Running head: QUALITY PROJECT 1

Quality Improvement Project for a Hospital Kitchen: Cleaning and Sanitizing Procedures

Kacy Shaffer

Fontbonne University
QUALITY IMPROVEMENT PROJECT 2

Executive Summary

Proper cleaning and sanitation practices are important for reducing the risk of cross

contamination and foodborne illnesses. A quality improvement intervention was created to

improve these practices, specifically cleaning and sanitizing food contact surfaces and changing

sanitizing solution every two hours. These are two things that were not being followed

consistently in this kitchen. This was communicated to the staff at daily huddles and a monthly

meeting. Sheets were created for the staff to initial and a manager to check each shift.

Literature Review

In 2008, none of the Healthy People 2010 targets were reached for reduction in

foodborne pathogens. Getting staff to practice what they are taught is a major challenge to food

safety (Schilling, 2009). Some of the Healthy People 2020 objectives include, reduce infections

caused by key pathogens transmitted commonly through food and Increase the proportion of

fast-food and full-service restaurants that follow food safety practices that prevent foodborne

illness outbreaks. One evidence based recommendation for these objectives is handling foods

safely by following four steps: clean, separate, cook, and chill. Clean refers to washing hands

and surfaces often, which is the focus of this intervention (U.S. Department of Health and

Human Services, 2017).

Cleaning and sanitizing food contact surfaces is common knowledge among employees at

this kitchen. This includes cleaning and sanitizing knives, utensils, cutting boards, and

countertops when switching tasks as well as changing the cleaning and sanitizing solutions every

two hours or when food particles are in the solution. It is discussed often in the daily huddle and

meetings are held each month where these topics are reviewed. However, getting staff to follow

these food safety procedures is a challenge. The purpose of this intervention is to improve
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compliance with food safety procedures. At this kitchen, proper sanitation and cleaning

procedures are not followed consistently. Cleaning and sanitizing correctly is important for food

safety and to prevent cross contamination. It is important that staff understand how to clean and

sanitize correctly and that they consistently follow these procedures.

The overall goal is to improve sanitary practices for food contact surfaces. The desired

outcomes include correctly cleaning and sanitizing food contact surfaces at appropriate times,

changing sanitizing water every two hours, and cleaning work stations. Staff will clean and

sanitize food contact surfaces when changing tasks. They will also clean their work stations

before leaving, wiping off shelves and sweeping under counters. A cleaning list was created for

the staff to initial each day before they leave. This list will be checked by a manager who will

also initial before the employee leaves. After the list is created, the staff will follow these 90% of

the time to account for busy days when there is not enough time to complete the cleaning.

Materials and Methods

After weeks of observing practices in the kitchen, areas for improvement in food safety

were identified. The areas that were being followed the least included washing and sanitizing

food contact surfaces and changing sanitizing solution every two hours. The first step to address

this was communication with the staff. Each morning, there is a huddle where the managers talk

with the staff, teaching, updating, and reminding them about important dates. During these

huddles, staff were reminded the importance of cleaning and sanitizing properly and changing

the sanitizing water every two hours.

During a monthly meeting for all food service employees, an in-service was given on

proper cleaning and sanitizing. It was detailed on the steps of cleaning and sanitizing and when

to change the soap and sanitizing solution. There are 24 positions that work with food. Lists were
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created for these employees, shown in appendix A, to initial before they leave saying they

cleaned and sanitized their work station. Sanitizing sheets were also created, to be placed near

areas where soap and sanitizer buckets are used. These will be changed every two hours and the

sheet will be initialed.

There are four managers who will be responsible for checking that the sanitation

procedures are being followed. One manager is responsible for the tray line area, one is

responsible for the production area, one is responsible for the caf area, and one works in the

evening and is responsible for all areas. The staff will need to check out with a manager before

leaving, who will sign the cleaning sheet and check to make sure the sanitizer log is initialed.

Managers may use test strips to make sure that sanitizing solution is in range, which indicates

whether the solution is still effective. These sheets will be kept on file to keep track of how often

they are initialed. The responsibility is on both the manager and the employee to make sure the

tasks are being completed and not just initialed.

Results

Although the cleaning sheets and sanitizer solution logs were not implemented, there

were meetings and several huddles where the new expectations were discussed. There was a

noticeable difference in the cleanliness of work stations, including counters, shelves above, and

floors underneath being thoroughly cleaned. The sanitizer solution, however, was not being

changed, even after frequent reminders were given. Some staff began changing it more

consistently while others did not change it at all. These staff perceived that they did not have

extra time to change it although they spent a fair amount of time standing at their stations

socializing.
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The benefits to following these sanitation practices are decreased risk of cross

contamination and foodborne illness. This can prevent the kitchen from having to address the

consequences of a foodborne illness outbreak. An outbreak can cause loss of business and

economic losses (Hussain & Dawson, 2013). Through observation, a lot of down time was

noticed for both the staff and for managers. This indicates that the intervention would not have

negative economic consequences, such as more labor time being spent.

Discussion & Recommendations

The standards for the facility are to follow sanitation recommendations. The intervention

is addressing some areas where these recommendations were not being followed consistently.

After discussing expectations at the huddles and giving reminders, employees became more

consistent with cleaning their work station and changing sanitizing solution every two hours. If

this project were to be fully implemented, the preceptor and her four managers would lead this as

a team. This should continually be discussed at huddles, reporting on progress and areas for

improvement.
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References

Hussain, M. A. & Dawson, C. O. (2013). Economic impact of food safety outbreaks on food

businesses. Foods, 2, 585 589.

Schilling, B. (2009). The little things still matter. Retrieved from

http://www.foodservicedirector.com/managing-your-business/ensuring-food-

safety/articles/little-things-still-matter

U.S. Department of Health and Human Services. (2017). Food safety. Retrieved from

https://www.healthypeople.gov/2020/topics-objectives/topic/food-safety
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Appendix A

Tray Line Employees: Clean and sanitize work station,

wiping shelves and counters and sweeping underneath them.
Date:
Position Employee initial Manager initial
T1
T2
T3
T4
T5
T6
T7
T8
T9
T10
T11
T12

Date:
Position Employee initial Manager initial
T1
T2
T3
T4
T5
T6
T7
T8
T9
T10
T11
T12
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Production Employees: Clean and sanitize work station,

wiping shelves and counters and sweeping underneath them.
Date:
Position Employee initial Manager initial
P1
P2
P3
P4
P5
P6

Date:
Position Employee initial Manager initial
P1
P2
P3
P4
P5
P6

Date:
Position Employee initial Manager initial
P1
P2
P3
P4
P5
P6
QUALITY IMPROVEMENT PROJECT 9

Caf Employees: Clean and sanitize work station,

wiping shelves and counters and sweeping underneath them.
Date:
Position Employee initial Manager initial
C1
C2
C3
C4

Date:
Position Employee initial Manager initial
C1
C2
C3
C4

Date:
Position Employee initial Manager initial
C1
C2
C3
C4
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Appendix B

Sanitizing Solution Log: Change every two hours, then initial. Month:
Day 6am 8am 10am 12pm 2pm 4pm 6pm 8pm
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