BUILDING A STRONG FOUNDATION in a Rapidly Changing Environment TOTAL QUALITY MANAGEMENT FOR A TOTAL QUALITY CIL July 22-23, 1996 Bloomington, Minnesota IL NETWORK NCIL/ILRU National Training & Technical Assistance Project Contributors to the TRAINING MANUAL: Greg Newton Cynthia Dresden June Kailes Dawn Heinsohn Bob Michaels Dawn Kemp-Moye Laurel Richards Anne-Marie Hughey ILRU Program 2323 S. Shepherd, Suite 1000 Houston, TX 77019 713-520-0232 (V) 713-520-5136 (TTY) 713-520-5785 (fax) Permission is granted for duplication of any portion of this manual, providing that the following credit is given to the project: Developed as part of the IL NETWORK: NCIL/ILRU National Training and Technical Assistance Project. OVERVIEW OF TRAINING OVERVIEW OF TRAINING TABLE OF CONTENTS SECTION I: PROJECT OVERVIEW List of Trainers and Project Staff About the IL NETWORK About the Trainers Greg Newton About NCIL About ILRU National Resources on Independent Living IL NETWORK Resource Materials Readings for the Independent Living and Disability Rights Movements List of Participants SECTION II: TQM MANUAL LIST OF TRAINERS TRAINER Greg Newton One Hanson Street Boston, MA 02118 (617) 426-5533 (V) 426-5588 (fax) NETWORK STAFF NCIL Anne-Marie Hughey Dawn Kemp-Moye 2111 Wilson Blvd., Suite 405 Arlington, VA 22201 (703) 525-3406 (V); 525-3407 (TTY) 525-3409 (fax) DIMENET: ncil June Isaacson Kailes 6201 Ocean Front Walk, Suite 2 Playa Del Rey, CA 90293 (310) 821-7080 (V); 827-0260 (fax) DIMENET: jkailes Roland Sykes President, Greater Independence through Management Programs, Inc. 6256 Ramblewood Drive Dayton, OH 45424 (513) 327-8360 (V) DIMENET: rsykes ILRU Laurel Richards Bob Michaels Quentin Smith Cynthia Dresden Dawn Heinsohn Laurie Gerken Redd 2323 S. Shepherd, Suite 1000 Houston, TX 77019 (713) 520-0232 (V); 520-5136 (TTY) 520-5785 (fax) DIMENET: ilru Steve Brown Institute on Disability Culture 2260 Sunrise Point Road Las Cruces, NM 88011 (505) 522-5225 (V/TTY/fax) DIMENET: stebrown ABOUT THE IL NETWORK The IL NETWORK: NCIL/ILRU National Training and Technical Assistance Project is a collaboration of the National Council on Independent Living (NCIL), the Independent Living Research Utilization (ILRU) Program, and several other organizations and individuals involved in independent living nationwide. The mission of the IL NETWORK is to provide training and technical assistance on a variety of issues central to independent living today--understanding the Rehab Act, what the statewide independent living council is and how it can operate most effectively, management issues for centers for independent living, systems advocacy, computer networking, and others. Training activities are conducted conference-style, via long-distance communication, through widely disseminated print and audio materials, and through the promotion of a strong national network of centers and individuals in the independent living field. IL NETWORK goals include: conducting training on provisions of the recently amended Rehabilitation Act, including federal reporting requirements, and on independent living center operations nationwide; establishing a technical assistance service through development of a network of individuals around the country who have expertise in various aspects of center operations and Title VII of the Rehab Act; identifying, adapting, and/or developing resource materials to support training and technical assistance activities related to the Rehab Act and center operations; using the DIMENET computer network to support training, technical assistance, and dissemination activities and promoting network development and information sharing among centers and other organizations involved in independent living; exploring the use of distance-learning technology in addressing the information, training, and technical assistance needs of the field; and fostering inclusion in the independent living field of people from various cultural and disability groups and geographic areas through activities carried out with NCIL's Multicultural Committee and the Association of Programs for Rural Independent Living (APRIL). IL NETWORK STAFF The IL NETWORK is managed by a directorate consisting of Anne-Marie Hughey of NCIL; June Isaacson Kailes, independent living consultant; and Bob Michaels, Laurel Richards, and Quentin Smith of ILRU. Principal responsibility for curriculum development and training is shared by Kailes and Michaels; logistical coordination by NCIL; materials development and technical assistance coordination by ILRU; and responsibility for information dissemination is shared between NCIL and ILRU. The IL NETWORK also works very closely with a number of individuals and organizations, particularly Roland Sykes of DIMENET, in fostering more effective computerized networking among centers, and Steve Brown, in evaluating project impact and identifying movement-wide factors which impede effective center operations. In addition, individuals with expertise on Title VII of the Rehab Act and on center operations will be involved throughout training and technical assistance activities. TRAINING ACTIVITIES During the first year, training programs were conducted in each of the ten federal regions and were attended by more than 600 representatives of independent living centers and SILCs. Year one training activities focused largely on the amended Rehab Act and its implications for independent living centers and statewide independent living councils. Issues related to center operations and to use of DIMENET as a networking and technical assistance tool were covered as well. Year two training and technical assistance activities emphasized the recently released compliance indicators for centers, critical issues related to statewide independent living councils and development of state IL plans, systems advocacy, computer networking, and a closer look at state-administered CILs in the seven "723" states. Most of these focal points were identified through training participants' input and technical assistance requests. In 1995, IL NETWORK piloted several new and dynamic training methods--national teleconferences, customized training programs for SILCs, and three five-day training sessions designed to be both comprehensive and intensive. Hands-on training for use of DIMENET and other computer networks was also incorporated into training sessions to allow new and experienced users to receive in person technical assistance. To build on training curricula developed during the first two years, project staff assessed participants' reactions to trainings and techniques received in 1994 and 1995, requests received for technical assistance, and priorities for future trainings as identified by centers and SILCs on the 704 Report. As a result, 1996 trainings will address the need for more information about conducting effective systems advocacy, doing outreach to underserved populations, computer networking, developing better presentation skills, innovative management techniques, and systems for collecting and reporting center information (MIS). These topics will again be presented in a variety of ways--through customized, one-on-one, distance learning, and traditional interactive styles. In addition, the IL NETWORK plans to convene a task force with representation by RSA central and regional offices, state voc rehab agencies, and independent living centers for the purpose of examining policies and procedures affecting center and agency interaction. TECHNICAL ASSISTANCE Requests for technical assistance, whether from center staff, board members, or others involved in independent activities, are handled through a single point of contact at ILRU. ILRU staff determines who among various partner organizations and individuals are the most qualified to respond to the request, then provides referral to one or more potential technical assistants who may be ILRU staff, NCIL staff or board members, or other members of the project's technical assistance network. In each project year, IL NETWORK staff responded to over 10,000 telephone requests from the field. Beginning in 1996, technical assistance requests may also be made through the ILRU homepage on the World Wide Web (http://www.bcm.tmc.edu/ilru). IL NETWORK STAFF NCIL Anne-Marie Hughey Dawn Kemp-Moye (703) 525-3406 (V), 525-3409 (TTY), 525-3407 (fax) ILRU Laurel Richards Bob Michaels (602) 961-0553 (V), 961-0533 (fax) Quentin Smith Cynthia Dresden Dawn Heinsohn Laurie Gerken Redd (713) 520-0232 (V), 520-5136 (TTY), 520-5785 (fax) June Isaacson Kailes (310) 821-7080 (V), 827-0269 (fax) Steve Brown (505) 522-5225 (V/TTY/fax) Roland Sykes (513) 237-8360 IL NETWORK SUPPORT This three-year project is supported in part by the Rehabilitation Services Administration of the U.S. Department of Education, with additional support provided by NCIL, ILRU, DIMENET and other project partners. ABOUT THE TRAINERS Greg Newton is a marketing, quality, and customer service specialist who shows public and nonprofit agencies how to use private-sector strategies to find success in a changing (and potentially threatening) environment. He is committed to assisting agencies develop trend-responsive, entrepreneurial strategies to position for the future. Since starting his business in 1981, he has worked with over 630 different organizations with a wide variety of purposes and customer types. Greg has an undergraduate degree in advertising from Ohio University and a Masters in Public Administration from Harvard University. ABOUT NCIL Founded in 1982, the National Council on Independent Living is a membership organization representing independent living centers and individuals with disabilities. NCIL has been instrumental in efforts to standardize requirements for consumer control in management and delivery of services provided through federally-funded independent living centers. Until 1992, NCIL's efforts to foster consumer control and direction in independent living services through changes in federal legislation and regulations were coordinated through an extensive network and involvement of volunteers from independent living centers and other organizations around the country. Since 1992, NCIL has had a national office in Arlington, Virginia, just minutes by subway or car from the major centers of government in Washington, D.C. While NCIL continues to rely on the commitment and dedication of volunteers from around the country, the establishment of a national office with staff and other resources has strengthened its capacity to serve as the voice for independent living in matters of critical importance in eliminating discrimination and unequal treatment based on disability. Today, NCIL is a strong voice for independent living in our nation's capital. With your participation, NCIL can deliver the message of independent living to even more people who are charged with the important responsibility of making laws and creating programs designed to assure equal rights for all. ABOUT ILRU The Independent Living Research Utilization (ILRU) Program was established in 1977 to serve as a national center for information, training, research, and technical assistance for independent living. In the mid-1980's, it began conducting management training programs for executive directors and middle managers of independent living centers in the U.S. Since 1985, it has operated the ILRU Research and Training Center on Independent Living at TIRR, conducting a comprehensive and coordinated set of research, training, and technical assistance projects focusing on leading issues facing the independent living field. ILRU has developed an extensive set of resource materials on various aspects of independent living, including a comprehensive directory of programs providing independent living services in the U.S. and Canada. ILRU is a program of TIRR, a nationally recognized, free-standing rehabilitation facility for persons with physical disabilities. TIRR is part of TIRR Systems, a not-for-profit corporation dedicated to providing a continuum of services to individuals with disabilities. Since 1959, TIRR has provided patient care, education, and research to promote the integration of people with physical and cognitive disabilities into all aspects of community living. NATIONAL RESOURCES ON INDEPENDENT LIVING Several national organizations have been established to provide technical assistance on particular concerns relevant to issues in independent living. National Council on Independent Living Founded in 1982, NCIL is a membership organization representing independent living centers and individuals with disabilities. NCIL has been instrumental in efforts to incorporate independent living philosophy in federal legislation and regulations. National headquarters are located outside Washington, D.C. at 2111 Wilson Blvd., Suite 405, Arlington, VA 22201; (703) 525-3406 (V), 525-3407 (TTY), 525-3409 (fax). Association of Programs for Rural Independent Living One of the best resources for information about rural independent living is APRIL. Established in 1986, APRIL is an association of 33 centers and other organizations and individuals across the country serving a predominantly rural constituencies. For further information, contact APRIL president Michael Mayer at the Summit Independent Living Center, 1900 Brooks Street, #120, Missoula, Montana 59801, (406) 728-1630 (V/TTY), or Linda Tonsing Gonzales at 1919 Kiva Road, Santa Fe, New Mexico, 87505, (505) 984-8035 (V/fax). Disability and Business Technical Assistance Centers on ADA There are ten regional DBTACs funded by the National Institute on Disability and Rehabilitation Research, the U.S. Department of Education, to provide technical assistance and training on the Americans with Disabilities Act (ADA). The Southwest DBTAC, operated by ILRU, features an Hispanic outreach program. By calling 1-800-949-4232 from anywhere in the country, your call will be routed automatically to the appropriate regional DBTAC. American Disabled for Attendant Programs Today One of the oldest and most active grassroots disability rights advocacy groups is ADAPT. Following its tremendous success in advocating for accessible transportation, ADAPT has focused its mission on personal assistance services. With local chapters in many cities around the country, ADAPT is centered in Colorado at 201 South Cherokee St., Denver, CO 80223; (303) 733-9324 (V), 733-6211 (fax). Disability Rights Education and Defense Fund DREDF is an organization dedicated to promoting the civil rights of individuals with disabilities through research, education, and advocacy. The DREDF offices are located at 1633 Q St., NW, Suite 220, Washington, D.C. 20009; (202) 986-0375 (V), 462-5624 (fax) and 2212 Sixth Street, Berkeley, CA 94710; (510) 644-2555 (V), 841-8645 (fax). Disabled Individuals Movement for Equality Network DIMENET is a computer network that serves the independent living and disability rights movements. It was established in 1985 to meet the demand for a computer network that directly serves the interests of all people with disabilities and that is fully accessible to people with visual impairments. You can access DIMENET from any of three host sites: (508) 880-5412 (Taunton, MA), (513) 439-0557 (Dayton, OH), and (918) 582-3622 (Tulsa, OK). If you have problems or questions regarding accessing DIMENET, technical assistance is also available from individuals at DIMENET regional host sites: Taunton (508) 880-5325 (V/TTY), Dayton (513) 439-0071 (V), 439-0072 (TTY), and Tulsa (918) 592-1235 (V/TTY). Additional help may be obtained from Roland Sykes at (513) 237-8360 (V) or Paul Spooner at (508) 875-7853 (V/TTY). Independent Living Research Utilization Program ILRU Program is a national center for information, training, research, and technical assistance on independent living. Founded in 1977, its goal is to expand the body of knowledge in independent living and to improve utilization of results of related research and demonstration projects. ILRU, 2323 S. Shepherd, Suite 1000, Houston, TX 77019; (713) 520-0232 (V), 520-5136 (TTY), and 520-5785 (fax). World Institute on Disability Originally founded in 1983 from within the grassroots disability rights movement, WID's focus is now international in scope. WID conducts research and training in public policy, personal assistance services, and independent living from its headquarters at 510 16th Street, #100, Oakland, CA 94612; (510) 763-4100 (V/TTY). RESEARCH AND TRAINING CENTERS ON INDEPENDENT LIVING Four research and training centers funded by the National Institute on Disability and Rehabilitation Research (NIDRR), U.S. Department of Education, focus on independent living. They are: the ILRU Research and Training Center on Independent Living at TIRR; the RTC: IL at the University of Kansas; the RTC on Personal Assistance Services at the World Institute on Disability (WID); and the RTC on Public Policy and Independent Living, also at WID. All four centers conduct research and training projects designed to address the needs of individuals with disabilities, as well as state and private entities involved with independent living. More information about each is given below. ILRU Research and Training Center on Independent Living at TIRR The goals of the ILRU RTC are to enhance management performance in independent living centers through improved management and operational practices developed and tested in research-based models, and disseminated through training, technical assistance, and materials development projects. A major emphasis of these training and technical assistance projects is the promotion of networking among individuals and organizations in the independent living field. ILRU RTC is guided by the independent living philosophy, particularly with regard to the substantial involvement of people with disabilities at all levels of RTC operations. Director: Lex Frieden Associate Director: Quentin Smith Director of Research: Peg Nosek Director of Training: Laurel Richards Coordinating Director: Laurie Gerken Redd For more information, contact: ILRU Program 2323 S. Shepherd, Suite 1000 Houston, TX 77019 (713) 520-0232 (V), 520-5136 (TTY), 520-5785 (fax) URL: http://www.bcm.tmc.edu/ilru Research and Training Center on Independent Living at the University of Kansas The University of Kansas operates a national research and training center which focuses on aspects of independent living particular to rural and other underserved populations, including persons with cognitive and psychiatric disabilities. In addition, the RTC conducts consumer control training, conducts research in prevention of secondary health conditions in people with disabilities, and studies successful attainment of vocational rehabilitation goals. Director: Glen W. White Co-Director: James F. Budde Assistant Director: John Youngbauer Training Director: Kenneth J. Golden For more information, contact: RTC-IL at Kansas 4089 Dole Building University of Kansas Lawrence, KS 66045 (913) 864-4095 (V/TTY), 864-5063 (fax) URL: http://www.lsi.ukans.edu/rtcil/rtcbro c.htm The Research and Training Center on Public Policy and Independent Living Funded by NIDRR at the World Institute on Disability, the RTC-PPIL conducts research and training on major disability policy issues including independent living, leadership development, peer support, and community integration. In addition, WID is attempting to establish the first full curriculum for disability studies. The program will offer courses of study at the undergraduate, graduate, professional training, and continuing education levels. Director: Herb Leibowitz Director of Research: Tanis Doe For more information, contact: RTC-PPIL World Institute on Disability 510 16th Street, Suite 100 Oakland, CA 94612-1500 (510) 763-4100 (V/TTY), 763-4109 (fax) The Research and Training Center on Personal Assistance Services at WID One of two RTCs operated by WID, the RTC-PAS was established for the purpose of creating greater understanding about how personal assistance service systems can further the self-sufficiency and economic independence of individuals with disabilities. The RTC will perform a comprehensive evaluation of PAS programs across the country and will seek to define effective PAS from the consumer's point of view. In developing new service programs, the RTC-PAS also focuses on underserved or unserved populations. Director of Training: Simi Litvak Research Assistant: Valerie Bivona For more information, contact: RTC-PAS World Institute on Disability 510 16th Street, Suite 100 Oakland, CA 94612-1500 (510) 763-4100 (V), 208-9493 (TTY), 763-4109 (fax) Revised 6/96 _________________________ Developed by the IL NETWORK: NCIL/ILRU National Training and Technical Assistance Project. Requests for technical assistance on this and other independent living issues may be directed to the IL NETWORK Project, c/o ILRU at (713) 520-0232 (voice), 520-5136 (TTY), 520-5785 (fax), or NCIL at (703) 525-3406 (voice), 525-3407 (TTY), 525-3409 (fax). IL NETWORK RESOURCE MATERIALS The IL NETWORK: National Training and Technical Assistance project, a collaboration of the National Council on Independent Living (NCIL) and the Independent Living Research and Utilization (ILRU) Program, is committed to promoting a national network of centers for independent living, statewide independent living councils, and others involved in the independent living field. Through training and technical assistance activities, project staff seek to provide individuals at all levels of expertise with educational and networking opportunities. To enhance our ability to reach as wide an audience as possible, we are making many of our training materials available in the form of individual fact sheets and packets. The following is a description of resource materials concerning the Rehab Act, statewide independent living councils, state IL plans, funding, and other topics. These materials may be duplicated without acquiring permission, providing that the following credit is given to the project: "Developed as part of the IL NETWORK: NCIL/ILRU National Training & Technical Assistance Project." All materials are available in accessible formats, including copies available to download in either WordPerfect or ASCII from DIMENET in the IL_NETWORK file area. For fact sheets about the Rehab Act, download file 'rehab1.wp' or 'rehab1.asc.' For fact sheets about SILCs, download 'silcpak1.wp' or 'silcpak1.asc.' You will also find each piece of the packets available individually. For assistance with downloading call (808) 880-5325 (V/TTY) or (513) 439-0071 (V), 439-0072 (TTY). For further information or technical assistance, contact ILRU at (713) 520-0232 (V), 520-5136 (TTY) or NCIL at (703) 525-3406 (V), 525-3407 (TTY). FACT SHEETS ABOUT THE REHAB ACT Amendments to the Rehab Act: 1986 & 1992: A Comparison--a set of charts showing changes in the Rehab Act which occurred from 1986 to 1992. Where to Get Information About the Rehabilitation Act--how to obtain copies of the Rehab Act and related background information from the government, from public records, and from DIMENET, the national computer bulletin board for independent living. Terminology Related to the Legislative and Regulatory Process--explanations of terms and concepts related to the legislative process. Key OSERS, RSA, and NIDRR Staff--a listing of top-level staff members of the Office of Special Education and Rehabilitation Services, the Rehabilitation Services Administration, and the National Institute on Disability and Rehabilitation Research (NIDRR). FACT SHEETS ABOUT STATEWIDE INDEPENDENT LIVING COUNCILS (SILCs) Composition of Statewide IL Councils--an easily understood overview of SILC responsibilities, composition criteria, and examples of some of the problems faced by state IL councils with direct, concrete suggestions for dealing with them. Questions About SILC Governance--identifies many of the pivotal questions an organization can use to establish the bylaws with which it governs itself; covers specific questions for councils operating as private, nonprofit corporations and seeking a tax exempt status. What Every SILC Member Should Know--a checklist of basic information that each SILC member should understand in order to be an effective, voting participant of a statewide IL planning body. Prototype Job Descriptions--basic duties, authorities, and qualifications for the SILC chair, vice-chair, secretary, treasurer, and member; intended as a guideline from which to build individualized descriptions. SILC Profile Analysis--a grid designed to reveal a basic profile of any SILC by mapping characteristics and affiliations of the members; simple, easy-to-follow instructions show whether or not a council is consumer controlled according to legal mandate. SILC Membership Compliance Assessment--a checklist for determining whether or not your SILC is in compliance with the compositional guidelines outlined in section 705(b)(2) the Rehab Act. Directory of Statewide IL Councils--a complete list of all SILCs with contact information for state chairs; current as of December 1995. AUTHORIZED USES OF FUNDS AVAILABLE TO THE STATE IL COUNCIL Authorized Uses of Title VII, Part B--this document gives an overview of the history and development of Title VII, with an emphasis on gains made in controlling how the dollars allotted to support independent living programs and services are spent. Funding Under SILC Jurisdiction--identifies funding sources available to the statewide IL council: Title VII, Parts B and C, Title I, Part C, Social Security Reimbursement Funds, and private or other sources. Funding for Title VII, Part B: Fiscal Years 1994 & 1995--exact 1995 dollar amounts allocated from this source for each state and territory. Funding for Title VII, Part C: Fiscal Year 1994--dollar amounts by state and territory showing 1994 allotments as well as post-reallotment amounts for fiscal year 1993. Revised 3/96 _________________________ Developed by the IL NETWORK: NCIL/ILRU National Training and Technical Assistance Project. Requests for technical assistance on this and other independent living subjects may be directed to the IL NETWORK Project, c/o ILRU at (713)520-0232 (voice), 520-5136 (TTY), 520-5785 (Fax), or NCIL at (703) 525-3406 (voice), 525-3407 (TTY), 525-3409 (Fax). READINGS FOR THE INDEPENDENT LIVING AND DISABILITY RIGHTS MOVEMENTS DeJong, Gerben. "Independent Living: From Social Movement to Analytic Paradigm." Archives of Physical Medicine and Rehabilitation 60 (October 1979): 435-446. DeJong, Gerben. "Physical Disability and Public Policy." Scientific American 248, no. 6 (June 1983): 40-49. DeJong, Gerben. Environmental Accessibility and Independent Living Outcomes: Directions for Disability Policy and Research. East Lansing: University Center for International Rehabilitation, 1981. DeJong, Gerben and Janice Hughes. Report of the Sturbridge Conference on Independent Living Services. Boston: Tufts Medical Rehabilitation Research and Training Center, 1981. Fasser, Carl E., Quentin Smith, Lex Frieden, Laura W. Smith, J. David Holcomb. "Addressing the Health Care Needs of People with Disabilities." Journal of the American Academy of Physician Assistants 7, no. 1 (January 1994): 26-32. Kailes, June. "Language is More Than a Trivial Concern!" (1984) reprinted in Disability Pride and A Guide to Planning Accessible Meetings (available through ILRU publications). Kailes, June Isaacson. Disability Pride: The Interrelationship of Self-Worth, Self-Empowerment, & Disability Culture. Houston: ILRU Program, 1993. Kailes, June Isaacson, and Darrell Jones. A Guide to Planning Accessible Meetings. Houston: ILRU Program, 1993. Kailes, June Isaacson. Putting Advocacy Rhetoric Into Practice: The Role of the Independent Living Center. Issues in Independent Living No. 8. Houston: ILRU Program, 1988. Lachat, Mary Ann. An Evaluation and Management Information System for Independent Living. Staying on Track: ILRU Management Support Series. Houston: ILRU Program, 1988. Lachat, Mary Ann. The Independent Living Service Model: Historical Roots, Core Elements, and Current Practice. Hampton: Center for Resource Management, 1988. National Council on the Handicapped (now the National Council on Disability). Toward Independence: An Assessment of Federal Laws and Programs Affecting Persons with Disabilities - With Legislative Recommendations. February 1986. Available from NCD, 1331 F Street, NW, Suite 1050, Washington, DC 20004 (202) 272-2004 (V), 272-2074 (TTY). National Council on the Handicapped (now the National Council on Disability). On the Threshold of Independence: A Report to the President and the Congress of the United States. January 1988. Available from NCD (see above). Nosek, Peg, Yayoi Narita, Yoshiko Dart, and Justin Dart. A Philosophical Foundation for the Independent Living & Disability Rights Movement. Occasional Paper No. 1. Houston: ILRU Program, 1982. Pflueger, Susan Stoddard. Independent Living. Emerging Issues in Rehabilitation. Washington, D.C.: Institute for Research Utilization, 1977. Richards, Laurel and Quentin Smith. An Orientation to Independent Living Centers. Houston: ILRU Program, 1987. Shapiro, Joseph P. No Pity. New York: Random House, Inc. 1993. Shreve Maggie, Patricia Spiller, Eric Griffin, Nancy Waldron, and Lynda Stolzman. Martha Williams, ed. Consumer Control in Independent Living. Available from: Center for Resource Management, 2 Highland Road, South Hampton, NH 03847; (603) 394-7040 (V/TTY), 394-7483 (fax). Smith, Quentin, Lex Frieden, and Laurel Richards. "Independent Living." Encyclopedia of Disability and Rehabilitation. New York: Macmillan, Inc., (in press, 1994). Smith, Quentin, Laura W. Smith, Kym King, Lex Frieden, and Laurel Richards. Health Care Reform, Independent Living, and People With Disabilities. Issues in Independent Living No. 11. Houston: ILRU Program, 1993. United States Department of Education. Comprehensive Evaluation of the Title VII, Part B of the Rehabilitation Act of 1973, as Amended, Centers for Independent Living Program. January 1986. Available through clearinghouses (see below). Willig, Chava Levy. A People's History of Independent Living. 1988. Available from the Research and Training Center on Independent Living, 4089 Dole Building, University of Kansas 66045; (913) 864-4095 (V/TTY). In a special edition on independent living in American Rehabilitation 20, no. 1 (Spring 1994): Giordiano, Gerard and Bruno J. D'Alonzo. "The Link Between Transition and Independent Living," 2-7. Shreve, Maggie. "The Greater Vision: An Advocate's Reflections on the Rehabilitation Act Amendments of 1992," 8-13. Smith, Laura W., Quentin W. Smith, Laurel Richards, Lex Frieden, and Kym King. "Independent Living Centers: Moving Into the 21st Century," 14-22. Chappell, John A., Jr. "The Whole is Greater Than the Sum of its Parts," 23-29. Moore, J. Elton and Barry C. Stephens. "Independent Living Services for Older Individuals Who are Blind: Issues and Practices," 30-34. Montagano, Tim. "Bringing the Rehabilitation Family Together: An IL-VR Partnership," 35-36. Lougheed, Val, Bev Hunter, and Susan Wilson. "Partners for Independence: A Team Approach to Community-Based Rehabilitation," 37-38. Baker, David. "Independent Living in Communities: The Role of the Independence Fund in Vermont," 39-41. Lachat, Mary Ann. "Using the Power of Management Information System Technology to Support the Goals of Centers for Independent Living," 42-48. In a special issue on independent living in OSERS 6, no. 2 (Winter-Spring 1994): French, Duane. "Independent Living: Driven By Principles of Democracy," 37-38. Kafka, Bob. "Perspectives on Personal Assistance Services," 11-13. Kennedy, Jae, Hale Zukas, and Simi Litvak. "Independent Living and Personal Assistance Services: The Research, Training, and Technical Assistance Programs at the World Institute on Disability," 43-45. Mathews, Mark R. "Learning from the Experts: Best Practices in Rural Independent Living," 23-29. Michaels, Robert E. "Title VII: A Major Step Forward," 8-10. Nelson, John. "Changes in the Rehabilitation Act of 1973 and Federal Regulations," 4-8. Smith, Quentin, Lex Frieden, Laurel Richards, and Laurie Gerken Redd. "Improving Management Effectiveness in Independent Living Centers through Research and Training," 30-36. Tate, Denise and Julie Daugherty. "The Effects of Insurance Benefits Coverage: Does It Affect Persons with Spinal Cord Injury?" 19-22. Westbrook, John D. "Consumer-Driven Supported Employment: Consolidating Services for People with Significant Disabilities," 14-18. Ziegler, Martha. "How Parent Networks Are Working with Independent Living Centers," 39-42. In a special issue on rural independent living in the Rural Special Education Quarterly 11, no.1 (1992): Clay, Julie Anna. "Native American Independent Living," 41-50. Curl, Rita M., Shanna M. Hall, Linda A. Chisholm, and Sarah Rule. "Co-workers as Trainers for Entry-level Workers: A Competitive Employment Model for Individuals with Disabilities," 31-35. Nosek, Margaret. "The Personal Assistance Dilemma for People with Disabilities Living in Rural Areas," 36-40. Potter, Carol G., Quentin W. Smith, Huong Quan, and Margaret A. Nosek. "Delivering Independent Living Services in Rural Communities: Options and Alternatives," 16-23. Richards, Laurel and Quentin Smith. "Independent Living Centers In Rural Communities," 5-10. Seekins, Tom, Craig Revesloot, and Bob Maffit. "Extending the Independent Living Center Model to Rural Areas: Expanding Services through State and Local Efforts," 11-15. Smith, Quentin W., Carl E. Fasser, Stacy Wallace, Laurel K. Richards, and Carol G. Potter. "Children with Disabilities in Rural Areas: The Critical Role of the Special Education Teacher in Promoting Independence," 24-30. We Won't Go Away, videocassette. Sells for $20 each, including postage, from the World Institute on Disability, 510 16th Street, Suite 100, Oakland, CA 94612 (510) 763-4100 (V), 208-9493 (TTY). The Disability Rag. A bi-monthly publication reflecting ideas and discussions in the disability rights movement. Available at $12 for a one-year subscription. Write to: Subscriptions, The Disability Rag, 1962 Roanoke Ave, Louisville, KY 40205 (502) 459-5343 (V/TTY/fax). Most of the readings cited above can be obtained from resource clearinghouses. Several are listed below and can be reached for further information about publications and modem-accessible databases by mail or telephone. National Clearinghouse of Rehabilitation Training Materials, Oklahoma State University, 816 West Sixth Ave., Stillwater, OK 74078 (800) 223-5219. National Rehabilitation Information Center (NARIC), 8455 Colesville Road, Suite 935, Silver Spring, MD 20910 (800) 346-2742 (V), 227-0216 (TTY). ERIC Clearinghouse on Disabilities and Gifted Education (formerly the ERIC Clearinghouse on Handicapped and Gifted Children), 1920 Association Dr., Reston, VA 22091, (800) 328-0272 (V/TTY) at the Council for Exceptional Children, (703) 620-3660, ext. 307 (V). ILRU also offers a number of publications and other materials on various independent living subjects. For a listing of resource materials contact ILRU at 2323 S. Shepherd, Suite 1000, Houston, TX 77019, (713) 520-0232 (V), 520-5136 (TTY). For resource materials and technical assistance on the Americans with Disabilities Act, there are ten regional Disability and Business Technical Assistance Centers (DBTACs). One toll-free number, 1-800-949-4232, will direct your call to a technical assistant in your region. Resource materials are published by the U.S. Department of Justice and many are available free of charge. The Southwest DBTAC in Houston, Texas offers technical assistance and some resource materials in Spanish as well as English. Revised 6/95 Developed by the IL NETWORK: NCIL/ILRU National Training and Technical Assistance Project. Requests for technical assistance on this and other independent living subjects may be directed to the IL NETWORK Project, c/o ILRU at (713) 520-0232 (voice), 520-5136 (TTY), 520-5785 (Fax), or NCIL at (703) 525-3406 (voice), 525-3407 (TTY), 525-3409 (Fax). TQM MANUAL Continuous Quality Improvement! Total Quality Management for Total Quality Services! Total Quality Management! Total Quality Services! Purposes... 1. Show why quality is the key for both mission and market success. 2. Discuss the eight major principles of Total Quality Management. 3. Apply these principles to your Independent Living Center's advocacy and service activities. 4. Present specific steps you can take to continuously improve the quality of what you do. 5. Exchange ideas and build upon your expertise. Total Quality Management! Total Quality Services! Agenda topics... 1. Getting started... - Introductions, purposes, and agenda review. - This seminar is about how to do an even better job and continue the quest for quality in both advocacy and service activities. - You may be surprised by how much the Independent Living philosophy reflects the TQM philosophy! - How the customers for this training helped define it. 2. Using TQM to respond to a turbulent, changing environment... - Ten megatrends affecting ILCs. - TQM can help ILCs successfully respond to the trends. - Are you ready to meet the challenges of change? 3. Moving your ILC to Total Quality Management for Total QualityServices... - Two big questions to answer! - How will you respond to both the market and your mission? - How will you create system change through advocacy while providing services and individual advocacy. - The TQM answers to these two questions. - Applying the answers to one core service: I and R! - The top ten reasons to move to TQM. - The eight most important principles of TQM: the four whats and the four hows. - TQM is a process not an outcome. - The transformation to a TQM organization is a long road. - Survey says: the principles identified as most important. - Should the presenter respond to these priorities? Total Quality Management! Total Quality Services! 4. Positioning on quality. - TQM Principle One: Customer-driven. (Putting the customer first and using customer preferences to offer quality services.) - "Quality" is what the customer thinks it is. - Who is/are the customer/s of ILC? Who will define quality? It's complicated! - First: Are they clients, participants, consumers, and/or customers? Does it depend upon the service and the role being played? - Many customer types: current, past, and potential; "trapped" and voluntary; payers, users, and suppliers; stakeholders; and internal customers. - How do these customers come together in the I and R process? - The chain of events to become customer-driven. - What is customer satisfaction? - Why customer satisfaction is important: Who tells whom? - Customer service is what you do and customer satisfaction is how people react. - Customer satisfaction is driven by both the procedural and personal aspects of service delivery. - Customer satisfaction is when you give me what I want, deliver what you promise, and meet or exceed my expectations. - Exceeding expectations to increase satisfaction: - Four things to do to cope with unrealistic expectations: - What are the expectations for your I and R service? - Five key factors for success with customers... - Quality; variety; customization; convenience; and, speed. - How would your I and R customers rank you on these? Total Quality Management! Total Quality Services! - How do you measure customer satisfaction? - Building on your current satisfaction measurement systems. What those who responded to the survey\said they learned. What have you learned? - Two methods: behavior measurement and preference measurement. Use both! - Two kinds: qualitative and quantitative. Use both! - Four systems you should have: You need them all! - How do you measure satisfaction with I and R? - The 18 most common mistakes in customer survey forms and how to avoid them. 5. Providing quality...each and every time! - TQM Principle Two: Focus on the service system and the delivery process. - Customer dissatisfaction and service failure can be attributed to the customer, the staff, and/or the service delivery system. - The primary improvements to be made are to the system and processes! - What is your toast-making system? - This is process mapping. Do you have a flow chart for the processes you use to deliver services? Why you should! - Standardizing the process does not preclude customization to meet individual customer needs. - Services and advocacy are both a series of process steps---you can map both! - What is your process map for receiving and responding to the first call in your I and R service? - The emerging service delivery paradigm---how to serve more people with less money! - How can your I and R service use this paradigm? Total Quality Management! Total Quality Services! - TQM Principle Three: Do the right thing right the first time. - Prevention is valued more than detection and correction. - ILC advocacy is a way to seek "wholesale change" to prevent the need for corrective "retail services". - By finding out where the earliest service failure occurs, you can increase quality and reduce service failure. - Reducing variation in service delivery ensures consistent quality and provides a method for increased efficiencies. - What are the five most common questions? Do you ensure consistent responses? What alternatives can you use? - Doing the right thing right the first time is doing what is most important to the customer. - Customer satisfaction is not determined by how will you did things in general, but how well you did what was most important to the customer. - Rightsize by doing what is most important! - What's most important to your I and R customer? 6. Using data for continuous quality improvement. - TQM Principle Four: Continuous improvement. - All results are measured and evaluated for never-ending quality enhancements. - TQM assumes only 100% quality counts! Customers deserve only the best each and every time. - Plan, do, check, act...continuously! - The seven-step problem solving process is a TQM classic and captures the continuous improvement process. - How can you use this process to improve I and R? - TQM Principle Five: Data-driven decision making and structured problem solving. - You can't improve what you can't measure! Total Quality Management! Total Quality Services! TQM requires Meaningful Information Systems. - Using data to make decisions helps everyone do a better job; each staff and team member should collect data to improve the quality of their process steps. - Service benchmarks are a way to provide quality each and every time. How to set and use them! - What are your service benchmarks for I and R? - Using data to make decisions---your quality tool box! 7. Leading your quality team. - TQM Principle Six: Everyone is involved. - Everyone is involved because they are whether you decide to include them or not! - To the customer, those on the bottom of the chart are on the top of the chart. - You must empower staff outward from the customer and make quality a part of every job. - How do you empower staff appropriately? - Successfully using quality improvement teams. - Should you have an I and R improvement team? - Tips and tools to help your teams perform even better. - TQM Principle Seven: Communication and training. - Why communication is so very, very important. - Does your staff have enough information for quality performance? Have they said they do? - Every time an external customer receives a service, the quality of that service transaction is the sum total of every internal transaction. - All internal customers make it possible directly or indirectly to serve external customers. Total Quality Management! Total Quality Services! - External customer satisfaction is dependent oninternal staff satisfaction. - Staff satisfaction is dependent upon the hygienics and the motivators. You must work on both. - Over forty ideas for improving staff satisfaction. - TQM Principle Eight: Leadership. Management is a science and leadership is an art. - Four major elements of for effective leadership. - How leadership and managership are different. - What survey respondents think makes for an effective ILC leader. - Leaders must create a vision. (They must help people see it before it's real.) - Create a vision! Make it happen! 8. Planning for continuous quality improvement! - What was most important to you? What will you do when you return? - Action steps for leaders of change! Your seminar leader... Greg Newton is a marketing, quality, and customer service specialist who shows public and nonprofit agencies how to use private-sector strategies to find success in a changing (and potentially threatening) environment. He is committed to assisting agencies develop trend-responsive, entrepreneurial strategies to position for the future. Since starting his business in 1981, he has worked with over 630 differ-ent organizations with a wide variety of purposes and customer types. Greg has an undergraduate degree in advertising from Ohio University and a Masters in Public Administration from Harvard University. How the customers for this training helped define it! Survey says...so, we will! - About 50% of the respondents have had at least some formal exposure to TQM... so, this seminar will cover both the basics of TQM and some of the more advanced practices. - Only six-percent said they had provided TQM training to their staff and boards... so, this training includes a way to follow-up and expand the universe of exposure. - About one-fourth know of other not-for-profit agencies in their community who have implemented TQM initiatives... so, this training is intended to give Independent Living Centers a competitive edge. - The most commonly identified challenges for ILCs in the next three years were: funding diversification; serving more people with fewer resources; changing state and federal policy and funding climate; board development; and staff retention and morale... so, this training will show how to use the principles of TQM to respond. - Those surveyed said the most important foci of this training should be how to: provide quality services; be consumer-driven; increase consumer satisfaction and involvement; develop clear measures of efficiency and effectiveness; and use continuous process improvement teams effectively... so, this training will give the greatest emphasis to these training topics. - Respondents shared their perspectives on each of the eight principles of TQM... so, those perspectives will be presented when each of the principles are presented. - Those responding indicated that the practical application of TQM principles to the "real world" of ILCs is exceptionally important... so, no principle will be presented without a menu of potential applications from which those attending can choose. - Information and referral is an ILC core service and was identified as an important service by many of the respondents... so, it will be the major, continuous example used to apply the principles presented. - About 60% said they learned best through small group interaction and activities... so, this seminar will include many chances to exchange ideas and work in small groups. Total Quality Management! Total Quality Services! Using TQM to respond to a turbulent, changing environment Environmental Scan! Ten Megatrends! ___________________________________________________________ 1. Reduced traditional resources. 2. Block grants/state control. 3. Higher performance expectations. 4. Universality and mainstreaming. 5. Empowering customers through choice, vouchers, fees, consumer reports, and responsibility. 6. Competitive service delivery and privatization. 7. "One-stop shopping". 8. Alternative service delivery methods and use of technology. 9. TQM as a policy drive. 10. Customer satisfaction as a performance standard. TQM can help you successfully respond and... ___________________________________________________________ - Do more with less by "right-sizing" and not "downsizing". - Compete successfully for more resources and customers. - Reengineer services to please and serve more customers. - Advocate for mainstream systems to be inclusive of and responsive to people with disabilities. - Meet performance standards and increase customer satisfaction. Discussion questions... 1. What are your strengths, weaknesses, opportunities, and threats in this environment? 2. How can you position your "information and referral" service for success in this new environment? Are you ready for the big changes ahead? Strengths Weaknesses Opportunities Threats What should be done right now? Total Quality Management! Total Quality Services! Moving your ILC to Total Quality Management for Total Quality Services You can use TQM to improve the quality of both your advocacy and service systems! Two questions... 1. Where will you position your Center on the mission-drive/market-drive spectrum? Should you do both? If so, how? 2. How will you create system change through advocacy while providing services and individual advocacy? The TQM answers... 1. You need mission drive and market drive. You conduct market-driven activities to support and fund the mission. 2. Services provided should help you identify common consumer needs and preferences so you can identify the most important areas to advocate for system change and responsiveness. Advocacy is a series of process steps which can be continuously improved (just like services). a spectrum of choices... Market Drive and Mission Drive Organizations always have both a market drive and a mission drive. The struggle in most organizations is to find a balance between what they want to be and who will provide the resources to do it. A pure market-driven organization responds to all external market opportunities with its consequent revenue streams, regardless of mission impact and preferences. A pure mission-driven organization responds only to its internal preferences and will sacrifice revenue to accomplish higher goals and objectives. These two extremes can be viewed as being on the two opposing ends of a spectrum. Most organizations have made the decision of where to be on this spectrum, either implicitly or explicitly. The major drive often changes de-pending on the environment and organizational status. In most nonprofit organizations the attempt is to have just enough market drive to be able to finance and subsidize the mission drive. Finding the balance is the goal! Market-driven activities are a means to develop resources for the mission. When you attempt to undertake market-driven and mission-driven activities simultaneously, you sometimes are successful in neither. Know when you are doing what and why! continuous improvement for I and R! 1. How can you make I and R both a mission and a market activity? 2. How can I and R be both an individual service and a system advocacy activity? The top 10 reasons why Total Quality Management is all the rage... _________________________________________________________ 10. Everybody wins---you, your staff, and your customers. 9. It's not a fad. It's here to stay. 8. Quality is key to public support. 7. Limited budgets and high demands mean you must find ways to do more with less. 6. You get better outcomes and increase the odds of meeting your mission. 5. Your competitors are using TQM methods. 4. Total quality services mean increased consumer/customer satisfaction and potentially increased service use. 3. It helps you meet quality standards. 2. It makes sense. 1. It works! The 8 most important principles of TQM! The 4 whats and the 4 hows. The four whats of TQM... 1. Customer-driven Putting the customer first! 2. Focus on the service system and the delivery process Systems are easier to change than people. People will do a good job if the system lets them. 3. Do the right thing right the first time How many resources are expended to check on quality, revise poor quality, and react to quality failure in service delivery? 4. Continuous improvement: Results are measured and evaluated for never-ending enhancements. The four hows of TQM... 5. Data-driven decisions and structured problem solving You can't improve what you can't measure. 6. Everyone is involved Empowering staff outward from the customer and making quality the business of everyone. 7. Communication and training Staff development and team service delivery increase customer satisfaction. In service businesses, the product is the staff! 8. Leadership Management is a science. Leadership is an art. Creating a vision and helping people do the good job they want to do. TQM is a process and not an outcome. The transformation to a TQM organization is a long road since it changes the agency culture and every organizational practice. You never reach the end of the quest for quality: you just keep improving all of the time. Survey says... Those responding identified which of the eight TQM principles were most important to them: 1. By far, the most important was "customer-driven". 2. The second group (almost equal in importance) were: - "everyone is involved"; - "communication and training"; and, - "leadership". 3. The third group (again, in almost equal importance) were: - "continuous improvement"; - "focus on the service system and the delivery process"; and, - "do the right thing right the first time". 4. By far, the least important was "data-driven decisions and structured problem solving". Discussion questions... 1. Why do you think these were ranked in this order? 2. Do you agree with the survey respondents? 3. What if I disagree--- should I still do what the customers want? Total Quality Management! Total Quality Services! Positioning on quality Principles of Total Quality Management Customer-driven! 1. Know who your customers are---as specifically as possible. This incudes all of your current customers and all of your potential customers. 2. Your customers define quality. You must capture and use the way they define quality for each of your products. 3. Know what each of your customers want---in priority order from "most" wanted to "least" wanted. 4. Determine whether or not your customers are satisfied and how satisfied/dissatisfied they are. Customer-driven! Who are the "customers" of ILC? Who will define quality? It's complicated! ___________________________________________________________ -Service users and advocacy beneficiaries. - Current and past customers/potential customers: those who use services and those who don't. - "Trapped customers" (those who have no choice or are required to use services) and "voluntary customers". - Payers and service users: third-party payers and those who receive the service. "Internal customers" to serve "external customers." - "Suppliers" who help you serve "customers". - "Stakeholders" who have an interest in organizational success. ___________________________________________________________ Survey results: 99% agreed with the statement "people with disabilities are the primary 'customers' of ILCs". Customers and Suppliers! Customers... Anyone who receives or wants services from your agency. When defining this more specifically to a particular process, a customer is any person or organization following and receiving something from the process. External Customers... Any individual, group, or organization that receives or wants services from your agency that are not staff members. Internal Customers... Staff members whenever they are receiving needed or wanted services from other staff members. Suppliers... A supplier is any person or organization who precedes and contributes something to the process. A staff member who provides a needed and/or wanted service to other staff is an example of an internal supplier Supplier Teams... When more than one staff member shares responsibility in providing a service, those staff become a supplier team who work together to ensure quality and increase customer satisfaction. Customer Teams... When more than one staff member receives the benefit of a series of staff supplier transactions, those staff are viewed as a customer team who must collectively and individually have high satisfaction and receive quality customer service. Trapped Customers... Any customer (internal or external) who has limited or no choice where to obtain needed or wanted services. Are those you work with and for clients, participants, consumers, and/or customers? ___________________________________________________________ The dictionary defines these words as: Client: "A person for whom a person or company is acting." (It is a case management term---are the individuals we serve "cases" and should we "manage them? Does this term disempower and negate self-help?) Participant: "One who shares in an activity with others." Consumer: "A person who 'consumes'; one who uses goods or services for his/her own needs rather than to produce goods for others." ("Consume" is "to use up".) Customer: "A person who receives or buys a product or service; especially one who receives or buys regularly." ____________________________________________________________ 1. Does it depend upon the interaction and activity? 2. Does it make a difference? 3. When you provide I and R are they clients, participants, consumers, and/or customers? Trend: Empowering the Customer 1. All service users become "customers"! 2. Viewing funding sources as financing---not the customer. Who is the customer? Segment: buying roles. Should you target... 1. The initiator? 2. The influentials? 3. The decision maker? 4. The purchaser? 5. The direct user of the service? Formal referral sources are suppliers! When someone is referred by a referral source, her perception of your service quality begins with the person and agency who are making the referral. The referral source sets the referred person's initial expectations and will make access either easier or more difficult. You must develop a partnership with your suppliers to ensure customers receive seamless, invisible, and coordinated services. You must help them set appropriate expectations, not waste the time of referred customers, and provide transitional support throughout the referral process. Strengthen your quality chain by: 1. Identifying your preferred suppliers and nurturing, strengthening, and supporting vital relationships. 2. Giving them referral tools and scripts to ensure appropriate expectations, reduce variation in referral, and minimize inappropriate referrals. 3. Keeping them updated on all of your service innovations. 4. Conducting cross-training sessions with your and their staffs on the services of both agencies and mutual quality standards. 5. Collecting customer satisfaction data, including the initial contact with the referral source, as well as your service delivery. 6. Including your preferred suppliers on your customer data interpretation teams. 7. Considering co-promotions and concurrent services. continuous improvement for I and R! Describe (by words or in picture form) the relationship between external customers, internal customers, payers, suppliers, and stakeholders in the I and R process. How do each have a role in defining what "quality is"? "Quality" is what the customer thinks it is! Quality must be defined by the customer. It is the sum total of the preferences, requirements, and expectations of the customer. Survey results... 55% of the respondents have asked those who receive services to formally and systematically define what quality service is. Which of these are the most important to a quality I and R service? _________________________________________________________________ _____________________________________ - Satisfaction of callers with information? - With referral? - Satisfaction of referral source with the referrals? - Effective assessment of problem? - Problem solved? - Information needed received on the first call. -Multiple choices of referrals? - Performance "report card" on referrals? - Accurate information. - A friendly and empathetic ear? - Number of times the phone rings before answered? - Hours of availability? - Methods for accessing the I and R service - Methods for receiving needed information and referral? - Follow-up with caller after first call? - Follow-up with referral source post-call? - Self-advocacy methods? Institutional and system changes? _________________________________________________________________ _____________________________________ You'll have to ask the customer! The chain of events to become even more customer-driven... Discover what each "customer" type wants (not just needs); which services and service attributes are most important to them; and their service expectations. Strive to provide what is most wanted and meet expectations. Reset expectations until services can be changed to meet customer preferences and requirements. Assess satisfaction with services received. Innovate and continuously improve with the goal of "100% satisfaction" each and every time. The RSA 704 report requires... "that the CIL assesses consumer satisfaction with the CIL's services and policies in facilitating con-sumers' achievement of IL goals and provides this information to its governing board and SILC." _________________________________________________________ What is customer satisfaction? - Customer service is what you do and customer satisfaction is how people react. - You can provide quality customer service and still not have customer satisfaction. - Customer satisfaction is driven by both the procedural and personal aspects of service delivery. - Staff determine the quality of customer service, but the agency determines whether or not customers are satisfied. - Customer satisfaction is when you give me what I want, deliver what you promise, and meet or exceed my expectations. Satisfied and Dissatisfied Customers: Who tells whom? - Every satisfied customer tells ____ people. - Every dissatisfied customer tells ____ people. - Only one of every ____ dissatisfied customers ever complains to you; the others tell everyone else. This means: Only 1 complaint = ____ complaints x ____ negative words-of-mouth = ____ negative words-of-mouth! - If you resolve the complaint of a dissatisfied customer, the newly satisfied customer tells ____ persons of his or her satisfaction. - If you are told (and do nothing to satisfy), the complaining dissatisfied customer will now tell ____ people about his or her dissatisfaction. Dissatisfied Customers! Most never complain... - 50% never complain. - 45% complain only to the front-line staff. - 5% complain to management. Why not... - It's not worth the time and trouble. - Belief that no one cares. - No useful or known channel for complaining. Now, you must ask! Ask for and welcome complaints that you can solve now! Don't wait for the customer satisfaction evaluation when it will be too late! What will be different for your agency when you become customer-driven? _________________________________________________________ A shift from only the quantitative to the qualitative. A shift from only the outputs to the inputs. A shift from only those who continue to those who do not. A shift from only what you do to how you do it. A shift from "did they get it?" to "did they like it?" Do you currently measure customer satisfaction? If so, how? If not, when are you going to start? You can use customer satisfaction data to... 1. Improve program operations and quality; 2. Know what benefits to stress; 3. "Appear" responsive; 4. Implement service recovery; 5. Identify staff training needs; and, 6. Justify budget requests and seek new funding. What are you doing currently? 1. Systematic collection of customer satisfaction data; 2. Informal collection of customer satisfaction data; or, 3. No collection of customer satisfaction data. Six important steps to establishing a customer satisfaction measurement system... 1. Develop a customer service/satisfaction statement; 2. Create service/satisfaction goals and display them; 3. Measure current satisfaction status; 4. Innovate; 5. Re-measure; and, 6. Restart with number two and continue forever! 9 reasons why some staff resist customer satisfaction measures: ____________________________________________________ 1. Do not like the word "customer" for users of human services. Believe users aren't customers. 2. Fear of customer evaluation. Afraid the feedback will be negative. Afraid the results will be used against them. 3. Loss of power. When a client becomes a customer, the power shifts from the provider to the user. 4. Lack of belief in the customer's capacity to make a realistic judgment of program quality. 5. Believe customer satisfaction is beyond program control and some people will never be satisfied. 6. Afraid that the only way customers will be satisfied is by responding to every customer whim, breaking the rules, and kissing-up. 7. Think outcomes are the only thing that really counts. Past systems have stressed only outcome performance standards. 8. Customer satisfaction systems will mean more paperwork. (They are right!) 9. "This, too, will pass." "If it is not one thing, it's another." Do you believe these customer satisfaction equations? High Program Quality = High Customer Satisfaction? Meeting Customer Needs = High Customer Satisfaction? Meeting Customer Wants = High Customer Satisfaction? Exceeding Customer Expectations = High Customer Satisfaction? Quality Customer Service = High Customer Satisfaction? Making the equations work... - A critical TQM principle is "the customer must define quality." - Customer satisfaction is often rooted in wants, not needs. - Satisfaction is achieved when expectations are met or exceeded. - Customer service is not the same as customer satisfaction! Customer service is how you provide your services to customers. Customer satisfaction is how customers perceive and react to the service. Satisfaction is driven by customer expectations, experiences and current life situations. False: "The customer is always right." True: "The customer is always the customer." What is customer service? ______________________________________________ P R O C E D U R A L ______________________________________________ P E R S O N A L Which counts most with whom? Customer Service is more than a Smile... BUT includes a Smile. LOW Procedural, LOW Personal---THE FREEZER! - The PROCEDURE is slow, inconsistent, disorganized, chaotic, and inconvenient. - The PERSONAL is insensitive, impersonal, apathetic, aloof, and uninterested. Customer Message: "We don't care." HIGH Procedural, LOW Personal---THE FACTORY! - The PROCEDURE is timely, efficient, and uniform. - The PERSONAL is insensitive, apathetic, aloof, uninterested. Customer Message: "You are a number...and we are here to process you." LOW Procedural, HIGH Personal---THE FRIENDLY ZOO! - The PROCEDURE is slow, inconsistent, disorganized, and chaotic. - The PERSONAL is friendly, personable, interested, and tactful. Customer Message: "We're trying hard to please...Sorry, we don't know what we are doing." HIGH Procedural, HIGH Personal---QUALITY SERVICE! - The PROCEDURE is timely, efficient, and uniform. - The PERSONAL is friendly, personable, interested, and tactful. Customer Message: "We Care, We Deliver." Ten needs of every customer... ____________________________________________________________ 1. The need to feel welcome. 2. The need to not be kept waiting. 3. The need to feel comfortable. 4. The need for orderly service. 5. The need to be understood. 6. The need to receive help, if wanted. 7. The need to feel important. 8. The need to be appreciated. 9. The need to be recognized or remembered. 10. The need for respect. ____________________________________________________________ Do you meet them? Moment of Truth From the first moment the customer comes in contact with you, s/he is making a decision on the quality of your services. This is the moment of truth--- ...is this something I want? ...is this something that is of value? ...is this a place I want to be affiliated with? ...is this a place that cares about me? It is this first impression that really counts...it will be the standard against which all other contacts will be measured. It sets the expectations for future contacts...and leads to the most frequent positive or negative word-of-mouth mentions. If the Moment of Truth was positive, you will probably be able to make some mistakes in the future, and be forgiven. If the Moment of Truth was negative, no matter how good the service is in the future, you will always be competing against this first service encounter. You never get a second chance to make a first impression. How do trapped customers determine satisfaction? 1. Customers that are not trapped will determine satisfaction using both the procedural and the personal criteria. 2. The primary criterion by which trapped customers will determine satisfaction is procedural. How quickly, efficiently, hassle-free, and accurately were services received? How infrequently did I have to see you? How little did it cost me in time and money? 3. Even with trapped customers, the personal counts. However, it merely enhances and does not mitigate. ___________________________________________________________ High Personal Low Personal ___________________________________________________________ High Procedure Unexpected; Expected; heaven! satisfied. ___________________________________________________________ Low Procedure Not enough; Contact dissatisfied. legislator. ___________________________________________________________ Customer satisfaction is determined by how the reality meets the expectations. If expectations are met or exceeded, the customer is satisfied. ____________________________________________________________ Customers come with expectations: - Past customers have had expectations set by previous experiences. - New customers may have no or unreasonable expectations. - You set expectations by what you say and do. ____________________________________________________________ Set consistent expectations! Under-promise and over-deliver! If you must, disappoint early! Have a service recovery strategy! 6 ways expectations are set... 1. Referrals; 2. Marketing materials; 3. Past customers; 4. Program orientations; 5. Initial staff presentations and/or; 6. Initial program impressions. 3 options to increase satisfaction... 1. Change the customers' expectations; 2. Change the customers' program services and/or; 3. Change the pool of customers. 6 methods to cope with expectations... 1. Measure entry expectations of customers. 2. Meet or exceed customer expectations where you can. 3. Set appropriate customer expectations. 4. Reset customer expectations. 5. Continuously remind customers of expectations. 6. Measure satisfaction by customers' expectation. Expectations for your I and R service! 1. List three of the common expectations your I and R customers have when they telephone: a. b. c. 2. Which of these expectations do you meet? Make statements to tell this to your customers. 3. Which of these expectations will you not meet? Make statements to tell this to your customers, along with an appropriate "resetting" of the expectations. 4. What are some expectations that you may want to set that customers may not know about? Remember, customers determine their satisfaction on the expectations they have! The five criteria for success in a competitive marketplace: _________________________________________________________ 1. Quality 2. Variety 3. Customization 4. Convenience 5. Speed _________________________________________________________ Which are your strengths? Which are your challenges? Convenience Where, when, and how you buy it... 1. Location... - Where it is and how you get to it. - What it looks like. - What it communicates. - What image the customer adopts. 2. Distribution... - How one buys. - How easy it is to buy. - How much trouble it is to buy. - Easy access. 3. Time... - Right offer, to right person, at right time. - Available when the customer wants. Speed! __________________________________________________ 1. You are in the anxiety-relief business. You must be available when people are motivated to use you. The motivational window between interest and initiation is small. You must strive for immediate access and rapid response to initial inquiries. 2. Speed does not mean less time with customers who want and need more time. It also does not mean working faster. It means working smarter and developing alternative service delivery methods. Using only one-on-one entry paradigms guarantees delay! 3. In manufacturing, cycle time is the amount of time it takes from "an order" to "fulfillment". The critical cycle times in many programs are: the time between inquiry and first step; between enrollment and first activity; between first activity and activity completion; and, between inquiry and program completion. Measure your current cycle time/s; set service benchmarks for reducing cycle time; monitor for results; and, strive for continuous improvement. 4. The perception of movement is as important as the reality of movement. You must feel like you are moving even if you are getting there slowly. Maintain momentum. continuous improvement for I and R! How would your customers rank your I and R service on these five criteria: 1. Quality? 2. Variety? 3. Customization? 4. Convenience? 5. Speed? What ILCs learned about the satisfaction of their customers! ___________________________________________________________ Survey says... - Some thought the ILC did good work, but did not get what they wanted. - Customers don't like surveys. - As customers change, services must change. - The importance of appropriate referral. - Customers want both quality and quantity. - Services are too limited. - Customers want it done for them. - Customers want involvement in service design. - How the funding source defines quality is not necessarily how customers define quality. - Simple things affect customer satisfaction. - Customers don't know ILC philosophy. - "You can satisfy everyone". _________________________________________________________________ ________________________________________ Use satisfaction data to improve and evaluate services! How do you measure customer satisfaction? _________________________________________________________ Two satisfaction measurement methods: 1. Behavior measurement; Example of behavior measurement: How many who were scheduled for a second meeting show up? 2. Preference measurement. Example of preference measurement: How was satisfaction with the first meeting ranked? You get the best measurement when you use both! _________________________________________________________ Two types of satisfaction data: 1. Qualitative; Example of qualitative data: advisory council comments. 2. Quantitative. Example of quantitative data: service feedback surveys. You get the best measurement when you use both! Survey says... - Those responding used a broad mix of methods for collecting customer satisfaction data, including behavior, preference, quantitative, and qualitative measurements - Customer surveys were used by about 55% of those who use any system to measure satisfaction. You must research customer expectations.... so you can meet or exceed them! Customer research and feedback options: - Customer Councils - Interviews - Customer Surveys - Focus Groups - Direct Customer Contact - Suggestion and Complaint Systems - Statistical Analysis of Behavior - Customer Feedback at Each Process Stage - Post-Service Customer Follow-Up Which ones are best for you? You must find out if they were met.... so you will know if they are satisfied. You may be surprised at the quality definition! Customers are continually giving you feedback! Informal... Formal... When they call Complaint letters When they show up Customer comment cards Body language Service evaluations Questions asked Suggestion boxes Unsolicited statements Surveys Common mistakes Focus groups Facilities confusion Mail-in responses Other: Other: Both sources of feedback provide valuable customer information! To capture satisfaction, reduce dissatisfaction, be customer-driven, and make continuous improvements... - Suggestion systems Throughout the program (both formally and informally), ask the customers (and those who serve them) what they think. - Complaint systems Always seek and welcome complaints from customers and move to correct or ameliorate immediately. - Feedback systems At the conclusion of each process step and within each program activity, seek formal assessment from customers. - Evaluation systems At the completion of the program, formally assess the final satisfaction and/or dissatisfaction with the final results. Collect your customers' ideas, reactions, and preferences! Seek suggestions... - Ask for ideas each and every time you are in contact. - Have receptionists ask for suggestions. - Say you want suggestions for your newsletter. - Convene a customer meeting to brainstorm ideas. Welcome complaints... - Have a system to proactively seek complaints. - Give complaint resolution a priority. - Look for repetitive complaints for service innovations. - Consider them as program improvement recommendations. Ask for feedback on process steps... - Seek feedback from both users and nonusers... at each and every step! - Use formal and informal methods. - Collect entry expectations and monitor for changes. - Have customers help you interpret the feedback data. Conduct post-service evaluation... - Get some of the best data after the service is over. - Hold focus groups with alumni. Tell us what you think... It is a good idea to develop a form available (and prominently displayed) in the waiting room and service areas which collects both complaints and compliments. There are at least six reasons for this: - If they have a way to put it in writing, it helps relieve their anger. - If you give them a form to complete, you have an alternative for responding to dissatisfied customers. - If they tell you, they are less likely to tell someone else. - This is a way for you to do your job even better. - People don't know they are satisfied until they say they are. - You may be surprised--- you'll get even more compliments than you think! When you get a complaint... _____________________________________________ 1. Say, "I'm sorry." 2. Empathize/Thank. 3. Tell them...what you can't do/can do! 4. If you can't do, give alternative! You can ask customers about... 1. Individual Treatment -Fair; -Prompt; -Courteous; -Respect. 2. Staff Services -Knowledgeable; -Responsive to questions; -Provision of services; -Helpful. 3. Facilities -Parking; -Office comfort; -Cleanliness; -Attractiveness. 4. Forms, Processes, and Procedures -Clarity; -Understandable; -Waiting time; -Productivity. 5. Results -Services expected/received; -Perceived usefulness; -Outcomes of services; -Recommendation to others. The 18 most common mistakes in designing customer satisfaction forms and how you can avoid them! Mistake #1: Not knowing why the data is being collected or how it will be used. The very first step in any research is establishing objectives -- which means answering the question "What do we need to know from our customers in order to successfully serve them?" Your answer to this question must be very specific. The second step is to identify how you will use the data before you collect it -- which will also help determine the best method for collecting the data. For example, one objective for customer satisfaction research might be: "Determine which service (from an entire menu of services) provided is most useful to helping our customers meet their goals." The application statement for this objective might be: "Focus 80% of our resources and capacity building efforts on the top three services identified as the most useful by customers." Mistake #2: Not asking specific information or not testing. Avoiding this common mistake requires you to look at the universe of customer issues and prioritize what information is most important. Rather than collect an overwhelming amount of feedback, select 2 or 3 critical areas to start with. This approach will prevent the "too much information" scenario. With this list of priorities and your research objectives, break one "overall questionnaire" into multiple, shorter surveys to use with different customers at different phases. Prior to full implementation, test your research tool on a small sample of customers to be sure that you are getting the feedback that you need in the most useful format. Mistake #3: Not differentiating between customer types. An absolute prerequisite for customer satisfaction research is specific, detailed definitions of your customers and predetermined major customer groups. One of the outcomes of the research is then to effectively apply the research not only by major customers groups, but also by issues specific to each group -- which may be very different. Mistake #4: Not asking the customer what was expected and/or why the customer made the initial contact. Customer satisfaction is determined by how the reality meets the expectations. So, in order to measure -- and improve -- customer satisfaction, you need to know the basis being used for the rating assigned. Customers must be asked "What did you expect from us?" or "Why did you choose our service?" In addition, if your research shows that a main reason for dissatisfied customers is due to unrealistic expectations, you can pursue a different approach to increasing satisfaction simply by better clarifying your program services at the outset. Mistake #5: Not asking the customer to define what is "most important". Your customer satisfaction efforts should be focused on improving those elements that are "most important" to the customer. Collecting this data will ensure you do not expend your valuable resources improving aspects that do not really matter to the customer. For example, "lack of parking" may be a frequent complaint, but "excess waiting time" may be much more critical. Whenever you collect feedback on a multiple listing, be sure to ask, "Which item is most important to you?" Mistake #6: Not asking the customer to define what quality is and what would make the customer satisfied. Asking the customer to define "quality" goes hand-in-hand with asking the customer to describe their expectations and what is most important to them. Collecting and using these three pieces of information is the core of any customer-focused organization. The "expectations" provide the starting point, what is "most important" helps you to focus your improvement efforts, and the definition of "quality" describes the goal. Mistake #7: Not separating the procedural aspects of customer service from the personal aspects of customer service. Services encompass both procedural and personal aspects. When you ask customers to rank their satisfaction with a particular attribute, make sure you are clear as to what is being asked. In this customer service survey, some of the attributes are clear, but the others are not---with-out clarity you will not know what or how to improve the service. the procedural... the personal... - prompt service - friendly/polite - convenient hours - personal attention - answered questions - answered my questions (accurately?) (responsive?) - cheerful office - cheerful office (physical appearance?) (people/atmosphere?) - flexible (break rules?) - flexible (responsive?) Mistake #8: Not asking for the reasons for rankings. It is always important to ask the customer why they answered a question the way they did, especially when asking for items to be evaluated on a scale. A ranking without a rationale does not tell you how to improve your services -- only what needs to be improved. Moreover, some people are hard judges with small reasons leading to the low ratings. Mistake #9: Not providing space for open-ended comments, including recommended improvements. Even the best research tools may not collect the most important feed-back that a customer wants to give you. The best way to prevent this problem is to include an opportunity for "any other comments" that the customer may want to add. You can also use this type of space on your survey form to prompt for their recommendations for improvements Often, these recommendations are the customer's way of "defining quality". Mistake #10: Not asking if the customer wants follow-up. One of the most powerful methods for acknowledging customers who provide feedback is to ask them if they want a follow-up contact from you. Whether or not they take you up on this (and most will not), you have indicated that their feedback is important to you. This is particularly important for customers where you are striving for long-term relationships and repetitive behaviors, such as referral sources. If you include this on your survey, be sure to ask for their name, address and telephone number, and preferred method and time for follow-up. (But don't ask if they want to be contacted, and not contact them. If they say yes---contact them immediately by phone or, for the most critical customers, in person.) Mistake #11: Not asking quickly enough after service delivery. The more time that elapses between the service receipt and the evaluation of satisfaction the less valid (and helpful) the information, since the service cannot be isolated from other intervening life events. If evaluation is after a long period of time, value tends to diminish. What is remembered is the most important "moment of truth" and a picture in the mind of the tell-tale signs of value. This visual is almost entirely a hygienic issue. If you do not do this immediately after each step, it is hard to separate the evaluation by process steps -- and the last process step will tend to be the one that is most evaluated. So, for example, a customer may be satisfied with your services at each step of the way, but does not like the final outcome and therefore he/she may see the service as "unsatisfactory." Mistake #12: Not asking for feedback at the conclusion of each service step. Customers' expectations and satisfaction criteria (and ratings) change during their experience with you and your program. For example, what you say and do during their first visit can change their ideas about what to expect, and how they rate their satisfaction during subsequent meetings. A request for feedback should occur at the conclusion of each service step in order to distinguish satisfaction ratings. (An additional benefit of asking for feedback more frequently, is that you can tell your customers more frequently that they "are getting" or "have gotten" a service from you -- an important, ongoing activity when you are in the "service" business.) Mistake #13: Not evaluating the satisfaction of those who do not continue in the process, as well as those who do. Some of your most valuable feedback comes from "lost customers" (those who inquire but do not enroll, or enroll but do not complete) when you ask them to tell you why they did not enroll/complete the program. This is particularly true if you have a recruitment problem or a high number of program drop-outs. In order to solve these problems, you have to find out what are the causes. Mistake #14: Not using the results to make improvements. Making program improvements is one of the primary reasons for collecting satisfaction data -- otherwise, why bother! And if you use the results successfully, it will show up in your future customer satisfaction research as increased satisfaction -- or decreased dissatisfaction as the case may be. And research results that are driven from objectives will have their applications clearly described before you even start! Mistake #15: Not disseminating to customers the ways their feedback was used and the results. One important way to show responsiveness to customers is to report to them the activities you have undertaken because of the valuable feed-back they were kind enough to provide. One way this can be done is to mail a follow-up action report to those surveyed. You can also mail it to current or potential customers -- those not yet surveyed. Or some of the research highlights can be added to your survey forms, in a section entitled: "Your feedback leads to changes to serve you better...". Mistake #16: Not using customer satisfaction forms as a means of continual market research on proposed products and procedures. Before you introduce any new products or change any procedures, you can test them in "pilot" form with your customers. This way you can get their feedback and incorporate it into your product design or new procedures -- and prevent customer dissatisfaction (while saving valuable resources normally spent on detection and correction). Mistake #17: Not using enough methods to collect the customer satisfaction data. Depending on the objectives for your research, there are several methods you may choose to use to collect customer feedback. You will usually get the best results when you use a combination of mail surveys, point-of-contact feedback forms, complaint systems, focus groups, and per-sonal interviews. Each of these will give you important (and different) perspectives in your quest for continual improvement. Mistake #18: Not making customer satisfaction an integral part of program operations. Don't just turn this important business survival tool over to those who see the issue only as a social research tool driven by statistical validity. There are very few operational decisions that don't require customer input in a "customer-driven" organization. If your customer feedback is not fully integrated into your daily decision making processes, you are not customer-focused and will lose customers. Surveying for the satisfaction of referral sources... The Center values your feedback... The Center wants to provide the highest possible quality services to people with disabil-ities and to you. If you will take a few moments to provide your feedback on the Center's performance with your recent referral, it will be very much appreciated. Any ideas for improving the Center's services and responsiveness are also welcomed. How did the Center respond to your referral in terms of: Excellent Very Good Fair Unsatisfactory 1. Timeliness of response o o o o Please Explain: _______________________________________________ _______ 2. Quality of response o o o o Please Explain: _______________________________________________ _______ 3. Courtesy & Professionalism o o o o Please Explain: _______________________________________________ _______ 4. Follow-up o o o o Please Explain: _______________________________________________ _______ 5. Which one of the above four (or any other aspect not listed) is most important to you in terms of our handling of your referral? ___ 1. ___ 2. ___ 3. ___ 4. Other: 6. Your recommendations to improve the Center's services are welcomed: If you know someone else who could benefit from the Center's Services, we would be happy to call them and tell them about our services. Name ____________________________ Name ____________________________ Telephone ________________________ Telephone _________________________ Would you like for Susan Smith, Director, to contact you to discuss your feedback ideas? ___Yes ___No If yes, be sure to complete the information below. Name (optional) ________________________________________________ ______ Agency _________________________________ Telephone _________________ Thank you for your feedback - and for your referral! continuous improvement for I and R! What are the best methods to measure the satisfaction of your I and R customers? Best Bets! Total Quality Management! Total Quality Services! Providing quality... each and every time Quality failure due to... 1. System-based problems; 2. Staff-based problems; and/or, 3. Customer-based problems? Principles of Total Quality Management Focus on the service systems and the delivery process. 1. It is easier to change system-based problems than to change people-based problems. 2. 85% of poor quality/failure is due to the process; only 15% to the employee(s). 3. Assume employees want to do a good job, and will do a good job if the system/process is right. 4. The Pareto Principle: 80% of the problem(s) are caused by 20% of the processes. 5. Most processes have been developed to build accountability to "taxpayers" (funders) and reduce risk of error---not to improve "user" (customer) satisfaction. 6. You can influence staff-based problems easier than you can change customer-based problems. 7. Influence customer-based problems by setting appropriate expectations and designing programs around preferences. How do you make toast? Why might you have toast quality failure? Quality Tools: Flow Charts Flow charts are... - A combination of narration and diagrams to show a step-by-step sequence of events/activities in a process. - A diagram of what actually happens during the process being studied for problem-solving. - A planning tool which shows how you want a new or corrected process to work. Three basic types of flow charts... 1. Top-down: This flow chart includes the major, most basic steps in a process (looking at it from "40,000 feet above"). Such charts can be used for planning (what should be true of a process) and data collection (what actually is occurring). Note: If you end up with more than six or seven, you may be charting a system instead of a process! 2. Detailed: This flow chart adds all of the major sub-steps between the basic steps. This flow chart is added if more details are needed in order to understand where problems arise. 3. Work-flow: This flow chart is a drawing of the movements made during a process. This is typically done on an office floor plan and shows the people or item moving geographically from start to finish of the process being studied. Your service and advocacy system is composed of a series of discreet processes which either lead to quality or quality failure. Do you have a flow chart for the processes you use to deliver services and advocate? You should map your processes to: 1. Identify critical quality points; 2. Develop benchmarks of quality; 3. Reduce variation in service delivery (to ensure customer equity and make it less dependent upon individual staff capacity); 4. Seek efficiencies and reduce duplication; and, 5. Provide effective staff training. Standardizing the process does not preclude customization to meet individual customer needs. Standardization is a system activity and customization is an individual activity. You must have a standard from which to customize. Survey says... 1. Two-thirds of survey respondents said they had developed a standard protocol for staff to provide certain services. 2. Respondents identified the following services as those which could be most improved though developing a service protocol: -Independent Living Skills Training; -Peer Support; -Intake and Assessment; and, -Information and Referral. continuous improvement for I and R! Develop a process map for receiving and responding to the first call to your I and R service: Trend: Alternative Service Delivery and Use of Technology 1. One-on-one services are very expensive and not the preference of all customers. You will be expected to serve more with fewer resources. 2. There is an emerging trend to use a service protocol to triage customers. 3. Technological service delivery is increasing. Triaging: A Service Protocol SELF-HELP GROUPS ONE ON ONE continuous improvement for I and R! How can your I and R service use technology and the emerging service delivery paradigm to serve more people with fewer resources? Principles of Total Quality Management Do the right thing right the first time 1. Prevention is valued more than detection and correction. 2. Effectiveness is doing the right things well. Efficiency is doing the things you do well. Aim for effectiveness. 3. Focus on the process---before the product is completed. 4. Determine the critical few "right things" (i.e., the 20%) to change. Doing the right thing right is doing what is important to the customer. Have your customers complete this grid. Important to customer Don't Do do well well Not important to customer First: List all of your service elements and ask your customers to rank each by importance. Then: Ask your customers to rank their satisfaction with each of the service elements. Make your priority the service elements which are most important to your customers! Doing the right thing right is doing what is important to the customer. - Customer satisfaction is not determined by how will you did things in general, but how well you did what was most important to the customer. - Many customer surveys only ask "how well did we do", not "how important was it". - Chart your services on two continuums: what is most important to your customers; how well you provide what is most important. - The best way to "rightsize" in a reduced resource environment is by eliminating what is less important to customers and increasing resources and attention to what is most important to customers. Doing the right thing right is preventing quality failure. - Prevention is valued more than detection and correction. ILC advocacy is a way to seek "wholesale change" to prevent the need for corrective "retail services". - By finding out where the earliest cause of service failure occurs, you can increase the odds of quality outcomes. - Reducing variation in service delivery ensures consistent quality and provides a method for increased efficiencies. Reduce variation! Protocols are used in the delivery of medical services for quality assurance. Protocols should also be established for key customer contact points, so staff will have help in responding effectively to these moments of truth. While each contact will be unique in some ways, there will also be many ways in which most contacts are similar. By establishing preferred responses (which may be modified to meet the specifics of each situation), you increase quality through reducing variation. Standardization permits you to train staff, collect customer data, and innovate for continuous improvement. The first call is a critical moment of truth! Have you... 1. Established a quality benchmark for the number of times the phone can ring before being answered? 2. Set a goal for the most desired outcome of the first call? 3. Collected the ten most common questions and developed a desk guide with a script of the best (and alternative) responses? Produced a "Q and A" for inquirers as an alternative means to communicate the information most important to your customers? 4. Identified the staff who will take the calls? Trained them in the outcome and the script? Established a benchmark time in which all inquiring calls must be returned? 5. Got a system for collecting information on the inquirers to know who they are, how they heard about you, and why they called? 6. Developed a protocol for following-up the call? 7. Got a system for seeking customer feedback on the first call for both those who continue and those who do not? Called your own agency to assess your first-call protocol? Tested innovations to improve your inquiry/enrollment ratios? continuous improvement for I and R! 1. What are the five most common questions asked in your I and R telephone calls? 2. Are they responded to in the same way, by every staff member, every time? 3. What are the alternative means which could be used to transmit this information to insure consistent quality and efficiency? The steps to take to prevent quality failure! _________________________________________________________ 1. Survey for initial customer expectations and service requirements/quality specifications (as defined by the customer). 2. Map the process outward from the customer. 3. Collect data at each process step to determine reasons for quality failure (including delay). 4. Consider starting with the earliest process step for the greatest impact on quality failure. 5. Determine how quality failure is driven by the system, by service providers, and/or by customers. 6. Start by improving the system for service delivery. 7. Develop process improvement teams and include staff representatives from all phases of the supplier/customer link. 8. Reorganize your services to meet expectations and requirements, whenever possible. 9. Give customers information on realistic expectations and how they can help themselves receive the most effective service. 10. Provide cross-training to the supplier/customer link team and unify service delivery, where possible. 11. Reduce variation in question response, service delivery, and customer expectations. 12. Eliminate duplicative service process steps. 13. Collect data on process steps and develop service benchmarks. 14. Monitor service benchmarks, innovate, measure, and strive for continuous improvement. 15. Survey customers for satisfaction impact after each process innovation and use the data to determine future changes. 16. Create a service recovery strategy until you achieve total quality services. Best Bets! Total Quality Management! Total Quality Services! Using data for continuous quality improvement Principles of Total Quality Management Continuous improvement 1. For total quality, you must adopt a "plan, do, check, act" cycle (PDCA). 2. All results are measured and evaluated. This information is used to start the cycle again. 3. It is "never ending." Good is not good enough! What percentage of your time and resources do you currently spend on each of these activities? What should you be spending on each of these? Continuous improvement! _________________________________________________________ Survey says... - 70% agreed with "good is never good enough". - 65% agreed with "we spend too much time doing and not enough time planning". - 65% agreed with "ILCs should strive to please its customers 100% of the time". _________________________________________________________ TQM: only 100% quality counts! Customers deserve only the best each and every time. The 7 Steps of Problem Solving 1. Theme Selection Identify the problem to be addressed. Discuss why the problem is important: its effect on the customer, organization, staff and others. Use tools to summarize and describe the history of the problem. Make sure data can be collected at the site. State a tentative theme. Set challenging, realistic, and measurable goals. Reflect and revise. 2. Data Collection Decide what data you need to collect and develop a plan. Be sure data will represent many different perspectives to find as many variations in the results as possible. Investigate the features of the problem using time, place, type, and symptom. Construct Pareto diagrams to illustrate the features of the problem. Make conclusions by selecting what bar on the chart the team will investigate further. Document what was collected, how it was collected, what period was covered and why it was collected. The 7 Steps of Problem Solving 3. Causal Analysis Establish a hypothesis for the root causes. Rewrite the selected bar (from the Pareto chart) as a specific question. This is the first why. Use the information in Data Collection to help identify major causes. This is the second why. Ask why 3 more times to uncover the root causes. Highlight the three main root causes. Collect more data to verify the relevance of the root causes. Reproduce the problem to verify the cause and effect. 4. Solution Planning and Implementation Develop several possible solutions that would eliminate root causes. Determine whether or not there will be negative effects from any of the possible solutions. What are the advantages/disadvantages of each possible solution? If necessary, create a matrix to compare one solution with another. Obtain group consensus on recommended solution. Create an implementation plan, with a clear explanation of the solution, as well as what, where, when, who and how the plan will be put in place. The 7 Steps of Problem Solving 5. Evaluation of Effects After implementing the solution as a "pilot," collect data to evaluate the tangible results. Compare before and after Pareto charts to see the impact on the effect. Convert the data into the monetary impact. List other effects during the implementation period. (Did your building burn down while the team was imple-menting the solution?) If the solution was successful, go on to Standardization. If not, go back to implementation and choose another possible solution or go back to Causal Analysis to see if all the root causes were named. Evaluate the intangible results of the solution. 6. Standardization Create a new standard by defining how the new problem solution will be implemented into your organization. Be sure to communicate the new standard clearly to those affected to avoid confusion and unnecessary mistakes. Incorporate the solution into your organization's training and education programs. Identify who will monitor the new standard and how. The 7 Steps of Problem Solving 7. Reflection and Future Plans Reflect on the process. Discuss what you learned from the project. Identify what went right and wrong, and why. What would you do differently next time? Identify whether or not the tools were used properly. Evaluate the team dynamics and performance. Sum up the remaining problems. Discuss tentative themes. Choose appropriate team members and start at step 1 again! Remember: Plan (Steps 1, 2, 3) Do (Step 4) Check (Step 5) Act (Steps 6,7) continuous improvement for I and R! 1. How have you recently improved your I and R service? 2. How might you use the seven-step process to make further improvements? Principles of Total Quality Management Data-driven decision making and structured problem solving 1. You can't improve what you can't measure. 2. Using data (instead of opinion) leads to effective decision making. 3. All staff should use the same structured tools for decision making. 4. Organizations often collect data which cannot be used for quality improvement. (No Meaningless Information Systems!) 5. Data is for organizations to use for quality improvement---not just for "reporting." What data do you currently use to make, support, and measure results of decisions? What do you need to know? In God we trust... all others bring data! - Survey says... Only 50% of the respondents frequently use the statistics required by funding sources to improve the quality of service delivery. - Survey says... 17% of respondents have trained staff how to improve the quality of service delivery - Using data to make decisions helps everyone do a better job; each staff and team members should collect data to improve the quality of their process steps. Service benchmarks are a way to provide quality each and every time! - Benchmarks are a way to know how you are doing and a means for continuous process improvement. Quality service benchmarks! Benchmarks are used to strive for continuous improvement and standards are set by using... Your customers' expectations and definition of quality; Your past and current performance; The performance of other Centers; The performance of other indirect/direct competitors; Best-in-the-field/world-class processes and practices. Eight steps to make service benchmarks work for you... 1. Measure customers' entry expectations for service. 2. Measure current performance. 3. Establish best-practice benchmarks. 4. Monitor for attainment. 5. Tell customers your service goals. 6. Report progress to staff regularly. 7. Post your performance. 8. Strive for continuous improvement. The Center's Quality Service Benchmarks.... 1. The phone answered before the fourth ring. 2. Customers entering office greeted within 1 minute. 3. Satisfaction with workshops ranked no less than 9. 4. Customers seen within 5 minutes of appointment time. continuous improvement for I and R! What are the best quality service benchmarks for your I and R service? The process for data-driven decision making... 1. Collect meaningful data. 2. Identify root causes of problems. 3. Develop appropriate solutions. 4. Plan and make changes. 5. Redo step 1. The quality tool box for data-driven decision making... 1. Flow charts 7. Control charts 2. Deployment charts 8. Dot plots 3. Operational definitions 9. Scatter diagrams 4. Checksheets 10. "The five whys" 5. Pareto charts 11. Cause/effect diagrams 6. Time plots 12. Many others. Quality Tools: Pareto Charts - This quality tool derives from the Pareto Principle: 80% of the trouble comes from 20% of the problems! - These charts organize data throughout a problem solving process. At the outset, you can use them to identify which problem to study (because it happens most frequently), and then again to narrow down the most frequent cause/s of the problem. - Pareto charts have a series of bars of differing heights which reflect a measured response to a problem. The bars are organized in relationship to frequency, with the left bar representing the problem or cause occuring most often, and then presented in descending order of frequency. - Your continuous improvement activities and efforts to prevent quality failure should focus on the most common causes and not the special causes. Spend your limited resources on the most important improvements. Quality Tools: Time Plots and Control Charts - A time plot is points charted in time order. A control chart adds upper and lower control limits to the chart. They show data relevant to information collected over time. - These tools help you discover patterns which are important to your problem-solving. Quality Tools: Dot Plots and Scatter Diagrams - Dot plots show how often a certain value occurs. Scatter diagrams are used to show the relationship of two variables. - A dot is entered on the chart to represent the data. For example, you can use a dot plot to determine the range of the number of I & R calls. The dot plot is a chart which shows the range. A dot is used to show how frequently a number of calls occur on a day. Best Bets! Total Quality Management! Total Quality Services! Leading your quality team Principles of Total Quality Management Everyone is involved 1. Everyone affects quality. Everyone is both a customer and a supplier in a chain of events. 2. Display measurement data to ensure focus. 3. Mobilize your staff's expertise and experience. 4. Employees work for customers and with supervisors. 5. Collaboration leads to better quality. 6. "Empowerment" is a by product of TQM. Principles of Total Quality Management Three common types of organizations... 1. Hierarchy 2. Individual Power Centers 3. Overlapping Work Teams Everyone is involved! - Everyone is involved because they are whether you decide to include them or not! - People closest to the job are best able to improve it. - To the customer, those on the bottom of the chart are on the top of the chart. Staff work for customers and with supervisors. The job of management is to support the customer/staff transacation. - Survey says: 90% agree with "employees work for customers and with supervisors." You must empower staff! - Empower outward from the customer and make quality a part of every job. - You empower staff by: - Defining the "what" and the parameters and staff defining the "how" within those parameters. - Providing and displaying data. - Giving staff the tools and skills to do the job. Quality improvement teams! - Mobilize the expertise of your staff. - Survey says: Approximately 80% of those responding indicated they sometimes use non-hierarchical, cross-functional teams to plan service improvements. - The team project work included development of a customer internal grievance process; methods to increase the timeliness of referrals; and improvement of the advocacy alert process. continuous improvement for I and R! 1. Who would you decide to put on an I and R service improvement team? Why? 2. How would you select them and give them the tools and training they need to do a quality job? 3. What would you do to empower the team for change? Tools for Making Team Decisions Team and idea-generating tools... - Complement the scientific, data collecting tools. These tools can be as formal or informal as the team wants, but the process should be consistent. - Facilitate participation in problem solving to mobilize the expertise and experience of your staff. Team Tools: Brainstorming - Used to generate ideas - as broad a range of options as possible. - Participants are as creative as possible. Nothing in a successful brainstorming session restricts or discourages input. - Create ground rules for your team brainstorming, such as: 1. Everyone participates. Don't hold back any ideas, even if they seem impossible, unrealistic. The more ideas the better. 2. No comments are made on any ideas during the session. 3. No judgements or evaluation of ideas are made during brainstorming...not even with body language or audible sounds! 4. You can build on ideas generated, snowballing them into more ideas or variations of ones already given. One Local Office Brainstorming Session... Review the topic and express it as a question: "How can we get back to employers on the status of their job orders within three days?" Give everyone a few minutes to think about the topic. Call for ideas, with participants freely contributing. (The facilitator should enforce the ground rules.) Write down all ideas without editorializing. Check with the source to ensure it has been recorded accurately. Team Tools: Multi-voting - Voting is repeated several times to proiritize or select items from a list (e.g., following a brainstorming session). - Useful with large amount of data, because discussion is limited. The multi-voting process... 1. Generate the list, combining similar items (if the team agrees). 2. Number the items. 3. Members individually select a number of items---equa to at least one-third of the total---for further discussion. 4. Votes are tallied; items with fewest votes are eliminated. 5. Repeat the process until only a few items remain. Team Tools: Consensus - Process all team proposals, decisions, or actions until all members are supporting and no one opposes. - This tool is used for major decisions (i.e., those having a significant impact on the project or direction of the team). - The outcome may not reflect each member's prefence, but consensus means each member "can live with it." - Is not "majority rules". Requires discussion to assess support and hesitations. Builds support by discussing hesitations. Building consensus... 1. Decide in advance whether or not a decision requires consensus. 2. Each member actively participates. States what is/is not supported and offers alternatives on aspects not supported. 3. Listen carefully, continue to double-check/revise position. 4. Consensus is reached when each member answers "yes" to the question, "can you live with this?". Principles of Total Quality Management Communication and training 1. Adopting a structured approach to problem solving creates a need for organization-wide, on-going training and communication. 2. By definition, communication is a two-way activity. 3. Listen, ask for ideas/opinions, foster authentic dialogue, and pass on information. 4. Self-improvement through training (for all employees) is one of the goals. 5. The greater the degree of interdependence between components, the greater the need for communication to be successful. Communication is very, very important: Complex transactions require plenty of info! 1. How do you make sure every staff member has the information they need to do their job? 2. What methods do you use? 3. Have you asked them if they know what they want and need to know? Internal customer relationships are important! - Every time an external customer receives a service, the quality of that service transaction is the sum total of every internal transaction. - All internal customers make it possible directly or indirectly to serve external customers. - Survey says: 97% agreed that ILC staff must consider each other as internal customers and work together to serve external customers. Does the customer come second? "Companies must put their people first. Yes, even before their customers. We're not saying choose your people over your customers we're saying focus on your people because of your customers. Happiness in the workplace is key to providing superior service. To serve our customers first, we have to put our people first. If we put our people first, they'll put our customers first. What works is creating an environment in which high-level needs are satisfied. Measuring happiness: Twice a year, I meet with staff for an entire day to get a read on the morale of our people. Each meeting begins with an anonymous questionnaire. It's the same one every time so we can monitor changes. While the questions are open-ended to solicit discussion, each contains a nuberical rating so we can quantify morale and track its fluctuations. Companies should strive to be as much lifestyle as business. It's said that its not a good idea to work with friends. Hogwash. Friends don't let each other down. It is the company's responsibility to ensure staff happiness. Profits are a natural extension of happiness in the workplace---and that happens when you put your peope first!" - Hal F. Rosenbluth and Diane McFerrin Peters. Read: The Customer Comes Second; Hal Rosenbluth and Diane McFerrin Peters; William Morrow; 1350 Avenue of the Americas, New York, NY 10019 In service businesses, people are the product. A chain reaction... Staff satisfaction equals Customer satisfaciton equals Even more success for your agency! TQM: Good people trapped in bad systems! "Take care of your employees and they will take care of your customers.: - J. Willard Marriot, Jr. External customer satisfaction is dependent on internal staff satisfaction! Survey says... - 95% agreed staff satisfaction is key to customer satisfaction - About 27% of the respondent had conducted a staff satisfaction survey. What they said they learned... - Communication is very important; - When staff skills are enhanced, they can provide better service. - They want to feel connected to something bigger than just their job and know how they fit in the process. - They enjoy team processes the most. - Some were unhappy. - They want involvement and responsibility. - They want working conditions improved. Staff motivation! Herzberg's Motivation-Hygiene Theory The two musts for high staff performance: 1. Hygiene Factors: - Rules and structure. - Policies/clarity of task. - Physical surroundings; resources; parking; and supplies. - Salary and benefits. 2. Motivators: - Sense of achievement and recognition. - Involvement and team spirit. - Increased responsibility and challenge. - Personal growth. Which of these factors do you emphasize? Which should be increased in your agency at this time? Start with hygiene... move to motivators! 1. Create a quality hygiene environment: - Make the office environment clean and attractive. - Focus on rules and create structure. 2. What you should do to have rules and structure: - Be clear on the rules, withour being petty or mean. - Set priorities and communicate them frequently. - Provide options within the established rules. - Follow the rules yourself. - Remind everybody of the rules, frequently. - Enforce the rules. - Assess progress on the rules. 3. Examples of hygiene factors: - Arrive on time. Leave on time. - Attendance rules. - Worker safety. - Dress requirements. - Adequate parking. - Clear performance expectations. The hygiene factors must be satisfied, before you can achieve high performance through motivators. Motivating staff in difficult times... working on the hygienics! 1. When staff complain about hygiene factors, don't dismiss them as beyond your control or as another example of "chronic complainers". Give resoulution of hygiene factors a high priority. 2. If you resolve the hygiene factor problem, tell your staff that you did it. 3. Improve your facilities and physical work environment to make it more attractive and more comfortable for your employees. 4. Have a clean your desk day! 5. Work on security issues. 6. Give even higher priority to management structures that even-out work flow and reduce waiting room over-crowding. 7. Work on the parking availability. 8. Make sure the staff can see that management and supervisors are busy, too. Make your work visible. 9. Obey the hygiene rules you set for your staff. 10. Access employee assistance programs to help people resolve personal and family problems that may stand in the way of job performance. It is another way to say you care about those who work for you. 11. Avoid large staff meetings in difficult times. Have more staff meetings, more frequently, in much smaller groups. 12. Keep everyone busy, as equally as possible. 13. Deal immediately with those not carrying their own weight. 14. Use work subtraction as a management method. Almost every office has some work being done that no longer needs to be done. Look for even the most minor requirements and stop the work you can. working on the hygienics! 15. But...don't just stop it---communicate that you've stopped it. Write memos about what no longer needs to be done. 16. Continually communicate priorities. State what is most important in the sea of work...and what is less important. Don't make the worker have to determine the priorities---that's your job! 17. Don't change priorities too frequently. Changing priorities frequently, does not add to stability, but subtracts from stability. 18. Tell staff frequently what is being done to improve the current "over- worked" situation. 19. Establish uninterrupted "quiet" time, to permit staff to catch-up on the paper work. 20. Don't continue to manage using the mind-set of the past. Motivating staff in diffucult times... working on the motivators! 1. Provide frequent rewards. Since monetary rewards are generally not available, you will need to provide increased non-monetary rewards. Frequency of reward is even more important than size of reward. 2. Reward team performance, as much as individual performance. 3. Make your work place as fun and enjoyable, as possible. Do you look like you are having fun? 4. Develop team spirit and bonding between employees. 5. Provide the opportunity for job variety and personal growth through stimulating and interesting assignments. Think about cross training and voluntarily switching-up jobs. working on the motivators! 6. Work on your own motivation. No one wants a wimp in hard times: They want someone who feels and looks in control. If you continually complain about the situation, you are modeling behavior that staff will see as acceptable. 7. Roll-up your sleeves and be a worker...wherever you are needed. 8. Seek feedback from employees frequently on job and work place satisfaction. Where possible, move quickly to respond to complaints. Involve them in seeking solutions to the problems. 9. Public praise...private praise. Catch them doing something right! Tell them about it immediately! Remind them of it often! 10. Thank you notes to staff members' homes. 11. Provide training and enrichment activities. 12. Provide help in career advancement, wherever possible. 13. Give small gifts and hold staff events, for example: birthday cards from management; flowers; mega-bucks pools; parties, pot luck lunches. (Can management host the party and provide the treats?) 14. Deal with the attitudes of continually negative individual staff members---negative attitudes are catching. 15. Spend informal time with staff in the lunch room and smoking room. 16. Provide active intervention and support to staff members who are dealing with difficult and hostile clients. Total Quality Management Leadership 1. Create a vision! Make is real! 2. TQM must be top-down because leaders own the system. 3. Coach staff for peak performance. Drive out fear to allow for risk and mistakes. 4. Remove barriers to pride of workmanship. Four elements of leadership... 1. Management of Attention Developing commitment to goals, direction, intention, and outcomes. 2. Management of Meaning Communicating with clarity. 3. Management of Trust Being focused, dependable, and reliable. 4. Management of Self Using ones own self effectively. Survey says... These were the characteristics most desired in ILC leaders: #1: Committed/Dedicated; #2: Visionary; #3: Knowledgeable; #4: Ethical/Principled; #5: Advocate; #6: Communicator; and, #7: Listener. Do you meet these expectations? How do you know? How will you "continually improve"? Good managers and good leaders are not always the same! Managers... Leaders... - Make decisions based on - Make decision based on an established directions. an envisioned future. - Emphasize the rational, - Emphasize intuition, supported by feeling. supported by reason. - Use given resources - Expand beyond given effectively. resources. - Work according to plans - Work according to what and schedules. is needed now. - Be analytical, objective - Be intuitive, subjective, and practical. and impractical. - Act in the present, - Act toward the future, based on the past. based on the present. - Emphasize knowledge - Emphasize belief and and facts. commitment. Mangers do things right! Leaders do the right thing! What is the difference between leaders and managers? Functions... Communications Problem-solving Decision-making Rewards & Recognition Direction Action Job Resoponsibilities Leaders... Managers... What is the biggest challenge for your leadership team? What are the "Moments of Truth" for leaders? - How leaders spend their time. - The questions leaders ask. - Leader's reactions to critical incidents. - What leaders reward and recognize. Formal power... 1. Your job description and the power it says you have. 2. Any powers formall delegated to you by the organization and/or higher powers. Informal power... 1. Any powers informally delegated by the organization. 2. Your technical competence. 3. Your perceived ability to influence. 4. The demonstrated accuracy of information you provide. 5. The results received because people took your advise. 6. Your consistency. 7. Your honesty. 8. Your self-confidence. 9. Your interpersonal skills. 10. You delivery what you promise, at the time you promised. Limits on you power... 1. Your status as an employee. 2. Limits implied or imposed by bosses. 3. Your perception of your power and your authority. 4. Other's perception of nature and extent of your authority. 5. Your knowledge, skills, and attitudes. Four critical areas for change! 1. Cultural change... - Customer-driven; - entrepreneurial orientation; - market responsiveness; - flexibility; - continuous improvement; - team performance. 2. Vision and mission change... - across system and partners; - alignment of operations; - core business focus. 3. Stuctural change... - partnering; - decentralization of "hows"; - cross-organizationl teams; - unified service delivery; - shared performance outcomes. 4. Process change... - reengineering; - streamlining; - technology applications; - benchmarking. Organizational Culture Expectations - What will happen? Beliefs - How do things work? Values - What is important? Norms - What is acceptable? You must change all four to change the culture! The four phases of change... Denial Resistance Commitment Exploration Denial: Lack of reaction. Resistance: Self-doubt, anger, anxiety, or uncertainty. Exploration: New responsibilities; envisioned opportunities. Commitment: Long range planning and new energy. Resistance to change goes up! when... 1. The purpose for the change is not clear. 2. Staff do not see a need for change. 3. Staff are not involved in planning the change. 4. The change is not clearly communicated. 5. Influentials do not support the change. 6. Change is introduced too quickly or too slowly. 7. Past changes were poorly implemented and had bad results. 8. Staff fear failure and lack confidence. 9. Staff lack respect for and distrust you. Resistance to change goes down! when... 1. Reduce ambiguity. Increase clarity. (No "poison turkey...more at eleven!") 2. Provide plenty of information and details. 3. Talk about what will change...and what will not change. 4. Use many methods and settings for communicating the change. 5. Develop constraints and then ask for participation within constraints. 6. Communicate your commitment. Describe and stress support to be given. 7. Play to reaseon and emotion, organizational and personal. 8. Stress the rewards of the change and how the change will be evaluated. Leadership is creating a compelling vision of a desired state of affairs A good vision statement... - defines the future clearly; - sets common purpose; - creates enthusiasm for achievement; - provides direction in an ambiguous environment; - ensures all current and proposed organizations activities are aligned with a desired outcome. Coca-Cola's Vision: "A Coke in the arm's reach of every person on the planet!" A good system vision aligns the partners Mission Vision Operations Leaders own the vision! What do you think is most important in defining a vision? Vision: help people see it before it's real! - Survey says 100% gave a mission statement. 33% have a vision statement. - Mission is the "why" you exist. - Vision is "what" you want to be. What are the next steps your leadership team will take to define your vision? Total Quality Management! Total Quality Services! Planning for continuous quality improvement Best Bets! ---------- End of Document