“Proactive Public Protection: A Risk Based Approach”

Derek J. Jakovich, J.D., M.B.A., M.H.A.,

Manager, Patient Quality Care Unit, Texas Department of State

Health Services

Presented at the 2004 CLEAR Annual Conference

September 30 – October 2 Kansas City, Missouri

Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri

What Does A “Risk Based” Approach to Regulation

Mean?• Define “Risk” • Who or what do you regulate?• Identify your resources• Develop a risk matrix• Develop and implement a work

plan based on risk assessment• Evaluate your results

Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri

Risk Analysis

• Risk is defined as “the element of uncertainty in an undertaking.”

• Goal is to reduce the risk to the public that we are mandated to protect = Be Proactive!

• Analysis:- who should you “target” ?

- is there a mandated frequency of inspection?

- prioritize complaints based on risk

Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri

Risk Analysis Continued

– Is an onsite visit necessary?– Is self-inspection an option?– What is the average

inspection/complaint investigation time? How many?

– Are there any political factors to consider with certain regulated activities?

– Are there required response times?– Is it a heavily regulated activity ?

Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri

Know Who/What you Regulate

• Does the regulated activity affect a large or small # of the public ?

• Do you inspect? Conduct complaint investigations?

• Where is the licensed population – to focus resources where needed?

• What is the compliance history of the “targeted” group?

Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri

Resource Issues

• Adequate number of staff • Location of staff – regionally based,

central office, or even home based? • Staff experience• Budget ($$$)• Geographic limitations of state• Law and rules – enforceability issue

Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri

Risk Matrix• Develop a risk matrix tool which

identifies and analyzes the criteria which determine the level of risk associated with each regulated activity

• In the following example, every firm is assigned a risk assessment of high (6-12 months), medium (12-18 months), or low (18-24 months) to determine inspection frequency

• Assessment based on # value of key criteria associated with risk of food borne illness

Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri

Inspection Frequency Assessment/Profile

• Inspections of Retail Food Establishments in Texas

• 8 Criteria - type of facility - main menu items - type of water system

- type of sewage disposal - type of food preparation (POH)

- food served or sold - average # meals served per

day - population served

Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri

Inspection/Investigation Workload Plan

• Identify your data base inventory and determine who must be inspected and how often, e.g.., Firm X every 6 months, Firm Y every 18 months etc.

• Analyze your complaint workload, based on categories of assigned risk

• Focus resources where the greatest identified need is in the state

• Adjust work plan as appropriate

Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri

Evaluate

• Monitor and evaluate your work plan monthly, quarterly, yearly, and as needed

• Perform quality assurance/CQI on performance results, including feedback to staff

• Develop management reports to analyze efficiency, effectiveness, and resource utilization

Presented at the 2004 CLEAR Annual ConferenceSeptember 30 – October 2 Kansas City, Missouri

Proactive Public Protection: A Risk Based

Approach • Speaker contact information:

• Derek J. Jakovich, J.D., M.B.A., M.H.A.,• Manager, Patient Quality Care Unit

Texas Department of State Health Services1100 W. 49th Street, Austin, Texas 78756PH# (512) 834-6700, Fax# (512) 834-6736E-mail: derek.jakovich@dshs.state.tx.usWebsite: www.dshs.state.tx.us