Morris Regional Public Health Partnership A mini-collaborative with the NJ Collaborative for Excellence in Public Health Measuring Customer Satisfaction of Risk 2 and 3 Food Service Managers

The Situation The goal for the Morris Regional Public Health Partnership is to improve the quality of regulatory inspections of Risk Type 2 and Risk Type 3 retail food establishments. A Risk Type 2 food establishment has a limited menu. A Risk Type 3 food establishment has a menu requiring the handling of raw ingredients and complex preparation that includes the cooking, cooling, and reheating of at least three or more potentially hazardous foods.

AIM STATEMENT By March 2011, 30% of Risk Type 2 and Risk Type 3 retail food establishment operators located in the MLC3 region will rate their satisfaction with the regulatory retail food program by completing and returning a customer satisfaction survey. Source: F8&source=univ&ei=9Ew4Taa9BpSugQeIq4CjCA&sa=X&oi=image_result_group&ct=ti tle&resnum=1&ved=0CB8QsAQwAA&biw=1131&bih=572

Plan a fishbone diagram (next slide) to pinpoint barriers and supports for the process Develop aim statement Create sub-committee of REHSs Develop survey Pilot survey Administer survey Evaluate

Fishbone Diagram

Do Survey developed Organized survey into sections – timing – performance – rules – enforcement The purpose of the survey was to gauge the satisfaction of the retail food operators with the health department regulatory inspections.

Do In May, 2010, the draft instrument was pilot-tested on a small group of Risk Type 2 and Risk Type 3 retail food establishment owner/operators at Mount Olive Township’s food handler class. Based on the comments and problems identified with the instrument, appropriate revisions were made to the instrument.

Do The final survey, together with a cover letter and a self-addressed stamped envelope, was mailed to a total of 570 Risk Type 2 and Risk Type 3 retail food establishments in: East Hanover Township Mount Olive Township Pequannock Township Randolph Township (color coded to differentiate Risk Type 2 & Risk Type 3 retail food establishments). The mailing also included establishments that contract with these municipalities and are located within Morris County.

Study After the target survey response rate of 30% was reached, the survey data was entered into a computer-based survey instrument (Zoomerang) where each question was statistically analyzed.

Retail Food Establishments as Recorded on 12/31/2009 Total Risk 2/3Number Number Who MunicipalityEstablishmentsRisk #2Risk #3 Responded to Survey East Hanover Township Mount Olive Township Pequannock Township Randolph Township Total Percentage Responded23.50%22.73%24.08%36.80% Morris Regional Public Health Partnership QI Project 10

Study Key findings: The most significant finding was that over 50% of the retail food owners/operators were seeking additional food handler/safety classes to be offered for their employees

Retail Food Owner/Operator Satisfaction Survey: I would like the health department to offer a food safety class for my employees.

Study Team members were also able to identify from survey results whether they were performing a quality inspection, and whether or not the restaurant owners were acquiring useful knowledge from the inspection process.

Study Findings of the survey: Restaurant owners preferred inspections to be conducted at times when the establishment is not busy. Request for more food handlers classes.

Act Educate food establishments during inspections why they need to be inspected when busy. Pilot county-wide food handlers class handlers.

Act In addition, the group will plan, develop and implement an on-line course in targeted languages for all food handlers interested in on-line training

Act The survey will be implemented yearly for ongoing customer satisfaction improvement.

Unanticipated Outcomes The involvement of REHSs from the four separate heath departments became advantageous, as all team members could provide useful information. By working collectively, the REHSs experienced the added benefit of gaining knowledge from each other, both for this effort and for other common work activities.

Next Steps The survey will be revised using a Likert scale and distributed to the remaining Morris County municipalities that have not yet participated Ongoing survey distribution to retail food establishments is likely, and additional surveys for other regulated entities is also being considered

Next Steps The REHS’s involved are considering implementing quarterly meetings for all REHS’s in Morris County since working with staff from the four health departments served to be a constructive addition to their profession.

Next Steps A comprehensive effort to provide food handlers education will be developed. This will include: – An in-class food handler’s course will be offered in English and Spanish to all interested food handlers

Next Steps An on-line food handler’s class, consisting of a comprehensive ‘Food Safety Training Manual’, pre and post-test, and final printable certificate upon passing the post-test.

Next Steps Distribution of the ‘Food Safety Training Manual’ during both regulatory inspections and during pre-operational inspections, so new food establishment owners/operators to gain food safety knowledge.

Team Members Kathy Nguyen, East Hanover Township Health Department Carl Reiners, Mount Olive Township Health Department Gail Gratzel, Pequannock Township Health Department Tim Zachok, Pequannock Township Health Department Stephanie Gorman, Pequannock Township Health Department Fatima Hurst, Pequannock Township Health Department Steve Widuta, Randolph Township Health Department

Morris Regional Public Health Partnership (MRPHP) Members Carlo DiLizia, Health Officer, President, MRPHP Mark Caputo, Health Officer,Vice President, MRPHP Peter Correale, Health Officer, Chairperson Program Committee, MRPHP Robert Schermer, Manager, MRPHP Carlos Perez, Health Officer, Morris County Office of Health Management Frank Wilpert, Health Officer, Mount Olive Township, Immunization Quality Improvement Project Leader

The Multi State Learning Collaborative Lead States in Public Health Quality Improvement is managed by the National Network of Public Health Institutes with support form the Robert Wood Johnson Foundation. Learn more about these activities at: