“Fashion designer Cynthia Rowley updates hospital wear for patients” (United Press International, June 1999)
“Diane von Furstenberg Redesigns the Hospital Gown” (GOOD, September 2010)
“The Hospital Gown Gets a Modest Redesign” (The New York Times, January 2018)
Each redesign, of course, targets the old-school, butt-baring gown that’s long been a touchstone of cultural commiseration in movies, TV, and comic strips.
But if everyone agrees that the old garments are horrible, and if fashion designers — working with doctors and nurses, no less — have created better gowns, why are we still having this conversation?
The higher cost of new gowns is a big reason why many hospitals still use traditional tie-in-the-back johnnies. In addition, some fans of the old design think the new versions aren’t patient-friendly enough, and the standard ones are just fine; they’re convenient and functional, giving easy access to parts of the body clinicians need to poke and prod.
“There’s now an effort to be more patient-centric, but really it’s the institutional viewpoint of what patient-centric means, not the individual’s viewpoint,” said Timothy Andrews, a health industry analyst at Booz Allen Hamilton, a Virginia-based consultancy. Andrews said he visits Boston hospitals regularly for diabetes and dermatology checkups, and he continues to receive traditional tie-in-the-back gowns.
“You might as well just walk around naked,” he said. “It’s probably easier — just give us a belt and a loincloth.”
For patients who still feel like the health care system leaves them flapping in the wind, there is reason for optimism.
“The first thing hospitals do is strip patients of their dignity,” said Bridget Duffy, chief medical officer of Vocera, which focuses on health care operations and communications. But hospitals are increasingly paying attention to patients’ experience, and that includes what they wear, she said: “I have a little bit of hope now.”
As Cleveland Clinic’s first chief experience officer in 2006, Duffy started the process of redesigning the institution’s gowns, which culminated, seven years later, with new apparel created by Diane von Furstenberg. The gowns feature deep V-neck (and back) cuts that offer clinicians easy access to the patient’s upper torso, with full coverage of the patient’s lower extremities.
Duffy played a role in a more recent redesign effort, as well. Last spring she volunteered with students and faculty at New York City’s Parsons School of Design, where they created a line of hospital gowns for the health apparel company Care+Wear. It is testing the gown at Montgomery Medical Center, a nonprofit community hospital in Olney, Md.
The gown resembles a kimono, wrapping the patient and tying in the front. At the back, the gown splits just below the patient’s buttocks, and the fabric overlaps broadly to prevent accidental exposure.
Other hospitals have mostly ignored Cleveland Clinic’s example, Duffy said, but she’s trying again because hospitals now have a financial incentive not to force patients into gowns that are uncomfortable, ugly and frequently humiliating: If hospitals boost patient-satisfaction scores on surveys, they can increase Medicare and Medicaid reimbursement levels.
That sort of calculus has driven interest in the new gowns, said Chaitenya Razdan, Care+Wear’s chief executive. At the recent J.P. Morgan health care industry conference in San Francisco, Razdan said hospital executives were eager to meet.
“I’ve gone four years in a row, and this is the first time that in every hospital presentation, ‘patient experience’ was one of the three core focus areas for the year,” he said.
But the medical staff’s experience was also important to designers of his new gown, Razdan said. His team sought a gown simple enough that nurses, physicians, and medical assistants needn’t consult a lengthy user’s manual before examining a patient. With nearly 590 million patients admitted to hospitals annually, even tiny delays in patient care add up to huge costs.
The Parsons design team also sought input from suppliers of raw materials, and, importantly, industrial launderers, who increasingly own the garments hospitals use.
As would be expected from a company with a smaller manufacturing base than the industry giants, Care+Wear’s gowns cost more than tie-in-the-back versions, for which hospitals will pay between $4 and $7 apiece, according to TRSA, a trade group representing suppliers and launderers.