New research conducted at the Harvard Business School found that 19 million foodborne illnesses and 51,000 hospitalizations, and billions of dollars in medical-related costs could be avoided each year if federal food safety inspectors do one simple thing: tweak their schedules.

The research is detailed in “How Scheduling Can Bias Quality Assessment: Evidence from Food Safety Inspections,” a paper co-written by doctoral student Maria Ibanez, and Mike Toffel, a Harvard Business School professor. The study was prompted by Ibanez’s own curiosity regarding how scheduling affects workers’ behavior, and how that affects their productivity and quality of their work, along with Toffel’s interest in studying the effectiveness of inspections of global supply chains and factories in the U.S. Although previous research seems to link the accuracy of third-party audits to the inspector’s gender and work experience, Ibanez and Toffel liked the idea of focusing on the effects of scheduling because it’s an easy fix for inspectors and their managers to implement.

Inspectors routinely visit restaurants, grocery stores, schools and other establishments that handle or serve food. Businesses that are found in serious violation of federal food safety regulations must correct their mistakes, or risk being shut down.

The researchers studied a sampling of data from Hazel Analytics, which gathers food safety inspections from local governments across the U.S. The sample included information on 12,017 inspections by 86 inspectors over several years; the inspected establishments included 3,399 restaurants, grocers, and schools in Alaska, Illinois, and New Jersey. The information contained names of the inspectors and establishments inspected, date and time of the inspection, and violations recorded.

Besides gathering this quantitative data, Ibanez supplemented that by spending time in the field with food safety inspectors, which allowed her to see first hand how they perform their jobs, the daily challenges they face, and how they make decisions regarding food safety violations.

The Findings:
Analyzing the food safety inspection records, the researchers found significant inconsistencies. Underreporting violations causes health risks, and also unfairly provides some establishments with better inspection scores than they deserve. According to the data, inspectors found an average 2.4 violations per inspection. Thus, citing just one fewer or one more violation can lead to a 42 percent decrease or increase from the average—and great potential for unfair assessments across the food industry, where establishments are judged on their safety records by consumers and inspectors alike.

On average, inspectors cited fewer violations at each successive establishment inspected throughout the day, the researchers found. In other words, inspectors tended to find and report the most violations at the first place they inspected and the fewest violations at the last place.

The researchers chalked this up to gradual workday fatigue; it takes effort to notice and document violations and communicate (and sometimes defend) them to an establishment’s personnel.

“The more inspections you have done earlier in the day, the more tired you’re going to be and the less energy you’re going to have to discover violations,” Ibáñez says.

They also found that when conducting an inspection risked making the inspector work later than usual, the inspection was conducted more quickly and fewer violations were cited. “This seems to indicate that when inspectors work late, they are more prone to rush a bit and not be as meticulous,” Toffel says.

The level of inspector scrutiny also depended on whatever had been found at the prior inspection that day. In short, finding more violations than usual at one place seemed to induce the inspectors to exhibit more scrutiny at the subsequent place.

With all of this in mind, the researchers’ solution is to reduce the number of daily inspections performed. Another suggestion is for inspections to be performed earlier in the day for the most high-risk establishments--schools or healthcare facilities--that serve the most vulnerable populations.

“Different scheduling regimes, new training, or better awareness could raise inspectors’ detection to the levels seen after they observe poor hygiene, which would reduce errors even more and result in more violations being detected, cited and corrected,” Ibáñez says.

The authors estimate that, if the daily schedule effects that erode an inspector’s scrutiny were eliminated and the establishment spillover effects that increase scrutiny were amplified by 100 percent, inspectors would detect many violations that are currently overlooked, citing 9.9 percent more violations.

“Scaled nationwide, this would result in 240,999 additional violations being cited annually, which would in turn yield 50,911 fewer foodborne illness-related hospitalizations and 19.01 million fewer foodborne illness cases per year, reducing annual foodborne illness costs by $14.20 billion to $30.91 billion,” the authors write.

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