improving donor experience

Blood Supply – Blood Donation Operations and Nursing

Improving Donor ExperienceImproving Donor Experience

Board Presentation March 2014 Board Presentation March 2014

Jane PearsonJane Pearson


Complaints - National

Donor Complaints per million Donations vs. Target (4,500) YTD

Teams above target

There are 41 teams above 4,500

YTD

West 6181, East 5457, North 4566

East Horsham 13466

West Exeter 10282

West City 9990

North Mitcham 9965

West H G 1 9736

East Portsmouth 9007

East Teeside 8609

EastKings Norton

8573

West Worcester 8466

East Ipswich 7844

Mobile teams:Mobile teams:North: 2567 / 562150West: 2858 / 462400East: 3354 / 614580

Donor centres:Donor centres:YTD 506 whole blood donors / 143506YTD 56 platelet donors

Numbers of donors complaining YTD / No of donationsNumbers of donors complaining YTD / No of donations


• Slot availability, Not seen at time and turned away are the highest causes of complaints.

• All five categories have deteriorated with particular focus on turned away and slot availability.

• The implication is that opportunity to walk-in is the major driver of complaints increase.

162

96

60 56 53

148 145151

7363

-14

49

91

17

Not seen atappt time

TurnedAway

SlotAvailability

StaffAttitude

Time Taken Cancellationof a Session

Top 5 Complaint Categories

KEY

December-12

December-13

YOY Change


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.


What is the problem (Hypothesis)?

Session Session CapacityCapacity

ClinicalClinical

Is waiting time satisfaction <56%?

Do donor satisfaction comments support

hypothesis?

Hypothesis Questions

Is peak queuing time above 40 mins?

Validation

Observe session flow and speak to donors on

session.

Is there a trend of staff attitude complaints?

Customer Customer ServiceService

Are deferrals and/or FVPs above the

national average?

Observe clinical practice and speak to donors on

session.

The majority of donor complaints can be separated into one of the above 3 categories. An initial hypothesis about the main cause of complaints on any team

can be confirmed and validated using the above approach.

11

22

33Do donor satisfaction

comments support hypothesis?

Is needle satisfaction lower than national

average?


hypothesis?

Observe staff-donor interactions and speak to donors on session.


Worcester example – Hypothesis


Is waiting time satisfaction <56%?


hypothesis?

Hypothesis Questions

Is peak queuing time above 40 mins?

Validation

Observe session flow and speak to donors on

session.

Yes – waiting time satisfaction is the

lowest in the country at 30.4%

YTD.

Yes – the majority of donor

comments relate to long waiting times.

Yes – peak queuing times are regularly above 40

mins.

Area Manager session visit

observed waiting times on under

attended session (confirmed by

donor feedback).

The expected problem on Worcester team was Session Capacity contributing to high waiting times and turned away donors. This hypothesis was proven and validated by

the steps above.

Team and review of data indicated that most issues were related to donor waiting

times and donors turned away.


Worcester example – Root Cause


Interrogate TPBs:

• Is target reflective of capacity?

• Is the balance of attendance even?

• Was donor attendance above 130% of grids?

• Is the throughput/ 20 mins reflective of number of beds?

• Is there an effective ramp up?

• Are beds kept full?

No

No

Establish:

• Were too many donors called up?

• Were the appointment grids reflective of donor attendance?

• Was there excessive marketing?

Pre Pre SessionSession

On On SessionSession

Yes

Yes

PlanningPlanning

MarketingMarketing

Establish:

• Were there venue issues?

• Was staffing reduced on the day?

• Are the team working at a slow pace?

Yes

Yes

ManagerManager

TeamTeam


Why does the problem exist (root cause)?

Customer Customer ServiceService

Investigate issues:

• Do complainants identify one individual?

• If donor does not know name, does review of DHC indicate individual?

• Do complainants indicate multiple individuals?

• Is there a poor team attitude to customer service?

Yes

Yes

Establish:

• Does investigation of circumstances indicate individual is at fault?

• Does investigation of circumstances indicate donor complaints were actually for a different reason?

IndividualIndividual

TeamTeam

Yes

Yes

IndividualIndividual

Establish:

• Are team at fault?

• Were cause of complaints a different reason?

Yes

Yes

TeamTeam

22

Restart process at different category

Restart process at different category


Worcester example – Action Planning

Root Cause Actions Deadlines

• The team will be taken off road for dedicated development day to increase understanding, set performance expectations, ensure understanding of operating model/task timings and Customer Service Improvement (CSI).

• Donors will be updated every 15 minutes on anticipated wait times.

• Complaints, Compliments and Comments to be fed back to the team regularly.

• Daily performance observations and feedback/coaching by managers and OTP experts on sessions.

• Supervisors and Nurses will visit and learn from a high performing team.

• Waiting time satisfaction and peak queue times will be displayed prominently on each session, with clear targets for improvement in each measure (targets to be agreed with Senior Sister).

• PDPR objectives will encompass session flow management, with clear standardised targets and objectives.

• The capability policy will be invoked if staff are unable to manage session flow effectively after training. Performance against targets and management observations will inform a decision to invoke this policy.

• Mar-14 .. .

• Mar-14

• Mar-14 .

• Mar-14 .

• Apr-14 .

• Apr-14 .

• May-14 .

• Jun-14

The team does not effectively manage the flow of the session, meaning that donors are often seen beyond their appointment time and walk ins are turned away.


Action Planning Options

PlanningPlanning MarketingMarketing ManagerManager TeamTeam IndividualIndividual

• Reduce calls ups.

• Reshape appointment grids.

• Move session times to fit donor attendance patterns.

• Reduce local marketing initiatives.

• Change marketing messages – encourage more appointment donors.

• Change NCC message to donors, “If you turn up, you will be seen”.

• Ensure NCC and Nurses are working to same guidelines (e.g. calendar month vs. days).

• Venue issues resolved, or new venues found.

• Communicate likely staff reductions to Planning well in advance of sessions.

• Feedback compliments and best practice to team staff.

• Ensure team ramp up session effectively and flex to maximise throughput.

• Review A/L management, Union Duties and all absence impact.

• Appropriate dedicated development time

• Controlled acceptance of return of staff on restricted duties. .

• Display waiting time expectations on session.

• Tie customer service levels into PDPR objectives.

• Team members to observe the process with donor’s eyes (15 Steps).

• Update on waiting time every 15 minutes.

• Disciplinary policy invoked in all proven staff attitude cases.

• Capability policy invoked for staff who cannot achieve required throughput.


What is CSI?

DEVELOPMENT OF PERSONNEL

Develop Achieving Excelling

Principles, Values and Core BehavioursChange Culture, Change behaviour

Peer to Peer

Training

Managers Commitment

Ongoing tools

Customer Service Model

Recruit the Right

People

Assessment Centre

Feedback on the floor and

in PDPR

Visibility & Participation

Keeping it ‘alive’

everyday

Observation of Team & Individual

Role Model, Coach & Give

Feedback

DVD & Discussion

PDPR Tool

Scripted Phraseology

Information Guide

Character Profiles

Our CS Approach

Nomination cards

Local ownership local solutions


CSI Team Roll Out – National

• Kings Norton

• Sutton Coldfield

• Teesside

• Newcastle

• Lincoln

• Hither Green

• Brighton

• Mitcham

1st Wave

Start: late Jan 14

2nd Wave

Start: late March 14

• Exeter

• Portsmouth

• Worcester

• Gloucester DC

• Liverpool

• Northwich

• Wrexham

• Leicester

• Horsham

• Harlow 2

• City

3rd Wave

Start: late May 14

• Cornwall

• Southampton

• Solihull

• Southampton DC

• Cumbria

• Hull

• Caernarfon

• Ipswich

• London Middlesex

• Maidstone

4th Wave

Start: late July 14

• Bristol DC

• Oxford DC

• Bristol North/South

• Bath

• Lancaster

• Nottingham

• Stoke

• Leeds/Bradford

• York

• Norwich

• Ashford

• Tooting DC

• Gloucester

• Manchester E & W

• Sheffield N & S

• Epsom

• WEDC

Trial Phase

Completed

Roll out of each phase will take a total of 12 months


Planned Initiatives (1)

Initiative Summary Team Date

Clinical leadership autonomy trial (no Hemocues, CST etc.)

Text Messaging Service trial (session running late) trial

Brighton/Horsham March 14

Kings Norton March 14

Stop call up text messages National Complete

Appointment and walk in only session trials Cambridge/Huntingdon March 14

Introduction of script for Welcomers Oxford/Newcastle TBC

Venue assessment change to enable venue WiFi if possible National TBC

Continuous session trial (bleed throughs) Cumbria March 14

11

22

33

44

55

66

77

88

99

“Sandwich” grids – appts at start and end, walk ins in middle Oxford May 14

1010 PDPR Reviewer training for Senior Sisters / Charge Nurses National TBC

PDPR objectives linked to Customer Service standards National April 2014

1111

1212

Session Management training for Sisters and DCSs National April 2014

Introduction of volunteer queue management training National TBC


“Sandwich” Grids

DNA

DNA

DNA

DNA

DEF

DEF

14:00

14:05

14:10

14:15

14:20

14:25

14:30

14:35

14:40

14:45

14:50

10 x walk ins

14:55

15:00

• Idea originates from staff and designed by staff on teams for roll out based on local knowledge.

• Evidence based on walk in, appointment attendance, deferral rates and times of walk ins per team.

• Pilot teams to design management at reception, including visual indicators.

• Appointment donors will be seen on or closer to appointment time and walk in donors can be more accurate donation time.

• Better staff experience – including more controlled session flow and fewer overruns.


Initiative Summary

Target the dissatisfied donors with a recovery programme letter

Undertake a portal promotion to those individuals who have walked-in over the last 12 months and to whom we have an email address – 170,000

55

66

77

88

Change the text reminder system and only text non-appointment call up at certain times of the year and for certain blood group

Roll-out the portal

Planned Initiatives (2)

99 Implement compliment and complaint of the month to illustrate and showcase positive behaviours

Date

May 14

May 14

May 14

Ongoing

March 14

1010 Work with Customer Service team and Comms team to improve standard responses

Ongoing

1111 Refresh the previous approach to seeking donor feedback via various donor engagement forums – proposal to SMT.

April 14

improving donor experience

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