The Right Tool for The Right Activity - Thinking Beyond Spreadsheets
How
many times have we found ourselves using a common tool to solve a multitude of
tasks knowing that this tool may not be optimal for the particular task at hand?
In the consulting industry, we rely on tools
that provide quick answers, and these tools are accessible to our clients as
well. But sometimes, things can be a bit like the old saying “If the only tool
you have is a hammer, you will start treating all your problems like a nail.”
For
instance, at an oil refinery, one wouldn’t use duct tape to stop a hydrocarbon
leakage, even though logically that may sound like a solution. As consultants,
we have the responsibility to assess the client’s most complex issues and
provide a solution that is specific to that issue.
One
example comes to mind: For a long time, many industries saw countless
dashboards developed in Excel. No complaints here, I use spreadsheets for
almost everything, even grocery shopping. Spreadsheets have provided,
spectacularly nonetheless, solutions to an almost infinite number of problems -
from the very simple bookkeeping to powerful answers to linear programming
models in the Oil & Gas industry.
Spreadsheets
have also allowed us to create management systems, where we can pull numbers,
transform them, plot them and generate actions. However, this can be a trap of
our own making: In the past, we never saw software versions coming up that
could make incompatible our old tools, but that is not the case currently.
The
questions we should be asking ourselves are - Should we acquire licenses for dashboard-specific
software when we need to share KPI’s with the upper management? Are we extracting
valuable information and transforming it into actions? Are we successfully upgrading
our tools to provide better insights?
One
area I want to highlight when it comes to upgrading and enhancing our
dashboards is the costs related to implementing these solutions. This is a list
of the top three that come to my mind:
- Converting
old dashboard from spreadsheet to a Business Intelligence solution: We find many times that
back-engineering dashboards can be time-consuming (hence, expensive), particularly
for dashboards that haven’t been in use for a while (did the previous user
leave instructions on how to maintain and update all the spreadsheets?) This
includes having the right resources to take care of the job, or if you are
considering developing in-house talent to take care of it. - The
cost of the solution itself: We see a wide range of prices, some very low coming
from a startup that has a particular feature we would like to have. Or even at
a zero-cost acquisition (there is a Python open-source library that can do the
trick), though user-friendliness is not anywhere nearby. Other are expensive
and provide powerful data analytics and impressive graphic displays. - IT
department:
Finally the company’s IT department will need to fully support the effort. On
the one hand, it is required that they provide accessibility to the data (permissions
and the right queries). On the other hand, this can be a shared responsibility between
IT and the Operations department, and it is critical: Data Quality. We have
encountered data fields that are a mixture of numeric and alphanumeric entries,
or typos if the data input is manual (as can be the case at a lab). An
additional effort would be required to guarantee that we are looking at the right
information by implementing features such as frequency histograms or time
series that allow us to spot outliers and errors and apply filters if required.
You have to spend time developing rules and filters, and many times this will
be an interactive process between the specialists and the developer to get to
an understanding of what is needed.
It is our view that dashboards provide visibility to different areas at different levels, promote accountability, and improve behaviour among all actors. As management consultants, we support moving to the next evolutionary level using and exploiting the right tool for a deeper insight. However, keep in mind that you should have the right resources in place, both for covering the cost of licenses, and the team to develop and maintain your new, shiny, and enhanced tool.
The author of this blog, Gerardo Luyando is a Senior Consultant at Trindent.
The Power Of Feedback
A common theme Trindent sees in our financial services engagements is time lost to excessive rework at the end of an application process cycle. In an insurance organization, multiple hand-offs between departments occur as a regular part of the cycle, from the intake of new applications to the final issuing of a policy. However, one crucial part of the cycle that tends to get overlooked is quality control.
What Trindent has found is that when there are no proper quality control steps built into the process, verification and correction ends up becoming the responsibility of the last department to touch the application before it heads out the door, creating a bottleneck that leads to longer processing time and decreased turnaround. Gatekeepers at the end of the process become de facto checkers of quality and fixers of errors – a responsibility that’s not factored into their output targets and one that goes well beyond their mandate. Often, department managers are not aware this a problem because it’s become status quo and the lost time it creates was long ago factored into the service level.
Quality Control Alone Isn’t Enough
The obvious solution to improve this inefficiency
would be to establish quality control checks earlier on in the process; for
example, the implementation of checklists or verification steps to ensure that
work is complete and accurate before an application moves to a subsequent
department. However, implementing quality checks isn’t a
complete solution; it’s a only first step that should lead to addressing the
underlying causes of the error, and this is where the power of feedback comes
in.
When there is no system in place to give
feedback to the person or team making the errors, then the errors will continue,
as will the time lost to verification and rework bottlenecks. Finding the errors early in the process is
good, but there needs to be a way to prevent the errors from persisting. Feedback is the key to this.
Feedback plays an important part in Active Management and allows team leaders to connect with their staff on performance. While feedback can – and should – be used as a tool for positive reinforcement, in cases of errors and rework it is a communication tool to be used to ensure mistakes don’t continue.
When a quality control check uncovers an
error, an active manager should use feedback to:
- Let their employee or team know
the error has been made. If someone is
unaware they’ve made an error, they won’t know to avoid repeating it. - Work with the employee or team
to understand why the error occurred.
Was it a one-time mistake? Is
there a flaw in the process that needs to be addressed? Is there coaching or training that should
take place? - Implement changes to avoid
repetition of the error. - Follow up to make sure the
underlying cause of the error has been eliminated. At this point, feedback can again be used as
a positive reinforcement tool to motivate the employee or team to adopt the
improved, error-free behaviour.
If quality control is 80% in the 80/20
rule, then feedback is the remaining 20%.
This last piece of the puzzle is designed to facilitate continuous
improvement in efforts to diminish errors and decrease time lost to rework.
In past engagements, Trindent clients have seen a reduction in error rates, increase in quality, and better overall turnaround time and customer satisfaction with active management training for their team leaders.
Click here to find out more about how Trindent can help your organization harness the power of feedback.
Good Customer Service vs Average Handling Time
In Trindent’s financial services call center
productivity engagements, we often work with clients who believe that call
centres can’t pursue efficiency without negatively impacting the quality of customer
service.
However, good customer service and efficiency don’t
have to be mutually exclusive. If
addressed correctly, a call center can have both.
Understanding Your Call Center Metrics
Even with smart IVR routing, the volume and complexity
of the calls coming into a bank or insurance call centre are uncontrollable
variables. A high volume of complicated calls
can negatively affect call center service levels, and customers service
representatives are constantly being pushed to stay within Average Handling
Time KPI targets to avoid that. However,
without understanding the underlying inefficiencies that exacerbate the length
of each transaction, this negatively impacts the level of customer service that
call center agents are able to provide without addressing the real issue.
To understand where inefficiencies in a call center
transaction can be found, the first step is to break Average Handling Time (AHT)
into its components.
AHT is measured when Average Talk Time (ATT), Average After-Call Work Time (AWT), and Average Time on Hold (ATH) are added together. All three AHT components contain the value-add activity of addressing customer issues, but often also include non-value activities that could be streamlined or avoided altogether.
AHT = ATT + AWT + ATH
Knowing Where to Look
In our financial industry call centre engagements,
Trindent has consistently found a number of common inefficiencies that affect
AHT metrics:
- Skills gaps and lack of training in
customer service representatives that lead to unnecessary escalations, excessive
call transfers and unneeded rework, which has an affect on all three components
of AHT; - Talk time beyond addressing customer needs
in an attempt to increase customer satisfaction, which affects ATT; - Lack of standardized processes or policies
for issue resolution, which affects AWT and ATH; - Lack of documentation standards, which affects
AWT; and - Lack of individual CSR performance
visibility to management, which affects all three components of AHT.
Getting Results
Once Trindent addressed these inefficiencies and
implemented process improvements, CSRs found themselves able to resolve the
same volume and complexity of customer requests in a significantly more efficient
manner. This allowed them to stay within
AHT targets without affecting customer service.
With the right approach, call centers don’t have to
choose between meeting Average Handling Time targets and good customer service.
Click
here
to learn more about how Trindent can Make It Happen ™ for your organization.
Excessive Processing is Costing You
A common challenge that Trindent tackles in
financial services engagements is rework
caused by excessive processing, an inefficiency that results from an attempt to
artificially create quality control.
Quality control is a vital part of any
service or product, and as such, should have its own established process,
system and behavior component. Relying
on an excessive amount of processing from multiple sources instead of putting
in place solid methodology to ensure quality is not a tenable approach. If not corrected, this rework translates into
poor service levels, long turnaround times, and excessive backlog – all of
which affect the customer’s service experience.
What We Saw Happening
Let’s use the example of a new insurance policy
application working its way through the pipeline. In previous engagements, when we followed the
intake of a new policy application submission from start to finish, we saw that
it had to make its ways through several departments. But what was most concerning is that, with
each handoff, more rework was performed.
Each department had to complete a certain set
of activities around each application and required several different pieces of information
from the application to perform those activities. It was here that we we found two areas of
opportunity to eliminate rework from excessive processing. We found an absence of a process to transfer
knowledge from one department to the next, so when a file was passed along, the
receiving department had to recheck the entire application. And even when information was transferred, we
found the receiving department still rechecked the entire application out of concern
that blame would fall on them if there were any inaccuracies.
What We Did
Through observations and process mapping, we
identified these two inefficiencies and the opportunity to improve them. The underlying cause of both types of
excessive processing was an attempt to create quality control. In both cases, there was unclear
communication, an ill-defined breakdown of responsibilities, and a lack of
active management – all of which led to a fear-based mentality and a duplication
of work.
To remedy this situation, we looked for a
solution that would prevent any further increase in processing time but would
reduce the rechecking. With the help of
subject matter experts from the client side, we mapped out current state to
bring overlaps in process into sharp relief.
From here, we were able to design a new process where the first
department to have their hands on an application implemented the use of a
checklist that would reduce the need for the second department to read the
entire application. Simultaneously, if
any inaccuracies were detected by the second department, they would be logged
and checked anonymously so that no one feared repercussions.
This solution to excessive processing not
only changed the process but its associated behaviour as well, taking both
rework and fear of repercussion out of equation, while creating a more robust
path to quality control.
Conclusion
The expression “time is money” is appropriate
to inefficiencies we’ve observed in these engagements. Excess processing is a common pitfall that
many financial service sector companies still encounter. A conscious effort to reduce or eliminate these
types of inefficiencies results in better service levels between departments, ultimately
decreasing the total end-to-end wait times that frustrate customers.
Implementing efficient processes, robust systems
and the right set of behavior can allow any financial services organization to
reduce waste and boost service levels. Click here to find
out how Trindent and our proven methodology can your organization make
sustainable changes to process, systems and behaviors.
Driving Operating Room Optimization From Outside the O.R.
Optimizing operating rooms is a difficult undertaking
because there are so many variables involved, including doctors and staff with
myriad responsibilities.
It’s hard to know where to start. How do you prioritize tasks and which
responsibilities take precedence? Does the process have an actively managed and
well supported set of steps? Do all team
members fully understand their role and how their role supports and interacts
with one another?
Many organizations begin their optimization
journey inside the operating theater and de-prioritize opportunities outside
the operating room to increase efficiency.
Where to Start the Optimization Journey?
Begin at the beginning and go on till you come to the end; then stop”.
Lewis Carroll, Alice in Wonderland
The greatest opportunity for improvement in
Turnaround Time for Operating Rooms is at the beginning of the process. Frequently, up to 50% of unaccounted for
patient experience time can be attributed to Pre-Operation processes. Many small improvements can be made to ensure
success and timeliness inside the operating room, but the greatest leap forward
is made between Patient Arrival and Wheels In. Often, each separate person in
that process becomes so focused on the completion of the many tasks required of
them they lose sight of how the team is providing overall patient experience
and the time being used to prep for the surgery.
Building a patient experience-focused
process increases perceived service levels, but more importantly, it also
increases efficiency. Frequently patients experience as many as four
pre-operation interviews from the pre-op nursing staff, CRNA, anesthesiology,
and the surgeon. Often the questions are
repetitive and create distress for patients, especially when each of the
interviews is spaced out and can give the impression the unit is not
communicating. Certain interview questions must be asked multiple times but
coordinating the process to ensure patient confidence is essential. And that the
coordination of the interview process decreases Patient Arrival to Wheels In
even further.
Essential staff need to have a well-organized
and robust process to be efficient. Metrics for each role and the overall process
must be created and reported on to all staff daily. A management operating
system for pre-op processes is essential to delivering optimized results by
illuminating opportunity in each role and task. Monitoring, reporting on, and
actively managing key metrics of pre-operation processes reduce Patient Arrival
to Wheels In Time.
Conclusion
Operating Rooms are complex and complicated
places to optimize based on the roles and responsibilities necessary to have
successful outcomes. Developing well-coordinated, efficient, and robust
pre-operation processes then Actively Managing those process through key
indicators as part of a Management Operating System delivers cost-efficient OR
optimization and increased patient satisfaction.
To learn more about how Trindent Consulting can assist your healthcare organization to improve the processes inside or outside of your Operating Rooms, click here.
Fast In Fast Out: Improving Patient Discharge and Increasing Throughput
Hospital emergency departments are fast-paced environments where physicians and nurses race against time to deliver care to patients. To be effective, hospitals rely on metrics to assess the performance of their emergency departments. One such metric is discharge time which is the time it takes for a patient to be seen and discharged.
The
discharge process is multifaceted and can involve various medical personnel
such as physicians, nurses, radiologists, cleaners, administrative staff, etc.
An emergency department with a short discharge time is indicative of a high
degree of efficiency and coordination.
The process of efficient patient discharge can be explained by the example of a relay race. To win a race, the baton must be seamlessly passed from runner to runner or in this case, the healthcare providers. For winning this race, communication is key. Similarly, one of the best ways to turbocharge the patient discharge process is to improve communication and awareness amongst the various personnel involved, i.e., passing the baton. This can be done in three ways:
- Sharing discharge
related information - Early Identification of
Potential Discharges - Prioritization of
patients that are being discharged
Sharing
Discharge Related Information
In an emergency department where medical staff members are highly specialized, silos could form amongst the various functional groups in the absence of information sharing. This is especially problematic because the lack of visibility of how work in one area flows into other areas can grind the discharge process to a halt. One of the ways to alleviate this is to circulate the discharge plan. Doing so will allow staff members to anticipate discharges and prepare ahead of time. For example, if a physician ordered a test prior to discharging a patient, case managers and social workers can begin the process of making discharge arrangements while the tests are being conducted. This way, the two processes can occur concurrently. If the discharge plan is not shared, the case managers and social workers will likely find out about the discharge once the patient’s tests are completed which adds extra time to the process.
Early
Identification of Potential Discharges
Patients should not have to wait until daily rounds to be identified for discharge. If a patient is fit for discharge at 8 am and daily rounds do not happen until 10 am, then we just lost 2 hours in the discharge process. By discharging patients earlier in the day, rooms can be vacated which increases capacity to admit more patients and improves throughput.
Prioritizing
Patients That Are Being Discharged
Patients that are being discharged should be prioritized throughout the emergency department. When the physician orders additional tests for a patient, are the lab technicians aware that the orders are for a patient waiting to be discharged? Improving communication, giving increased visibility to the technicians, and streamlining the process will allow the technicians to prioritize the orders for discharge patients by moving them up the work queue.
An efficient patient discharge process is indicative of a coordinated emergency department. By combining active management with the three ways of improving patient discharge, emergency departments can increase throughput without sacrificing the quality of care which would increase patient satisfaction and reduce the number of patients that leave without treatment.
The author of this blog, George Xu is a Senior Consultant and Trindent Consulting.
The Importance of Setting SMART KPIs
Organizations succeed or fail based on their capability to set, track, and enforce key performance indicators (KPIs). KPIs are widely considered as measures by which businesses evaluate whether their actual performance is in line with their strategic business goals. However, if an organization’s KPIs can’t be easily tracked, quantified, and tied to an organization’s bottom line, then it will not deliver the intended result. Therefore, how should businesses establish performance measures that provide a consistent method of tracking an organizations’ goals, targets, and objectives? By setting SMART KPIs:
- Specific – Clearly explain why a certain KPI is used and what it measures. Moreover, the KPI should be specific to the individual department/job itself with focus on the exact behaviour.
- Measurable - KPIs have to be measurable and based on clearly defined behaviour. It should be evaluated to provide feedback to the organization’s employees on their performance and help to compare the actual outcome with the set target.
- Achievable – KPIs should be realistic. All employees within the organization must have an aligned belief that the set targets are fair and can be readily attained.
- Relevant – KPIs must be essential to a department’s function and be tied to the company’s bottom line. If a change in KPI does not impact an organization’s profitability/bottom line, that KPI is inadequate.
- Timely – KPIs should be measured and adjusted within an appropriate time frame. Organization’s goals and objectives tend to vary over time; thus, KPIs must be adjusted accordingly to drive success.
This blog was written by Val Iukin, Senior Consultant at Trindent Consulting. He has experience improving the efficiency and effectiveness of organizations in the healthcare, energy and financial services industries.
Managing Customer Expectations To Control Call Center Volume
A common KPI for financial industry contact centers is the Service Level, whose targets can be found in the Service Level Agreement (SLA) committed to customers. The SLA aims to maintain a certain level of service, and its targets are expressed as a percentage of inbound calls answered within a given timeframe (e.g. 80% of questions will be answered within 20 seconds).
Industry standards vary depending on the type of business, the type of callers it draws, and what the calls are about. Nonetheless, Service Levels allow organizations to ensure their call centers are maintaining an optimal level of service to keep client satisfaction sufficiently high. They also create an opportunity for companies to measure themselves against their competitors and give them ongoing motivation to strive for Service Level improvements.
There are numerous variables that affect the Service Level, including Average Talk Time (how long each call lasts), After-Call Work (how long it takes an agent to complete necessary tasks after each call) and Scheduled Adherence (the percentage of a scheduled shift that an agent is available for calls). These variables, among others, are ones that call center representatives are often coached to improve.
However, there is one other simple but often overlooked idea
that can be a quick win for call centers to consistently stay within their
Service Level targets.
Controlling the Controllable Volume of Inbound Calls
Incoming call volume is commonly perceived as an impossible variable to control since it is driven by external factors. However, throughout its various engagements with financial industry clients, Trindent has found a recurring pattern of excess customer repeat calls that invariably led to a failure of call centers to stay within acceptable Service Levels. For contact centers that do not have an active repeat call reduction program, for example, we have typically seen approximately 20-30% of total calls are repeat calls.
Although there were a number of reasons for the repeat calls, the majority were follow-ups from customers whose expectations were not properly managed on the original call. Customers were not told, for example, how long it would take to get a certain request processed, so they would call back to check on the status. Or, in cases where a customer request touched multiple departments, there would be a lack of coordination or miscommunication between them as to who is responsible for answering queries, leaving callers to cycle through different call centers in confusion.
In both cases, the volume of repeat calls could have been
avoided by setting proper expectations with the caller at the outset.
“One and Done” - Managing Expectations
Managing client expectations should be an organization-wide
effort to ensure that all customer communication –written and verbal – set out a
reasonable expectation of how long a customer can assume a process to take. For larger companies with multiple call
centers, it’s also important to give customers clear guidelines on what
department they should be reaching out to.
Simply put, in order to help call centers stay within Service Level targets, customer interaction needs to have a “one and done” approach. Properly messaged communications take care of customer needs in one call, which avoids the repeat calls that put pressure on contact centers and their ability to meet SLA.
Click here to read more about Trindent’s wholistic approach to improving call center processes by finding and remedying inefficiencies like excess incoming call volume.
The Tenets of Process (Re-)Design
Trindent’s approach to profit improvement is based on solving complex problems, where we drive improvements in three key areas:
- Process, which refers to the
way things are done; - Systems, the tools used to
manage a business; and - Behaviors, the actions taken
based on information provided by the System.
This article will focus on processes, which can be classified into a number of varieties: Legacy processes that are colloquially described as “the way things have always been done” and are often highly inefficient; undocumented processes based on institutional knowledge and experience that are highly variable and poorly managed; and finally, well-documented standard processes that can be measured and continuously improved. The first two are what we commonly find in our initial assessment of a client’s operation, the last one is what we’re striving for.
One of the key deliverables of an assessment is a deep analysis of the organization’s end-to-end processes. Working alongside our clients, this exercise uncovers and quantifies constraints and variances. While clients are often aware of these issues, even if anecdotally, it can be difficult for them to fully understood the impact, let alone fix it. As we move from assessment to engagement, there will be dozens of method changes developed and implemented in collaboration with our client’s project team.
This is done using a structured, data-driven approach to process design, one based on three tenets:
- Discrete, actionable changes
that address specific pain points in the process; - Quantification of the impact
and benefits based on rigorous analysis; - Clear implementation plans with
timelines and accountable parties.
First and foremost, our solutions are based
on discrete, actionable steps. From experience, consolidating process changes
only injects confusion into the new process. The additional complexity also
makes the approval process more challenging, as the proposed change may infringe
on multiple stakeholders. For these reasons, method changes should instead be
broken down to specific process steps with a singular focus. This also allows
for both rapid implementation and clear requirements when course correcting to
any variance in results. Finally, these changes need to be rigidly documented
to ensure sustainability and business continuity.
Second, we prioritize implementation based
on the P&L impact of proposed changes. This is based on rigorous analysis
and deep industry knowledge that allows us to quantify the impact of
improvements – historically generating between 300-1500% ROI on project fees. As well, this approach allows us to
effectively measure results on a weekly basis – celebrating areas that are
performing at or above target and quickly pivoting to address underperforming
areas. We also install a framework that allows this process to be continued and
carried out elsewhere in the business.
Finally, all of this is done in
collaboration with our clients to produce clear implementation plans that
include timelines and accountable parties. Following implementation, typically
six months after the completion of an engagement, we complete a Sustainability
Audit to ensure results have been maintained, or as often the case, improved
on!
Process redesign, poorly executed, can actually harm both performance and morale within an organization. This can be attributed to process design efforts that include compounded process changes, solutions that lack quantification, and unclear lines of accountability. Trindent’s approach ensures accountability and buy-in at all levels of an organization, resulting in sustainable P&L improvements.
Contact us today to learn more about how our approach to solving complex problems can benefit your organization.
The author of this article - David Kerry, is a Senior Engagement Manager at Trindent Consulting.