hygienic Testing, which established a consistent way to verify hygienic outcomes through testing. Since its introduction, accredited facilities have incorporated the program into their operations, providing another layer of confidence in their hygienic processes.
Earlier revisions also streamlined the Standards by removing requirements that were not directly related to hygienic linen processing. That work allowed the Standards to focus more clearly on the practices that have the greatest impact on producing hygienically clean healthcare textiles.
Reflecting on the 2023 revision process, former HLAC President Rocco Romeo said:
“The 2023 HLAC Standards represent the pinnacle of excellence in processing healthcare textiles. By actively listening to our stakeholders, the Standards Committee was able to streamline the requirements, reducing or removing elements that did not directly impact patient care, while firmly embedding data-driven best practices. The result is a sharper, more effective framework of standards that ensures the delivery of hygienically clean linen and elevates safety across the entire industry. I am incredibly proud of what the committee and Board achieved.”
What goes into reviewing a standard?
The current review is not about making major changes just to have a new version. The committee is going through the existing Standards line by line, looking at what still works, what needs clarification, and whether references or other information need to be updated since the 2023 edition.
Carol McLay, Market Director of Infection Prevention with Ascension Health in Florida, has more than 25 years of experience in infection prevention. She also served on HLAC’s Board of Directors from 2016 to 2019 and was involved in the post-pandemic Standards revision.
When asked what surprised her most about the revision process, McLay said it was how challenging it can be to develop standards that are both evidence-based and practical.
“We continually asked: What does the science say? Does it improve patient safety? Can healthcare laundries consistently implement it? Good standards must accomplish all three,” she said.
That balance is something the current committee is keeping in mind as it works through the Standards. Every proposed revision is discussed carefully and, where appropriate, supported by current references. The committee also considers how a change could affect healthcare laundries, surveyors, and the organizations that rely on HLAC accreditation.
The goal is to improve the Standards without changing requirements simply for the sake of change.
Why standards need to evolve
Healthcare continues to change. New research, technology, outbreaks, and other challenges can all affect how healthcare organizations approach infection prevention and patient safety.
“Healthcare is always evolving through new research, technology, outbreaks, and challenges,” McLay said. “If standards don’t evolve, they stop reflecting best practice. HLAC’s commitment to reviewing and revising its standards is what gives accreditation its value.”
Another important part of that conversation is understanding what it means for a textile to be hygienic. “Clean is what we can see. Hygienically clean is the result of validated, controlled processes designed to minimize microbial contamination,” McLay said. “It’s not just about the finished product, but every step from the laundry to the bedside.”
For HLAC, that means looking at the entire process, not just the appearance of the finished textile.
Different perspectives make stronger standards
The current revision committee includes people with different areas of expertise, and that is intentional.
Laundry owners and operators understand the realities of running a healthcare laundry. Infection Preventionists bring a clinical perspective and an understanding of risk. A microbiologist brings expertise in microbial control and testing, while research and development experience adds another perspective on processes and technology.
McLay believes having those different perspectives at the table is important.
“No single profession has all the answers,” she said. “Laundry operators understand workflow, engineers understand equipment and processes, and infection preventionists understand risk and clinical application. Together, they create stronger, more balanced standards.”
Her advice to the current revision committee is to keep asking questions. “Continue asking difficult questions. Challenge long-held assumptions and let the evidence guide the discussion. Standards must protect patients while remaining practical for facilities to implement.”
That is the approach HLAC is taking with this review. The committee will continue looking at the Standards, asking whether requirements remain relevant, whether language is clear, and whether changes in science or industry practices need to be reflected.
Looking toward 2027 and beyond
HLAC is working toward releasing the next edition of the Standards in 2027. Before the Standards are finalized, there will be a public comment period, giving stakeholders the opportunity to review the proposed revisions and provide feedback.
Industry input is an important part of the process. Feedback from healthcare laundries, Infection Preventionists, surveyors, and other stakeholders can help identify areas that may need clarification or further consideration.
The healthcare laundry industry will continue to change as well. Looking ahead five to ten years, McLay expects to see greater automation, artificial intelligence, predictive maintenance, real-time quality monitoring, advances in textile science, and increased attention to sustainability.
“The challenge will be reducing environmental impact while maintaining the highest standards for hygienically clean textiles,” she said.
The Standards have evolved through careful review rather than sweeping change. This update will continue that approach, building on a strong foundation while making thoughtful improvements to keep HLAC accreditation relevant, consistent, and grounded in today’s healthcare environment.
The goal is simple: to make sure the Standards continue to provide healthcare laundries with clear, practical guidance for producing hygienic healthcare textiles.