1. Quality Improvement: Applied to Food, Lodging, and Institutional Sanitation Programs Larry D. Michael, RS, MPH Program Manager Dairy and Food Protection Branch

2. Quality Improvement Focusing on the process to improve the quality of the program. Why Focused (Positive) Employee Focused (Involving)

3. Why Conduct Program Reviews? Consistency Accuracy Effectiveness Local Program State Program Laws and Rules

4. Typical Scope of a Program Review Program administration and supervision Staffing and workload Employee training Inspection frequency and accuracy Outbreak investigation response and preparedness Complaints and reinspections

5. Typical Scope of a Program Review Technical and educational materials Documentation and filing Public relations and educational outreach Adequate and proper use of equipment

6. Quality Control Tools and Techniques Field Evaluation Inspection Control Charts Pareto Diagrams

7. Field Evaluation Inspections Improves consistency Interpreting laws and rules Improves Focus Risk Factors Food from Unsafe Sources Inadequate Cooking Improper Holding Temperatures Contaminated Equipment Poor Personal Hygiene

8. Field Evaluation Inspections Uncovers problems With an employee With a procedure With equipment With a policy With a rule/law

9. Measuring Food Protection Inspection data Overall scores Risk Factors Critical Item Violations (Return Visits) Foodborne Illness is a poor indicator Underreporting Milder cases undetected Role of foodborne transmission is obscured since foodborne pathogens may also be transmitted by water or person-to-person.

10. Control Charts Graphic display of results, over time, of a process. Can be used to monitor any type of output variable.

11. Pareto Diagrams A histogram ordered by frequency of occurrence. Pareto’s Law A relatively small number of causes will typically produce a large majority of the problems or defects. 80-20 Rule 80% of the effect is a result of 20% of the causes.

12. What do you do with the Results? Identify trends Why is it occurring? Refocus inspection Continuing education Most frequently violated items Why? Refocus educational efforts Compare over time for improvement Don’t forget to include the Positive

13. Quality Improvement Management Philosophy Management Method Investment in the Program

14. Questions Larry Michael (919) 715-0927 Larry.Michael@ncmail.n et