Enforcing Public Health Law: Improving the Administrative Hearing Process to Reduce Staff Time


Impact Statement: 
Enforcement of food safety regulations plays a significant role in preventing food borne illness outbreaks. A local health department used the Lean method to increase efficiencies, standardize the process and reduce staff time and other costs for the administrative hearing process that enforces public health laws when a facility or restaurant fails inspection.

The aim of the initiative was to reduce staff time associated with the administrative hearing process from 6 hours per hearing to 5 hours per hearing in the Onondaga County Health Department's (OCHD's) Division of Environmental Health, Food Protection Section. In discussions with the quality improvement (QI) coach, the QI team decided to work with a local facilitator to use the Lean process for this project. The team began by creating a process map to outline the steps that occur from the time a restaurant or facility fails an inspection to the time a hearing is held. With the help of the facilitator, the team then completed a value stream mapping process to identify possible areas for improvement. The team prioritized these areas and brainstormed solutions for the top three. The three interventions involved procedural changes and an information technology solution. The two procedural interventions were successfully implemented and resulted in a savings of 15 hours of staff time for the 7 administrative hearings that were conducted over the 4-month intervention period. Before the interventions, holding 7 hearings would have required 42 hours of staff time. After implementing the two interventions, only 27 hours of staff time were required for 7 hearings. The time saved was calculated separately for each intervention. Additional savings of $220 in certified mail costs were realized during the study period. It has been recommended to the Commissioner of Health that the procedural changes be formally adopted and made permanent.

Organization that conducted the QI initiative: 

Shultz, R. Public Health Quality Improvement Exchange. Enforcing Public Health Law: Improving the Administrative Hearing Process to Reduce Staff Time . Wed, 05/28/2014 - 21:57. Available at https://phqix.org/content/enforcing-public-health-law-improving-administrative-hearing-process-reduce-staff-time. Accessed July 25, 2024.

Submission Status: 
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Grace Gorenflo's picture
Submitted by Grace Gorenflo on

This is a great example of the power of using a Lean process to reduce waste. Please share any additional information, if available, that you've collected since submitting this -- e.g., additional savings in staff time or costs, specific areas of potential replication, etc. Thanks for contributing!

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Submitted by sjarvis on

Great to see the focus on something many health departments work on. Administrative Hearings for KCHD are few and far between, but they do take time.

Recently, we've tried to break out of the standard fines/remediation/etc. and look at other ways we think we can meet compliance.

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Samuel Jarvis, M.S. LEHP, CERC
Emergency Preparedness Planner
Johnson County Public Health
855 S. Dubuque Street
Iowa City, Iowa

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