Restaurant Grading Solutions: We Need Consistency

restaurant kitchen

After obtaining several million health department inspections, reviewing tens of thousands of health department reports, sifting through hundreds of health department websites, and analyzing dozens of scoring schema, we offer some conclusions.

For restaurant health department inspections to really be useful, we need consistency.

Consistency in a Score Card

The FDA has developed, over decades, a simple sample inspection report. The report has 56 key line items and is further divided into Foodborne Illness Risk Factors and Public Health Interventions and Good Retail Practices. Using this standardized report is the first key to consistency. In my blog titled Problems With Restaurant Food Safety Grading, I review variances we have found in food safety definitions.

There can be very few reasons not to use a universal score card and none of them hold any merit in the goal of improving the public health.

Consistency in Compliance Measurement

Compliance measurement consistency becomes a greater challenge. The first step in improving this is creating a database that allows analyzing for variability and assessing variance. As professionals, Health Department Inspectors are rightfully given latitude to make judgment on compliance. If noteworthy variance exists in the latitude and the application of compliance measurement, the scoring becomes less valuable in protecting the public safety, is unfair to the restaurant, and confusing to the public. Ultimately, everyone loses faith in the process. In my blog titled Problems with Restaurant Food Safety Grading, I discuss the reaction to this unfairness.

The Dr. Stueven’s Dining Grades database has identified major inconsistencies in compliance measurement. Between 97-100% of all inspections are perfect in multiple municipalities, yet the probability of getting a perfect grade in other municipalities may be as low as 28%. Periodic report cards on the inspector’s scoring range will point out variance, and is the second consistency key that will likely drive compliance measurement toward a norm.

Consistency in Reporting Results

In an article about restaurant letter grades in Los Angeles, Angelo Bellomo the director of the county’s environmental health program commented, “There is something very recognizable about the A, B, C letter grading and it’s something that people can relate to because they know what A, B, and C means from a lifetime of experience. If we can maintain the credibility of our letter grading in L.A. and actually enhance and improve it then I would say it’s better.”

The public can easily be confused by reports listing type and number of violations, demerits, numerical scores, color systems; words like intermediate, priority foundation, core, or adjectives like excellent, good, etc. We are likely all familiar with letter grades measuring performance. There is no logical reason not to use letter grades that allow for a spread of excellent to average or below. We are all familiar with grading on a curve. To divide and report inspections in any other way is confusing. Using a letter grading system is the third consistency key.

It has been challenging converting variant scoring systems into a letter grade, but with over 3 million health department reports in our database, Dining Grades has created adjustment rules, applied standard mathematical principles of distribution curves, and created a nationalized grading system.

Consistency in Access to Data

Universal access to health department data is essential for widespread public use. It is unreasonable to expect, and improbable, that the public will search municipality websites to search for this critical data. It becomes simply lost in a maze of websites. The public is left to rely on limited opinions of the public rather than expert evaluations of a restaurant’s food safety. In my blog titled Restaurant Grading is Difficult to Find and Understand, I discuss website variability. Our fourth and final consistency key is widespread but universal access and becomes essential for the public to embrace its value.

One of our goals at Dining Grades is providing a universal reporting system offering widespread access to health department data. That system and access has become a valuable resource for the public in choosing restaurants valuing food safety. As the Founder of Dining Grades, I welcome the opportunity to share our tool with other companies or organizations offering overlapping resources to the dining public.



Author: Dr. Harlan Stueven, MD

Harlan Stueven M.D. is a Board-Certified Emergency physician with sub-specialization in Environmental Toxicology and Board Certification in Medical Toxicology. Starting his career in the USAF, he served as a Flight Surgeon and Environmental Health Consultant Physician where one of his duties was monitoring food safety. In his nearly 40-year practice, he treated a range of medical, surgical and poisoning emergencies. He has been a Medical Director and/or Chairman of several hospital-based Emergency Medicine Departments, served as the President of Emergency and Environmental Medicine consulting group, a physician group Chief Financial Officer and sat on many national, state and local committees. Dr. Stueven founded Dining Grades and the Dining Safety Alliance to improve food safety by increasing awareness of food borne illness and the formation of partnerships within the food industry. He is a consultant to the Wisconsin Retail Food Establishment Grading Work Group; a Co-investigator in a CDC funded “Evaluation of Health Department Restaurant Inspection Programs” project. He has presented at several National, State and Regional conferences on restaurant grading and food safety. He is an accomplished leader, medical researcher, a champion of process improvement, author, and national and international speaker.

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