Two Lives: A Mandate for Quality Customer Service in Community Rehabilitation (Page 5)

By Cary Griffin, Director of Training
The Rural Institute
The University of Montana

Structural waste is a common problem area in organizations. Typically, the older an organization the more these processes have become embedded in the corporate culture and the daily routine of workers. Routine or habitual work can be quite difficult to change. Often, for example, accounting processes are set up to comply with specific funding streams and program offerings. If values alignment has not taken place in coordination with the change in process, changing this to meet the requirements of powerful consumers will prove difficult. For instance, if an organization has a long history of managing all consumers' money, a shift to vouchers or personal bank accounts may prove troubling to accounting department personnel who have learned to focus on protection and on minimizing risk because of the belief that many people with disabilities are incapable of money management. The good intentions of those who wish to provide protection may sabotage a move to more consumer control without a concentrated re-education on the values of inclusion, customer service, and empowerment.

But, structural issues remain even after a values alignment. Key indicators of problems to come include the existence of excessive departments and specialization; obvious program boundaries and "Us and Them" thinking; inadequate capability and opportunity for personnel to interact internally and externally; and excessive complexity within the system that makes it hard for staff and consumers to understand and foster outcomes. Add to the structural issues the deleterious effects of process waste, and patterns of decay and habit become evident.

In many organizations, process waste is the most difficult to recognize and change because processes are often imposed from outside by funders or certifying/accrediting bodies, or they are held dear and sacred by the person who designed and/or performs these process functions. Other process disconnects are easier to recognize. Variation in process, for instance, from one staff person to another, or from department to department, is common. In performing an individualized consumer assessment, as an example, the residential department may use a Social Skills checklist in a group home setting, whereas the vocational evaluator may perform a work try-out in industry to capture social interaction data. Chances are the two processes will reveal very different data, resulting in different habilitation program recommendations. Regardless, the discussion and decision over which is more accurate produces more waste. Values alignment regarding the use of typical, non-segregated settings would solve this problem and reduce testing expenses and departmental bickering.

Other wasteful components include the use of internal measures of quality instead of external measures. Typically, internal measures include accreditation audits, exhaustive case notes, and program plans (IPPs, ISPs, ITPs, IHPs) that relate to process outcomes having little to do with consumer employment or emancipation. Many individualized program plans still focus on readiness and compliance issues and are used as a barrier to moving into the community. External measures would more accurately reflect what consumers want, how well supports are provided in community settings of choice, and how well the organizational image portrays staff and consumers in the attempt at inclusion.

Finally, there exists a key process function that is ubiquitously hated but that is seldom analyzed and improved. This is the function of meeting: team, council, board, staff, parent, consumer meetings ad nauseam. While many easily adopted improvement strategies for meetings exist (Scholtes, 1988; Griffin, 1999b), few appear to be implemented. The habit of doing things the company way, the belief that nothing will change, and the unpleasant realization that for many staff the essential job function is to attend meetings, points to one easily remedied waste center, if only leaders are motivated to act upon the waste of money and human potential so obvious to the observer.

One strategy in approaching the structural and process changes that hold an organization together is what one might call the technique of the obvious. That is, when examining an agency for structural or process waste, ask why five times:

"Why do we use this form?"
"It's used to collect personal data."
"Why do we fill it out each time we have a meeting?"
"In case something has changed."
"Why don't we just send a note to case management instead of completing the whole form?"
"Probably because they need a consistent looking file."
"Why would they need a consistent looking file? Aren't they using a word processor template anyway?"
"I don't know."
"Why don't we try just sending over a note."

This process works for all types of habitual and established processes and is exceptionally telling in the initial analysis of challenging behaviors. When this technique was used regarding Winston's aggression towards his co-worker we found that: 1)Winston hit his co-worker because he was being teased; 2) he was being teased because his co-worker thought it odd that an adult would go to Disneyland with two human service workers instead of a girlfriend or family; 3) Winston was upset because upon his return from Disneyland he found that the residential staff had moved him to a new apartment without his consent or knowledge; 4) Winston had not slept all night before work due to his anger about being moved. Winston was not treated as an equal human being in the service delivery process and his savings were mismanaged, resulting in the loss of his job and dignity. Great waste of effort, time, and human capacity was the result. Had the leadership of the organization been truly invested in customer service, they would have capitalized on serving someone as hard working and independent as Winston. Instead, they created new behaviors that justify more waste through the implementation of restrictive behavior programs, produced further reliance on public funding for Winston (who could have been self-supporting) and increased destructive and partnership-inhibiting friction between the vocational and residential agencies. This residential provide's primary funder learned of this and other such incidents and is reducing this provider's funding while inviting consumers to utilize more progressive and responsive providers.

Winston's story is about waste. There are four critical areas of concern once the process and structural waste issues have been recognized and the rebuilding stage is anticipated. The questions that need to be asked relate to: Service Functionality, Service Flexibility, Development Capabilities, and Process Quality Standardization.

Service Functionality: Does the service meet customer expectations in terms of price, convenience, quality, delivery, simplicity, options, features, and consistency? Customers include people with disabilities, as well as employers, Board members, funders, and other publics.

Service Flexibility: Can the service be adapted to meet new needs; utilize the latest technologies; be customized with little cost; offer variety and uniqueness? Organizations need to anticipate the future without investing in capital assets that are non-liquid or that do not provide a direct benefit to the customer.

Development Capabilities: Does the service effectively use current resources and current processes that can be modified to deliver new services: Are suppliers available for referrals? What is the delivery cycle time? Organizations need to position themselves for change and adaptability through functional design based upon customer need while remembering that any function performed that does not directly satisfy the customer is waste that eats away at reinvestment capital.

Process Quality Standardization: Does the service use proven processes already utilized by this or other successful organizations? Does it use expertise from within and without? If unique skills and processes are needed, are they easily obtainable and easily implemented? Leaders need to hire for skill, knowledge, and action and raise the level of organizational commitment through task accomplishment and values coherence. Learning organizations will prosper in the twenty-first century (McNair, 1994; Senge, et al., 1994; Floyd & Wooldridge, 1996; Griffin, 1996).

Conclusion

The road to high performance customer service appears to be littered with lost opportunities and management challenges as diverse as the communities served. However, a number of organizations are creating a new customer service orientation and are using the resiliency and accomplishments of people such as Winston and Leanne as their benchmarks. Those organizations that are succeeding are focused on:

• improving personnel core competencies;
• adopting modern information technology to streamline communication;
• examining employee turnover and hiring for the long haul;
• using best practice and staff training to reduce process variation in such critical undertakings as job match and functional analysis of behavior;
• reducing office complexity through computer technology and rooting out duplication and redundancy of operations;
• asking customers what they need and taking them seriously;
• recognizing that lack of success leads to a high degree of staff frustration and stress;
• seeing that turnover and poor performance result in extensive lost opportunities throughout their communities;
• knowing that at the heart of any substantive organizational change, values alignment is more critical than funding.