Patchwork is most often used to make quilts, but it can also be used to make rugs, bags, wall hangings, warm jackets, cushion covers, skirts, waistcoats, and other items of clothing. Some textile artists work with patchwork, often combining it with embroidery and other forms of stitchery. When used to make a quilt, this larger patchwork or pieced design becomes the "top" of a three-layered quilt, the middle layer being the batting and the bottom layer the backing. To keep the batting from shifting, a patchwork or pieced quilt is often quilted by hand using a running stitch in order to outline the individual shapes that make up the pieced top, or the quilting stitches may be random or highly ordered overall patterns that contrast with the patchwork composition.