Healthcare Customer Satisfaction: More Talk AND More Action Customer satisfaction (Voice of the customer) is a recurrent th...
Monday, September 1, 2014
Is the Public Sector a place for ISO 9001?
Over the last decade I have become a firm believer in the use of ISO 9001 as a guide to implement and maintain a Quality Management System for my organization. Our proficiency testing program has been strongly enhanced as a direct consequence of our commitment along with the annual review by our certification body. While our Program Office is not similarly certified, for practical and pragmatic reasons, we follow many of the same processes, which has enabled us to be accredited within our university system.
As anyone who knows ISO9001, customer satisfaction is a central component. For our programs, seeking and listening to the Voice of the Customer is critical to understanding where the organization is and where it is going
[see: http://www.medicallaboratoryquality.com/2012/11/voc-voice-of-complainer.html]. In my experience, even though we work in a public sector university environment, in the absence of VoC, the laboratories that participate in our proficiency testing program would gradually fall away and the program would lose its raison d’etre. In the absence of listening closely to the voice of our course participants, new participants would cease to register and the course would end. We may be academics working in an academic environment, but it is all business all the time, and Quality is essential.
But in the last while I have had three experiences that have given me some pause about the universality of the place of Quality, especially in the public sector. I am less convinced of how much of what we do and study really works in the public sector and when it does, why.
Recently I have been with my one son and also my daughter-in-law as the applied for visas associated with travel and work requirements. In both cases we had to go to the border security office at an international boarding crossing. I am sure that you think you know how this story goes, but you would be wrong. The office was set up as “customer friendly” with many fast moving lanes. The personnel were clearly all business, but not in a demeaning or officious way… courteous, but definitely to the point. In both cases the outcomes were positive, and the business was completely. What impressed me was that these officers had nothing to gain by making the process so efficient and effective, other than for their own professionalism and making their own work day more relaxed and enjoyable. They were never going to see us again, and there was absolutely nothing in it them if I told others that they were jerks or good guys. Their job is not dependent of good will. There will always be an endless supply of people needing travel documents.
Recently I have been a patient in our public health care system, requiring for my first time, seeing doctors and having tests and procedures performed. To date everyone has been very pleasant, indeed very similar to the story above. But the system stumbles so frequently, one wonders how anything gets done. An example: I received a phone message that I have an appointment coming up on a specific day and time to have a test done. Two days before the procedure I get another message as a reminder, but I was told to come at a different time. I got to the office and was told by the receptionist that there was a mistake because there is no appointment, but I when she checks she finds out that I have, but the paperwork was never created and now she has to do that. As that is being completed, the technologist comes and says that I have missed my scheduled appointment. Eventually we worked things out, but here we have a typical situation where nobody knows what is going on. If that was the only episode, I would write it off to a bad day, but it seems that with this group every day is a bad day. Once again everyone was friendly, but chaos ensued. The system was neither efficient nor effective, and for a moment, no one was very happy. There seems to be a real lack of learning from the past, and no improving the process, and I suspect that on my next visit I will go through the exact same exercise. Being friendly may be a small part of customer satisfaction, but only a small part.
The third story has to do with a colossal mess in my home province with a public sector teacher union on strike for months with little chance for resolution. Without going into any detail what this has in common with the other stories is that the sector has an endless capture of students (one customer) and the process has not only faltered, but failed. But in this situation, the union has made it all too clear that not only do they choose to not listen to their customer, they don’t even know who their major customers are. Hint: it is not the kindergarten kids.
What ties these stories together is that they all involve public sector workers with an endless capture of customers independent of word of mouth; one succeeds, one falters, and one fails.
So to me, here is the bottom line, ISO 9001 can work in a public sector environment, but only if conditions are right and if people are committed to a culture for Quality.