Improving Donor Experience
Board Presentation March 2014
Jane Pearson
Blood Supply – Blood Donation Operations and Nursing
Complaints - National
Teams above target
Donor Complaints per million
Donations vs. Target (4,500) YTD
East
Horsham
13466
There are 41 teams above 4,500
West
Exeter
10282
West
City
9990
North
Mitcham
9965
West
HG1
9736
East
Portsmouth
9007
East
Teeside
8609
East
Kings
Norton
8573
West
Worcester
8466
East
Ipswich
7844
YTD
West 6181, East 5457, North 4566
Numbers of donors complaining YTD / No of donations
Mobile teams:
North: 2567 / 562150
West: 2858 / 462400
East: 3354 / 614580
Blood Supply – Blood Donation Operations and Nursing
Donor centres:
YTD 506 whole blood donors / 143506
YTD 56 platelet donors
Top 5 Complaint Categories
162
148
KEY
151
145
•
Slot availability,
Not seen at time
and turned away
are the highest
causes of
complaints.
•
All five categories
have deteriorated
with particular
focus on turned
away and slot
availability.
•
The implication is
that opportunity to
walk-in is the
major driver of
complaints
increase.
December-12
December-13
YOY Change
96
91
73
60
49
63
56
53
17
-14
Not seen at
appt time
Turned
Away
Slot
Availability
Staff
Attitude
Blood Supply – Blood Donation Operations and Nursing
Time Taken Cancellation
of a Session
Team Level Diagnostics
Two Steps to Diagnostics:
1. What is the problem? (Hypothesis)
2. Why does the problem exist? (Root Cause Analysis holistic and whole team and donor engagement)
This simple approach will ensure that even incoming managers with little to no
experience of managing session environments (e.g. external appointments) will be able
to easily understand issues and action plan appropriately.
Blood Supply – Blood Donation Operations and Nursing
What is the problem (Hypothesis)?
Hypothesis
Questions
Validation
1
Session
Capacity
Is waiting time
satisfaction <56%?
Do donor
satisfaction
comments support
hypothesis?
2
Customer
Service
Is there a trend of
staff attitude
complaints?
Do donor
satisfaction
comments support
hypothesis?
Clinical
Are deferrals and/or
FVPs above the
national average?
Do donor
satisfaction
comments support
hypothesis?
3
Is peak queuing time
above 40 mins?
Observe session flow
and speak to donors on
session.
Observe staff-donor
interactions and speak
to donors on session.
Is needle satisfaction
lower than national
average?
Observe clinical practice
and speak to donors on
session.
The majority of donor complaints can be separated into one of the above 3
categories. An initial hypothesis about the main cause of complaints on any team
can be confirmed and validated using the above approach.
Blood Supply – Blood Donation Operations and Nursing
Worcester example – Hypothesis
Hypothesis
Questions
Validation
Session
Capacity
Is waiting time
satisfaction <56%?
Do donor
satisfaction
comments support
hypothesis?
Team and review
of data indicated
that most issues
were related to
donor waiting
times and donors
turned away.
Yes – waiting time
satisfaction is the
lowest in the
country at 30.4%
YTD.
Yes – the majority
of donor
comments relate
to long waiting
times.
Is peak queuing time
above 40 mins?
Yes – peak
queuing times are
regularly above 40
mins.
Observe session flow
and speak to donors on
session.
Area Manager
session visit
observed waiting
times on under
attended session
(confirmed by
donor feedback).
The expected problem on Worcester team was Session Capacity contributing to high
waiting times and turned away donors. This hypothesis was proven and validated by
the steps above.
Blood Supply – Blood Donation Operations and Nursing
Worcester example – Root Cause
Establish:
Interrogate TPBs:
• Were too many
donors called up?
• Is target reflective
of capacity?
• Is the balance of
attendance even?
Session
Capacity
No
• Was donor
attendance above
130% of grids?
Pre
Session
• Was there
excessive
marketing?
• Is the throughput/
20 mins reflective
of number of
beds?
• Is there an
effective ramp
up?
• Were the
appointment grids
reflective of donor
attendance?
Yes
Planning
Yes
Marketing
Yes
Manager
Yes
Team
Establish:
• Were there venue
issues?
No
On
Session
• Are beds kept
full?
Blood Supply – Blood Donation Operations and Nursing
• Was staffing
reduced on the
day?
• Are the team
working at a slow
pace?
Why does the problem exist (root cause)?
Establish:
Investigate issues:
• Do complainants
identify one
individual?
2 Customer
Service
• If donor does not
know name, does
review of DHC
indicate
individual?
Yes
• Do complainants
indicate multiple
individuals?
• Is there a poor
team attitude to
customer service?
Individual
• Does
investigation of
circumstances
indicate individual
is at fault?
• Does
investigation of
circumstances
indicate donor
complaints were
actually for a
different reason?
Yes
Individual
Yes
Restart
process at
different
category
Establish:
Yes
Team
Blood Supply – Blood Donation Operations and Nursing
• Are team at fault?
• Were cause of
complaints a
different reason?
Yes
Yes
Team
Restart
process at
different
category
Worcester example – Action Planning
Root Cause
Actions
• The team will be taken off road for dedicated development day to
increase understanding, set performance expectations, ensure
understanding of operating model/task timings and Customer Service
Improvement (CSI).
• Donors will be updated every 15 minutes on anticipated wait times.
The team does not
effectively manage the
flow of the session,
meaning that donors
are often seen beyond
their appointment
time and walk ins are
turned away.
• Complaints, Compliments and Comments to be fed back to the team
regularly.
• Daily performance observations and feedback/coaching by managers
and OTP experts on sessions.
Deadlines
• Mar-14
..
.
• Mar-14
• Mar-14
.
• Mar-14
.
• Apr-14
• Supervisors and Nurses will visit and learn from a high performing team. .
• Waiting time satisfaction and peak queue times will be displayed
• Apr-14
prominently on each session, with clear targets for improvement in each
.
measure (targets to be agreed with Senior Sister).
• May-14
• PDPR objectives will encompass session flow management, with clear
.
standardised targets and objectives.
• Jun-14
• The capability policy will be invoked if staff are unable to manage
session flow effectively after training. Performance against targets and
management observations will inform a decision to invoke this policy.
Blood Supply – Blood Donation Operations and Nursing
Action Planning Options
Planning
• Reduce calls ups.
• Reshape
appointment grids.
• Move session times
to fit donor
attendance
patterns.
Marketing
Manager
Team
• Reduce local
marketing
initiatives.
• Venue issues
resolved, or new
venues found.
• Appropriate
dedicated
development time
• Change marketing
messages –
encourage more
appointment
donors.
• Communicate likely
staff reductions to
Planning well in
advance of
sessions.
• Controlled
acceptance of
return of staff on
restricted duties. .
• Change NCC
message to donors,
“If you turn up, you
will be seen”.
• Feedback
compliments and
best practice to
team staff.
• Ensure NCC and
Nurses are working
to same guidelines
(e.g. calendar
month vs. days).
• Ensure team ramp
up session
effectively and flex
to maximise
throughput.
• Review A/L
management, Union
Duties and all
absence impact.
Blood Supply – Blood Donation Operations and Nursing
• Display waiting time
expectations on
session.
• Tie customer
service levels into
PDPR objectives.
• Team members to
observe the process
with donor’s eyes
(15 Steps).
• Update on waiting
time every 15
minutes.
Individual
• Disciplinary policy
invoked in all
proven staff attitude
cases.
• Capability policy
invoked for staff
who cannot achieve
required throughput.
What is CSI? Customer Service Model
Change Culture, Change behaviour Principles, Values and Core Behaviours
Recruit the
Right
People
Peer to
Peer
Training
Develop
Ongoing
tools
Managers
Commitment
Achieving
Excelling
Local ownership local solutions
Assessment
Centre
DVD &
Discussion
Role Model,
Coach & Give
Feedback
Information
Guide
Visibility &
Participation
Keeping
it ‘alive’
everyday
DEVELOPMENT OF PERSONNEL
Our CS
Approach
Feedback on
the floor and
in PDPR
Nomination
cards
PDPR Tool
Character
Profiles
Blood Supply – Blood Donation Operations and Nursing
Scripted
Phraseology
Observation
of Team &
Individual
CSI Team Roll Out – National
Trial Phase
1st Wave
2nd Wave
3rd Wave
4th Wave
• Gloucester
• Kings Norton
• Exeter
• Cornwall
• Bristol DC
• Manchester E & W
• Sutton Coldfield
• Portsmouth
• Southampton
• Oxford DC
• Sheffield N & S
• Teesside
• Worcester
• Solihull
• Bristol North/South
• Epsom
• Newcastle
• Gloucester DC
• Southampton DC
• Bath
• WEDC
• Lincoln
• Liverpool
• Cumbria
• Lancaster
• Hither Green
• Northwich
• Hull
• Nottingham
• Brighton
• Wrexham
• Caernarfon
• Stoke
• Mitcham
• Leicester
• Ipswich
• Leeds/Bradford
• Horsham
• London Middlesex
• York
• Harlow 2
• Maidstone
• Norwich
• City
• Ashford
• Tooting DC
Completed
Start: late Jan 14
Start: late March 14
Start: late May 14
Roll out of each phase will take a total of 12 months
Blood Supply – Blood Donation Operations and Nursing
Start: late July 14
Planned Initiatives (1)
Initiative Summary
Team
Date
1
“Sandwich” grids – appts at start and end, walk ins in middle
Oxford
May 14
2
Clinical leadership autonomy trial (no Hemocues, CST etc.)
Brighton/Horsham
March 14
3
Text Messaging Service trial (session running late) trial
Kings Norton
March 14
4
Stop call up text messages
National
Complete
5
Appointment and walk in only session trials
Cambridge/Huntingdon
March 14
6
Introduction of script for Welcomers
Oxford/Newcastle
TBC
7
Venue assessment change to enable venue WiFi if possible
National
TBC
8
Continuous session trial (bleed throughs)
Cumbria
March 14
9
PDPR objectives linked to Customer Service standards
National
April 2014
10
PDPR Reviewer training for Senior Sisters / Charge Nurses
National
TBC
11
Session Management training for Sisters and DCSs
National
April 2014
12
Introduction of volunteer queue management training
National
TBC
Blood Supply – Blood Donation Operations and Nursing
“Sandwich” Grids
14:00
• Idea originates from staff and
designed by staff on teams for roll
out based on local knowledge.
DNA
14:05
14:10
DNA
14:15
DEF
14:20
DNA
14:25
DEF
14:30
DNA
10 x walk ins
14:35
14:40
14:45
14:50
14:55
15:00
Blood Supply – Blood Donation Operations and Nursing
• Evidence based on walk in,
appointment attendance, deferral
rates and times of walk ins per
team.
• Pilot teams to design
management at reception,
including visual indicators.
• Appointment donors will be seen
on or closer to appointment time
and walk in donors can be more
accurate donation time.
• Better staff experience – including
more controlled session flow and
fewer overruns.
Planned Initiatives (2)
Initiative Summary
Date
5
Target the dissatisfied donors with a recovery programme letter
May 14
6
Undertake a portal promotion to those individuals who have walked-in over the last 12
months and to whom we have an email address – 170,000
May 14
7
Change the text reminder system and only text non-appointment call up at certain times of the
year and for certain blood group
May 14
8
Roll-out the portal
Ongoing
9
Implement compliment and complaint of the month to illustrate and showcase positive
behaviours
March 14
10
Work with Customer Service team and Comms team to improve standard
responses
Ongoing
11
Refresh the previous approach to seeking donor feedback via various donor
engagement forums – proposal to SMT.
April 14
Blood Supply – Blood Donation Operations and Nursing