Reducing Critical Violations in Wicomico County's Food Service Facilities

Summary

Impact Statement: 
Wicomico County had a salmonella infection rate twice as high as the state average. Their QI project found that by focusing on reducing critical violations in retail food service facilities through increasing its outreach and education services to those facilities, the Wicomico County Health Department was able to decrease these violations that were the greatest threat to food safety in their community.
Summary: 
According to the state of Maryland’s State Health improvement Process, Wicomico County has a salmonella infection rate twice as high as the state average. Because the number of confirmed foodborne illness outbreaks has been low, the source of the high infection rate is unknown. In an effort to reduce this rate, the Wicomico County Health Department focused on reducing critical violations in retail food service facilities. These violations represent the greatest threat to food safety. The Department analyzed the data from 1,339 inspections conducted in 2012. Of all critical violations, 51% observed were attributed to improper cold holding of potentially hazardous foods. These foods were stored above the maximum temperature of 41°F, creating an environment that could promote the growth of dangerous pathogens. The Department focused on reducing the occurrence of this violation by increasing its outreach and education among the food service facilities. Promotional materials were developed and distributed to owners and managers. The core activities of the quality improvement (QI) initiative began in April 2013. In the short amount of time since then, the percentage of cold-holding violations has not changed significantly. However, the Department has improved its relationship with the facilities through increased communication. The root cause for the high number of cold-holding violations, and potentially salmonella infections, is the lack of managerial control in the facilities. Without being held accountable, food service workers neglect their responsibilities of monitoring temperatures at regular intervals. By incorporating the managers into the QI initiative, the Department hopes to increase their involvement in the food safety plan. Long-term monitoring of the violations will be required to ascertain the initiative’s effect on the rate of salmonella infections.
Organization that conducted the QI initiative: 
Wicomico County Health Department
Citation: 

DiCintio, D. Public Health Quality Improvement Exchange. Reducing Critical Violations in Wicomico County's Food Service Facilities. Fri, 02/16/2018 - 09:39. Available at https://www.phqix.org/content/reducing-critical-violations-wicomico-countys-food-service-facilities. Accessed February 24, 2018.

Submission Status: 
Completed
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Comments

marni's picture
Submitted by marni on

Research has demonstrated that food establishments with higher number of critical violations are correlated with higher levels of food borne-illness. This Maryland QI project to reduce critical violations by improving the outreach and education among the food service facilities about improper cold holding of hazardous foods, the health department’s highest type of critical violation. State and local health departments should consider adapting this promising practice in their food safety programs. Marni Mason

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jcpatterson's picture
Submitted by jcpatterson on

Interesting project, can't wait to see the outcomes of this project.

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Julia Patterson RN, BSN
Cabarrus Health Alliance
Accreditation /Quality Improvement Director

Submitted by brandi_wamhoff on

Hi Dennis,

Thank you for sharing this project.  I am doing a QI Training tomorrow with our Enviromental Health section and I was wondering, would you be willing to share the completed QI tools you used?  Specifically the cause and effect diagram, pareto, fishbone, and flowchart?  I think this group really could use some demonstrations to help them understand how QI is applicable to EH.  I know this is last minute, but if you have time, my email is wamhoffbrandi@co.kane.il.us.  Thank you!

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Brandi Wamhoff, MPH
Kane County Health Department
Data and Quality Coordinator