Increasing the Efficiency of Environmental Health Program Inspections Through Use of Tablet Technology

State: FL Type: Neither Year: 2015

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DOH-Broward Environmental Health section conducts approximately 20,000 inspections per year in 15 different programs including Drinking Water, Wells, Public Pools, Coastal Beach Monitoring, Onsite Sewage and Disposal Systems, Mobile Home Parks, Rodent and Arthropod Control, Food Hygiene, Group Care Facilities, Tattoo and Body Piercing Establishments, Biomedical Waste, Radiological Health, Tanning and Sanitary Nuisance Complaints. The inspection process included hand entering data onto an inspection form then manually bubbling in the same data onto a Scantron form for scanning in the office. Once this process was accomplished, a copy of the inspection report would be mailed to the facility owner. DOH-Broward also utilizes a multitude of internal and external databases and information sources to inform and guide the programmatic activities. This process was very time consuming and costly due to the price of postage and staff time thus diminishing the capacity to effectively provide the Ten Essential Services in all areas.  Supervisors met to evaluate various methods to improve efficiencies if the process.  The Environmental Health Supervisor researched alternative means of conducting inspections that would provide timely results and improve efficiencies of the program. Pen tablets were purchased for 4 field staff to evaluate the effectiveness of a implementing a paperless program. The objective was to decrease office time thus increasing field time which would free up staff to provide more services, increase the ease of data gathering, and decrease the amount of time to deliver inspection reports to owners thus decreasing the violation correction time. The project also evaluated the cost savings of postage and paper form printing costs. Through initial evaluation of the 4 pen tablets, it was determined that use of tablets was a more effective and efficient delivery ensuring the Environmental staff were able to offer the Ten Essential Services of Public Health. Additional field tablets were ordered to include a total of 15 field inspectors.
The Florida Department of Health in Broward County (DOH-Broward) is one of sixty-seven county health departments under the State of Florida Department of Health and is the official public health agency of Broward County, Florida. According to www.census.gov, Broward County’s estimated population in 2011 was 1,780,172. The population served consists of all ages; from infants to senior citizens. The intent of the paperless inspection project was to more effectively provide the Ten Essential Services to the public and better communicate inspection results and compliance requirements to the owners. An additional intent included a cost savings in time, postage, and supplies. DOH-Broward Environmental Health section issues approximately 9,768 operating permits yearly that utilized the pen tablet project. The permit breakdown is as follows:• Public Pools – 4,321 entities• Tattoo - 99 entities• Tanning - 38 entities• Biomedical Waste – 3,642 entities• Body Piercing - 37 entities• Group Care - 705 entities• Mobile Home Parks - 119 entities• Food Safety - 971 entities The Food Safety program affects 100% of all school age children attending both public and private schools. This program also includes inspections of bars and movie theaters which a large number of the population attends which includes visitors and residents. The Public Pool program routinely inspects pools located in apartment complexes, condominiums, townhomes, home owners associations, parks and recreation centers. This is another program which affects a large portion of the population.The Biomedical Waste program inspects all facilities which generate biomedical waste. These include but are not limited to the following; doctor’s offices, hospitals, veterinary clinics, labs, dental offices, funeral homes, and tattoo establishments. This program also affects a large percentage of the population. Prior to implementation, data from 2008-2013 was examined. It was determined that staff had issues with the amount of office time required to complete the inspection forms, difficulty in getting data needed to complete the inspections, and efficiency of delivery of results to the owners. Administration also observed the cost effectiveness of a paperless system cutting costs such as postage, hard inspection forms, printing costs and labor costs to efficiently deliver the Ten Essential Services. In evaluating alternative methods of gathering data in a more efficient manner, these factors were considered and a pilot program of using pen tablets to conduct field inspections was implemented. The inspection process included hand entering data onto an inspection form then manually bubbling in the same data onto a Scantron form for scanning in the office. Once this process was accomplished, a copy of the inspection report would be mailed to the facility owner. DOH-Broward also utilizes a multitude of internal and external databases and information sources to inform and guide the programmatic activities. This process was very time consuming and costly due to the price of postage and staff time thus diminishing the capacity to effectively provide the Ten Essential Services in all areas.  Supervisors met to evaluate various methods to improve efficiencies if the process.  The Environmental Health Supervisor researched alternative means of conducting inspections that would provide timely results and improve efficiencies of the program. Pen tablets were purchased for 4 field staff to evaluate the effectiveness of a implementing a paperless program. The objective was to decrease office time thus increasing field time which would free up staff to provide more services, increase the ease of data gathering, and decrease the amount of time to deliver inspection reports to owners thus decreasing the violation correction time. The project also evaluated the cost savings of postage and paper form printing costs.
Food Safety
The goals of this project in regards to community collaboration are to better communicate inspection results and violation correction requirements in a timely and cost efficient manner. In doing so, violations are able to be promptly addressed to ensure public safety. Customer service improves due to decreased wait times for receipt of inspection reports. Affected entities included Public Pools, Tattoo establishments, Tanning facilities, Biomedical Waste entities, Body Piercing facilities, Group Care, Mobile Home Parks, Food Safety entities. As a result of this project, inspection reports are e-mailed to the designee immediately following the inspection. There is no longer a need to manually enter hand written results and correction requirements. This new process has shown to eliminate the misinterpretation of handwriting and clearly communicates any re-inspection dates and what violations need to be corrected and why which has improved overall safety of programs inspected. The project software has the ability to e-mail the results of the inspection to other community stakeholders including management companies, board members, managers, staff assistants as well as owners. This ensures better communication with the party directly responsible for correction and to let all interested parties know that an inspection has occurred and the results thereof.Start up costs for this project were $2,903.23 each pen tablet and increased the number of field visits the inspectors could make as their office time decreased. Program travel costs also decreased as a result of this project.  To achieve this goal required data gathering. Correct e-mail addresses for over 9,000 entities had to be collected and properly entered into the environmental health database. In collecting email addresses, inspectors were able to email the inspection report directly to the inspected site immediately upon inspection. Prior to implementation of the pen tablet program, formal training on the database was performed for the staff. To this day, constant communication with the regulated entities continues to ensure up to date contact information is correct. The entire process of training, purchasing and preparing equipment for use and data collection took approximately one year from 2012-2013.  This has also eliminated the need for postage costs which has resulted in a postage saving of $9,000 plus the costs of materials.
The main lesson learned from this project is that accurate and faster communication is the key to quicker compliance which protects public health and ensures enhanced and efficient delivery of the Ten Essentials Services. The paperless system has improved service delivery in comparison with the system of manual inspection entries. Manual entering data on inspection forms leads to errors and misinterpretations by the regulated entity. Clear and concise reports contribute to better and faster compliance. Using pen tablets in the field frees up additional field time for doing inspections in that office time has decreased. Since 2009, the DOH-Broward Environmental Health program percentage of inspections completed has risen from 63.25% to 99.89%. These percentages are based on quota reports from the DOH Environmental Health Database System. There is also a cost benefit to this paperless project. There is an overall savings of $7,271.54 compared to the previous manual entry system of conducting field inspections. Through regular communication with the regulated entities for contact information updates this system has and will continue to demonstrate enhancement of the delivery Ten Essentials Services.
The startup cost breakdown is as follows:• 15 Panasonic pen tablet computers x $2,903.23 = $43,548.45• 15 extended warranties x $225.00 = $3,375.00• 15 styluses x 31.88 = $478.20• 15 docking stations x $318.00 = $4770• 15 mouse and keyboards x $88.61 = $1,329.15• 15 carry bags x $32.99 = $494.85• Total startup costs = $53,995.45Cost/Benefit AnalysisCosts• The computer equipment is replaced every 4 years• Startup cost $53,995.45/4= $13,499.86 per year expenseSavings Benefit• Postage savings 9000 inspections x .47 = $4230.00 per year• Postage savings re-inspections 2700 x .47 = $1269.00Total postage savings per year = $5499.00• Inspection forms cost savings 11,700 forms x .12 = $1404.00• Each inspector now spends one hour less in the office and one hour more in the field providing better service, communication and 1 to 2 additional inspections per day. • $17.79 per hour x 780 hour per year = $13,868.40• Total costs per year = $13,499.86• Total savings per year $20,771.40Savings – Costs = $7271.54 overall savings per year The pen tablet program saves the Environmental Health program an average of $7,271.54 per year. Lessons learned is that Senior Leadership realized the importance of using existing or piloting emerging technology to complete field inspections and providing the inspection reports in a timely manner. In doing so, public safety is improved and customer satisfaction increases. Therefore, this program will continue, is sustainable, and meets the DOH-Broward mission “to protect, promote, & improve the health of all people in Florida through integrated state, county, & community efforts”.
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