Years of poor handwashing in restaurants have resulted in unnecessary risk for operators. They have been exposed to unrelenting cost cuts under a banner of value-engineering solutions without any way to defend the most important values: safety and business continuity.
New technologies are at the ready to define the best-in-class consultant — the guys and gals who design kitchens capable of process control, even for handwashing. This group of leaders is respected for their design solutions, which carry forward well beyond the plan review process.
Trivializing handwashing is an ongoing threat in spite of the U.S. Centers for Disease Control and Prevention (CDC)’s advice that “handwashing is the single-most important means of preventing the spread of infection.” In other words, poor hand hygiene continues to be the restaurant’s number-one unresolved risk of an outbreak.
Operators typically manage their overall risk by looking at a projected income flow disruption, self-insuring a portion and buying commercial policies to fill gaps.
Risk managers for chain operations spend much of their effort on workman’s compensation issues. The frequency of these claims overwhelms concern for a much bigger but less frequent risk: food-borne outbreaks.
Case studies of outbreaks provide vivid documentation of costs, but operators often pay them no mind, working under the philosophy of “We haven’t had a problem” or “If we have an incident, we have an outbreak readiness plan in place, agreed upon by our legal and public relations departments.” In other words, they think they are fine just the way they are.
The HandsOn System’s Approach
A simple sequence of five steps provides a framework to assess the real risk of missed handwashes and sets up a sustainable solution: assess the risk, set standards, optimize by setting conditions for success, train and motivate staff and monitor the results.
This framework keeps the objective in focus at each step and provides a sustainable risk-based resolution. The process opens with an intuitive approximation for each step by experienced stakeholders. The sequence repeats again and again as drill-downs open eyes to new solutions. The HandsOn System analyzes everything from the strategic plan down to operational budgets and workflow.
This approach is an answer to the risks created by overzealous “value engineering” through which staff have been rewarded for productivity and cost savings without adequate consideration of the risks to the enterprise, with measured savings trumping unmeasured risk.
Solutions for Risk Assessment
Current practices in risk assessment tend to ignore those flowing from missed handwashes. First, it is not a subject of C-suite discussions. Variances from our standard? Near misses? This gap in executive awareness is the first symptom of a process that is out of control. It flies under the radar until a crash occurs without any warning. This breach in the defenses against foodborne outbreaks is not one of pure complacency, but it has simply slipped into a routine that now serves as an indicator of the current culture of cleanliness.
Poor handwashing is now an established standard, a habit from the boardroom to the dishroom. Breaking this habit starts with interrupting it long enough to seed a solution and attentively nurture the replacement behavior for at least three months.
A remodel or new construction provides one of the best stages for this transformation, an opportunity to break through the status quo. The foodservice designer brings forward a discussion based on construction objectives and risk-reduction opportunities. The first step might be a framework for a self-assessment to capture the views of multiple departments and set the stage for a collaborative view of risk-based process designs.
Setting Risk-Based Standards
Handwashing and high-touch surface cleanliness serve as starting points for setting up process control to minimize the threat of an outbreak. Handwashing for Life recommends a blend of HACCP and Active Managerial Control principles to identify, set and achieve those standards 24/7.
Operators should set an initial standard by documenting their current approaches to cleaning and monitoring high-touch, nonfood contact surfaces. We suggest food contact surfaces be similarly analyzed to provide a total picture.
Handwashing effectiveness can be measured and documented with a highly effective individual experience. Staff members simply apply a UV tracer like GlitterBug and then wash hands according to operator policy. Results are visually observed and transferred to a ProGrade template that serves as a record. The operator sets the passing grade that calls out the importance of handwashing technique and sets the minimum performance.
Handwashing frequency standards are set first by the workers, in groups of three to five people, after reviewing their work patterns and the infection susceptibility of those served. Numbers for an eight-hour shift are reviewed. Once agreed, it is divided by eight to normalize the standard as Hand Washes per Employee Hour: HW/EH. Supervision makes the final call.
Conditions for success should be established prior to starting a behavior-changing handwash initiative.
Hand sink location is critical, as requiring staff to travel long distances clearly discourages use. At high-risk food prep stations, the hand sink should be within three to five steps. Touch-free dispensers and faucets encourage frequent washing, as does supply quality. A clean, well-lit space is another helpful environmental inducement for positive action.
Reliability is another key often underappreciated by the purchasing value engineers. Equipment malfunctions, harsh soaps, disintegrating paper towels and empty dispensers are among the cues that reveal management’s true priority and give the staff a green light for skipping handwashes.
Train and Motivate
Good training and trainers have been long-standing hallmarks of the food industry, but realistic goals and a system of employee feedback have been missing. Why train without a measurable goal and performance feedback mechanism? Perhaps the wasted training budgets can fund the missing links of monitoring and a performance-based incentive system.
The ability to measure and monitor hand and high-touch surface cleanliness ties together all the critical environmental and behavioral factors required for sustainable solutions. Handwashing becomes a process with reportable elements, as discussed in the preceding section.
By virtue of electronic data gathering and wireless communication technologies, C-suite executives can now be added as resources in resolving the industry’s handwashing dilemma — risk versus efficiency. They represent the ownership and are the only ones who can define the acceptable risk, knowing it will never be zero. Their fiduciary responsibility goes beyond the short-term budget and calls on them to protect the long-term profitability and avoid brand-damaging risks. This is the core of sustainability.
Data-gathering technologies now include video, thermal imaging, infrared, RTLS (real-time location system), manual entry and combinations of those elements. Some require employees to wear individual badges.
Later this month, look for a demonstration of the equipment and process on the exhibition floor at The NAFEM Show.