Disney and Ritz Carlton Customer Service - NationalCouncil · PDF fileDisney and Ritz Carlton Customer Service Tailored for Your Organization Thought Leader: David Lloyd, Founder MTM

Disney and Ritz Carlton Customer Service

Tailored for Your Organization

Thought Leader:

David Lloyd, Founder MTM Services

Email: [email protected] Website: mtmservices.org

mailto:[email protected]

The Growing Importance of Customer

Service for CBHCs

• 1993 – Two staff attended first Customer

Service Training session. “Important

operational concept in private corporations,

but does not apply to non-profit CBHCs!”

• 2012 – Over 600 CBHCs attended National

Webinar on Customer Service

• Current era of Healthcare Reform has

changed the “competitive landscape” for

CBHCs.. Such as..

Presented By: David Lloyd, Founder, MTM Services 1

States Shifting From 1915 (b), (c) Carve

Out Medicaid Waivers

• Shift from carve out Medicaid BH funding to Section

1115 General Integrated Waivers (Alabama, Arizona,

Arkansas, California, Colorado, Delaware, Florida,

Illinois, Iowa, Kansas, Kentucky, Illinois, Louisiana,

Maryland, Massachusetts, Maine, Minnesota, New

Mexico, New Hampshire, New York, Oklahoma,

Oregon, Tennessee, Texas, Utah, Vermont,

Washington, Wisconsin, etc.)

• Over 40 states have modified their State Medicaid

Plans since March 2010


Healthcare Reform Trends in 2015

• Accountable Care Organizations (ACOs) are

being certified by CMS with over 600 announced

Federal Certifications for both Medicare and

Now Medicaid Share Savings Plans

• 14 plus states have applied under Section 2703

of the ACA to develop Integrated Care Health

Homes (e.g., Missouri)

• FQHCs have over 8,000 Federally Certified

locations nationally and are still growing


Growth in Numbers of ACOs Nationally

Chart 1: Total Accountable Care Organizations by Quarter beginning Q4 2010 Source: Leavitt Partners Center for Accountable Care Intelligence


Growth in Numbers of ACOs Nationally Chart 2: Total Accountable Care Organizations by Sponsoring Entity

Source: Leavitt Partners Center for Accountable Care Intelligence


Growth in Number of ACO Covered Lives Chart 3: Total Covered Lives Growth for ACOs Beginning January 2010

Source: Leavitt Partners Center for Accountable Care Intelligence


Growth in Numbers of Clients Served by FQHCs

Chart 4: Estimate Growth of Patients for Community Health Centers (FQHCs):

Source: National Association of Community Health Centers, Inc., Bethesda, MD, June 2010


What Customer Service Thoughts Come to

Mind?

• When you think of Disney World or

Disneyland?

• When you think of the Ritz Carlton Hotel?

• When you think of Amazon and Amazon

Prime?

• When you think of your local CBHC?


Important Questions That Assess the Level of

Support for Excellent Customer Service

• Does your center have a customer service based key

performance indicator for all staff?

• Does your center evaluate each staff on their customer

service capabilities in their individual annual performance

evaluations?

• Does your center employ mystery shoppers model to

confirm level of customer service being provided?

• Does your center have an image building/ marketing/public

information plan in place?


Important Questions That Assess the Level of

Support for Excellent Customer Service

• Over 600 people attended the national customer service webinar

in October 2013

• Poll Questions and Results:

– Does your center have a customer service based key

performance indicator for all staff? NO – 63% YES – 37%

– Does your center employ mystery shoppers model to confirm

level of customer service being provided? NO - 82% YES –

18%

– How often does your center send Referral Source Satisfaction

Surveys to all sources of referral? NEVER –

50% QUARTERLY – 14% ANNUALLY – 36%

– How often does your center measure customer/client

satisfaction? NEVER – 6% QUARTERLY – 45% ANNUALLY –

49%


Historical Myth and Stigma Creates

Barriers to Customer Service

1. Community Relations: The good will factor the organization has

earned in the market area based on consistent development of

marketing initiatives to share service delivery capacity, capabilities

and outcomes with the publics.

2. Myths: A declining negative organizational public image drives

myths about the organization’s service delivery system and/or

about consumers who seek services through the system.

3. Stigma: Myths that have been perpetuated and uncorrected for a

period of time formalize into stigma about receiving services at

CBHCs.

4. Public Image: The total value of Community Relations less

Myths and Stigma = Public Image


Customer Service Approach

Disney/Ritz Carlton vs. Behavioral Healthcare

1. The Customer comes first

2. Customers define excellent service

3. What's best for the customer is best for the organization

4. Managers are responsible for spreading a culture of service to the employees

5. Providers of customer service must pay attention to every detail of the customer experience

1. Payer Requirements/ Standards are often

the top Priority

2. Staff members tend to focus on meeting

the service delivery system’s needs

3. Access to care is usually based on

clinicians’ availability not on when the

client calls or walks in for help

4. Less than 5% of publically funded human

service agencies have Customer Service

KPIs for staff

5. CBHCs have tended to use “silos” of

service into treatment instead of a

“horizontal” service experience (i.e., Avg.

CBHC asks 450 to 750 redundant

questions in the access to treatment

process)


Core Customer Service Questions

1. Are the staff primarily focused on serving the ‘system’,

or serving the individual presenting for care that the

system was originally designed to serve?”

2. How is the internal staff to staff or program to program

customer service working?

3. What is the level of internal “system noise” that takes

your staff’s attention daily?

4. Is the focus more on resolving the noise/crisis model

for internal staff or more on how the staff can meet the

needs of “customers” today?


Performance Measurement Needed to

Support Effective Supervision/ Coaching

A. Customer Service Performance Standards for Direct

Care and Support/Admin Staff

B. Objective Job Descriptions that support key performance

standards (KPI)

C. Objective Performance Evaluations that provide an

honest/effective system learning environment related to

attainment of the KPIs per staff

D. Formal Supervision Plan with Supervision Types and

Supervision Session Guidelines

E. Performance Measurement with Full Disclosure

F. Accountability with Positive and Negative Consequences


SAMPLE Customer Service Performance

Indicators

1. Telephone access

2. After/before hours telephone access to a human being for emergency

triage and counseling, and message capability

3. Time On hold

4. Background sounds while on hold

5. Number of people talked to

6. Initial personal greeting

7. Intake Process

8. Number of forms and signatures required

9. Politeness/professionalism of intake person

10.Intake person language skills/clear speaker

11.Concern felt from intake person

12.Terminology/jargon

13.Level of risk assessed

14.Access to clinician


SAMPLE Customer Service KPI Expectations

1. Customer service will begin at the front door and every customer will be treated like you would want

your Mom, child, or friend to be treated.

2. All customers will be provided a Comprehensive Intake the same day services are requested.

3. The Intake process will incorporate both the Access Standards and Customer Engagement

Standards listed below:

4. Tentative treatment plan completed

5. Tentative diagnosis completed

6. A level of care will be defined

7. An episode of care will be defined

8. 2nd clinical appointment within 8 days

9. 1st medical appointment within 3 to 5 days

10. Electronic signatures on all treatment plans and treatment plan reviews mandatory – preference is

for 100 percent electronic signatures on all documents – communicates customer involvement.

11. CSR will gather all demographic data via a face to face interview in a private room – no more

customer packets.

12. All appointments will be confirmed 48 hours in advance.

13. CSR will use the Will Call list to backfill all cancellations.

• All clinicians will provide CSR with a weekly Will Call list.

14. All customers who no-show will receive a letter asking them if they intend to participate in treatment

after the first and second no-show.


Staff and Manager Best Customer Service Qualities


Staff and Manager Best Customer Service Qualities


Core Staff Attitude Attributes Essential for

Customer Service

1. Positive- We can do this…

2. Respectful

3. Responsive

4. Cooperative

5. Creative

6. Flexible

7. Responsible

8. Adaptive

9. Low Crisis Levels

10. Willing to be cross-trained

11. Professional in Approach and in Dress/Appearance


Core Elements for Customer Service

• A Place of Business -Conducting Personal Business At

Work

– Key Work Ethic Rule: “Where is your primary

focus/energy – taking care of your personal business

or taking care of the customers?”

– At the end of the day do you feel good about your work

effort related to the needs of the customers?

• Dress to Present a Professional Image

– Compare your general staff appearance approach to

other healthcare providers

– Can you be identified by the customers as a member

of the Team?



• Waiting Area Needs

– Clean and orderly – no clutter

– Current magazines with full covers

– Light bulbs in the lamps

– Comfortable chairs

– Privacy needs

– Children/Adolescent needs

• Signage - Need to Facilitate Movement of Consumers

– The “Three Question Rule”

– Professional thematic signage - logo and color

scheme



• Eye To Eye Contact

– Please don’t look above the person’s face, beside the

person’s face or beneath the person’s face

– Looking into the eyes of the customer will provide you with

important information about how your efforts to provide

customer service is going

• The Value of A Smile

– MOST IMPORTANT ATTRIBUTE

• Acknowledging Arrival of Consumer

– National Customer Service Standard is within 10 seconds

– Staff meetings at the reception desk model



• Answering the Phone and Telephonic Standards

– Answer by the second ring

– Do not leave a person on hold more than 30

seconds without re-empowering them

– Have standard scripts for all persons who answer

the phone for the center

– Voice mail protocols to ensure responsive

customer service instead of a customer service

dumping ground


“Five Sensing” Based Customer Service

Assessment

1. What did the premises look like – was the parking lot clean striped and

manicured, was the front door glass clean and easily opened, was there

adequate signs/information to help direct the customer to the appropriate place,

etc.?

2. What did the premises smell like – were there unpleasant odors, did the

restrooms smell clean, were there musky smells in the offices, etc.?

3. What did the premises touch like – was the furniture sticky or dirty, was the pin

we provided to fill out a form clean, where the magazines in the waiting room

fresh and crisp or worn out, where the fixtures in the restrooms clean and shiny,

etc.?

4. What did the premises sound like – was there a sense of crisis, was there verbal

disagreement evident, was there soothing background music, was there music

and information when the individual served called and was placed on hold, etc.

5. What did the premises taste like – was the coffee offered to the individual served

fresh and in a clean cup, where there adequate refreshment/snacks available,

etc.


Customer Service Action Plan

Service Area/Opportunity Typical Customer Service

Concerns Solution Options/

Change Status

1. Telephone Access: Number of Rings before answering Greeting/Friendliness Time On Hold/Re-Empowerment Background Music/Information Transfer Levels to Staff Protocol for Voice Mail Responsiveness

2. Physical Facility: Identification Signage Parking Adequate/Clean Landscaping/Flowers/Lawn Maintenance Entrance Clean, Easy to Locate, and ADA

Accessible

Ease of Opening Door(s) Lobby Area Appearance/Capacity Magazines, Artwork, Furniture & Carpeting Registration/Front Desk Accessibility &

Hospitality

Restrooms – Availability/Cleanliness Signage – Adequate, Clear & Positive Background Music

3. Reception/Intake Staff: Politeness/Attentiveness/Responsiveness Professionalism/Boundaries/Language

Skills/Communication Skills

Customer Service Empowerment Level Terminology/Acronyms Utilization Consumer Recognition Wait Time Re-Empowerment Wait Time Protocols Knowledge of Services/Staff Level of Client Wait Time in Lobby


http://www.thenationalcouncil.org/

Customer Service Action Plan

Service Area/Opportunity Typical Customer Service Concerns

Solution Options/ Change Status

4. Access to Care: Single Number for Access After Hours Clinical Triage Capacity Clinical Staff Availability Consistency of Screening/Triage

5. Intake Process: Wait Time from call/walk in to Intake Efficiency of Financial Intake Number of Client Signatures Required Number of Forms to be completed by Client Number of No Shows Satisfaction Surveys for Access/Intake Process

for Shows and No Shows

5. Intake Process (continued): Access to Clinician Efficiency of Clinical Intake Number of Forms Utilized in Intake Number of Questions Asked of Client

6. General Customer Service: Efficiency of Scheduling Next Appointment Managing Customer/Consumer Service

Complaint Protocols

Information on Center-wide Services Confidentiality Concerns Meeting Special ADA, Language, & Cultural

Diversity Needs

Brochures, Newsletters & Information Bulletin Boards

Information/Linkage to Community/Self-Help Supports

Ability of Organization to Listen to Consumer/Customer and Change Organizational Behavior

Timely and Accurate Client Billings Follow up Visit Customer Satisfaction Phone

Calls

Mystery Visitor Program Participation Customer Service Focus at All Staff Meetings


http://www.thenationalcouncil.org/

Re-Consider Customer Service Focus?

“It’s Not My Job” Focus Client Focus Customer Focus 1. Individuals served are not the

focus of my work

1. Individuals are not

empowered

1. Individuals are fully

empowered

2. The needs of individuals

served are “not in my job

description”

2. Individuals usually don’t know

what they need

2. Individuals know what they

want and need

3. Where will individuals served

go if they don’t go here.

3. Individuals have little or no

choice

3. Individuals have choices

4. Individuals served are here

because they have to be

hear

4. Individuals are here to

receive treatment

4. Individuals are here to

participate in their recovery

1. It is not my job!

2. They Need Us!

3. We Need Them!


Assess your Organizations Customer

Centric IQ

• Executive Walk Through Protocols

• Awareness of Time and Cost for Access to

Treatment

• Secret Shopper Model – Texas has done a

really good job of incorporating this level of

case study and training for CBHCs

• Customer Service Focus Groups

• Customer Service Surveys


Access to Treatment As A Customer Service Focus…

1. Primary Access – Time to provide client face to face initial

intake/assessment after call for help – Same Day/Open

Access Model implemented at over 400 CBHCs nationally

2. Secondary Access – Time to provide client face to face

service with his/her treating clinician following

intake/assessment date – 3 to 5 days but not later than 8

days after same day assessment provided

3. Tertiary Access – Time to first face to face service with

Psychiatrist/APRN following the intake/assessment date - 3 to

5 days but no later than 8 days after the same day

assessment provided.

NOTE: New 72 hour Just in Time Medical Services Models

have been implemented by CBHOs in 10 states


Referral Source Customer

Satisfaction Survey Model



What do you tell your customers?


References • Guidelines on Mystery Customer Research. (2003 March).

Market Research Society.

www.mrs.org.uk/standards/downloads/revised/active/Mystery

%20shopping%20guidelines.pdf.

• Health Care Taps 'Mystery Shoppers': To Improve Service,

Hospitals and Doctors Hire Spies to Pose as Patients and

Report Back. Wang, Shirley. (2006, August 8). The Wall

Street Journal.

http://online.wsj.com/article/SB115499684792929340-

search.html.

• How to Deliver Accountable Care. Lloyd, David (2003

April), The National Council for Behavioral Health,

Washington, DC


http://www.mrs.org.uk/standards/downloads/revised/active/Mystery shopping guidelines.pdf

http://www.mrs.org.uk/standards/downloads/revised/active/Mystery shopping guidelines.pdf

http://online.wsj.com/article/SB115499684792929340-search.html



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Disney and Ritz Carlton Customer Service - NationalCouncil · PDF fileDisney and Ritz Carlton Customer Service Tailored for Your Organization Thought Leader: David Lloyd, Founder MTM