Tuesday, April 26, 2016

When the VoC is screaming

When the VoC is screaming

Today I received an on-line satisfaction survey from a company that I use regularly.  They are a well-informed “partner” of ours, in the sense that we use their product on a regular basis, and the quality of our program is in part linked to the quality of their product.  That is exactly the type of company to which I will respond.  

These days, every time you go to a store, every time you go to a hotel, every time you travel, you get another survey request, most of which I have found best to ignore, because responding just leads to more surveys.  So I, like I am sure most of you, limit the number of satisfaction surveys that I complete.  I suspect that many of you go one step further and delete them all.

So I open up the survey and the first page has 3 straightforward single answer demographic type questions designed to get some basic information but nothing that could be construed as personal or invasive.  A good start.  The second and third pages are a little longer, but clear in intend with a request for multiple answers, if appropriate.  This is followed by another 4 pages with single questions only.  

And then we hit page 8 and all of a sudden things change.  Now we have 2 grids, each with 5 rows and 6 columns, with a complex set of instructions.  Further both grids are marked as must be completed in order to proceed.  I look to the top of the page to see how far I am into the survey to make a guesstimate on how much more time I am going to have to commit to the survey, but there is not guide provided. 

And my attitude towards this survey starts to change, in a real hurry.  I have three choices.  I can either quit not bother any longer, or I can continue on, row-by-row, or I can send a message.  

And I decide that this is message time.  So I fill in the two grids by random choice just so that I can get to the next page, of which I ultimately discover there are 5 more, all of which get the same sort of treatment.  

On the second to last page I find a text box, in which I comment, “send out crap surveys, get crap information”.  (I found the text box by ultimately getting to the last page and looking for the “Many thanks.  Please leave any additional comments here” box, which did not exist).  Then I hit the “previous” button to find an available text box.

Maybe they read my comment, probably they will not.  What is more likely is that some analyst looks at the collective compiled data, does a bunch of cross-cuts, creates a report which someone reads (or not) and the world goes on.
 The problem with this is that Quality Managed companies actually do need to be able to get information from their customers in order to find out how if they are meeting their needs and requirements.  It is a Crosbyesque as you can get.  

You can get information in a number of ways, one of which is on-line surveys.  There are a lot of other choices, but if done well and carefully, on-line surveys provide a combination of immediacy and directness and distribution that few other choices can provide.  

So if you are going to send out surveys, the least you should do if create them in a manner that optimizes the opportunity for good information and reduces the opportunity for bad information.  

In previous writings [http://www.medicallaboratoryquality.com/2011/06/satisfaction.html ] , I created a number of recommendations to increase your potential for good information, which include:

a.    Focus them to a single issue
b.    Limit the survey to only a few questions , best is to keep it to 5-6 and NEVER more than 10,
c.     Make the questions as uncomplicated as possible.

d.    Pre-test the questions to reduce (you can never avoid) ambiguity and
e.    Make sure that it can always be completed in 3 minutes or less.
f.      Never require an answer. That is a guaranteed invitation to bogus information.
g.    Decide in advance which slice of your audience you are interested in and then only focus your energy on that group. General send-outs are a total waste of time.

Now, some 5 years later, these still seem to be very useful rules to live by, although I would probably now raise the recommendation to limit the questions to 9-10 and never more than 12, provided that you don’t break the 3 minute rule.

In our programs, we continue to rely heavily on our surveys for information from clients, and course participants, and organization members. 

There is no doubt that when performed properly on-line surveys are extremely useful.  When performed improperly they are not only a waste of time and energy, they result in poor information and potential poor decision making.

Saturday, April 2, 2016

Making the Healthcare Mission Real

Making the Mission Real
In a previous post [see:  http://www.medicallaboratoryquality.com/2016/03/cum-minus-facerent-malum.html ] I railed against the tragic levels of customer service in  Canadian Healthcare.  In as much as being a disgruntled healthcare customer (nobody really wants to be in a position of needing healthcare services) as a Quality person I was appalled at how far off track we have come.  

 If there was a single irritant above all the irritants experienced it was the declarative Mission Statement (however named) Embed patient-centered practices in the delivery of all care and services.”  This might have been written in some aspirational moment of hope, but in reality it was both meaningless and, at least from the perspective of this one observer, galling.  In my experience there was no evidence of any effort to support or justify such a declarative statement.
What it made me appreciate all the more is the concept that Mission Statements have to be more than a bunch of nice words, they have to be credible and achievable in a way that the customer and employees can point to an say “Yes, and good-on-ya”  

So it made me think of all those statements that sound good but are of little use.  They remind me of the Crystalian character Fernando, “It is better to look good than to feel good”.  All SHOW and no GO. 

Here are a few:
Quality is Job 1
We meet and beat all requirements and standards of excellence
We provide world-class service.
We are the world leaders in care.
Excellence in all actions all the time.
(and with apologies to Philip Crosby) “Doing it Right the First Time Every Time”

Mission statements are important.  As pointed out in ISO 9000, the organization's mission statement or policy is its “purpose for existing as expressed by top management”.  If it is not real, staff and customers have nothing to hold on to and either ignore or scoff, or as in this situation get angry.  It doesn’t make the organization better; it makes the organization worse because it provides the opportunity for cynicism.  Good words-No substance.

So here is how I see it. 
There are some organizations that need the Fernando Format.  It is not about Quality; it is about profile and promotion; high profile major manufacturers may need at least as much pizazz as punch.  That is about advertising and promotion.   But healthcare organizations do not fall in that category.  Healthcare needs to “put up.  Period.”  Healthcare needs to be good, not just look good. 

So can we agree that unachievable mission statements achieve little other than make the promotion folks feel good.  So put out the message that we want to be there and intend to work damn hard to get there.  And on that point you can hold us accountable.

Our vision is to be recognized by our community and peers in Canada and beyond as a valued contributor to healthcare delivery and  innovation and as a passionate advocate for continued quality improvement for the benefit of patients and their families. 

Too long?  Maybe, but it  delivers  real measurable aspiration. 

I am open to suggestions for improvement.