Restaurateurs had their moment in the New York City political sun today, and wasted the opportunity with a barrage of complaints about the unfairness of restaurant inspections as well as the letter grades.

They could have said, most of us take food safety seriously, we’re proud of our establishments, so proud that we want to work with health types to make the system better, and we want to brag about our great food safety.

More representative of the 300 people who filled a City Council chamber today was Dimitri Kafchitsas, who heads a group of 1,000 restaurants in New York City: The average food-safety visit “feels like a criminal raid and not an inspection. There is a lack of sensitivity.”

More sensitivity and less in-your-face? In New York City?

NYC could have saved itself some grief by doing some significant consumer and food service research before launching the system and figuring out what kind of disclosure would work best for New Yorkers (we did this in New Zealand).

A major criticism from restaurateurs has been the city's imposition of significant fines for issues that they say have no bearing on food safety. Among them have been fines for inadequate lighting, employees' drinking beverages while on duty, leaky faucets, leaky faucets, broken tiles and open doors.

Risk-based, consistent inspections are a problem in every municipality and state. Work on it; improve the system. But don’t just whine.

The City's health commissioner Thomas Farley told the hearing (from a prepared statement), “I know that you will hear complaints today from some restaurant owners. But just imagine this scenario: Salmonella cases are up 14 percent; the number of restaurants with rodents has increased by 50 percent and viral videos of rats in kitchens dominate the web; and restaurant sales are plummeting.

What would happen? The Council would hold a hearing and demand to know why the Health Department wasn't doing its job. You would describe horror stories of constituents getting sick, and you would demand swift action. And you would be right, because my job is to protect the health of New Yorkers.

Fortunately, the opposite scenario is happening right now. Since restaurant grading began, salmonella cases are down 14 percent. The Department's website shows that 72 percent of restaurants have received the top grade for cleanliness. Restaurant sales are up almost 10% since grading began, increasing by $800 million. And 91 percent of New Yorkers say they support restaurant grading.”

Daniel E. Ho, a professor of law at Stanford and a visiting professor of law at Yale this spring, takes a stab at suggestions for improvement, writing in the New York Times this morning that the well-intentioned system is broken.

“Along with researchers at New York University, Stanford and Yale law schools, I have studied data from more than 500,000 inspections of more than 100,000 restaurants from the last few years in nine jurisdictions: Austin, Tex.; Catawba County, N.C.; Chicago; El Paso; Florida; Louisville, Ky.; New York City; San Diego; and Seattle. Our research examined the process for tallying violations and the consistency of inspections across repeat, unannounced visits to the same restaurant. In a critical dimension, New York performed the worst of the nine.
At their core, the inspections work similarly across the jurisdictions. From once to a few times a year, a health inspector shows up unannounced to tally health code violations, like failure to wash hands or to maintain food temperatures. If violations amount to a public health hazard, the restaurant may be shut down until they are resolved.

“Our examination found key deficiencies in New York’s inspection system.

First, the score a restaurant gets in New York says little about how it will perform in the future. Grades are based on a point system: in New York, 0 to 13 points yields an A, 14 to 27 points a B, and 28 or more points a C. In other jurisdictions, numerical scores substantively predict future scores. In San Diego, for example, prior scores account for roughly 25 percent of the variation in future scores. But New York is an outlier: Prior scores predict less than 2 percent of the variation in future scores. New York City’s posted restaurant grades therefore fail the most basic criterion: they communicate little about future cleanliness.

Why such inconsistency? Although the jurisdictions share broad similarities, the details of New York’s inspection process are far more complex. There are more inspectors (some 180, not all of whom necessarily specialize full time in restaurant inspections), more violations to score and far wider point ranges for each violation.

“While San Diego, for example, has a single violation for vermin, New York records separate violations for evidence of rats or live rats; evidence of mice or live mice; live roaches; and flies — each scored at 5, 6, 7, 8 or 28 points, depending on the evidence. Thirty “fresh mice droppings in one area” result in 6 points, but 31 droppings result in 7 points.

“To reduce imprecision, the city should apply the key insight of grading — simplification — not only for information consumers, but also for information producers — i.e., the inspectors. To increase efficiency, the city should abandon inspections for the purpose of resolving grades and instead redeploy those resources to focus on the worst offenders. It’s time for grade reform.”

OK. Get on with it. Restaurant managers, health types and consumers need to figure out how best to improve the system. But disclosure is here to stay.

Filion, K. and Powell, D.A. 2011. Designing a national restaurant inspection disclosure system for New Zealand
. Journal of Food Protection 74(11): 1869-1874
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http://www.ingentaconnect.com/content/iafp/jfp/2011/00000074/00000011/art00010
The World Health Organization estimates that up to 30% of individuals in developed countries become ill from contaminated food or water each year, and up to 70% of these illnesses are estimated to be linked to food service facilities. The aim of restaurant inspections is to reduce foodborne outbreaks and enhance consumer confidence in food service. Inspection disclosure systems have been developed as tools for consumers and incentives for food service operators. Disclosure systems are common in developed countries but are inconsistently used, possibly because previous research has not determined the best format for disclosing inspection results. This study was conducted to develop a consistent, compelling, and trusted inspection disclosure system for New Zealand. Existing international and national disclosure systems were evaluated. Two cards, a letter grade (A, B, C, or F) and a gauge (speedometer style), were designed to represent a restaurant's inspection result and were provided to 371 premises in six districts for 3 months. Operators (n = 269) and consumers (n = 991) were interviewed to determine which card design best communicated inspection results. Less than half of the consumers noticed cards before entering the premises; these data indicated that the letter attracted more initial attention (78%) than the gauge (45%). Fifty-eight percent (38) of the operators with the gauge preferred the letter; and 79% (47) of the operators with letter preferred the letter. Eighty-eight percent (133) of the consumers in gauge districts preferred the letter, and 72% (161) of those in letter districts preferring the letter. Based on these data, the letter method was recommended for a national disclosure system for New Zealand.

Filion, K. and Powell, D.A. 2009. The use of restaurant inspection disclosure systems as a means of communicating food safety information. Journal of Foodservice 20: 287-297.
The World Health Organization estimates that up to 30% of individuals in developed countries become ill from food or water each year. Up to 70% of these illnesses are estimated to be linked to food prepared at foodservice establishments. Consumer confidence in the safety of food prepared in restaurants is fragile, varying significantly from year to year, with many consumers attributing foodborne illness to foodservice. One of the key drivers of restaurant choice is consumer perception of the hygiene of a restaurant. Restaurant hygiene information is something consumers desire, and when available, may use to make dining decisions.

Pete Snyder told the Chicago Tribune he's not a fan of publishing the results of spot inspections online because "there is no evidence that posting does any good."

Instead, he favors a system where employees are trained by food service managers in controlling safety hazards, then demonstrate their mastery of the procedures to an inspector.

"This is the only effective full-control program," said Snyder, founder of the Hospitality Institute of Technology and Management in St. Paul, Minn. "The reason inspectors don't do this and (instead) simply inspect for things is because it takes too long."

What evidence is there that Pete’s program does any good?

What evidence is there that all those food safety messages repeated ad nauseam, especially during the holidays, do any good? (None)

What evidence is there food safety training programs do any good? (it’s mixed, but fairly lousy; more on that in a month).

In Sept.. 2007, my friend Frank was running food safety things at Disney in Orlando, and asked me to visit and speak with his staff.

“Doug, I want you to talk about food safety messages that have been proven to work, that are supported by peer-reviewed evidence and lead to demonstrated behavior change,” or something like that.

I said it would be a brief talk.

There was nothing – nothing – that could be rigorously demonstrated to have changed food safety behavior in any group, positive or negative. Everything was about as effective as those, ‘Employees must wash hands’ signs.

Chapman finally showed a food safety message can be translated into better food safety practices at food service; but that took direct video observation. After exposure to food safety infosheets, cross-contamination events went down 20 per cent, and handwashing attempts went up 7 per cent. We controlled for various factors as best we could.

Pete is right in that “there’s no evidence that posting does any good” but only because there’s no evidence that most things do any good.

I want to figure out how to best collect evidence that is compelling and meaningful, right or wrong.

We’ve reviewed the literature, we’ve trialed a disclosure program in New Zealand, and compiled a lot of anecdotal evidence from restaurant patrons and managers who say public disclosure of inspection grades keeps everyone awake. It can’t be linked to lower or higher rates of foodborne illness, despite some attempts to do so, but public disclosure does seem to insert some consideration of microbial food safety into a national conversation of food that is dominated by porn.

I haven’t figured out how to measure that.

Snyder did say that a restaurant with multiple, back-to-back failed inspections is "an indication the manager isn't paying attention."

Maricopa County, which includes Phoenix, Arizona, has decided to scrap a longtime scoring system that informed customers how restaurants across the Valley performed in health inspections.

The Arizona Republic reports inspections of the 22,500 food establishments in Maricopa County are still taking place, monitoring things such as kitchen cleanliness, safe food handling and rodent control. But county officials say the voluntary award system that went along with it - one designed to help diners gauge which eateries had the best scores - didn't accurately reflect how restaurants performed.

The system gave gold awards to restaurants that were among the top 10 percent of their peers in health-inspection scores. A silver award went to those in the top 20 percent. Those outside the top 20 percent did not get an award.

John Kolman, director of the county's Environmental Services Department, said the decision to scrap the old system was prompted by a new health code, a new computer system and criticisms of the old scoring system by the local restaurant industry.

In recent months, he said, county officials met with representatives of the restaurant and hospitality industries to find out what kind of scoring systems they would favor. Kolman said he hoped to propose alternatives later this month and post them on the department's website for citizens to vote on.

He said his agency is considering a system that would give "A, B, C or D" awards, similar to systems implemented by California and New York.

Jonathan Fielding, director of the Los Angeles County Department of Public Health, said, "In trying to develop a system, the most important question to ask is: How do you provide the most protection against food-borne illnesses? That should be the question, rather than, 'Does the restaurant industry like it?' "

And Mr. Kolman of Maricopa County, rather than just asking the restaurant industry, you may want to ask public health types, and consumers about the kind of grading system they would find valuable. To get started on you research, here’s a review paper.

Filion, K. and Powell, D.A. 2009. The use of restaurant inspection disclosure systems as a means of communicating food safety information. Journal of Foodservice 20: 287-297.

Abstract
The World Health Organization estimates that up to 30% of individuals in developed countries become ill from food or water each year. Up to 70% of these illnesses are estimated to be linked to food prepared at foodservice establishments. Consumer confidence in the safety of food prepared in restaurants is fragile, varying significantly from year to year, with many consumers attributing foodborne illness to foodservice. One of the key drivers of restaurant choice is consumer perception of the hygiene of a restaurant. Restaurant hygiene information is something consumers desire, and when available, may use to make dining decisions.
 

Canberra’s cute enough; really boring on weekends, even if Elvis Costello is playing in a park. In the late 19th century the Australians decided they needed a federal capital, and eventually picked a sheep farm halfway between Melbourne and Sydney.

Like Washington, D.C., the Australian Capital Territory is a unique government structure all its own. Although located within the Australian state of New South Wales, which includes Sydney, ACT and the federal capital of Canberra can apparently make its own rules – at least regarding restaurant inspection disclosure.

A senior health official told the Canberra Times that Canberrans must not be told which of the city's restaurants were deemed too unhygienic to serve food, because naming them would undermine the rule of law.

Earlier this year, ACT Health suppressed the identities of up to 10 eateries it shut down in 2010, saying naming the businesses could cause them ''unreasonable'' harm.

The Canberra Times, which had sought access to the list under freedom of information law, appealed against the initial decision, citing interstate and overseas governments that used ''name-and-shame'' policies to encourage food safety.

Health Minister Katy Gallagher agreed in February to consider introducing laws similar to those in NSW, where food businesses that fail hygiene inspections are named on a government website.

However, the deputy head of the ACT Government's health directorate, Ian Thompson, has now ruled out revealing last year's worst offenders, saying to do so might unfairly influence a trial.

In reviewing the earlier decision to censor the businesses' names, he dropped the argument that disclosing their identities would unreasonably affect them.

But he invoked his power under the FoI Act to suppress documents ''affecting enforcement of the law and protection of public safety.”

The censored reports show officials issued 63 warnings in 2009 and 2010 to businesses that failed hygiene checks. Inspectors also banned up to 10 eateries last year from serving food, because they had either ignored warnings or posed ''a serious danger to public health''.

Mr Thompson allowed only one of them Dickson's Domino's Pizza store to be named, because it had already faced charges in court. That franchise now has new managers.

The reports' most common criticism was that kitchens lacked a sink and soap for washing hands.

However, several of the documents described filthy and vermin-infested workplaces, where rotting scraps were piled behind fryers and meat was stored in dangerously warm fridges.

Meanwhile, Restaurant and Catering Australia has panned the effectiveness of name-and-shame registers such as NSW's, saying it sometimes punishes innocent businesspeople. Chief executive John Hart said yesterday the NSW laws were flawed because they ''have no gradation.”

However, Mr Hart said a so-called ''scores-on-doors'' or hygiene ratings scheme would help the public.