Spurred in part by a two-time victim of E. coli food poisoning, King County health officials have agreed to launch a new restaurant grading system that allows customers to get a look at the inspection status when they walk in the door.
Instead of searching through what critics say is a convoluted and confusing website, diners at the county’s 12,000 restaurants and food trucks will find storefront signs to tell at a glance where it’s safe to eat.
“We really want to respond to the public desire for this kind of information,” said Becky Elias, food and facilities section manager for Public Health — Seattle & King County. “The finish line is on the horizon.”
It won’t happen for at least a year and it’s not yet clear what the signs will say, but a group of health officials, restaurant owners and others who met last summer concluded their work last week with the mandate to move forward — cautiously.
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“We’re not going to go out there and just slap an A, B or C on it,” said Hilary Karasz, an agency spokeswoman. “We want to get it right.”
Experts say it’s harder than it appears to create a rating system that accurately reflects food-safety practices and translates them into symbols the public can recognize — and use. County officials plan to study the issue for several months and pilot a grading system by fall 2015, with plans to implement it fully in 2016.
The goal is to help prevent foodborne illness, which sickened nearly 400 people in Washington state last year, including 15 probable or confirmed illnesses in King County. Nationwide, some 48 million people get sick from food poisoning each year and 3,000 die, according to the Centers for Disease Control and Prevention.
Overhauling the county’s restaurant-inspection system can’t come fast enough for Sarah Schacht, 35, of Seattle, who started an online campaign last year demanding a publicly visible grading system and other changes.
Schacht contracted a dangerous E. coli infection as a child, when she was part of the notorious Jack-in-the-Box hamburger outbreak of 1993, and again in February 2013, after she ate at a Seattle Ethiopian restaurant that had a history of unsatisfactory inspections.
“If I had seen that placard, I never would have gone in,” said Schacht, who was one of three people sickened with the same type of E. coli 0157:H7 at the Ethiopian restaurant. Health inspectors closed the Ambassel restaurant weeks after those customers fell ill. (It is no longer in business.)
Schacht said she became severely ill, suffered internal bleeding and racked up at least $30,000 in medical expenses. Nearly two years later, she’s still suffering from the effects of the infection.
“Food poisoning is not just food poisoning,” she said. “It can cause death.”
It would have been difficult to know about the restaurant’s problems because the existing health-department website offers a “convoluted inspection ratings system that confuses consumers,” and doesn’t post scores at the restaurant sites, said Schacht’s petition. More than 2,000 people agreed, a response that got the attention of county officials, who were already considering revamping the inspection reporting system started in 2001.
“It strengthened the priority,” said Elias.
At least one international food-safety expert said an area like Seattle is long overdue for an upgrade.
“You’d figure the mecca of all things food would have a decent grading system,” said Doug Powell, a former Kansas State University professor who now lives in Australia, where he runs the popular barfblog, which focuses on food safety.
He’s one of only a few scientists who have researched restaurant grading systems. Powell noted that Toronto, Canada, has had a system for a dozen years. It’s based on color-coded cards that indicate green for pass, yellow for conditional pass and red for closed.
Still, designing a new grading system isn’t as simple as it sounds, Elias said. Even choosing a symbol can be difficult: In addition to letter-grade scores, and Toronto’s stoplight-coded system, other sites in the U.S. and around the world have adopted signs that rate restaurants with everything from stars and numbers to smiley faces.
In Norwalk, Conn., restaurants are rated with lighthouse symbols, with one lighthouse for poor performance and three for high compliance.
Even tougher is making sure that any new system encompasses all of the elements of a health inspection, from minor infractions to severe violations, and then conveys that information in a way that properly informs the public.
In King County, 55 inspectors conduct about 35,000 restaurant inspections a year, visiting from one to three times. They use a point system in which zero is perfect and a restaurant can be closed if it racks up 90 points or more.
Daniel E. Ho, a Stanford University law professor who has studied 700,000 restaurant inspections in 10 jurisdictions, including New York and San Diego, said there are challenges to creating a meaningful inspection ratings system.
“Despite grading’s great promise, we show that the regulatory design, implementation and practice suffer from serious flaws: jurisdictions fudge more than nudge,” he wrote in a 2012 paper in The Yale Law Journal.
In some places with grading systems, nearly every restaurant gets an A. Scores can be poor predictors of cleanliness down the road, Ho said. There also are questions about the consistency of scores among inspectors.
“What our research suggests is that there are some first-order issues to solve before simply transforming scores into grades,” said Ho, who is serving as an unpaid consultant to King County on the new ratings system.
In addition, evidence that letter grading has a direct effect on reducing foodborne illness is limited. The best evidence so far dates back to a 2003 paper in the Quarterly Journal of Economics, Ho said. Researchers found that implementing rating systems in the Los Angeles area in 1997 coincided with a 20 percent reduction in hospitalizations for foodborne illness. But more current research is needed, he added.
Any rating system must be both accurate and fair, said Josh McDonald, local government-affairs manager for the Washington Restaurant Association. Restaurant operators are worried that bad scores or grades could send customers fleeing and revenues plunging.
“In some cities, a C is perfectly normal, a C is great. But if you’re a consumer, what does a C mean to you?” he said.
In addition, the restaurant association doesn’t want a system in which a sign is based on a single inspection. Instead, it should reflect an aggregate score of several inspections, McDonald said.
Any new rating system will have to juggle those demands, Elias said.
“We don’t want to falsely imply a restaurant practices good food safety or falsely imply that they don’t,” Elias said.
Schacht, who works as a consultant on open-government issues, is a regular customer at Bus Stop Espresso in Seattle’s Roosevelt neighborhood. Elias Dotis, who has owned the shop for a year, said he’s in favor of changing the existing county inspection-records system because it “makes no sense.”
“A grade makes a lot of sense,” he said. “If you do it right, take the time.”
For her part, Schacht said, she plans to continue to push county officials to make sure a new system is implemented.
She points out that she was the only member of the public in the stakeholder group and felt a big responsibility to represent consumer interests — and to get something done.
“I don’t want it to be an eternal Seattle process,” she said, adding: “I have to bird-dog this. I have no room to let up.”