Delivery of Quality Services
Many people are familiar with the phrase, "Lead, follow or get out of the way." It is time for us to start making organizational decisions based upon that phrase, or we are going to fail. Those organizations that do things a year--or more--after others have done them might feel like they're constantly playing catch-up to the leaders, but that's better than nothing. Getting out of the way is for those who can't keep up. They're bound to fail and we can no longer support failure.
Today, our customers are more knowledgeable and demanding than ever; they know what they want and how they want it delivered. They're quick to criticize poor performance and will use the ballot box to show their displeasure. Meanwhile, public funding is getting tougher to obtain and many organizations have resorted to billing for services to supplement dwindling funds. It's only going to get harder, and it's our obligation to become the public service that is recognized for meeting the goals and expectations of those customers, the public.
How do we accomplish this formidable task? By focusing on our commitment to the delivery of quality services.
Defining Quality Service
Here are some definitions of quality:
- Quality is the highest level of care that can be provided to customers within the scope of the organization.
- Quality management is a process of continuous improvement through which everyone strives to create and support an environment in which people are committed to serving and meeting the needs of customers.
- Quality is conformance to standards that meet or exceed customer expectations.
- Quality is being the best individual you can be within a departmental structure.
Requiring Quality from Start to Finish
Implementing quality customer services takes more than just snapping your fingers. Delivering quality is a long-term, far-reaching and continual process affecting departmental practices in every area.
- Hiring standards. Hire only people who fully understand that yours is an organization dedicated to the highest standards in delivering quality services to customers.
- Employee orientation. Educate every employee as to your standards and how you measure success. Each individual must understand he is accountable for meeting every standard of quality.
- Job requirements. Establish quality as a requirement of the job. To keep their positions, employees must understand, stand by and--most important--practice at the highest level of quality service.
- Evaluation process. Employee evaluations must include a component identifying individual success in following the organization's standards of quality.
- Rewards. Reward employees when they accomplish customer service goals.
Quality Control Myths
"Practice Makes Perfect"
Many of us believe that practice makes perfect. This is not necessarily true. What is the goal when you drill and practice in your department? Is it to improve the quality of how you do business, or are you drilling old ways in, practicing ways of doing things that may not be the best? Practicing a procedure the wrong way will not lead to perfection. Can you show--with documentation of proof--that loading a hose bed a certain way or laying out a cabinet in the squad a certain way leads to improved performance and higher quality? If not, you need to rethink it.
High-quality performance comes from perfect practice. That's accomplished by identifying areas needing improvement and designing quality improvement models to achieve desired outcomes.
"The 85% Benchmark Is a Good One"
Does your organization use a benchmark of 85% for achieving goals and objectives? Are you happy with that figure? Maybe if you're talking about a National Registry test. Let's look closer at such benchmarks:
- Is 85% a good standard for getting your rig out the door in a specified time?
- Is 85% a good standard for initiating oxygen when a patient needs it?
- Is 85% a good standard for a successful intubation? What if you were the patient?
- Is 85% a good standard for pushing the correct drug?
- Is 85% a good standard for practicing safety standards on your job?
Shouldn't some benchmarks be 100%?
"Everyone Wants Quality"
Quality is not a constant. There are variations in how individuals, organizations and community leaders perceive and define quality, and how high they are willing to reach to implement the changes needed to achieve it. Some of these variations include:
- Variations in tasks. Some tasks require much greater effort to implement a process of change, and consequently much better planning to make them happen.
- Variations in personnel. Every department is made up of people with wide-ranging backgrounds and skills. There are people who are committed to promoting a program of quality delivery of services, but there are also those who want to maintain the status quo. Change can be difficult, so there may be resistance. Some will become like "problem children" and get in the way of meeting customer expectations.
- Variations in standards. Local traditions and established standards are difficult to change, even when you know it's in the best interest of the community and will allow you to operate at maximum efficiency.
For example: Your agency has set a quality standard for response time, requiring you to reach every household in your community in four minutes. But the region has undergone rapid growth in recent years, so changes must be made. In order to continue to achieve your goal, you must do one of two things: move your existing station to a new location or build an additional station, strategically located to meet the four-minute standard. Now, you have to sell the idea to political leaders whom you need to fund it. Do that and you're a genius. Sadly, you will probably find out that quality has a different definition when it comes to dollars.
- Variations in external pressures. We are pressured politically because politicians have personal or constituent-influenced agendas that may not always agree with ours. We are influenced by our own executive leaders who may not have kept up with the times or the need for changes in operations. Ever heard "Because that's the way we've always done it"? They might have been doing it wrong.
How Do We Get There?
Quality performance is not about winning. In our business, performance cannot be based on winners and losers. It must be about setting a standard, learning how to achieve the standard and not allowing the organization to deviate from delivering on it day-by-day, hour-by-hour and minute-by-minute. Anything and everything we do must be done with a commitment to meet and exceed the expectations of our customers. So, what does all this mean? Consider these points:
- Customer Feedback. We need to have means for our customers to tell us what they want and why they want it. We then need to be able to digest that information and begin implementing appropriate changes to help us meet the customers' expectations.
- Improve on the Competition. If we don't change, our competition will swallow us up. We have to slam the door on anyone getting a foothold in our business by making sure we are maintaining the highest quality standards and that our customers can recognize we are the best game in town to meet their needs.
- Evolve Forward. Survival of the fittest is what we're talking about. Positioning ourselves to be survivors over the next 25 years will require massive changes in the way we do business. Those who can only maintain the status quo will drop by the wayside. Count on it!
- Organizational Self-Examination. It's about being honest with ourselves. We know we aren't doing the very best job we can do in all our practices. We know we need to improve. We know our customers have high expectations. We know we're not being good stewards of taxpayer dollars at all times. We know we're lacking in setting benchmarks and goals that require a dedicated effort from all personnel. If we know this, why aren't we changing it?
The Continuous Quality Cycle
Continuous quality improvement (CQI) is a means of identifying areas that need improvement and establishing methods to initiate change in a consistent manner. It's not a management process; it's an organizational process that must include all political/community, administrative/management and field/office staff participants in order to be effective. This is how it works:
- Identify an area of opportunity. Avoid using the word "problem." A problem is better seen as an opportunity to initiate improvement in your operations.
- Organize a team comprised of a cross-section of the organization--including a customer--to work together to set the improvement guidelines.
- Collect all data that will clarify what is known.
- Analyze the data to understand why your goals aren't being reached.
- Design the means to make your improvements (resources, training, timeline, new data collection, etc.).
- Implement the new process.
- Measure the effect. Use the new data to measure whether your plan succeeded in achieving the desired results.
- Was it successful? If Yes: Continue with the new standard. If No: Regroup, analyze the failure and develop a new means to achieve the desired results.
- Standardize the change. Once a positive result is achieved, make the new protocol part of the organization's operating procedures.
- Review your operations and procedures on an ongoing basis to identify each new opportunity to improve your delivery of services.
Become the leader in delivering quality services to your community. The lead dog always has the best view of what's ahead. Demand the very best from your organization and allow for input in establishing your leadership. Never look back. The past is gone. It's what you do with the future that will count in the success of your organization.
Do the right thing; do it right; do it right now.