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Operator Outbreak Protection: Specifying a Better Fence

Jim Mann's picture

How to stop the virus migration from the restrooms to the food.

Virus escaping from the restroom is a daily threat to restaurant business continuity. Keeping pathogens in the restroom and off the menu – and the owners out of court – starts with the consultants who understand the threat and design for integrated best practices.

The virus is clearly the primary predator on a long list of pathogens putting restaurants at risk. Most viruses start in the restroom with invisible particles of fecal matter. For years the focus has been on bacteria and the kitchen’s food-sourced pathogens. But viruses are much smaller, more virulent and harder to control than bacteria. As the battlefront changes, so must hand-washing standards and practices.

Viruses come in the front door and the back door and meet the unsuspecting customers in what we call The Xchange – the service and restroom areas. Consultants and operators are responding by specifing more integrated designs, with fewer holes in the now porous pathogen fence.

It is not surprising when you look at the overwhelming statistics on norovirus and hep A, that we see this response from the Centers for Disease Control (CDC) indicating that hand-washing is the single most important means of preventing the spread of infection.

Poor hand hygiene is the virus’ best friend. It’s all about escape, survival and the chain which starts in the restroom: fecal-hand-oral. Hands are the documented bridge for the migrating virus. Holes in the operator’s hand hygiene fence, always dangerous, often invisible, are easy to identify and worth fixing.

The back door is wide open.

The ill employee is the first major hole in the virus fence. Luckily, employers have made major strides in improving implementation of sick worker exclusion policies. However, often such employees may not show any symptoms (asymptomatic) and thus, penetrate this first line of defense. A rigorous, aggressive and highly visible handwashing program is the required response. A vaccine program, as used in Las Vegas, can take the hep A virus off the table and should be considered, especially when operating or building in endemic areas.

The second flaw in this operator fence is the lack of a consistent approach. Most all operators will boast of their handwashing training, beam at the question of certified managers, but go silent when asked about their handwashing system. Without a system, what do Quality Assurance and third party auditors monitor? Where is the customary documentation to review? What are the standards?

Plugging the no system hole starts with Operations, QA and Risk Management convening to put the known risks of poor hand hygiene into the context of their own business, their menu, their facility, their customers, their purchasing policies and their managers’ effectiveness in motivating and controlling their staff. The operation’s tolerance for risk should be included in this baseline discussion. The basic task for this meeting is to start converting the staff’s food handling practices into a Safe Level of handwashing, the number of handwashes per shift that will likely keep us out of the courtroom. This standard can now be monitored by simply placing a digital counter in the soap dispenser. Local managers can now add this line to their Quality Assurance/Operational reporting and highlight dangerous deviations.

Good hand hygiene behaviors are best achieved with equipment and products that make it easier for the staff to consistently do the right thing. Convenient, touch-free hand hygiene dispensers are good examples: handsoap, paper towel and electronic faucets. Added to the hygienic factor are time and water savings which normally cover their investment in the first year.

Quick access to fused-bristle nailbrushes and well-fitted NSF approved gloves will improve compliance.

Staff training is an important factor now that standards are in place. The effectiveness and sustainability of training will be multiplied by having Safe Level standards accompanied by a monitoring system. What gets measured gets done!

The front door virus.

Keeping the ill employee off the foodservice premises continues to be difficult. Keeping ill customers at bay is impossible. Just ask the cruise industry and their health inspectors – the CDC’s Vessel Sanitation group. It is the passengers and their microbes that are turning ships back to port for costly decontaminations.
Customers are increasingly protected by operator leaders who are placing hand sanitizers at entrances, at play areas and at the head of serving lines. Recent research indicates much better effectiveness for ‘synergized’ alcohol hand sanitizers than previously estimated.

The Xchange area virus

Restrooms are a critical repository of viruses that arrive through both the front and rear doors. Almost all viral outbreaks start in a home or an away-from-home restroom. Again, fecal-hand-oral is the pathway. As contaminated or sick customers return from restrooms to their table, a chain of contamination is ignited as servers and bussers cross-contaminate with innocent touches of service.

Consider these three common situations:

  1. Mom is thrilled as the family is dining out today. Junior is coming down with something, but the symptoms aren’t severe at the moment. She decides that they will go anyway.
  2. A person driving along endures a sudden and powerful stomach cramp. It could be explosive. Where is the nearest port to weather the oncoming storm? Here’s a restaurant and its restroom.
  3. Who spends the most time in the restroom – the sick or the healthy?

Cleaner surfaces > cleaner hands > safer food.

Restroom cleanliness is increasingly affecting the consumer’s choice in away-from-home dining.

This article was originally published in the 2007 NAFEM issue of The Consultant magazine.

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