QI Leaders Academy Kaizen Program: The Frankfort 500

Summary

Impact Statement:

Franklin County Health Department (FCHD), a small local health department (LHD) in Kentucky, needed to improve the completion and timeliness of restaurant inspections to meet regulatory requirements. By using the Kaizen process and involving leaders from the LHD, the QI project team identified root causes and exceeded targets for improvement. Within 3 months of the week-long Kaizen event, FCHD environmental staff completed the last inspection that did not comply with the requirement of having an inspection every 6 months. As of February 15, 2016, the environmental staff members were on track for all food establishments to have two regular inspections in the fiscal year. Check out the great tools used and the PrISM summary of the project (included as an attachment to this QI initiative description).

Summary:

Ensuring that the community has safe, inspected food establishments is one of the most important public health activities that FCHD public health practitioners perform. Protecting the public’s health from foodborne illnesses and food handling violations is FCHD’s responsibility to Franklin County. FCHD staff live by the 10 Essential Public Health Services, and by having past-due inspections, they were failing to meet 2 of them. Before the Kaizen event, 134 food establishments had not recieved regular inspections.

The team used the Kaizen event approach to complete all steps of the improvement cycle in 5 days. The steps were as follows:

1. Understand the gap/goal and the current state in order to identify waste in the targeted work process.
2. Analyze the root causes of the prioritized issues to identify solutions.
3. Develop and test solutions to learn.
4. Continue to develop and test solutions to learn.
5. Install improvements and create a system for ongoing improvement.

As the event progressed, many QI and change management methods and techniques were applied.

FCHD planned to have all regular inspections of cost center 605 and 607 food establishments caught up by January 1, 2016. Starting on September 7, 2015, FCHD was behind on 34% of regular inspections. The team expected that by the end of 2015, inspections would be caught up, and current inspections would also be caught up.

Organization that conducted the QI initiative:

FCHD

Citation:

Parker, B. Public Health Quality Improvement Exchange. QI Leaders Academy Kaizen Program: The Frankfort 500. Thu, 11/16/2017 - 14:39. Available at http://www.phqix.org/content/qi-leaders-academy-kaizen-program-frankfort-500. Accessed April 24, 2024.

Background and Aim

Aim statement:

TO: Perform one regular inspection of cost center 605 and 607 food establishments every 6 months. FOR • General public • Franklin County food establishments • Franklin County environmentalist team • FCHD SO THAT • Foodborne illness decreases • Food safety knowledge increases among Franklin County food establishments HOW Beneficiaries: Restaurant owners, FCHD environmentalists What measured: Restaurant inspection history How measured: 2 years of Environmental Health Management Information System (EHMIS) inspection data are downloaded quarterly for 605 and 607 food establishments and grouped into 6-month periods How much: 100% of establishments have at least two inspections in a 1-year period By when: 4 months after the Kaizen event Actual: 2.5 months after the Kaizen event Beneficiaries: Environmental staff What measured: Prioritization How measured: Schedule timeliness By when: 4 months after the Kaizen event Actual: 2.5 months after the Kaizen event Conditions • Maintain the quality of the current inspections. • Ensure that inspection requirements meet state law. • Maintain inspectors' work within current budgeted hours. • Ensure that inspectors' other job duties will not be affected.

Need For The QI Initiative:

Public Health Accreditation Board QI Leaders Academy Kaizen program: This project was selected for Kaizen training and application.

Area for Improvement:

1. Starting Point • The continued rise in expired restaurant inspections is an ongoing gap within FCHD. • The director, QI plan, and performance management established the need. • The need is being measured by the weekly printout of Report 57. • Report 57 provides data on the delinquent food establishments. Because taxpayer dollars hold FCHD responsible for preventing, promoting, and protecting the community from having foodborne illness outbreaks, the QI initiative will have a key impact on the Franklin County community. • The expected scope of impact is the Franklin County community. 2. Vision • To have 100% of all restaurants inspected per state regulation each year using current staff. • All inspected establishments will have no violations. • No foodborne illnesses are reported from customers of Franklin County restaurants. 3. Current State Stakeholder: Customers Description: Establishments have not been inspected as frequently as regulations require. Data: Report 58 data Stakeholder: Financial Description: There is no money for another environmentalist, and more staff time is required to “catch up” on already-behind inspections. Stakeholder: FCHD staff Description: Staff are behind on inspections and have never completed a formal QI project. Data: Report 58 data Stakeholder: Society Description: Community members know that inspections are out of date. Data: Anecdotal

Root Cause:

See Sections 12 and 13 of the document attached to this QI initiative description.

Planning and Execution Details

Results

Measurable QI Outcomes:

On November 18, 2015, FCHD environmental staff completed their last inspection that did not comply with the requirement of having an inspection every 6 months. As of February 15, 2016, FCHD environmental staff are on track for all food establishments to have two regular inspections in the fiscal year.

Future Plans:

Area: Job aids What: Electronic boil water notice Who: Jenny By when: Checklist by December 31, 2015; reverse 911 by June 30, 2016 Area: Job aids What: Working with others Who: Brittany By when: Cards for environmentalists' desks by September 11, 2015; all-staff training by December 15, 2015 Area: Job aids What: Job aids for creating measure Who: Brittany and Morry By when: September 4, 2015 Area: Outreach What: Website/Facebook update Who: Becki By when: Facebook by September 8, 2015; website by January 2016 Area: Outreach What: Business cards with office hours Who: Priscilla By when: Stickers by September 10, 2015; reprint cards by a date to be determined Area: Outreach What: New signage posted on the door Who: Becki, Judy, and Brittany By when: Temporary sign by September 2, 2015; door wrap by October 30, 2015 Area: Outreach What: State journal article Who: Wes and Debbie By when: September 13, 2015 Area: Outreach What: Working on Wellness program Who: Environmental team, Debbie, and Judy (script) By when: Script by September 3, 2015; media release by September 5, 2015; air by November 30, 2015 Area: Outreach What: Board of Health reports Who: Brittany and Kendra By when: Quarterly report by November 19, 2015; spotlight by February 2016 Area: Outreach What: News & Views article Who: Brittany By when: September 30, 2015 Area: Outreach What: Phone recording and voicemail messages, e-mail signatures, and out-of-office updates Who: Becki (phone, voicemail), Jenny (e-mail, out-of-office updates) By when: voicemail by September 2, 2015; recording by September 11, 2015; e-mail signatures by September 11, 2015; out-of-office updates by September 11, 2015 Area: Outreach What: Content for Cable 10 scrolling ad Who: Judy By when: November 30, 2015 Area: Outreach What: Chamber newsletter Who: Wes By when: September 2, 2015 Area: Outreach What: Call matrix about ring numbers Who: Becki By when: September 3, 2015 Area: Outreach What: Obtain access to EHMIS for Brittany Who: Jenny By when: Request sent by September 3, 2015; access obtained by September 30, 2015 Area: Work process What: Develop master list Who: Morry and Brittany By when: September 4, 2015 Area: Work process What: Weekly planning meeting on Mondays Who: Kendra By when: October 5, 2015 Area: Work process What: Priscilla to teach food safety classes Who: Jenny and Priscilla By when: Hand off by February 3, 2016; ride along by February 3, 2016 Area: Work process What: Fax out-of-county dog bite records to the appropriate location Who: Priscilla and Jenny By when: September 8, 2015 Area: Work process What: Screen complaints (follow-up to regular) Who: Kendra By when: October 5, 2015 Area: Work process What: Meet weekly to set and review plan Who: Environmental team By when: October 5, 2015 Area: Work process What: Schedule for “disaster” time adjustments (who handles what if…) Who: Kendra By when: October 5, 2015 Area: Work process What: Justin Carey follow-up Who: Jenny By when: September 3, 2015

QI Leaders Academy Kaizen Program: The Frankfort 500

Summary

Background and Aim

Planning and Execution Details

Results

Information about the Community

Information about the Health Department

QI Staff Information

Accreditation Details

Contact Information of the Submitter

QI Spotlight

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QI Leaders Academy Kaizen Program: The Frankfort 500

Summary

Background and Aim

Planning and Execution Details

Results

Information about the Community

Information about the Health Department

QI Staff Information

Accreditation Details

Contact Information of the Submitter

QI Spotlight