Leadership Forum Members
Safe Levels for handwashing must be set prior to food-service productivity rates. Both the quality and frequency of handwashing are important Best Practices to measure and monitor. In this case, specifying electronic faucets for employee convenience and food safety resulted in unexpected savings — enough to pay for the Best Practices faucets.
See your potential savings:
Blending available resources into an effective protocol.
From a Food Code perspective there is but one handwash. We like to think of it as a minimum and one of perhaps many. Handwashing For Life designates a soap-water 15 second hand wash, with a 2.0 gpm flow of warm water and paper towel drying, as its Core Hand Wash. Depending on risk, adjustments are made at the operator level to exceed the minimum where required.
Technically, a handwash is blend of four factors, four resource categories:
Sometimes training handwashing feels futile and frustrating. For the professional who daily works through this repetitive task, we found a parallel image from back in Greek mythology. Sisyphus, the king of Corinth, was charged with rolling a stone uphill for eternity.
Luckily for our dedicated handwash trainers, their toil has a more rewarding outcome, especially when they introduce performance standards and incorporate success into staff rewards.
Light duty hand cleaning may increase frequency
The Model Food Code serves as a minimum standard, providing a foundation on which operators can build solutions tailored to their operation and their assessment of risk.
There is an unresolved handwashing dilemma in the Model Food Code in that it prescribes the same wash whether the hands are very lightly contaminated (visibly unsoiled) or are heavily soiled. The identical 15 second scrub time is specified for both.
Intuitively this doesn't make sense to the kitchen staff. Some, perhaps many, compensate by not washing at all when hands are seen as unsoiled. This likely accounts for over half of the 8.6 hand washes per employee hour identified in a CDC observational study as the number required to conform to the Model Food Code. (J Food Prot. 2006 Oct;69(10):2417-23)
How should innovation be treated in a regulated environment?
SaniTwice® as an alternative protocol for soap/water handwashing was rejected by at least one of the Conference for Food Protection (CFP) Council III delegates because SaniTwice works best with patented Purell VF-481. This is based on its unique effectiveness on norovirus, the leading pathogen in foodborne outbreaks.
In reality, the SaniTwice protocol potentiates all alcohol hand sanitizers as it simply adds a cleaning step.
There are three shortcomings in the Model Food Code that are exposed in this 7 year pursuit of a protocol immediately accepted by the US military, for whom it was originally developed:
Simplicity of installation is a distinctive feature of CloudClean's wireless hand wash monitoring technology. It encourages trial by making it easy to install and use. And it just got easier with the introduction of two even simpler systems with the same degree of accuracy and reliability. This family of innovation is now known as CloudClean's ...
Standard - Team monitoring without requiring identification badges. Full description will follow.
Ehanced - Individual monitoring. Description under development.
Premium - acknowledges the circumstance. Reports compliance ratio to the required behavior. It is the system decribed here and the option covered in this video clip and schematic.
It is based on a combination of RFID (Radio Frequency Identification) and IR (Infrared) and requires wearing a badge.
The most successful foodservice operations have learned the value of teammanship.
Helping kitchen teams self-monitor their handwashing rates motivates enhanced behaviors. These two team options collect actual handwashing counts at all the non-restroom handsinks via an electonically enabled soap dispenser such as GOJO's SmartLink which connects to a variety of data processing and reporting technologies. The dispenser numbers are gathered wirelessly, time-stamped by location, totaled, and then divided by the number of employee hours to yield a Handwashes per Employee Hour rate, HW/EH. Tailored reporting can also provide handwashes per handsink, per hour, per unit or per meal served. This can be extended to compare different restaurant locations and be rolled up for an enterprise view.
Handwash monitoring by observation has been an important component in understanding employee handwash behaviors but it is not a stand-alone solution to motivating more handwashing. Handwashing rates in most of the foodservice industry are less than desired by the operators themselves.
Increasingly the away-from-home dining public is appreciating the visual acts of staff handwashing and glove changes. Some operators are building an action plan to raise hand and high-touch surface cleanliness from being an expense up into the revenue row.
Can this be a business differentiator?
Confirmed by the presiding doctor, salmonella drifted through his system, finding the knee cartilage as a long-term harbor to feed, breed and accumulate. The result was a full knee replacement.
FDA's Captain Wendy Fanaselle took attendees of the Food Safety Summit on a research guided graphical trip of the restroom to emphasize the importance of killing the fecal-pathogens before they escape into public areas.
Toilet paper, designed by those more concerned about flushability than its barrier properties, doesn't do the job. Single or double ply, soft or strong, research indicates pathogens still escape the basic maneuver and often proceed beyond the restroom doors.
Toilet paper is an advance over at least three of its earlier substitutes:
The Southwest Environmental Health Association, during their 2013 annual meeting, volunteered to help establish a reference number for restaurant outbreaks due to poor hand hygiene. The group, largely local, state and national regulators, was asked What percentage of foodborne outbreaks are attributable to poor hand hygiene? They were given these choices: 20%, 40%, 60% or 80%.
Defining a safe level for handwashing frequency
Norovirus outbreaks commonly raise this question: What is a safe level for handwashing frequency?
If we look to the FDA for answers, the Model Food Code wisely avoids getting over prescriptive, considering all the variables.
The CDC conducted a valuable observational study using the Model Food Code as its benchmark. They concluded 8.6 Handwashes/Employee Hour (HW/EH) were required to be code-compliant, a total of 69 Handwashes per 8 hour shift
This led to other questions: Is the Model Food Code already over-prescriptive or truly risk-based? Would this level of handwashing be in conflict with customer service? In general, a level of 8.6 HW/EH is seen as too much to ask of employees. Regulators generally agree.
More effective use of tongs and wraps can lower the need for handwashing but the basic issue remains. Some situations, like following restroom use, clearly demand a good handwash. A casual touch of the face or hair is a lot less risky yet the Code specifies the same handwash for both. Is that risk-based or inspection based?
A frequency rate target of 8.6 HW/EH discourages reasonable, attainable compliance improvement. It protects the status quo. "Don't let perfect be the enemy of good."
We believe the Food Code in this case should prioritize the risks by establishing categories of High, Moderate and Low. Operators then set up a controllable process based on risk, a process to which they are committed.
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