Improving the Environment and Keeping Local Politicians Happy: The Solid Waste Code Enforcement Process Improvement Project


Impact Statement: 
TPCHD sped its response time for solid waste complaints, resulting in greater protection of the public’s health, better customer service, and greater accountability to its community members.

The solid waste code enforcement program at the Tacoma–Pierce County Health Department (TPCHD) responds to reports of solid waste and onsite sewage issues, ranging from illegal dumping or improper storage of solid waste to septic systems that are actively failing and discharging sewage to streets, neighborhoods, and waterways. Timely response and resolution of these issues is important for public health—few things are more fundamental to public health than proper waste and sewage management. Timely response is also important to complainants, the community, and elected officials.

The program team used a quality improvement (QI) approach to decrease the time to resolve solid waste complaints to improve customer satisfaction with health department solid waste services and ultimately to lead to improved vector control. The project team received just-in-time training on QI concepts, followed a rapid cycle improvement/Plan-Do-Study-Act (PDSA) method, and used multiple QI tools including workflow analysis, Pareto charts, and fishbone diagrams. The team re-evaluated its overall process map, then identified, tested, and implemented shortening the default time-to-first-inspection date (time between an initial “warning” letter and the first onsite inspection). This implementation required several process modifications to expedite complaint intake, generation of letters out of the agency’s data management system, and review of inspector field areas and routing.

The project resulted in a significant increase in the percentage of solid waste code complaints responded to within 20 days and an overall decrease in the number of days to resolve solid waste code complaints.

Organization that conducted the QI initiative: 
Tacoma–Pierce County Health Department

Sherman, J. Public Health Quality Improvement Exchange. Improving the Environment and Keeping Local Politicians Happy: The Solid Waste Code Enforcement Process Improvement Project. Mon, 12/11/2017 - 13:56. Available at Accessed June 21, 2024.

Submission Status: 
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Submitted by John Sherman on

A couple of follow-up items:
Since the date of this project, the trajectory (rate of increase) in complaints to which this program responds has moderated. Our ability to maintain service levels is in many respects a function of the significant multi-year investment in technology (field computers and automation) and extensive analysis of program work-flows. Consistent application of QI principles and tools by all levels (field staff, administrative support, and supervision/management) have allowed this program to continually identify process and outcome efficiencies. These successes have resulted in this workgroup assuming additional environmental health 'enforcement' responsibilities, and consulting with still other programs as they design/implement their regulatory/enforcement systems.

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