. "Appendix F: Quality Improvement and Proactive Hazard Analysis Models: Deciphering a New Tower of Babel." Patient Safety: Achieving a New Standard for Care. Washington, DC: The National Academies Press, 2004.
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Patient Safety: Achieving a New Standard for Care
the entire food production process—from receiving food products from vendors, through holding, storage, cooking, and preparation, through service to the patients/residents, visitors, and workers. Ivins points to a number of types of entrees in which HACCP has made a significant impact in reducing the risk of foodborne illness. She believes HACCP has been used to safely prepare ground meat and chicken in a way that prevents diseases, including E. coli, salmonella, and campylobacter; to use luncheon meats safely; and to develop methods to ensure the safe cold storage of hot foods.
To keep the program on track, Morrison uses a comprehensive system of internal and third-party auditing with customer service feedback. Critical Control Points and corresponding acceptable physical constraints are established for each part of the process. Temperature, holding/storage time, storage location (e.g., raw food stored below cooked foods), labeling criteria (e.g., name and expiration date), as well as strict guidelines for cleanliness, disinfection, and hygiene of both the facility and food service workers are all important criteria within Morrison’s HACCP compliance process. Morrison also audits its vendors by checking and documenting the temperature of a minimum of 10 percent of all potentially hazardous foods at the time of delivery by the vendor.
Morrison’s regional directors of operations are responsible for ensuring that each account is monitoring and documenting compliance with HACCP guidelines. Quality assurance management plays a key role, including keeping a policies and procedures manual readily available, posting food safety signage and professional information, and providing a certified food safety manager at each site. All monitoring and documenting are vital to complying with current HACCP guidelines and in determining if the processes and HACCP should be modified to mitigate variations of existing or newly identified hazards.
Ivins sees the long-term gains from Morrison’s use of HACCP as the comfort of knowing the company is serving quality, safe food to patients/ residents, clients, and employees and a well-educated supervisory and service staff.
Hazard Analysis and Operability Studies
HAZOP has been successful in identifying security threats in certain safety-critical information and communication technology systems.26 CORAS27 (risk assessment of security critical systems) has used HAZOP for information security risk analysis involving medical databases and telemedicine. Areas include (1) authentication procedures (e.g., password poli