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Scorecard System in Public Health Work
By James A. Tobey, Scientific Assistant, U. S. Public Health Service
HE scorecard system in pub- wants to be at the bottom of the
lic health work has now list, especially if it is to be pub
been in use for a number lished. Publicity is one of the of years and is increasing in scope most inspirational factors in health and influence. A scorecard for work. Even the announcement dairies was first used in Washing- that scores are to be published in ton, D. C., by Health Officer newspapers or bulletins causes a Woodward and soon produced ex- sudden increase in interest and a cellent results. In fact, scorecards decided improvement among those have proved useful and beneficial scored. To be fair, however, only wherever they have been skillfully an average of a number of inspecdevised and intelligently applied. tions should be published, as this They help to systematize the keep- procedure gives a man a chance to ing of records as they can be filed improve. Copies of the score for reference and they serve as a should always be sent to those who ready comparison of conditions have been inspected. which can be easily presented to The one objection which might the public.
be offered against the system is The advantages of the system
score is general and not are many. It assists the inspector specific. It is a form of standardby putting before him in black
ization but sometimes two equally and white the items he should
good places, as measured by relook for, SO that he overlooks sults like milk analysis with renone and soon learns to evaluate
spect to dairy scores, may be given the various factors of sanitary im- very dissimilar scores. A trained portance. It serves to instruct the
inspector, however, who has good person scored by attracting his at
judgment and common sense will tention to those points in which
usually get fair comparisons. Obhe is deficient. This is best done
viously, to prevent differences in by marking in red ink all scores
opinion due to the personal elewhich are below the allowable
ment, one man should wherever limit, while those which come up possible do all the scoring for a to standard are marked in black. set of inspections. Thus, at a glance he sees where bis faults are and his interest is
Scorecard Essentials aroused. If a card is marked only in black, too often it is placed aside
The scorecard itself should be for future perusal and then for
so framed that it covers the im
portant items of the sanitary code gotten.
which applies to that which is to be Stimulates Competition
scored. Incidentally, the code itThe system creates rivalry and self should be accurate and up to stimulates competition. No man
date. The card should likewise
be clear and so drawn up that the more important factors are phasized. Simplicity and concentration are important, but above all accuracy should be sought. A scorecard which gives a dairy ten points for odors in the barn and only one for small top pails is from the sanitary standpoint worse than useless.
The card should generally be
arranged in two parts, no matter what it is scoring, for these two main headings apply to anything worth scoring. They are “Equipment” and “Methods”. In some cases more divisions are used or indicate less directly these two points. Herewith are reproduced four original scorecards which are now in use and have proved satisfactory.
Possible Allowed I. Stables (15) a) Well lighted, 400 cu. ft. air per cow.
d) No contaminating surroundings. II. Milk House (10)
a) Concrete floor, light and well ventilated, screens.
a) Sterilized in steam, 5; scalded, 3.
d) Cans clean IV. Cows (17)
a) Tuberculin tested
d) Disposal of manure (at least 50 ft. from barn). V. Employees (23)
a) Free from disease, vaccinated for typhoid..
d) Milk dry handed...... VI. Milk (19)
a) Not poured in cow stable...
crer CT CT CT DO 1007 0907
St. Operated by..
Owner of building
Possible Allowed Source and condition at time Water and ice...
Milk and milk products. 10
From flies and insects.... 10
From dust, dirt, etc......
Storage rooms... Score
Allowed Toilet and washing facili30
ties for employees..
4 HEALTH OF EMPLOYEES:
Employees certified as free Possible
from disease by Score
Allowed aminer for Board of 15
Board of Health......
Storage, protection from
flies and vermin... 10
Collection or disposal.. Possible total score.... Total score allowed. Inspected and scored (date).
Scoring the Dairy The first of these is for dairies and was devised by the author. It differs from that of the U. S. Bureau of Animal Industry in that equipment is given 25 instead of 40 and methods 75 instead of 60, and the number of items is also reduced and condensed. The experiments of Dr. C. E. North of New York City have proved con
clusively that clean pure milk can be produced in an old wooden shack by means of proper sanitary methods, while dirty milk can come from a palatial, expensive stable. This has also been the experience of the writer, who has seen milk which gave a count of millions of bacteria per cubic centimeter come from a dairy that was in the certified class, while a small dealer with a tumble-down some psychological effect in good barn consistently produced milk equipment, for a clean whitewith about three or four thousand washed barn induces a man to atbacteria per cubic centimeter. tempt to practice cleanliness.
Dr, North's experiments have led him to recommend a dairy
The Other Cards score in which equipment is given The second scorecard shown only ten and methods ninety, but was devised for restaurants. It while concurring in his conclusions, emphasizes the health of smployees, the writer believes that the change an item which should be backed up is too radical for the present. The by requiring a medical certificate ideas of farmers and the vast from every food handler. Protecquantity of small producers must tion of food, source and condition be some what more gradually of same and garbage disposal are changed. If we wipe out our pre- also given prominence. The third vious teachings with one fell swoop, card is for barber shops devised as it were, the farmer will distrust when the author was health officer what we give him now and say of West Orange, N. J. In these that we
were wrong before and shops the relation of barber and probably are now. There is also customer is one of personal contact
BARBER SHOP SCORECARD
Possible Allowed 1. Well lighted (natural)
4 2. Well lighted (artificial).
3 3. Running water, hot and cold (allow 8 for heater)
10 4. Basin for washing hands..
8 5. Unconnected by door or hall with room used for other
business 6. Sanitary toilet (proper plumbing).
3 7. Screens, free from flies.
METHODS (65) 8. Mugs, shaving brushes, razors, clippers, etc... 9. Individual equipment for persons with skin diseases. 10. Hands washed before attending each customer. 11. Clean towel used for each customer. ... 12. No stick alum used..... 13. Employees clean, free from disease. 14. Floors, walls, furniture clean.. 15. Disposal of refuse.
Deduct for spitting on floor or other unclean action...
1. Above ground
Score Possible Allowed
8 8 4 5 4
METHODS (66). 7. Floors, walls, ceilings, windows clean... 8. Utensils, mixers, dough troughs, racks clean. 9. Protection of raw materials. 10. Mechanical mixer 11. Basin for washing hands, towels, sanitary plumbing... 12. Employees free from disease, clean in person, wear
clean uniforms 13. Handling of product during manufacture. 14. Handling of final product.. 15. Bread wrapped in bakery., 16. Delivered in sanitary condition.
and the opportunity for infection is By the new regulations, restaurgreat. They deserve more atten- ants and their employees are comtion than is generally paid to them. pelled to submit to inspections The fourth card is for bakeries whenever the health authorities deand is modified after that used in sire, and employees of restaurants Monteclair, N. J. Other uses of must submit to vaccination in case scorecards are in inspecting gro- it is deemed necessary. A fee of ceries and markets, ice cream fac- $1 will be charged for restaurant tories and laundries.
permits. Such inspections have
been going on for some time as a CHILLICOTHE INSTALLS measure of protection for the solMORE RIGID CODE OF
diers' health. SANITARY REGULATIONS Inspection of private as well as Additions to Chillicothe's sani
public wells is provided for, and tary code, growing out of the cam
any found unsanitary may be con
demned. Manure bins must be paign of sanitation which has been waged by representatives of the
elevated one foot, and must be United States Public Health Serv- emptied twice weekly from March ice in the Camp Sherman zone,
to November and once weekly have been approved by the board from November to
March. of health in that city.
Privies must be screened.