Hand drying in healthcare settings has evolved from a routine detail to a critical component of infection prevention and operational strategy. As hospitals balance hygiene standards with sustainability goals and cost pressures, the choice between paper towels and electric hand dryers is no longer about preference but performance in environments where sanitation is paramount.
At Northwestern Memorial Hospital, this decision became central to a broader “Clean hands every time” initiative. Facilities leadership reevaluated restroom design to align with infection control, efficiency, and long-term sustainability, recognizing that hand drying impacts labor, plumbing systems, waste streams, and user perception.
The hospital’s Infection Control Board determined that traditional high velocity dryers, where hands are held beneath the airflow, offer a more hygienic solution than trough style units, which can collect standing water, and debris. This distinction proved vital in a setting where every surface must support infection prevention goals.
Paper towels, while familiar and easy to use, introduced persistent challenges in high-traffic healthcare environments. Dispensers required constant monitoring, inventory needed ongoing management, and waste had to be continuously collected and removed. At Northwestern Memorial Hospital, these issues were worsened by low-flow plumbing fixtures, which led to frequent blockages when paper towels were flushed down toilets.
As David Stout, director of facilities engineering, noted, “The paper towels were getting flushed down the low flow toilets, causing blockages.” What began as a convenience issue escalated into a significant operational burden, consuming staff time through frequent plumbing calls, restocking, and cleanup.
This intersection revealed a critical flaw in sustainable restroom design: low-flow toilets, while environmentally beneficial, can undermine performance when paired with paper towels. Clogs, overflows, and increased maintenance costs became common, especially as handwashing rates rose in recent years.
In response, the hospital evaluated alternatives with hygiene as the top priority. Working closely with the Infection Control Board, facilities teams assessed hand drying options. While unfounded concerns about air dryers have circulated for years, a 2020 critical review published in the Journal of Applied Microbiology analyzed dozens of studies and found the evidence to be mixed and inconsistent, concluding that no data links hand drying methods to actual health outcomes. However, the review affirmed that proper handwashing followed by thorough drying is essential, as wet hands are far more likely to transfer bacteria.
Not all dryer designs perform equally. After evaluation, the Infection Control Board determined that traditional high velocity dryers, where hands are held beneath the airflow, offered a more hygienic solution than trough style units. This distinction was crucial in healthcare settings where surfaces must be minimized for contamination risk.
With approval in place, Northwestern Memorial Hospital began installing XLERATOR® high speed hand dryers across its campus. The results were immediate: plumbing issues tied to paper towel disposal were eliminated, restrooms became easier to maintain, and waste streams were reduced.
The impact extended beyond maintenance. A global survey conducted with MetrixLab found that cleanliness is the top concern in restrooms and that paper towels are the leading factor making spaces appear dirty, whether in overflowing bins or scattered on the floor. In healthcare environments, where perception is closely tied to trust, this carries added importance.
Following the switch, the hospital reported annual savings exceeding $20,000 in the initial phase from reduced paper towel usage. Additional benefits included lower storage needs, reduced transportation costs, and less waste handling. Over time, more than 120 dryers were installed across the main campus, with additional units planned for new facilities.
For healthcare construction and facility planning, the implications are clear: restroom design decisions do not operate in isolation. Choices around fixtures, materials, and systems must work together. Pairing low-flow plumbing with paper towels can introduce unintended consequences, while integrating high-efficiency hand dryers offers a more cohesive solution.
Architects and designers must ensure sustainability goals are not compromised by downstream maintenance issues. Facility managers gain an opportunity to reduce labor demands and eliminate recurring problems. Owners and operators reinforce the link between cleanliness, efficiency, and patient confidence. For procurement professionals, the shift moves budgeting from ongoing consumable costs to a long-term investment with measurable return.
Modern touchless hand dryers equipped with electrostatic HEPA (eHEPA®) filtration now provide an added layer of air quality control while supporting fast, effective drying without the waste of paper towels. In environments where infection control is paramount, this combination of performance and efficiency is increasingly significant.
The debate between paper towels and hand dryers is not new. But in healthcare, the stakes are higher and the variables more complex. When evaluated through the lens of infection control, plumbing compatibility, maintenance efficiency, and sustainability, the case for high-velocity hand dryers becomes clearer.
At Northwestern Memorial Hospital, the shift was not merely about replacing one technology with another. It was about aligning every element of restroom design with the broader goal of its campaign: clean hands every time, supported by systems designed to make that standard easier to achieve.
William Gagnon is the Executive Vice President and COO of Excel Dryer Inc.