Author: jaustin

Tooele County Health Department
Size: 2 locations, 42 staff
Population served: 58,335

Plan
Identify an opportunity and Plan for Improvement

4. Identify Potential Solutions
A Cause and Effect Diagram was implemented to identify reasons for the low percentage of permitted clerks and to identify solutions.

the importance of having a valid permit and describing the penalties and consequences for not having a valid permit.

Getting Started
The TCHD recognized a need to improve the percentage of tobacco clerks in the county who held current tobacco handler permits. Baseline data was collected which showed that only 42.5% of clerks held valid permits. Data was collected through surveys administered over the phone and in person.

2. Assemble the Team
Abby Weymouth
Kim Clausing
Amy Bate
Jeff Coombs
Matt LaFrance
Malaena Toohey
3. AIM Statement: By September 1, 2014, the clerks who sell tobacco in Tooele County who hold a current tobacco handler permit will increase from 42.5% to 62.5%

4. Examine the Current Approach
In the old approach a tobacco clerk would have to come into the health department to take a test that was only offered once a month. If they had a conflict with their schedule they would have to wait a whole month before the test was offered again. Many tobacco clerks speak English as a second language and had trouble understanding test questions. The TCHD had no formal protocol for verifying if a clerk was permitted.

5. Develop an Improvement Theory
The next step was to conduct a Prioritization Matrix to determine which of the potential solutions would be most cost and time effective. The QI team discovered that penalizing retailers and clerks would be most time and cost effective.

Do
Test the Theory for Improvement

6. Test the Theory
The TCHD developed an online tobacco handler test in English and Spanish, developed a formal flow chart enforcement protocol for how to proceed with an unpermitted clerks during compliance checks, and developed form letters for clerks and owners explaining

Study
Use Data to Study Results of
the Test

7. Study the Results
In August 2014, the TCHD measured the % of current tobacco clerks in possession of a valid permit and found that it was 74% that held valid food handler permits. This represents an increase of 32% since November 2013.

Act
Standardize the Improvement and Establish Future Plans

8. Standardize the Improvement: The online food handler test, as well as the tobacco enforcement protocol, and the 2 form letters have all been standardized.

9. Establish Future Plans: Continue to monitor % of clerks with valid permits and train staff on new protocol.