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Improving Donor Experience. Board Presentation March 2014 Jane Pearson. Complaints - National. Teams above target. Donor Complaints per million Donations vs. Target (4,500) YTD. There are 41 teams above 4,500 YTD West 6181, East 5457, North 4566. - PowerPoint PPT Presentation
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Blood Supply – Blood Donation Operations and Nursing
Improving Donor ExperienceImproving Donor Experience
Board Presentation March 2014 Board Presentation March 2014
Jane PearsonJane Pearson
Blood Supply – Blood Donation Operations and Nursing
Complaints - National
Donor Complaints per million Donations vs. Target (4,500) YTD
Teams above target
There are 41 teams above 4,500
YTD
West 6181, East 5457, North 4566
East Horsham 13466
West Exeter 10282
West City 9990
North Mitcham 9965
West H G 1 9736
East Portsmouth 9007
East Teeside 8609
EastKings Norton
8573
West Worcester 8466
East Ipswich 7844
Mobile teams:Mobile teams:North: 2567 / 562150West: 2858 / 462400East: 3354 / 614580
Donor centres:Donor centres:YTD 506 whole blood donors / 143506YTD 56 platelet donors
Numbers of donors complaining YTD / No of donationsNumbers of donors complaining YTD / No of donations
Blood Supply – Blood Donation Operations and Nursing
• Slot availability, Not seen at time and turned away are the highest causes of complaints.
• All five categories have deteriorated with particular focus on turned away and slot availability.
• The implication is that opportunity to walk-in is the major driver of complaints increase.
162
96
60 56 53
148 145151
7363
-14
49
91
17
Not seen atappt time
TurnedAway
SlotAvailability
StaffAttitude
Time Taken Cancellationof a Session
Top 5 Complaint Categories
KEY
December-12
December-13
YOY Change
Blood Supply – Blood Donation Operations and Nursing
Team Level Diagnostics
Two Steps to Diagnostics:
1. What is the problem? (Hypothesis)
2. Why does the problem exist? (Root Cause Analysis - holistic and whole team and donor engagement)
This simple approach will ensure that even incoming managers with little to no experience of managing session environments (e.g. external appointments) will be able
to easily understand issues and action plan appropriately.
Blood Supply – Blood Donation Operations and Nursing
What is the problem (Hypothesis)?
Session Session CapacityCapacity
ClinicalClinical
Is waiting time satisfaction <56%?
Do donor satisfaction comments support
hypothesis?
Hypothesis Questions
Is peak queuing time above 40 mins?
Validation
Observe session flow and speak to donors on
session.
Is there a trend of staff attitude complaints?
Customer Customer ServiceService
Are deferrals and/or FVPs above the
national average?
Observe clinical practice and speak to donors on
session.
The majority of donor complaints can be separated into one of the above 3 categories. An initial hypothesis about the main cause of complaints on any team
can be confirmed and validated using the above approach.
11
22
33Do donor satisfaction
comments support hypothesis?
Is needle satisfaction lower than national
average?
Do donor satisfaction comments support
hypothesis?
Observe staff-donor interactions and speak to donors on session.
Blood Supply – Blood Donation Operations and Nursing
Worcester example – Hypothesis
Session Session CapacityCapacity
Is waiting time satisfaction <56%?
Do donor satisfaction comments support
hypothesis?
Hypothesis Questions
Is peak queuing time above 40 mins?
Validation
Observe session flow and speak to donors on
session.
Yes – waiting time satisfaction is the
lowest in the country at 30.4%
YTD.
Yes – the majority of donor
comments relate to long waiting times.
Yes – peak queuing times are regularly above 40
mins.
Area Manager session visit
observed waiting times on under
attended session (confirmed by
donor feedback).
The expected problem on Worcester team was Session Capacity contributing to high waiting times and turned away donors. This hypothesis was proven and validated by
the steps above.
Team and review of data indicated that most issues were related to donor waiting
times and donors turned away.
Blood Supply – Blood Donation Operations and Nursing
Worcester example – Root Cause
Session Session CapacityCapacity
Interrogate TPBs:
• Is target reflective of capacity?
• Is the balance of attendance even?
• Was donor attendance above 130% of grids?
• Is the throughput/ 20 mins reflective of number of beds?
• Is there an effective ramp up?
• Are beds kept full?
No
No
Establish:
• Were too many donors called up?
• Were the appointment grids reflective of donor attendance?
• Was there excessive marketing?
Pre Pre SessionSession
On On SessionSession
Yes
Yes
PlanningPlanning
MarketingMarketing
Establish:
• Were there venue issues?
• Was staffing reduced on the day?
• Are the team working at a slow pace?
Yes
Yes
ManagerManager
TeamTeam
Blood Supply – Blood Donation Operations and Nursing
Why does the problem exist (root cause)?
Customer Customer ServiceService
Investigate issues:
• Do complainants identify one individual?
• If donor does not know name, does review of DHC indicate individual?
• Do complainants indicate multiple individuals?
• Is there a poor team attitude to customer service?
Yes
Yes
Establish:
• Does investigation of circumstances indicate individual is at fault?
• Does investigation of circumstances indicate donor complaints were actually for a different reason?
IndividualIndividual
TeamTeam
Yes
Yes
IndividualIndividual
Establish:
• Are team at fault?
• Were cause of complaints a different reason?
Yes
Yes
TeamTeam
22
Restart process at different category
Restart process at different category
Blood Supply – Blood Donation Operations and Nursing
Worcester example – Action Planning
Root Cause Actions Deadlines
• The team will be taken off road for dedicated development day to increase understanding, set performance expectations, ensure understanding of operating model/task timings and Customer Service Improvement (CSI).
• Donors will be updated every 15 minutes on anticipated wait times.
• Complaints, Compliments and Comments to be fed back to the team regularly.
• Daily performance observations and feedback/coaching by managers and OTP experts on sessions.
• Supervisors and Nurses will visit and learn from a high performing team.
• Waiting time satisfaction and peak queue times will be displayed prominently on each session, with clear targets for improvement in each measure (targets to be agreed with Senior Sister).
• PDPR objectives will encompass session flow management, with clear standardised targets and objectives.
• The capability policy will be invoked if staff are unable to manage session flow effectively after training. Performance against targets and management observations will inform a decision to invoke this policy.
• Mar-14 .. .
• Mar-14
• Mar-14 .
• Mar-14 .
• Apr-14 .
• Apr-14 .
• May-14 .
• Jun-14
The team does not effectively manage the flow of the session, meaning that donors are often seen beyond their appointment time and walk ins are turned away.
Blood Supply – Blood Donation Operations and Nursing
Action Planning Options
PlanningPlanning MarketingMarketing ManagerManager TeamTeam IndividualIndividual
• Reduce calls ups.
• Reshape appointment grids.
• Move session times to fit donor attendance patterns.
• Reduce local marketing initiatives.
• Change marketing messages – encourage more appointment donors.
• Change NCC message to donors, “If you turn up, you will be seen”.
• Ensure NCC and Nurses are working to same guidelines (e.g. calendar month vs. days).
• Venue issues resolved, or new venues found.
• Communicate likely staff reductions to Planning well in advance of sessions.
• Feedback compliments and best practice to team staff.
• Ensure team ramp up session effectively and flex to maximise throughput.
• Review A/L management, Union Duties and all absence impact.
• Appropriate dedicated development time
• Controlled acceptance of return of staff on restricted duties. .
• Display waiting time expectations on session.
• Tie customer service levels into PDPR objectives.
• Team members to observe the process with donor’s eyes (15 Steps).
• Update on waiting time every 15 minutes.
• Disciplinary policy invoked in all proven staff attitude cases.
• Capability policy invoked for staff who cannot achieve required throughput.
Blood Supply – Blood Donation Operations and Nursing
What is CSI?
DEVELOPMENT OF PERSONNEL
Develop Achieving Excelling
Principles, Values and Core BehavioursChange Culture, Change behaviour
Peer to Peer
Training
Managers Commitment
Ongoing tools
Customer Service Model
Recruit the Right
People
Assessment Centre
Feedback on the floor and
in PDPR
Visibility & Participation
Keeping it ‘alive’
everyday
Observation of Team & Individual
Role Model, Coach & Give
Feedback
DVD & Discussion
PDPR Tool
Scripted Phraseology
Information Guide
Character Profiles
Our CS Approach
Nomination cards
Local ownership local solutions
Blood Supply – Blood Donation Operations and Nursing
CSI Team Roll Out – National
• Kings Norton
• Sutton Coldfield
• Teesside
• Newcastle
• Lincoln
• Hither Green
• Brighton
• Mitcham
1st Wave
Start: late Jan 14
2nd Wave
Start: late March 14
• Exeter
• Portsmouth
• Worcester
• Gloucester DC
• Liverpool
• Northwich
• Wrexham
• Leicester
• Horsham
• Harlow 2
• City
3rd Wave
Start: late May 14
• Cornwall
• Southampton
• Solihull
• Southampton DC
• Cumbria
• Hull
• Caernarfon
• Ipswich
• London Middlesex
• Maidstone
4th Wave
Start: late July 14
• Bristol DC
• Oxford DC
• Bristol North/South
• Bath
• Lancaster
• Nottingham
• Stoke
• Leeds/Bradford
• York
• Norwich
• Ashford
• Tooting DC
• Gloucester
• Manchester E & W
• Sheffield N & S
• Epsom
• WEDC
Trial Phase
Completed
Roll out of each phase will take a total of 12 months
Blood Supply – Blood Donation Operations and Nursing
Planned Initiatives (1)
Initiative Summary Team Date
Clinical leadership autonomy trial (no Hemocues, CST etc.)
Text Messaging Service trial (session running late) trial
Brighton/Horsham March 14
Kings Norton March 14
Stop call up text messages National Complete
Appointment and walk in only session trials Cambridge/Huntingdon March 14
Introduction of script for Welcomers Oxford/Newcastle TBC
Venue assessment change to enable venue WiFi if possible National TBC
Continuous session trial (bleed throughs) Cumbria March 14
11
22
33
44
55
66
77
88
99
“Sandwich” grids – appts at start and end, walk ins in middle Oxford May 14
1010 PDPR Reviewer training for Senior Sisters / Charge Nurses National TBC
PDPR objectives linked to Customer Service standards National April 2014
1111
1212
Session Management training for Sisters and DCSs National April 2014
Introduction of volunteer queue management training National TBC
Blood Supply – Blood Donation Operations and Nursing
“Sandwich” Grids
DNA
DNA
DNA
DNA
DEF
DEF
14:00
14:05
14:10
14:15
14:20
14:25
14:30
14:35
14:40
14:45
14:50
10 x walk ins
14:55
15:00
• Idea originates from staff and designed by staff on teams for roll out based on local knowledge.
• Evidence based on walk in, appointment attendance, deferral rates and times of walk ins per team.
• Pilot teams to design management at reception, including visual indicators.
• Appointment donors will be seen on or closer to appointment time and walk in donors can be more accurate donation time.
• Better staff experience – including more controlled session flow and fewer overruns.
Blood Supply – Blood Donation Operations and Nursing
Initiative Summary
Target the dissatisfied donors with a recovery programme letter
Undertake a portal promotion to those individuals who have walked-in over the last 12 months and to whom we have an email address – 170,000
55
66
77
88
Change the text reminder system and only text non-appointment call up at certain times of the year and for certain blood group
Roll-out the portal
Planned Initiatives (2)
99 Implement compliment and complaint of the month to illustrate and showcase positive behaviours
Date
May 14
May 14
May 14
Ongoing
March 14
1010 Work with Customer Service team and Comms team to improve standard responses
Ongoing
1111 Refresh the previous approach to seeking donor feedback via various donor engagement forums – proposal to SMT.
April 14