An Efficient Certificate: My Lean Six Sigma Yellow Belt Certification

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Jillian Regan, consultant at Rillian holding her Lean Six Sigma Yellow Belt certification from the Technical University of Munich (TUM). Photo © Jillian Regan 2018.

I recently got my Lean Six Sigma Yellow Belt certification from the Technical University of Munich (TUM) through an online course offered by TUM on the edX platform. I admire how the certificate itself and the process of obtaining it was highly efficient, exemplifying the ideas of Lean and Six Sigma, reducing waste and reducing variation in quality improvement.

Lean and Six Sigma are two separate, but related philosophies in the quality improvement and management realm across a variety of different industries. I was first introduced to the concept in the healthcare industry and in the field of public health.

Wanting to further my knowledge and be able to better apply the data and fact driven quality improvement Lean and Six Sigma tools to improve my performance and range of services offered as a consultant, I decided to get certified in Lean and Six Sigma.

I found that an online series of three courses offered by TUM through the edX platform was the most efficient and cost effective way to gain this certification. Online courses allowed me to work my continuing education around my work schedule. Also the cost was low enough to not waste or strain the resources of a fresh, innovative, new consulting agency for providing professional growth and development for its consultants. 

I also thought it would be interesting to take online courses from a German university, TUM, with professors from backgrounds in industries, such as manufacturing, that I am not experienced in as I learned of Lean and Six Sigma from a public health and healthcare background, thus providing a different perspective.

Today Lean and Six Sigma are often combined, and I wanted to be able to provide the combined effect that has been shown to reduce costs, improve customer, client or other stakeholder satisfaction with quality control and continuous quality improvement in processes, services, or products in the projects I work on.

Though they are often combined, Lean and Six Sigma are two separate, but related philosophies. It can be useful to differentiate between the two.

Lean focuses on reducing waste while Six Sigma focus on reducing variation, such as variation in a process, product, or service that is out of specification. Variations are often considered to be errors or mistakes, depending on how far out of specification the variation is and how the variation affects the process, service, or product. 

My Lean Six Sigma Yellow Belt certification from TUM efficiently lists out and differentiates which topics covered in the series of certification courses I took fall under each umbrella: Lean or Six Sigma. Most professional continuing education certificates do not include such detail, which causes wastes in time or an increased risk of error in understanding what topics were included in the course(s) that the certification was obtained through. The listing out of the topics on my Yellow Belt certificate allows me to easily, efficiently, and with a reduced chance of errors in listing the topic under the wrong umbrella, list them out in the table below if you are curious to learn which umbrella each topic falls under.

Differences between Topics in Lean vs Six Sigma at the Yellow Belt Level

Lean
Six Sigma
Continuous Improvement (Kaizen)DMAIC = Define Measure Analyze Improve Control
 8D Problem SolovingSIPOC
 Value Stream MappingProcess Mapping/Flow Diagram
3 Ms: Mura, Muri, MudaProbability Distributions
Poka Yoke SolutionsDescriptive Statistics
Visual ManagementPlots (Pareto, Scatter, Time Series)
Workplace OrganizationProcess Capability: Yield, ppm, DPMO, Sigma Level
Capacity Analysis, Little’s Law Inductive Statistics: Confidence Intervals, Hypothesis Tests
 Queuing TheoryLinear Regression / ANOVA 
Setups and BatchesDOE
Mixed Model ProductionFailure Mode and Effect Analysis
JIT/Pull SystemsSPC, Control Charts
Scheduling Pull SystemsControl and Response Plan
KanbanDesign for Six Sigma
Total Productive MaintenanceTolerance Design
Single Minute Exchange of DieProject Identification and Definition
Overall Equipment Effectiveness Critical-to-Quality Parameters, Customer Expectations, VOC, Kano

It has taken a longer than expected amount of time to post about getting Lean Six Sigma certified consultant becoming certified at the Yellow Belt level because I have been busy getting Jill + Ian’s bicycle rental service started — a service that Rillian provided research and development for and is now being added as a service provided by of our affiliated businesses, Jill + Ian–and applying Lean Six Sigma principles to the service from the start to improve access to bicycles through a quality focused and innovative bicycle rental service.

However, due to the application of Lean and Six Sigma principles in my photography business, Jillian Regan Photography, LLC, I was able to quickly and efficiently add photos to complement this blog post.

Jillian Regan, consultant at Rillian, has been very busy getting Jill + Ian’s bicycle rental service started–a service that Rillian provided research and development services for–and only just now had time to pose for a photo with her Lean Six Sigma Yellow Belt Certificate and her bicycle. Her bicycle is available for rent through Jill + Ian’s Bicycle Rentals. Photo © Jillian Regan 2018.

Conclusion

Getting my Lean Six Sigma Yellow belt certification from TUM through the edX platform was an efficient way to improve my performance as a consultant and be able to better offer data driven quality improvement technical assistance and support and consulting to other organizations.

The certificate itself is created to reduce waste and variation by efficiently listing out the topics covered under Six Sigma and Lean and details not normally included on a professional continuing education certificate itself for easy and efficient access and comprehension. 

 

Community Driven Population Health Improvement Efforts with Health Equity & Cultural Competence: Healthy Food Programs in Sitka, Alaska

public health accreditation board healthy food programs systems health equity
Shoppers, vendors, and fresh produce at a Farmer’s Market. Photo © Jillian Regan 2017 courtesy of Jillian Regan Photography, LLC.

Community driven population health improvement efforts that include a health equity lens as well as cultural competence in their programs and initiative work to address population health issues. Through a community driven, collaborative approach, essential stakeholders as well individual citizens provide valuable insight, data, research, ideas for ways to address the population health issues, funding, and gives the stakeholders more of a stake and ownership of the programs and initiative. When  health equity is taken into account, programs and initiatives can be designed to provide additional help those who may be at a higher risk of a certain issue or at more of a disadvantage in some way than others in the same community. Looking at examples of real-world examples of a community driven, health equity focused population health improvement efforts can provide better understanding of and ideas for practical ways to do this in one’s own community.

The Sitka Health Summit’s healthy food programs are a one example to of a community driven population health improvement programs that include a health equity lens.

healthy food programs systems community health public health accreditation board health equity
Eggplants and vendor at table at a farmer’s market. Photo © Jillian Regan 2017. courtesy of Jillian Regan Photography, LLC.

The Sitka Health Summit, is an ongoing, community driven population health improvement annual event that started in 2008 in the small, coastal town of Sitka, Alaska (population 8,863 as of 2015). The Summit was began through a partnership between Sitka’s two hospitals. Local citizens identify and decide on two health initiatives to work on in the next year during the Summit. Each initiative is then funded with a $2,000 grant with the funding for the grant provided by the two hospitals as well as other community organizations. At many of the Summits, health issues relating to lack of access to and consumption of healthy food was recognized as a major challenge.

Factors such as Sitka’s relatively remote location in a cold climate meant that a lot of foods had to be imported in, thus increasing the cost of healthy foods like oranges as well as food overall. For example the average family food cost per week in Sitka is higher than in other communities in Alaska such as Juneau and Anchorage, as well as higher than that of the US average.  As a result, several healthy food programs were developed, beginning with the Sitka Local Foods Network. Several interesting and innovative healthy foods programs have come out of the Sitka Health Summit’s annual initiatives.

The healthy food programs include finding ways to improve access to both healthy, fresh locally -grown foods as well as traditional, healthy Tlingit food because of their focus on food as important for nutrition as well as having cultural importance. The Tlingit are the Alaska native people who have inhabited the Sitka, Alaska area for a long time. The healthy food programs in Sitka include The Sitka Local Foods Network, St. Peter’s Fellowship Farm, Sitka Farmer’s Market, Garden Mentoring Program, Sick-A-Waste Sitka Composting Project, the Sitka Kich, serving local fish in school lunches, Stream to Plate Fish to School Classroom Lessons, and an annual Sitka Seafood Festival.

Sitka Local Foods Network

This is a nonprofit organization whose mission is to increase the amount of locally produced and harvested food in the diets of Southeast Alaskans that began as a result of the first Sitka Health Summit in 2008 as a way to tie two, healthy food initiatives together: creation of a community garden and greenhouse as well as a farmer’s market. It has since then expanded it’s programs to include expanding community and family gardens, providing educational opportunities, technical expertise and encouragement, Promoting the responsible and sustainable use of traditional foods, also called subsistence foods, and conducting a community food needs assessment in 2012.

Throughout their programs, the food network takes into consideration health equity as well as cultural competence. For example, they try to provide assistance so that those in the community who may be at a economic disadvantage can also participate in and purchase healthy, local produce. Also, their promotion of sustainable use of traditional or subsistence foods includes collaborating with the Alaska Native communities to promote foods such as local salmon, halibut, cod, herring eggs, deer, berries, seaweeds and other foods that were traditionally consumed by the Tlingít, Haida and Tsimshian diets before non-Native Alaskans arrived in Sitka.

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Fresh, organic produce at a farmer’s market. Photo © Jillian Regan 2017 courtesy of Jillian Regan Photography, LLC.

St. Peter’s Fellowship Farm

This community farm was created in partnership with the Sitka Local Foods Network and St. Peter’s By-The-Sea Episcopal Church. Community members organized by the Sitka Local Foods Network built raised garden beds on the church’s land. Local contractors provided the soil. Engaging people from all different sectors of the community was an important aspect of the project, involving different groups, like elementary school students who were involved with planting, weeding, harvesting some of the crops. Celebrated. The opening of the farm was celebrated a big community potluck, featuring healthy produce from the gardens.

Sitka Farmer’s Market

This farmer’s market was created and operated by the Sitka Local Foods Network initially as a way to sell off the extra produce from the St. Peter’s Fellowship Farm. Over time it grew to include other local vendors as well as vendors from other parts of the region. One interesting aspect of this program is that it partnered with the Alaska Native Brotherhood and the Alaska Native Sisterhood to use part of their building and parking lot for the farmer’s market. Another is how it was adapted to accept SNAP benefits to help those at a economic disadvantage being able to purchasing healthy foods from the farmers market.

Later on the Farmer’s Market added an additional program, Quest cards, once the program realized that even with SNAP benefits, the healthy produce at the farmer’s market was too expensive. Quest cards are a Sitka initiative to encourage families who qualify for SNAP to buy healthy food from the farmer’s market. The Quest card gives the participants $1 for every dollar spent on purchase of healthy foods at the farmer’s market to encourage and enable them to buy fresh, healthy produce from the farmer’s market instead of buying unhealthy foods from convenience stores.

healthy food programs systems public health accreditation community health assessment
An outdoor farmer’s market. Photo © Jillian Regan 2017 courtesy of Jillian Regan Photography, LLC.

Garden Mentoring Program

This program run by the Sitka Local Foods Network provides education, training, and technical assistance to local organizations or citizens who want to grow their own gardens to increase the amount of food grown and harvested locally. This helps provide those without previous experience gardening with valuable resources.

Sick-A-Waste Sitka Composting Project

As a companion project to the Garden Mentoring Program and St. Peter’s Fellowship Farm, this initiative by the Sitka Local Foods Network was to create a community compost with contributions of compostable waste by community members that could be turned into compost used in community and family gardens.

Sitka Kich

A commercial kitchen for community members to use for for processing and canning the food grown, harvested, farmed, or caught locally was created through the Sitka Local Food Network partnering with: the Sitka Conservation Society, the Sitka Health Summit, the First Presbyterian Church, the Sitka Food Co-op, the Sustainable Southeast Partnership and the University of Alaska-Southeast Cooperative Extension.

In addition to offering the use of a commercial kitchen, they hold classes teaching people how to can foods such as salmon and vegetables, with the idea of encouraging individuals in the community to create a cottage food industry of healthy, locally sourced foods.

A commercial kitchen is great for supporting healthy food programs because food safety is an important aspect of healthy food, that is sometimes overlooked when healthy food programs solely focus on nutritional value and healthy diet. Without proper equipment when preparing large batches of food for sale, there is a much higher risk of contamination of the food with pathogens, leading to an increased risk of contracting a foodborne illness for those who consume the food.

Serving local fish in school lunches

Local schools in Sitka now serve locally harvested fish once a week in the school cafeterias along with a coordinating educational program for the elementary school students that came to be as a result of a partnership between the Sitka Conservation Society, local schools, commercial fishermen, local seafood processors, the school food service provider, Sitka Native Education Program (SNEP), the Alaska Department of Fish and Game (ADF&G) and the National Park Service.

healthy food programs community health assessment public health board accreditation seafood
Filets of freshly caught fish at a market. Photo © Jillian Regan 2010 courtesy of Jillian Regan Photography, LLC

A Guide to Serving Local Fish in School Cafeterias

This guide was created to help other schools in similar communities, such as those in Southeast Alaska, adopt similar programs. It provides details on the organizations and process involved with getting local fish to be served in school cafeterias as well as getting the students interested in and excited about eating the  

Stream to Plate Fish to School Classroom Lessons

This document includes lesson plans, worksheets, and picture cards for teaching a program called “Stream to Plate” about the local fishing industry to get young students excited about and interested in learning more about the fish they’re eating in the cafeteria for lunch. The lessons are geared towards 2nd to 5th grade elementary school students.

healthy food programs public health accreditation board community health assessments fish
Fresh seafood at a market. Photo © Jillian Regan 2010 courtesy of Jillian Regan Photography, LLC

Sitka Seafood Festival

Held every year to celebrate local seafood, this festival includes a contest where people make a fish dish and judges award prizes, such as Alaska Airline tickets. Including locally harvested seafood as well as celebrating the different cultures within the community helps to emphasize the cultural importance of seafood as well as its nutritional, environmental, and economic importance.

healthy food programs public health accreditation board accreditation community health assessment restaurant
A seafood dish. Photo © Jillian Regan 2011 courtesy of Jillian Regan Photography, LLC
Sharing

In addition to having some very interesting healthy food programs including a focus on health equity, the Sitka Health Summit shares information about their programs in order to inspire and inform other communities looking to start, grow, or improve their healthy food programs. One way they share about their healthy food programs is through Live Stories. LiveStories is an all-in-one data platform makes it easy to analyze local data, get benchmarks, and create interactive stories. The Sitka Health Summit’s Live Story on their healthy food programs includes interactive graphs of data such as the difference between food costs in Sitka compared to the US average, two other cities in Alaska–Juneau  and Anchorage–, and two cities in mainland US — Seattle, WA, and Portland. Check out the Sitka Health Summit LiveStories page to take a look at these data visualizations and narratives.

Another way Sitka’s healthy food programs get shared with others in the public health or community development field is through discussing their healthy food programs in online webinars. Loyd Platson, with Sitka Counseling and who is on the board of the Sitka Health Summit recently told the story of and shared details about Sitka’s healthy food programs on LiveStories webinar on the topic of Healthy Food Access on February 13, 2018.

healthy food programs systems public health accreditation board community health assessment
A customer buying fresh produce from a vendor at a farmer’s market. Photo © Jillian Regan 2017 courtesy of Jillian Regan Photography, LLC.
Conclusion

Partnerships with a multitude of organizations in a collaborative, community driven process, that includes a focus on health equity have created innovative healthy food programs to increase access to healthy foods in Sitka, Alaska. By looking at the example of the Sitka Health Summit’s healthy food programs other communities may be able to use ideas, lessons learned from these programs in Sitka and find ways that will help create or improve on existing healthy food initiatives in their own community in ways that may provide additional resources to those most at risk or at a disadvantage compared to the rest of the community so that more of the community can access and benefit from the healthy food programs.

Are there healthy food programs similar to these in your community?

Share a link below to a website, article, about the healthy food program so everyone reading the comments can check them out!

Jillian Regan, MPH is a consultant at Rillian. She enjoys helping organizations find new ways or evaluate improve existing community health improvement efforts, so that the organization can better serve its community members, clients, customers, patients, or other stakeholders. Connect with her by email at Jillian.Regan@RillianConsulting.com or Twitter (@JillianReganMPH) or LinkedIn.

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Systems and Software for Six Sigma Projects: Review of SixSigma Guide Software

Six Sigma is a quality improvement methodology that organizations in many different fields utilize to improve their organization’s processes and performance.

A systematic way for keeping track of Six Sigma projects is essential to being able to effectively use Six Sigma to improve the processes and performance of the organization. It is also important that this system is standardized throughout the organization and that all employees who will be using it are trained on how to correctly use it.

A good system will include a way to decide if the problem identified is enough a problem to be addressed in a Six Sigma project, before proceeding to conducting a Six Sigma project. In addition there should be a way to track both the impact of the problem and solution on the customer (voice of the customer) as well as on the business (voice of the business). It is important to document attributes of the data that is to be collected, such as if it is ordinal scale or nominal scale, to make it easier to keep track of which types of statistical analysis are appropriate to apply to the data.

One way to have a good system for Six Sigma projects could be to use a software program specifically designed for this, such as SixSigma Guide. SixSigma Guide is a software guide designed specifically for Six Sigma Projects.

quality improvement strategic planning
The homepage for SoftLogic, with SixSigma guide on the far right and two other software programs on the left and middle.

About SixSigma Guide:

  • It was created by Dr. Reiner Hutwelker
    • He is a business consultant,
    • Master Black Belt in Six Sigma,
    • and an adjunct professor at Hochschule für angewandte Wissenschaften München and Management Center Innsbruck in Eresing, Germany.
  • More details about the software can be found here (orginal website is in German-will need to have your browser translate it): http://www.softlogik.de/p_sigmaGuide_description_de.html
  • There is a trial version of this software available at http://www.softlogik.de/p_service_download_de.html
  • Note: this software tool does not provide the statistical analytic capabilities needed in most Six Sigma projects, so a statistical software program like R, SAS, Minitab, or Stata can be used for statistical analysis of the data in conjunction with this software tool

Review of SixSigma Guide:

  • This software is a useful and practical tool, although it may not be the right fit for every organization. It was clearly developed by a Master Black Belt in Six Sigma who used his many years of practical experience in conducting Six Sigma projects as well as in educating future Six Sigma quality improvement professionals. This software is relatively easy to learn how to use for people who are familiar with other software like Microsoft Excel. One of the best things about it is that it walks the user, step by step through the whole Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) cycle. Instead of having all these steps and sub-steps saved in different spreadsheets in folders on a shared drive, with this software, everything can be kept track of in one place.
  • While it is functional and relatively user friendly, I feel that in order to be more marketable the design of the user interface might need to be enhanced. While it is perfectly functional, people have become used to seeing beautifully designed software programs. Large organizations may also wish to be able to customize it with their logos and branding when implementing it across the organization.
quality improvement
A screenshot of the download page to download the SixSigma Guide software. The option to download the free trial is listed first. Both English and German slides with examples of using the software for a Six Sigma project are linked below the download link.

Another way could be to use a combination of different types of software the organization is currently using, such as Microsoft Excel or Google Docs, combined with a file sharing system, such as a server or cloud based storage solution, such as DropBox, so that all stakeholders who need access to the projects can easily access it.

Whichever systems and software you choose to use, it is essential that it there is a systematic and standardized way of conducting and keeping track of Six Sigma projects across your organization.

I’d love to hear your thoughts! Have you used SixSigma Guide software or a similar software for Six Sigma projects? What do you think about it?

Disclaimer: This is an independent review of software, I am not sponsored in anyway by any of the software companies or individuals listed or reviewed in this article. None of the links are affiliate links. I am just sharing my thoughts about software that could be useful for Six Sigma projects. I learned of this software while taking an online course on Six Sigma, from the Technical University of Munich (TUM) in Germany and edX.org, in which Dr. Hutwelker was a guest lecturer.

Jillian Regan, MPH is a consultant at Rillian. She enjoys quality  improvement using data to improve processes within the organization, so that the organization can better serve its clients, customers, patients, or others. Connect with her by email at Jillian.Regan@RillianConsulting.com or Twitter (@JillianReganMPH) or LinkedIn

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Cross Sector Collaborations Addressing Population Health Issues

Cross sector collaborations can be a great way to address population health issues. There are myriad ways and types of cross sector collaborations as well as a variety of types of organizations involved in cross sector collaborations. Here are a few examples of current or recent collaborations.

Examples

Engaging Youth in Building a Culture of Health — Collaboration between the National 4-H Council, the Robert Wood Johnson Foundation, the national Cooperative Extension System, and Local Health Councils

The National 4-H Council is partnering with the Robert Wood Johnson Foundation, the national Cooperative Extension System and local Health Councils in 1,000 different communities in the U.S. with a focus on engaging youth in to promote a culture of health in their communities. (1).

The 4-H organization is a youth development organization that focuses on empowering youth to by providing youth with experiences that help to develop critical life skills. The Robert Wood Johnson Foundation works to improve health and health care, with an emphasis on creating a culture of health.

This new partnership will focus on involving youth in addressing top public health priorities in cross-sector collaborations between the youth and community members, local public health organizations, businesses, government entities, and non-profit agencies. Three main focus areas of this partnership will be designing a network to promote health and wellness  in communities, creating and disseminating tools for healthier communities, and launching a training curriculum for local community advocates. The network, tools, and curriculum created from this partnership will be able to be applied to other communities in the U.S. (1)

Opioid Addiction Treatment through Telemedicine in Rural Communities– a Cross-Disciplinary Team

The opioid addiction epidemic is a serious and severe population health issues. Many different organizations are working to address this issue. One way is through cross sector collaboration. An example is a cross disciplinary team of psychiatrists, a nurse practitioner, and a social worker from the University of Maryland School of Medicine and health system working with a non-profit organization to develop and implement opioid telemedicine programs in rural communities as part of Robert Wood Johnson Foundation’s Clinical Scholars program.(2)

Collaborators:

  • Eric Weintraub, MD, director of substance abuse services at University of Maryland School of Medicine (UMSOM)
  • Seth Himelhoch, MD, professor of psychiatry at UMSOM
  • Jewell Benford, LCSW-C, a lead social worker at UMSOM,
  • Marian Currens, director of chemical dependency, University of Maryland Medical System
  • Wells House, a non-profit providing recovery services to community members battling drug and alcohol dependencies in Hagerstown, MD

NACCHO – FDA – Health Departments Collaboration to offer a Mentorship program to improve and standardize Retail Food Regulatory programs

Having robust, standardized retail food protection programs can improve food safety inspections and help to reduce the risk and occurrence of foodborne illness outbreaks in retail food establishments.

The National Association of City and County Health Officials (NACCHO) and the Food and Drug Administration (FDA) connect retail food regulatory programs (RFRP) that are looking to improve and standardize their retail food protection services with mentors from RFRP’s that are already experienced with implementing the FDA’s Retail Food Regulatory Program standards.(3) The FDA’s RFRP standards are a set of 9 standards that focus on the improving the design and management of existing RFRP’s so that they can better provide their services to reduce risk factors that contribute to foodborne illnesses in their jurisdiction. (4)

In addition to facilitating the mentorship experience NACCHO and the FDA provide funding for both the mentee and the mentor RFRP’s. Other assistance is also provided, such as sharing of policies, procedures, tools, and technical assistance to help RFRP’s implement the FDA’s RFRP standards to better be able to improve food safety in their community or jurisdiction.(5)  

Conclusion

Learning about different cross sector collaborations has hopefully given you some ideas for how your organization or an organization you work with can collaborate with other organizations in different sectors to address a population health issue.

Organizations collaborating in cross sector collaborations can come from a variety of industries, ranging from the federal government, national non-profits focused on supporting local health officials or creating a culture of health, university hospitals, health departments, and more. Cross sector collaborations can be a great way to address population health issues.

Do you have any examples of cross sector collaborations working to improve community health issues, or have you or your organization been a part of a cross sector collaboration that you would like to share about? Then leave a comment below!

Jillian Regan, MPH is a consultant at Rillian. She enjoys providing technical assistance to organizations, so that the organization can better serve its clients, customers, patients, or other stakeholders. Connect with her by email at Jillian.Regan@RillianConsulting.com or Twitter (@JillianReganMPH) or LinkedIn

Follow Rillian on Facebook to get updates on articles like this one or updates about current projects, like a bicycling survey!



 

Sources:

  1. National 4-H Council and the Robert Wood Johnson Foundation Partner to Empower Youth in Creating Healthier Communities. Robert Wood Johnson Foundation. Retrieved 9/14/17 from https://www.rwjf.org/en/library/articles-and-news/2017/09/national-4-h-council-and-rwjf-partner-to-empower-youth-in-creating-healthier-communities.html
  2. Felix, K. New Leaders Use Telehealth—and Teamwork—to Tackle Opioid Use. Robert Wood Johnson Foundation. Retrieved 9/26/17 from https://www.rwjf.org/en/culture-of-health/2017/09/new-leaders-use-telehealth-to-tackle-opioid-use.html
  3. National Associated of City and County Health Officials (NACCHO). NACCHO Mentorship Program. Retrieved 11/5/17 from https://www.naccho.org/programs/environmental-health/hazards/food-safety/mentorship
  4. Food and Drug Administration (FDA). 2015. Voluntary National Retail Food Regulatory Program Standards – Introduction. Retrieved 11/5/17 from https://www.fda.gov/downloads/Food/GuidanceRegulation/RetailFoodProtection/ProgramStandards/UCM372399.pdf
  5. National Associated of City and County Health Officials (NACCHO). Retail Food Program Standards Flyer. Retrieved 11/5/17 from https://www.naccho.org/uploads/downloadable-resources/Retail-Program-Standards-Mentorship-Program-Flyer.pdf