Tag Archives: operations management articles

Talent Versus Determination: The Key to Hiring Right

By Walt Grassl

Bob and Mark are new managers who are having lunch in the company cafeteria. They are discussing their respective hiring strategies for an upcoming job fair. Their conversation turns into a debate on what type of graduate made the best employee.

Mark prefers to hire the 4.0 GPA graduates, regardless of how driven they appear or how well they seem to “play with others.” He figures he can instill the drive and the teamwork.

Bob believes in hiring smart – but not necessarily the smartest (3.0 and above GPAs) – who demonstrate determination and good collaboration skills. He thinks they are smart enough to learn and believes their drive and teamwork will carry the day.

Patricia, a seasoned manager, joins the discussion and shares her thoughts about the importance of hard work and talent in the workforce. She believes that if people don’t have a minimum amount of talent, hard work may not be enough for them to be successful. Conversely, some of the most talented people aren’t successful in their careers because they don’t work hard. The most successful people have talent and work hard.

Patricia is right. Hardworking, talented people make the best employees. Employees must consider what is in their control and what they can influence. Individuals cannot control how much talent they have, but individuals can control how hard they work and how hard they persevere when times get tough.

Here are five character traits for hiring managers to consider.

1) Reaction to Praise: Studies show that when people are praised for their intelligence, they tend to avoid risk when given a choice of their next assignments. Why? If they are less than perfect in the future, they are afraid of not looking as smart. However, when people are praised for their hard work in completing their assignment, they welcome more challenging assignments. If they work hard on a task that their leadership recognizes has a high degree of difficulty and they come up short, they have a history that indicates their hard work will be acknowledged.

2) Ability to Adapt to Change: In the workplace, success often depends upon the ability to change from one process to another. Oftentimes, highly talented people have a set way of doing things that works extremely well for them. They do not like to change what worked in the past and made them successful. Change requires hard work, and while many talented people do well adapting to change, some who feel that they have extraordinary talent are not so flexible.

3) Willingness to Learn: Many talented people feel they do not have anything new to learn in their chosen field. They believe what got them there is enough.

Those who are determined and who work hard often spend a lot of time and effort to maintain their skills and learn new skills. They typically display the most current knowledge of new technology and ideas. Having employees who will improve themselves over and above company-sponsored training is critical to an organization wanting to innovate and improve.

4) Different Expectations: People who are highly talented may believe they are entitled to a certain pay level, promotional opportunities, and respect. They can be the workplace equivalent of rock stars or elite athletes.

Those who succeed based on hard work over talent tend to have expectations that are more realistic. Those who depend on demonstrating their work ethic and their determination to succeed often will find that their hard work pays off in terms of promotions, pay increases, and the level of respect they earn in the workplace. Unlike their more talented co-workers, they tend to avoid resting on their laurels.

Not everyone who is talented depends entirely on his or her talent to find success in the workplace. Many of those with a great deal of talent work hard – often as hard as their less-talented co-workers. However, in some cases, those who are highly talented don’t feel they need to work as hard to get ahead. Nearly anyone who sets their mind to finding success can be successful; however, without hard work, few will ever find the level of success that will pay off for them over time.

5) Goal Setting: People who set goals are usually more successful than those who don’t. The best goals to set are “stretch” goals. Stretch goals are attainable and challenging but realistic. If you set goals that are too easy, you will accomplish them more often but not be as satisfied. Satisfaction comes from pursuing a goal, not from ultimately achieving it.

Successful employees generally focus on one objective at a time, and they always have the next goal in mind. They break more difficult tasks into smaller tasks, with mini goals along the way. They map out several different paths to their target; this allows flexibility if one path becomes blocked. Activity itself generates the impetus for further activity.

Conclusion: Determination and perseverance are important traits in the workplace. Employers want employees who are determined to get things done, make things happen, and constantly look for better ways of doing things. Employees are more likely to continue in the face of adversity if they think talent is only peripheral to their future success. Persistence and purposeful effort are more important than talent.

Studies have observed that when facing difficulties, those who believed their performance was transformable through effort not only persevered but actually improved, whereas those who believed that talent was everything regressed.

Don’t hire based on talent alone. To maximize the chance of hiring success, seek employees who work with determination and perseverance.

Walt Grassl is a speaker, author of Stand Up and Speak Up, and host of the Internet radio show with the same name. Walt’s accomplishments include success in Toastmasters International speech contests and performing standup comedy at the Hollywood Improv and the Flamingo in Las Vegas. For more information, visit waltgrassl.com.

[From the Aug/Sep 2014 issue of AnswerStat magazine]

Mindful Compassion in the Workplace: Improving Quality of Life in Your Call Center

By Ruth W. Crocker

If you find yourself listening to co-workers complain at work, you’re not alone. Jane, a registered nurse, often eats her lunch sitting on a curb in the parking lot next to the call center where she works. She’s looking for just a few minutes of peace and quiet from the chaos and complaints that echo off the walls in the employee break room where people wolf down their meals amid a chorus of gripes about work and working conditions.

A recent Harris poll found that 80 percent of workers feel stressed about one or more things in the workplace. Feelings of persistent high stress among workers have been shown to be related to negative outcomes, including personal and professional burnout, absenteeism, lower productivity, and lower job satisfaction. Besides the normal sources of stress – such as employment uncertainty due to globalization and increased job flux – agents and nurses like Jane must deal with meeting the needs of sick patients and coordinating and documenting care across healthcare systems. The sources of stress for workers at all levels and in all settings seem to be growing.

Is there a panacea or some secret potion that can be applied in a variety of work situations? Employers can help by offering wellness programs aimed at boosting mental and physical health. One highly recommended approach is the use of mindfulness training. Mindfulness is a method of learning how, and to what, we pay attention, in a particular way, on purpose, in the present moment, and without judgment. It is the process of learning a calm awareness of one’s body, feelings, and thoughts. Basically it demonstrates that we are what we think; it reminds us of the impermanence that everything we think is extremely important. Without becoming more mindful, we can focus continually on the same problems over and over again without resolving them.

Managers who practice mindfulness have discovered that it improves their ability to encourage calm and stability in the workplace. They actually increase productivity when they model “mindful manager” qualities, such as listening before acting and leading people by focusing less on hierarchical relationships. “Do this because I told you to” becomes “Let’s talk about how and why we do things this way.”

Managers report seeing themselves differently when they can introduce workers to a culture of mindfulness, which supports the notion that making occasional mistakes is part of learning; they can ask questions that require people to think about where they are in a work situation and how they got there.

Most people are more familiar with “mindlessness” – feeling forgetful, separate from ourselves, and as if we are living mechanically, like a puppet, controlled by others. Exercises that focus on mindfulness restore a sense of comfort with our decisions and ourselves. We feel whole rather than fragmented.

Formalized programs conducting mindfulness training at worksites have shown that employee stress levels decreased by 35 to 40 percent with an average of one hour of mindfulness practice per week. Exercises include meditation (a form of quiet thought without the goal of thinking), breathing in a focused, mindful way, gentle physical exercises, and conversations with a trained workshop leader. Jon Kabat-Zinn launched one of the original mindfulness-based stress reduction programs at the University of Massachusetts Medical School in 1979. Since then, many companies have used mindfulness-based programs to reduce stress in the workplace.

Here are some benefits of becoming more mindful:

  • Mindfulness practice brings the mind into the present and alleviates the stress of thinking about the past and the future. Relaxation can occur because obsession about problems is at least temporarily paused. Research has linked greater mindfulness with lowering blood pressure, decreasing anxiety, and reducing depression.
  • Mindfulness increases openness to new information and different points of view, thus increasing tolerance and decreasing prejudice.
  • Mindfulness enhances the consideration of ethics and wisdom in decision making.
  • Mindfulness encourages flexibility, productivity, innovation, leadership ability, and satisfaction. It decreases worry: If only three people show up for a job that normally requires four people, a more mindful manager will have greater ability to reassess the job and figure out how to get it done without adding new stress.
  • Mindfulness circumvents fatigue by encouraging people to change the context of a situation before reaching the point where they expect to be tired. Staggering different kinds of paperwork, moving to a different work setting or getting up to take a short walk are mindful ways to tap latent energy and change the mindset leading to exhaustion. Some people describe this as getting a second wind, but it is, in fact, a great example of mindfulness at work. Changing context before reaching exhaustion does prevent fatigue.

The advantage of focusing on becoming more mindful is that it’s a quality we already possess but don’t often use. Mindfulness relates directly to paying attention to whatever is happening in your life presently without blaming or judging. It’s a way of taking charge that enhances a sense of having control over your life rather than feeling like a victim of circumstances. It involves consciously working with your own stress, pain, and illnesses.

Hopefully, Jane has had time enough on the curb outside her call center to empty her mind of the sights and sounds of work, paying attention only to how she breathes and noticing which thoughts occur again and again when she is quietly alone. These are the first steps towards paying full attention to herself and discovering how to survive healthfully in a noisy, busy world with the mindful skills she already possesses. Her coworkers and callers will probably notice when she returns that she is calmer, smiles more, and seems to have discovered a happy secret.

Ruth W. Crocker, PhD, is an author, writing consultant, and expert on recovery from trauma and personal tragedy. Her book, Those Who Remain: Remembrance and Reunion After War, describes her experience following her husband’s death in Vietnam and how she found resources for healing. An excerpt has been nominated for a Pushcart Prize in 2014. She is writer-in-residence at Riverlight Wellness Center in Stonington, Connecticut, where she teaches the art of writing memoir and personal stories. She is available for workshops, readings, and public speaking. Contact her at ruthwcrocker.com.

[From the Aug/Sep 2014 issue of AnswerStat magazine]

The Fast-Food Factor: Does Your Call Center Have a Fast-Food Hiring Mentality?

By Peter Lyle DeHaan, Ph.D.

Author Peter Lyle DeHaan

I’ve never met anyone who felt they were overpaid. Occasionally someone will admit to being adequately compensated, but most people say their pay doesn’t reflect their work or value to the organization. This is especially true of call center agents. I’ve seen this both in running call centers and as a consultant. It matters not what the pay rate is, the universal belief is that the pay is too low.

Compensation is the single greatest expense for call centers. It accounts for anywhere from 40 percent to 85 percent of total expenses, depending on call center size. Pay too little, and turnover shoots up, training costs increase, and morale decreases. Pay too much, and the outflow of money exceeds the inflow of cash. No organization can stay in business if it loses money every month.

But what is an appropriate pay rate? Fortunately, the answer is close to home. I call it the “fast-food factor.”

Quite simply, if you hire call center agents at a fast-food wage, you’ll get a fast-food mentality and a fast-food performance. Yes, you will find the occasional star employee, but how long do you expect to retain him or her? Generally, you’ll find people with little work experience. They’ll view the job as temporary, not understand customer service, and fail to comprehend the necessity of being at work on time (much less giving two weeks’ notice before quitting). With the average agent training time exceeding the average fast-food employee tenure, you can’t afford to hire agents who might quit before they finish training. Yet when you compete with fast-food restaurants for entry-level employees, this is the likely outcome.

To succeed, call centers must pay more than fast-food restaurants, but how much more? Even fifty cents an hour can make a difference. A dollar more will have a much greater effect – if you do it right. What you must avoid when raising your starting wage is merely making it easier to find the same caliber of people; you must raise your standards, too. When you pay more, you can expect more.

As a consultant, one client’s staff kept complaining, “People working in fast food make more than we do.” After hearing five such complaints, I visited the seven fast-food restaurants within walking distance of the center. The staff’s perception was wrong, but the misinformation had gone unchallenged and been repeated enough that the lie was seen as truth.

Another client’s agents enjoyed a much higher starting wage, but they, too, complained of being under-compensated. Again, I surveyed the pay at nearby fast-food restaurants and discovered the call center’s starting wage was three dollars higher than the local fast-food benchmark. Fortunately, accompanying this higher starting wage were tighter pre-employment screening and higher performance expectations. The caliber of the staff was noticeably greater. No adjustment to their compensation was needed.

To determine the appropriate hourly rate for your call center agents, you have four options:

  1. Continue what you are doing (which probably isn’t working).
  2. Pay someone thousands of dollars to do a wage study.
  3. Refer to local wage surveys (which seldom list data for call center agents).
  4. Visit local fast-food restaurants, and then distinguish your hourly rate – and agent expectations – from theirs.

Applying the “fast-food factor” has never let me down and, I suspect, it won’t let you down either.

Peter Lyle DeHaan, PhD, is the publisher and editor-in-chief of AnswerStat. He’s a passionate wordsmith whose goal is to change the world one word at a time.

[From the Aug/Sep 2014 issue of AnswerStat magazine]

Severe Weather Doesn’t Have to Be Disastrous for Business

By Scott Kinka

Though signs of summer are apparent, it’s tough to forget that winter 2013–2014 was one of the coldest on record in parts of the country, according to the government’s official monthly climate report released recently. The cold and snow had a direct impact on the bottom line of many businesses as offices across the U.S. shut down for days, resulting in business disruptions and revenue loss – especially if employees were not to work from home. Now with hurricane season upon us, businesses should take a lesson from this past winter’s experiences to minimize potential further disruption to come.

While some industries cannot avoid losses due to severe weather, it is possible for many organizations to be productive and profitable even when workers can’t get to the office. Companies that implement cloud-based technology in some capacity are seeing far less business disruption associated with inclement weather or extreme weather-related disasters.

The John M. Glover Agency and Hurricane Sandy: The IT and executive teams at a national insurance company, The John M. Glover Agency, know firsthand how valuable a redundant cloud platform can be during a natural disaster. In 2012, as Hurricane Sandy raged off the mid-Atlantic coast, the organization was able to access all of its key systems and data to proactively service customers. As the storm bore down, associates at the firm were able to take advantage of virtualization services to stay safe and productive from home. With a cloud-based platform in addition to glitch-free unified communications systems, Glover employees had no problem connecting to applications like Office, QuickBooks, ACT, and proprietary databases, helping them stay in constant communication with customers and prospects.

According to a Dun & Bradstreet report, the devastation of Hurricane Sandy potentially affected some 1.5 million businesses located across nineteen counties in the tri-state region. These businesses employ 9.3 million individuals across 1,000 different industries, all who were vulnerable to the effects of Hurricane Sandy.

Cloud Computing Survey: Glover is just one example of a company seeing the tangible benefits of using a cloud-based infrastructure. A recent survey asked 1,000 executives and IT professionals in mid-market organization about cloud adoption. The survey found that nine out of ten agree: The future model of IT is definitely cloud computing. In accordance with that number, Forrester Research expects the global market for cloud to reach $118 billion in 2014. More simply put, the cloud delivers tangible benefits, and IT pros and executives know it.

In the survey, “disaster avoidance/recovery/business continuity” was the highest ranked expected benefit of moving to the cloud, as cited by 72 percent of respondents. Regardless of the specific plan, it is safe to say that in the wake of significant weather emergencies and unforeseen events, businesses are more concerned today than ever before about operational continuity and disaster recovery.

Most businesses have a simple disaster recovery plan that involves sending backups to an off-site facility or using an online service to back up data. However, those plans often do not detail exactly how that data and applications will be recovered, how quickly they can be recovered, or how they will be used in the event that the server or infrastructure on which it was originally located is lost or destroyed. Nor do most organizations’ disaster recovery plans account for how users will continue to communicate with the server, applications, each other, customers, and vendors if a location is unreachable. While there is a perception that implementing a comprehensive disaster recovery plan could be complex, cloud-based technologies enable businesses to remain productive even in the height of a weather emergency.

The Cloud Keeps Productivity at Peak Levels: The cloud can help organizations rise above natural disasters, a realization that became clear to executives at Apria Healthcare following Hurricane Katrina. As the devastating hurricane hit New Orleans and storm waters knocked out telephone service, Apria, a national deliverer of home healthcare services, could not take calls from customers, many of whom had made hurried departures from the area and were now in need of extra oxygen tanks and other supplies. Following Katrina, executives at Apria sought a new communication solution that would provide cost savings, simplification, and a good customer experience, as well as a disaster recovery and business continuity capability.

With more than 550 offices nationwide, Apria selected a geographically redundant, active-active cloud solution for placing calls, routing, and data. Through this deployment, phone systems could be accessible from any branch at any time and calls could be shared without geographical constraints. Moreover, if a branch was compromised due to a local issue, such as a power outage, Apria could redirect calls for that branch to a location that had not been compromised.

Sure enough, the new infrastructure was tested shortly after implementation, as twenty of Apria’s offices were directly in Sandy’s path. The company was able to change their call routing to forward calls from sites impacted by Sandy to other locations that could serve those customers. As a result, the company avoided downtime, even though both phone and data connectivity were lost due to the storm.

Cloud hosting affords businesses access to resources, servers, and software, virtually eliminating any concern that a disaster – or even a simple outage – will affect productivity. Moving applications and infrastructure to a cloud – be it private, public, or hybrid – ensures that applications are available from any location regardless of what’s happening at the physical site.

Summary: In August 2005, Hurricane Katrina became the seventh most intense Atlantic hurricane ever recorded. In October 2012, Hurricane Sandy ravaged the Atlantic coast, affecting eight million people and causing billions of dollars in damage. The primary concern during a severe weather event is, undoubtedly, the safety and well-being of the people and communities that are hit. Secondarily, businesses must think about the potential impact on business operations, revenue, and the bottom line. A solid IT shift toward cloud computing might have saved some of the companies affected by these hurricanes from the devastating lack of business continuity and revenue loss. The cloud is a proven strategy to circumvent many of the problems inherent to surviving a disaster of any kind.

Scott Kinka is CTO at Evolve IP (www.evolveip.net), the Cloud Services Company™ that provides center managers with more control and deeper insight into their operations.

[From the Aug/Sep 2014 issue of AnswerStat magazine]

Three Reasons Your Emergency Plan Will Fail

By Lucien Canton

When the Exxon Valdez ran aground in Prince William Sound in 1989, it was one of those extremely rare occurrences where the conditions of the crisis almost exactly matched the planning assumptions in the company’s emergency plan. This included the weather conditions and the size of the spill. It was as if the plan had been tailor-made for this specific event.

Nevertheless, the response was characterized by confusion and delays, and it soon became obvious that the plan was a failure. The planners had created what sociologist Lee Clarke calls a “fantasy document” – a plan that ignores potential consequences and the capacity of the organization to implement it.

Unfortunately, the Exxon Valdez is not an isolated case. Your organization – and your call center – may convince itself that the mere fact that you have a plan is sufficient to keep you from harm in a crisis. However, without addressing three critical elements, your plan will fail.

1) Misunderstanding the True Cost of Crisis: It is surprising how many organizations fail to understand that the true cost of a crisis can be both tangible and intangible and can occur on both a micro and macro level. Most focus on the obvious tangible costs: damage to property, lost productivity, etc. But, failing to fulfill commitments may also carry reputational costs that can affect future business.

Your ability to continue to meet their needs will be a primary consideration to your customers. The way you communicate with your customers, staff, and public can affect future business. How you deal with employee issues at the time may affect your employee’s willingness to return to work.

There are also macro effects. Large crises can generate dramatic population shifts that may eliminate the need for your product or services or change the demographics of your labor pool. Conversely, you may also see an increased demand for your product or services or the emergence of potential new lines of business. You may or may not be able to anticipate these macro changes, but your plan should allow you to recognize when they are occurring and the flexibility to react to them.

2) Treating Your Plan as External to Your Business: To many organizations, a plan is little more than a fire extinguisher, a necessary expense that no one ever really expects to use. But, treating your plan as external to your business means that there is no connection between how you deal with day-to-day problems and what you will do in a crisis.

Ideally, your plan should be scalable. It should be integrated with your business and allow you to ramp up as situations become more complex. The same people you turn to for help on a daily basis will most likely be the core members of your crisis management team, and they will default to their normal roles and responsibilities. The closer your emergency plan aligns with these established roles, the easier it will be to implement.

Plans that are not aligned with your business will fail. Disaster researchers have found that even in the best run organizations, few people consult their plans at the time of crisis. If your planning process does not provide a close integration between day-to-day problem solving and crisis management, your staff will either forget that a plan exists or completely ignore it and default to the roles they fulfill on a daily basis.

3) Failing to Consider the Human Factor: A common failure in planning is to use a template or sample plan without considering the effect of your corporate culture on your plan. Factors such as risk tolerance, decision-making strategies, and team cohesiveness will affect the implementation of any plan. For example, organizations where decisions are made by consensus don’t always do well with plans that enforce a rigid hierarchy. Similarly, companies with strong hierarchies don’t do well with plans that rely on decentralization.

Taking this further, you need to consider how your workforce will react in a crisis. People respond differently to certain types of crises based on their culture and experience with past disasters. For example, survivors of the Mexico City earthquake who had immigrated to Los Angeles were reluctant to return to their homes after the Northridge earthquake because of their memories of that event. Parents may want to leave to take care of their families.

The one thing people will not do is panic. There are only limited situations where this occurs. Instead, people are resilient and extremely creative in solving problems. This is a resource that can reap dividends at the time of crisis if your plan takes into consideration the needs and strengths of your staff.

Conclusion: The military has a maxim; “No plan survives contact with the enemy.” This is true of emergency planning as well. Ultimately the success or failure of your plan does not depend on how well it is written or how well it conforms to an external standard. It depends on your understanding of the nature of crisis and the level to which you have integrated your plan with your business processes and corporate culture. Only by considering these basic factors can your plan be truly realistic.

Lucien G. Canton, CEM, is a consultant specializing in preparing managers to lead better in crisis by understanding the human factors often overlooked in crisis planning. A popular speaker and lecturer, he is the author of the best-selling book Emergency Management: Concepts and Strategies for Effective Programs.

What Are Your Call Metrics Really Telling You?

By Vasudha K. Deming

One of the great things about the call center as a workplace is the ready availability and near-instant access to metrics, that is, measures of quality and productivity. Unfortunately, this easy access often results in a shortsighted assessment of what the numbers really mean. The following is an examination of what might be lurking behind four of the key metrics used to assess medical call center agents.

1) Average Handle Time (AHT): This is one of the most commonly used metrics and a favorite with call center management. This makes perfect sense; if calls can be handled quickly and efficiently, everyone wins, right? The problem is that quick does not always mean efficient.

When agents are told (and in some cases incentivized) to keep AHT low, they tend to focus primarily on call length and will take all reasonable shortcuts to keep it short. There are a number of possible pitfalls:

The agent may be missing or skipping opportunities to provide the patient with valuable education/information; in some cases, they may be missing cross-sell opportunities.

The agent may do away with small but crucial courtesies, such as thanking a caller for holding, executing a warm transfer, or building rapport, all of which factor into customer satisfaction.

The agent might omit the step of updating a customer’s account data or otherwise capturing valuable information that can only be obtained during a live contact.

The key to success is to maintain a strategic equilibrium between AHT numbers and other metrics, such as customer satisfaction, first-contact resolution, and revenue per call (if applicable).

2) After Call Work (ACW), also known as Wrap Time: It’s easy to understand why this metric is so commonly used in centers; a key factor of workforce management is making sure agents are moving briskly from one call to the next. Unfortunately, I’ve repeatedly seen the hazards of overemphasizing this metric.

For example, getting that extra few moments between calls can make all the difference to an agent’s ability to handle the next call with a positive, professional attitude. This is particularly true in cases where the agent is dealing with an ill, injured, or distraught caller.

If ACW is a metric that is stressed in your call center, make sure you put other measures in place to guard against agent fatigue, low morale, high turnover rate, and a poor relationship between agents and management. One tip that might prove helpful is to hold agents to a stringent ACW standard during periods of high volume but then ease up on it once or twice per shift, as call volume relaxes.

3) Staff Shrinkage: The amount of time that employees are on the clock but not available to handle calls is often referred to as shrinkage. Granted, call handling is an agent’s primary job role, but if the expectation related to shrinkage – and the related measure of “utilization” – is too severe, it’s likely to create issues of low morale and high turnover.

When call center agents are given sufficient time for training and career path projects not only are they more knowledgeable and productive, but they also tend to feel like well-rounded employees. This, in turn, can lead to higher performance, increased employee engagement and satisfaction, and lower turnover.

4) First-Contact Resolution (FCR): It’s difficult to come up with any cautions against using first-contact resolution as a key metric in your call center. This tends to be an essential measure relevant to profitability, efficiency, and customer satisfaction – and it’s one that I consistently espouse for call center performance optimization. So, if you’re not yet measuring this one, start now.

That being said, there is one pitfall that I’ve occasionally seen in technical support environments. It’s the danger that agents, striving for FCR, will stay on the phone too long when, in fact, the customer would be better served by a callback after the agent has done additional research or consulted with the appropriate peers.

In summary, think of metrics as more a scale than a yardstick. The data yield weights and counterweights that help you to achieve that all -important balance between quality, productivity, customer service, and employee satisfaction.

Vasudha K. Deming is an author, customer service consultant, and principal with Impact Learning Systems, a communication skills training company.

[From the December 2010/January 2011 issue of AnswerStat magazine]

Just Ignore It, It’s Only a False Alarm

By Peter Lyle DeHaan, PhD

Peter DeHaan, Publisher and Editor of AnswerStatIf you have technology in your call center, then you’ve likely been frustrated by false alarms and erroneous error messages. I was recently reminded of this as I searched for the source of an alarm, warning me that something was awry at home. The culprit: was a carbon monoxide detector. After an hour of futile troubleshooting, I began to consider that maybe there were actually unsafe carbon dioxide levels in my home.

What a novel thought; in all my years at call centers, I never experienced a smoke, fire, or carbon monoxide alarm that actually alerted an unsafe situation. In fact, I’d been conditioned to assume that any alarm was a malfunction. Smoke detectors were high on that list, with their low battery beeps and an occasional false alarm. When I would test them, no one ever left their station or asked if there was a fire. They merely said, “Make it stop so we can hear.”

UPSs also seemed to do more harm than good. It’s confounding for a malfunctioning UPS to take down the servers and switch when perfectly good utility power is available. Yet it happens. For a while, I kept track: UPSs were actually causing more downtime then they prevented. Generators also fit that category. Regardless if there was an automatic transfer switch or a manual bypass, inevitably something would go wrong. Despite agent training and trial runs, nothing seemed to adequately prepare staff to deal with an actual power outage.

Spare parts and backup circuits were another cause for frustration. You have them in case of an emergency, periodically testing them to make sure they work. Unfortunately, it seems that efforts to do so invariably result in unexpected problems, including system crashes.

The last category of irritations involves data backups. As if making successful backups isn’t challenging enough, retrieval is fraught with peril. Attempts to do so have crashed systems and corrupted good data.

Despite these frustrations, it would be irresponsible not to do all that can be done to keep staff safe, systems functioning, lines open, and data secure. The false alarms and problems are merely side-effects of the process.

As far as my issue at home, it was a false alarm after all.

[Posted by Peter DeHaan for AnswerStat magazine, a medical healthcare publication from Peter DeHaan Publishing Inc.]

Lean Six Sigma in Health Call Centers

By Sherry Smith, RN, MSN, MBA

The economic crisis is affecting numerous industries across the nation. Almost daily, we are exposed to news about layoffs, tightening credit markets, bankruptcies, bailouts, and their implications for the future.

Healthcare, and more specifically healthcare call centers, are not immune to the trickle down impact. Medical call centers have typically been viewed as cost centers and, therefore, are now more than ever at risk for closer scrutiny. While most organizations might be inclined to slash positions, the opportunity exists to focus on customers and processes that add value to the telephone encounter. Elimination of waste will create greater efficiency in call processes. In turn, excess capacity will open an opportunity for increased value-added activities that increase customer satisfaction. Implementing Lean Six Sigma in healthcare call centers, as a quality improvement initiative, is one way to accomplish these results.

Why Lean Six Sigma versus Six SigmaSix Sigma approaches focus on statistical analysis to reduce errors, thus are quite prevalent in manufacturing industries. Lean Six Sigma focuses on process evaluation to reduce waste and has spread from industry to industry after initial adaptation from Toyota Production Systems. According to the Institute of Medicine, 30 to 40 cents of every dollar spent on healthcare is for costs associated with waste such as overuse, misuse, underuse, duplication, unnecessary repetition, system failure, inefficiency, and poor communication.

While a focus on reducing errors is important, most organizations don’t have reliable, consistent data to pursue the rigor of statistical analysis required of Six Sigma. Fortunately, given the rigor and concordance of triage decision support tools, the call center is not a common practice area prone to errors. Thus, the application of Lean Six Sigma strategies to reduce waste makes more sense.

Others believe that the proportion of waste in healthcare can be estimated anywhere from between 30 to 60 percent, with only 10 percent of work performed being considered as value-added. These are disturbing facts, but consider some of the common issues of waste such as waiting, handoff breakdown, errors and mistakes, correcting, revising, inaccessible information (such as a patient EMR), lack of tools or equipment, limited resources, inflexible processes that limit opportunities to improvise, and unnecessary movements that take time.

A prime example of waste is work-around, otherwise known as those additional tasks or steps that become imbedded into processes during times of crisis or demand to meet a short-term need. Many times these are put in place by well-meaning individuals, but work-arounds unfortunately get ingrained as “policy” through future on the job training and orientation – and are never revisited.

Webster’s Dictionary defines value-added as “of, relating to, or being a product whose value has been increased especially by special manufacturing, marketing, or processing.”  Non-value-added tasks increase cost, time, and consume extra resources without directly delighting customers or callers. Focusing on these types of additional activities is a gold mine for applying Lean thinking and strategies.

Strategies and Tools to Utilize: To stay competitive, healthcare call centers need to be able to provide consistently high quality services. In essence, callers should expect uniformity in how their calls are handled, as well as the outcome or disposition regardless of shift, day, or agent. Key elements include:

  • Stabilization: remove excess variation in the call flow or call handling processes
  • Standardize: establish work rules or procedures to outline best practice (charts or visual guides are usually helpful)
  • Simplify: explore ways to keep it simple through work redistribution or technology

In order to achieve success, organizations must outline what teams will use as a standard improvement model. A commonly used model is known as DMAIC (Define-Measure-Analyze-Improve-Control). There are a number of resources available in the literature that outline different approaches DMAIC in Lean Six Sigma projects. Organizations most commonly struggle with choosing appropriate tools to best help achieve success in accomplishing these steps. The most commonly utilized tools include:

  • Value stream mapping
  • Non-value-added analysis
  • Operational definitions
  • Queuing theory
  • Visual process control

A critical component for any Lean project is creating the infrastructure to champion and support the work teams. It will not succeed if it becomes another “silo” in an organization. Leadership most often makes decisions around infrastructure design to develop the business case, establish goals and budgets, and benchmark performance against other organizations if data is available. The team members typically include managers, white or green belts, sponsors, champions, and for larger institutions, access to black belts. The key factor is to be sure an include people from all aspects of the call handling process and those who have real work connections to how calls flow through the technology and phone switches. These individuals involved in the front lines should have some initial training as either white or green belts.

Leadership must then make it a priority to provide the time to review progress and hold line managers accountable for successfully engaging the work force. As with any change, the mechanisms for communication (both up and down) become integral for any projects success. This vital step ensures continued engagement and excitement for all involved.

Case Study from a Healthcare Call Center: Lean Six Sigma was applied in a rather large call center that employs over 300 nurses and processes greater than a million triage calls per year from multiple sites. The organization had noticed that its call handling times were increasingly creeping up over the past few years, with no one indicator or reason identified as the cause. Lackluster performance overall was jeopardizing client service levels resulting in financial penalties. Next, the DMAIC model was applied:

  • Define stage: The leadership team was noticing increasing complaints from callers about unnecessary questions being asked and re-asked. In addition, the call handling metrics had increased from 10.5 minutes for a triage call up to 12-13 minutes. RN turnover was another contributing factor to the call center’s overall poor fiscal performance from quarter to quarter. These were the three metrics chosen for the project.
  • Measure phase: The organization brought in a consultant to provide an unbiased assessment in order to thoroughly understand the current state of call processing. This was accomplished via observations at different times of day, involving multiple nurses and agents. The organization had already collected data on team member satisfaction, quality audits, and productivity trending.
  • Analyze: A number of areas were identified during the intake and triage processing steps as non-value-added.
    • Agents were manually logging all calls on intake and then entering them in to the system in case “the system went down” (a duplication of effort).
    • Nurses asking irrelevant opening questions to assess for ABCs, regardless of the reason for the call (a source of frustration to nurses and callers).
    • Inadequate queue management strategies were being utilized.
    • Various call process “rules,” developed over time, led to punitive auditing practices, eliminating critical thinking skills (leading to fear and frustration).
  • Improve: With key stakeholder input, the entire call handling process was retooled, focusing on minimizing non-value-added steps while ensuring there was no deviation from sound risk management practices. Queue management was revitalized to ensure a “focus on the core” by assuring clinical oversight, prioritization, and realigning staffing patterns to cover peak call volumes. The team was cognizant of inevitable “scope creep,” and this was mitigated through solid group facilitation techniques.
  • Control: Initial results have yielded an impressive ROI based on decreasing call handle time by an average of 15 percent, improving service levels, and turnover of clinical staff down by 20 percent. Validation of persistent improved performance will continue over the next six months to further quantify the financial results. Plans are underway for celebrating the hard work and successful efforts. Other opportunities identified during the process included exploring a remote workforce program, revamping the entire QI program from a focus of auditing to continuous improvement, and commitment to work with technology vendor to influence sustained input on enhancements.

Presently, not much current literature exists relating to the success or failure of Lean Six Sigma strategies in healthcare call centers. We need to encourage colleagues and call centers to share their experiences and celebrate their accomplishments to contribute to the overall success of health call centers during these troubled economic times.

Sherry Smith, RN, MSN, MBA, is a senior consultant for 3CN – Call Center Consulting Network, a network of health call center experts available to assist with strategic, operational, or technical projects. Sherry can be contacted at 603-707-0151 or sherry.smith@3-ct.org.

[From the August/September 2009 issue of AnswerStat magazine]

Surviving and Thriving in a Recession

By Julie Bruns and Sue Altman

Healthcare is often cited as a safe industry during downward economic times, but we know that no industry is immune to the effects of a recession. What may cause healthcare to experience difficult times in this current recession? There are several theories:

  • People may be deferring elective, self-referred procedures, like screening colonoscopies and mammograms, if these tests aren’t fully covered by insurance.
  • They may also be delaying “necessary” procedures, which are non-urgent: things like arthroscopy and other repairs, which would improve life but can be postponed until the economy is better (and a sense of job security returns).
  • The number of uninsured and underinsured grows with the unemployment rate. This, in turn, causes bad debt at hospitals to increase when patients can’t afford to pay for the care they receive.
  • Ongoing issues with cuts in government reimbursement (Medicare and Medicaid) have a significant impact on the hospital’s bottom line.

The healthcare industry has not escaped layoffs and program cuts in recent months. Thirty-three percent of call centers responding to a survey conducted by C3N attested to job losses in their organizations. Another 71% reported budget cuts in the past few months. So, is our call center industry safe? With this in mind, the following article addresses selected strategies you can use to position your call center for survival and even long-term growth.

Running a Tight Ship: Our first recommendation is to tighten up your processes and make sure you are operating at optimal efficiency. Call center managers have mentioned belt-tightening strategies, from cutting specific budget items, such as travel and conferences, to really digging into efficiency. Approximately 70% of any call center budget is spent on wages and benefits. Therefore, to best leverage your contribution, you need to focus your staff on the right services, supported by efficient processes and performance.

Erlanger Health System in Chattanooga, Tennessee, went through an enterprise-wide belt-tightening in mid-2008. During budget discussions, senior leadership asked for a 10% cut across all programs. Beyond this first measure, specific programs were examined more closely, with the pediatric call center being one of them. Their challenge was to develop a strategy to become budget-neutral.

Chris Vaughn, RN, BSN, clinical director of marketing and medical call centers, worked on the business plan, pricing model adjustments and new service strategies. Kathy Guidry, RN, lead technical nurse of their medical call center, knew she would have to reduce staff to achieve the immediate 10% reduction. And with that, she realized the remaining staff would need to increase their efficiencies to maintain the center’s service levels. She and Rhonda Garth, RN, lead clinical nurse, evaluated their current metrics and developed a course of action.

First came communication. The staff knew that FTE counts were being reduced in many departments. The next step was to describe the “how” and “why” of improving productivity and efficiency. They worked closely with the remaining nurses to evaluate areas for improvement and offer focused education. The following tactics were helpful:

  • Developing scripts to help nurses take greater control of the call from the beginning
  • Encouraging more concise nurse’s notes, eliminating details that were not necessary to make a decision on the current problem
  • Encouraging greater use of initial assessment questions
  • Having the nurses listen to call recordings and evaluate instances when a call could have been better controlled

The story has a positive ending: productivity has increased, more favorable pricing model was instituted, and the center actively pursued additional after-hours contracts.

Proposed Actions:

  • Examine your current service offerings. Are there any that no longer make sense or provide less value to the organization? How does each service rank in order of contribution?
  • What service might you be doing “because you’ve always done it?” Stopping these activities or finding another way to do them may free up valuable capacity for more important tasks.
  • Use Six Sigma or LEAN. If you have trained staff in your organization, seek their help. “Black belts” and “yellow belts” are trained specifically to analyze a process, review data, and lead you to ideas for improvement.
  • If you don’t have the luxury of Six Sigma trained staff, you can still look at call processes. What can you do to safely reduce call times? Are you using your software effectively? Pull together a team of your top performers and challenge them to take a closer look.
  • What staffing options do you have available? Can you flex your staff to make your services more productive? Are there hours when you are overstaffed and you could free up people for other work?
  • Look at call volume and staffing hour by hour, day by day. This could be an exercise to reduce the budget and FTEs. Instead, view it as a way to increase your capacity to accept new business, thereby making your service more vital.

Communicating Your Value: If members of your senior leadership team were asked, “What does the call center do and why is it valuable?” what would they say? Don’t wait to be asked about the call center’s contributions. Be proactive and tell your story. Here are four suggestions:

  • Invite senior leaders and service line directors to tour the call center and listen in on a few calls. No presentation or report can describe your world like actually living in it, even briefly. Moreover, they may come away with ideas for growth that haven’t occurred to you.
  • Design and distribute reports that concisely illustrate what value the call center provides. Focus on results using action verbs and graphs that convey clear, positive messages. Don’t bury the reader with pages of data.
  • Prepare brief case studies or vignettes to highlight call center success stories.  Real examples, especially those that increased business or decreased cost or waste, can be more effective than charts or spreadsheets.
  • Remember that your senior leaders come from varied backgrounds. An executive meeting may be comprised of experts in information systems, finance, marketing, planning, medicine, nursing, human resources, operations, and support services. Some may even be new to healthcare. Be aware of any jargon you may use specific to telecom, call center services, or clinical processes. If you provide a handout, be sure the information is clear and leaves no room for misinterpretation.

Look for New Growth Opportunities: Sometimes we lose sight of the fact that call centers were initially designed to centralize communication in order to reduce costs and gain efficiencies. Before the recession, there was already a growing trend to centralize functions, such as scheduling, navigation, and outreach. In the spirit of cost containment, now may be the time to move an idea forward.

Managers are sometimes so focused on pet projects (such as post-discharge calls, nurse navigator services, and access management) that they may not recognize them as services that your call center could provide. There is opportunity to proactively describe your capabilities, even if they are not services you perform today. Consider the following approach:

  • Schedule a meeting with planning or business development. They usually have the pulse of the future of your organization and know what ideas and new service lines are in the pipeline. It is crucial to make sure that planning knows how the call center functions and what it can do. It is equally important is for them to know that you are willing to take on new opportunities.
  • Look for committees or work groups you can join that will expose the call center to other departments.
  • Invite leaders in your organization to visit the call center and observe your operation. Have them put on a headset and listen to calls with your staff. Help them see the call center “in action.”
  • Design a capabilities presentation and ask for time on the agenda at leadership meetings, operations meetings, and key service lines that drive volume.
    • Your presentation should be brief and to the point.  Use no more than 8 to 10 slides and limit your message to 15 minutes.
    • Focus on the value and results of your activities instead of merely reporting call volumes. For example, describe the percentage of referral calls that are converted to appointments or how your center handled the XYZ project that resulted in X% volume growth for heart services. The focus should be on the business-driven.
    • Offer your vision for the call center and your willingness to work with other departments to achieve success.
  • Is your call center open outside of normal business hours? Can you provide after-hours services for other departments, such as outpatient testing? If you step up, will fewer callers go to voicemail?
  • You have two things that perhaps no one else in your organization does: first-hand “voice of the customer” information and a rich database of people interested in your hospital. Help planning and service line managers understand how your data can help them with target marketing and outreach.
  • Expand your horizons outside of your organization. Do you collaborate with any other businesses or community organizations that could benefit from your services? Not only could you increase the revenue you’re bringing in, you may also create indirect revenue by growing referrals.

Geri Hammes, RN, BSN, is the supervisor of the Franciscan Skemp Call Center in LaCrosse, Wisconsin. “I know call centers can be considered money-pits, just another overhead expense,” she stated. “Well, we are becoming a spider’s web in a good way, taking on as many operational functions as makes sense, until we are truly irreplaceable.”

One of the creative services the Franciscan Skemp Call Center has recently planned is collaboration with the system’s clinics. The 4 p.m. to 5 p.m. time slot has historically been less productive for the triage center but for the clinics, it’s chaos. “We will soon be taking over their phones to help sort out their remaining calls of the day. While our staff is providing triage and customer service, the clinic staff will have a chance to get caught up on the referrals, paperwork, labs, and other necessary activities, without the added stress and distraction of the phones,” states Hammes. “Call center productivity will be optimized and our hope is that once the data is interpreted, the clinics will incur less overtime (over-budget) hours.”

In exploring other growth opportunities, Mrs. Hammes realized that many departments in her organization did not understand the call center’s services or their capabilities. To address this, she and her staff wrote the call center’s resume.

One growing theme, regardless of the economic conditions, is to claim a more mainstream role in scheduling and patient access services. Through referral and wayfinding, most call centers fulfill a small piece of this larger picture. Scheduling, order management, registration, and insurance verification continue being handled in other departments and other call centers.

Kathy Ingalls Hefni, RN BA, of Detroit Medical Center, serves as the corporate director of the Health Access Center & Central Region Operator Services. She describes their evolution from a triage and referral call center to the central scheduling service for six of their seven hospitals. Five years later, her team continues to learn and implement new ways to improve throughput and reimbursement not only for the health system, but also for their affiliated physicians.

Julie Bruns, director, Call Center & Market Research, BJC Healthcare, was the lead writer of this article. Sue Altman, president of Call Center Consulting Network (3CN) was a contributing writer and editor.

[From the June/July 2009 issue of AnswerStat magazine]

Call Center Basics

By Peter DeHaan, PhD

Peter DeHaan, Publisher and Editor of AnswerStat

When I ask folks if they work at an in-house or an outsource call center, I am surprised at how frequently this question is fumbled. At risk of offending knowledgeable veterans, I offer the following call center basics:

Inbound Call Centers answer calls. Their agents react, waiting for the phone to ring or for the next call in queue. Inbound call centers are equipped with ACDs (Automatic Call Distributors) to efficiently send calls to the “next available agent.” Many inbound operations are staffed 24 x 7, with their agents scheduled in anticipation of projected calls based on historical data and marketing initiatives.

Outbound Call Centers make calls to customers and sales prospects; it is proactive. Even if agents’ work is not “sales” per se, they still need a sales mentality. They must engage the called party, lead them towards an objective, and deal with rejection. Outbound centers rely on predictive dialers to place calls. Agents are scheduled as needed to complete a desired number of calls within a certain time, as limited by law.

In-house Call Centers are an internal department of an organization; they provide services exclusively for their own company. An in-house call center can be a cost-center or a profit-center. Cost-centers are subsidized by corporate, whereas profit-centers charge other departments for the work they do.

Outsourcing Call Centers do work for other organizations; their business is making and receiving calls. They often enjoy an economy-of-scale that is not feasible with in-house operations. Therefore, their margins allow clients to save money, while they make money. Agents at an outsource centers work for their clients, but work with their client’ customers or prospects. Outsource call centers are increasingly desirable as more organizations consider outsourcing to increase service levels and options, return to their core competencies, save money, or all three.

Offshore Call Centers are simply any call center that is located in a different country, or”offshore.” Off shoring is often erroneously considered synonymous with outsourcing, but they are not the same.

Whatever type of call center work you do, do it well — that is the critical lesson of Call Center Basics.

(For more call center basics, go to StartACall.com or StartAnAnsweringService.com.)

[Posted by Peter Lyle DeHaan, PhD for AnswerStat magazine, a medical healthcare publication from Peter DeHaan Publishing Inc.]