ADVANCEMENT OF THE PRACTICE
THE PRACTITIONER’S TOOL KIT
The Art and Science of Inspection: A Short Introduction
ments. Using the food safety example, this objective involves conducting a mini plan re- view as part of the prelude to the inspection by scanning the menu and assessing if the kitchen equipment and layout can handle the complexity oered to the public. It is dicult to do sushi justice in a pizza parlor. Understanding the purposes and objec- tives of an inspection is only the starting point. There are goals that ensure inspec- tion accuracy, repeatability, and fairness. The most important of these goals is also the most dicult to understand—the goal to develop a predictive model to evaluate potential risks to the health of the public. This goal requires approaching the inspec- tion process without bias (for which we are all guilty). Because most regulations are not absolute and their outcomes are not com- pletely authoritarian, no situation fits neatly into a regulation box. Consider the variability of time as it relates to temperature in food safety, as well as other considerations such as water activity and pH that might contribute to compliance. There- fore, try approaching an inspection with a null hypothesis in which everything is com- pliant at the onset of the inspection. It is then our professional knowledge, observation, and monitoring skills that identify the deviations from the ideal. We need to be impartial and if possible, completely objective. We under- stand there are regulatory criteria that require yes or no answers. But even with these cri- teria, allow for a degree of objectivity, along with an explanation. Approaching an inspec- tion with the null hypothesis helps avoid the most common type 1 statistical error of James J. Balsamo, Jr., MS, MPH, MHA, RS, CP-FS, CSP, CHMM, DEAAS Nancy Pees Coleman, MPH, PhD, RPS, RPES, DAAS Brian Collins, MS, REHS, DLAAS Gary P. Noonan, CAPT (Retired), MPA, RS/REHS, DEAAS Robert W. Powitz, MPH, PhD, RS, CP-FS, DABFET, DLAAS Vincent J. Radke, MPH, RS, CP-FS, CPH, DLAAS Charles D. Treser, MPH, DEAAS
Editor’s Note: The National Environmental Health Association (NEHA) strives to provide relevant and useful information for environmental health practitioners. In a recent membership survey, we heard your request for information in the Journal that is more applicable to your daily work. We listened and are pleased to feature this column from a cadre of environmental health luminaries with over 300 years of combined experience in the environmental health field. This group will share their tricks of the trade to help you create a tool kit of resources for your daily work. The conclusions of this column are those of the authors and do not necessarily represent the ocial position of NEHA, nor does it imply endorsement of any products, services, or resources mentioned.
W hen we introduced this column in 2022, we promised to share tricks of the trade that we take into the field that are based on good science and use a practical, common-sense approach to environ- mental health practice. In fact, the topics we oer started as mistakes, misinterpretations, or blatant errors in our practice. The columns are based on what we learned as we set out to make it right. Over the years, the most significant of our embarrassments was the realization that we lacked instruction on how to inspect. As we said before, we are all quite adept at interpreting codes, rules, regulations, and policies. Unfortunately, applying this skill did not come with an owner’s manual. Tradition has it that we learned to perform inspections from a mentor, who learned from a mentor, and so on ad infinitum. The very definition of inspection gives us an idea of how to use it and apply it as both an art and a science. So please, bear with us as we reintroduce this ba- sic structure of an inspection and try to make it as painless as possible. To begin, an inspection is more than an electronic tablet or clipboard, pen, inspection form, and a gimme-cap. There is nothing rou- tine about a routine inspection. Simply put, an inspection is observation and verification.
That is, checking or testing against established standards—regardless of the type of inspection (and yes, there are other categories of inspec- tions)—in an objective manner that embodies scientific methods. Therefore, imagine every inspection as a miniature thesis with two pri- mary purposes. The first purpose is to identify the change in circumstances or arrangements, whether at a restaurant, on-site disposal site, private well, tattoo parlor, or day care center. The second purpose of an inspection is to identify human error, failures in equipment and procedures, or policies and practices that present a risk to human health, safety, or well- being. Our job is to do this work within the backdrop of applicable regulations. All inspections have a primary objective, which is to determine if practices and con- trols are adequate to meet requirements and whether the client implements and consis- tently maintains those practices and controls. The best example of this primary objective is measuring time and temperature and ob- serving personal hygiene habits, particularly handwashing. The secondary objectives of inspections are to identify areas of potential improvement and to evaluate eectiveness in meeting requirements, as well as determine the facility’s capability to meet those require-
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Volume 86 • Number 4
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