When Sarah Schacht walked through the doors of an Ethiopian restaurant in Seattle in February 2013 to grab a meal with a friend, the only accessible information she had about the place was its Yelp score: It had the highest-rated Ethiopian cuisine in the city. What Schacht didn’t know was that the restaurant, Ambassel, also had major health violations on five of its past six health inspections. That was information she didn’t learn until later when she decided to look up the restaurant’s health inspection reports online while bedridden with an E. coli infection from food she ate there. What makes Schacht’s situation unique is that this was not the first time she had fallen ill with an E. coli infection. Twenty years earlier, she was one of hundreds of children sickened in the 1993 Jack in the Box E. coli outbreak, and she spent the intervening years doing her best to limit the risk of repeating the experience. “I had no idea this restaurant’s [health inspection] scores were plummeting,” Schacht told Food Safety News in 2013. “Had I known that, I never would have walked in there.” But in Seattle and the rest of King County, the only way for consumers to learn the health record of a restaurant has been to look it up online. To their credit, the county was the first to put health inspection records online in a searchable database back in 2001, but, by 2015 standards, the website feels outdated and too cumbersome for the average user. So Schacht, an open-government consultant, posted a petition on Change.org to get the health department to create a restaurant rating system and make it easily accessible to the public. The petition gained 2,000 signatures, and Public Health — Seattle & King County said that while they were already planning to revamp the system, the petition fast-tracked it to the top of their priority list. However, accepting the challenge hasn’t been as simple as introducing a grading system and putting up a placard. The health department’s goal is to develop a system not yet seen in other U.S. cities, which tend to post a letter grade (A, B, C, D, or F) in a restaurant’s window signifying the overall score from their most recent health inspection. Neither Schacht nor the decision-makers at the health department feel like a simple grade would convey enough vital information about the 11,000 restaurants in King County, which get inspected one to three times a year. For one, a single grade doesn’t communicate the restaurant’s track record over time, said Becky Elias, food program manager at Public Health — Seattle & King County. What if they were just having an off-day during an inspection despite years of high standards? Or what about the opposite: They have a track record of poor hygiene, but they got their act together just in time for the most recent inspection? And if an A is the highest score one can receive for not committing any major violations, that system also doesn’t indicate restaurants that go above and beyond to ensure that their customers don’t get food poisoning. There needs to be a way to communicate excellence, such as consistently receiving perfect scores, having employees take additional food safety training, or using additional technologies or techniques to ensure the food is safe. Instead, they’re taking inspiration from grading systems found in countries such as New Zealand and the U.K., and they’re aiming to develop something possibly not yet seen anywhere else. The system they’re now designing will do at least two things differently than most systems in U.S. cities: It will communicate the restaurant’s track record of inspections, and it will identify establishments taking additional steps to protect consumer health. But getting it right is a long process, Elias said. Beginning in summer 2014, the health department held stakeholder committee meetings, getting input from restaurant and grocery association representatives alongside health officials and Schacht, who represented the public. “Restaurant owners are aware that this is something the public wants,” Elias said. “It’s so important to get it right because we know these placarding systems have a big impact on the business and consumers,” added Hilary Karasz, the health department’s communications officer. And placards can impact more than just business: Cases of foodborne illness in Toronto dropped by 30 percent since the city introduced an inspection placarding system in 2002. On Monday, the restaurant-review website Yelp revealed that it performed its own tests relaying restaurant inspection grades for some restaurants to consumers. They found that restaurants with scores displayed on the website took more steps to improve their future inspection scores compared to restaurants with no visible score. In Seattle, the new system is still under development, and health department officials hope to be testing a pilot program in late 2015 or early 2016. While she waits for the new system like the rest of the Seattle and King County public, Schacht has organized students at the University of Washington to conduct a usability study comparing the effectiveness of various restaurant grading systems. The results are due in a few weeks. “It’s great to have valuable expert stakeholders making decisions, but at the end of the day, this is a tool that will be used by regular citizens,” she said. Schacht said she’s not yet ready to accept pats on the back for her efforts to catalyze change. There’s still a lot of work to be done, and the health department is still developing its early designs. “If you’ve worked with government long enough and you’re a public advocate, you’re never able to leave the field,” she said. “Until I see the placards, the scores on Yelp, and a redesigned [health inspection] website, it’s not done. I don’t want anyone in the Seattle food safety community to think this is done.”