Achieving Enterprise Process Mobility With Sequence Kinetics
Using Voice Of The Customer To Align Processes In Service Industries
1. Using Voice of the Customer to Align Processes
in Service Industries
Do you know how well your processes meet customer
expectations? Many organizations don't, say John W. Moran
and Grace L. Duffy. And you can waste a lot of time and
resources focusing on problems that your customers just
don't care about.
Introduction
The Voice of the Process (VOP) is how the process communicates with the organization
on performance against customer needs and expectations. This communication takes
place through process measures which are descriptors of how the process is performing
in its current state. It is critical to understand how the current state is operating to define
a baseline before attempting any change or improvement activities. It is important not to
change a process before understanding where performance is centered or the amount of
variation currently present.
The most common statistical measures of a process are mean and standard deviation.
Once these measures have been calculated, conducting a capability study is possible. A
capability study measures the number of standard deviations between the process mean
and the nearest specification limit in sigma units. In general, as a process’s standard
deviation rises, or the mean of the process moves away from the center of the tolerance,
fewer standard deviations will fit between the mean and the nearest specification limit.
This proximity to the upper or lower limits of tolerable range increases the likelihood of
items outside specification, allowing more errors to occur.
What is Voice of the Process?
Every stable process exhibits a predicable range of performance for which it is designed.
A stable process is one which is in statistical control. This means that all special causes
of variation have been removed from the process. The only variation of performance for
the process is that which is expected within normal operation. Performance measures
are centered on the average of outcome values reflecting the expectations of the
customer.
Organizations must develop a reliable process to collect regular and timely data for the
performance of its most important processes. It is imperative to the survival of the
organization that these processes are satisfying both internal and external customer
needs. A quote from Dr. W. Edwards Deming [1] “In God we trust, all others bring data,”
is very applicable to the VoP, since too often we think we know how the process is
performing through intuition. Intuition is not good enough however. We need facts.
To determine if a process is capable of satisfying its customers, two most commonly
used indices are:
Cp, which measures the variation in a process or how well the data fits within the upper
and lower specification limits (USL, LSL) [2]. This measure is the width of the process
distribution relative to a set of limits and is sometimes referred to as the process potential.
The Cp should be as high as possible since the higher the Cp the lower the variability. One
2. problem with Cp is a process may have a high Cp but is producing many defects since the
actual spread does not coincide with the allowable spread of the specification limits. This
is why we need the second index called the Cpk.
The Cpk index measures the central tendency of the process. The Cpk measures how
close a process is performing to its specification limits and how centered the data is
between those limits. It is an indicator of the ability of a process to create product within
specification. Cpk index can never be greater than the Cp, only equal to it and can only
have positive values. It will equal zero when the actual process average matches or falls
outside one of the specification limits.
Since process capability is a function of the specification, these process capability
indices are only as good as the specifications being used. The concept of process
capability only holds meaning for processes that are in a state of statistical control and
normally distributed. Process capability indices measure how much "natural variation" a
process experiences relative to its specification limits and allows different processes to
be compared with respect to how well an organization controls them [3]. Dr. Deming
describes the benefits of a stable process as one where a process has an identity and its
performance is predictable; therefore there is a rational basis for planning.
The larger the index, the more stable the process is, and the less likely any item will be
outside the specification. A literature review places an acceptable value range of C p for a
process somewhere between 1.33 to a high of 2.0. When a C pk is less than 1.0 the
process is considered incapable but when the value is 1.0 or greater it is considered
capable. In general, Cpk values should range from 1.33 (minimal industry standard
acceptable level to satisfy customers) to a 2.0 for six sigma processes. These
acceptable ranges for Cp and Cpk indices have been well vetted for manufacturing
processes but do they apply to service industry processes where specifications are not
well established?
Determining What the Customer Will Accept
To provide an example: a study was conducted of a health clinic’s service wait time for a
four week period. The data collected for a process capability study indicates how the
process is centered and its variability. The clinic study showed that the service process
had a mean wait time of 8 minutes with a standard deviation of 1 minute for delivering
the service under study.
How well does this process meet customer expectations? This is a question most
organizations cannot answer. Unless we know what the customer will tolerate as an
upper and lower time boundary while waiting for a service, we have nothing against
which to compare our performance. Organizations can spend a lot of time and resources
trying to drive wait times to zero, when that may not be what the customer expects.
The real question for the organization is how well does this process meet its customer
expectations? This is a question most service organizations cannot answer since they do
not know what their customer will tolerate as an upper or lower boundary for the delivery
of service.
In the service industries, healthcare, and public health, many processes do not have
defined customer specifications. It is important to develop acceptable limits for processes
without defined customer specifications. This tolerable variation must be identified by the
actual customers of the process The authors propose developing an Upper Toleration
Limit (UTL) and Lower Toleration Limit (LTL) [4] to allow the use of either Run Charts or
Control Charts. This Upper Toleration Limit (UTL) and Lower Toleration Limit (LTL) will
3. be used in place of the Upper and Lower Control Limits for specifications in calculating
Cp and Cpk.
The questions to ask a customer might be “How long are you willing to wait for the
doctor, for a flu shot, to get through registration at a hospital, to get service in a WIC
clinic, to obtain a permit, to get an HIV test, or to get a meal at a fast food restaurant?”
Since many customers understand that waits are inevitable, it is important to compile an
average from many customers on what the Upper Toleration Limit would be on wait time.
Everyone would like zero wait time, but realistically people will accept a minimal wait.
Defining that minimal acceptable wait as the Lower Toleration Limit is important. A lot of
resources can be expended trying to get wait time to zero, which may not be expected
by the customer. We need to focus our scarce resources on improving our processes to
align with customer expectations.
Recent research [5] demonstrates that simply showing people why it is taking so long
helps customers tolerate wait times more easily. If the customer understands what work
is being done on their behalf while they are waiting they tend to value the service more.
Communicating the reason for a wait while something is done on their behalf
(authorization, copy a form, update records, retrieve a vaccine, etc.) helps the customer
understand the wait. Regular communication with the customer keeps them informed,
builds a relationship, and reduces complaints.
Returning to our example; the previously mentioned organization surveyed customers
using a specific process during a one month period. The survey data indicated the
customers would accept an average wait time to get that service of an Upper Tolerate
Limit of 15 minutes and a Lower Tolerate Limit of 5 minutes.
Based on this data and the process data collected earlier, the C pcan be calculated as
follows: Cp = (UTL-LTL)/6 = (15-5)/6(1) = 1.67. As stated earlier, the larger the index, the
more stable the process is, and the less likely any item will be outside the specification
limits. The Cpk = min (CpU, CpL) for this process thus would be equal to a CpU* of 2.33
or a CpL of 1. For this process the minimum value would be a C pk= 1.0. This Cpk would
indicate that the process is barely capable of meeting its customer’s needs and requires
improvement and centering.
The Voice of the Customer
To obtain the VoP we must obtain the Voice of the Customer (VoC) first so we
understand what our customers expect when they obtain a service from our organization.
Then we can compare how the process’s output aligns with what the customer expects.
Obtaining the VoC is a complicated process that requires real diligence. It is vital to
understand who the customers are for our service and then separate the total customer
population into a number of categories such as:
Internal customer
External customer
Primary customer
Secondary customer
Ultimate purchaser
Once we have a clear understanding of who our customers are, we need to develop a
methodology to obtain the VOC. This is not an easy process. A methodology must be
4. designed that will regularly track and record the wants and needs of our customer base
and alert us to any changes that result. Some organizations use surveys, telephone
interviews, or person to person questionnaires at the touch points in the process. Others
use market firms to survey their customers. It is beyond the scope of this article to
discuss all the potential ways to capture the Voice of the Customer. It is imperative that
each organization use one or more of these ways to capture its VoC in a regular and
timely manner since we depend on our customers and their satisfaction for our
existence. Quality Function Deployment [6] has many unique features that can be used
to capture the VoC. Organizations are encouraged to use customer touch points [7] in
their processes to obtain this valuable data on a regular basis.
However we obtain the VOC, we need to make sure we understand in the customer’s
words their required:
Wants
Needs
Satisfiers
Dis-satisfiers
Future needs
Expectations
The level of detail for each of the potential VOC categories must be decided in advance.
One way to think of customer’s wants and needs is in terms of a Kano Model, [8] shown
in figure 1. The Kano Model defines three types of quality [9]:
1. Expected Quality, also called Basic Quality, is the minimum for entry into any
market. Since this type of quality goes without saying, it is important to uncover
these unstated needs in any customer survey.
2. Normal Quality, also called Performance Quality, is what the customer will state
when asked what they want – it is what they specify.
3. Exciting Quality is what you supply that delights or Wows the customer. It is
unexpected by the customer
but something they definitely
like and will want in the future.
This type of quality is
something significantly more
than the customer expected to
experience. One rule to
remember is, once you Wow a
customer they will want it the
next time.
Customer requirements shift
over time, so it is critical have a
regular monitoring process to
catch those shifts in wants and
needs.
Figure 1: The Kano Model
6. About John W. Moran and Grace L. Duffy
Grace L. Duffy, CMQ/OE, CQA, CQIA, CSSGB, CLSSMBB provides
services in organizational and process improvement, leadership, quality,
customer service and teamwork. Her clients include government, health
care, public health, education, manufacturing, services and not-for-profit
organizations. Duffy holds a master’s in business administration from
Georgia State University. She is an ASQ Fellow and past vice president
of ASQ. Duffy can be reached at grace683@embarqmail.com.
John W. Moran, MBA, Ph.D., CMC, CMQ/OE, CQIA, is senior quality advisor to the
Public Health Foundation. He has over 30 years of quality improvement expertise in
developing tools and training programs, implementing and evaluating QI programs, and
writing articles and books on QI methods. Dr. Moran is a retired senior vice president of
information systems, administrative and diagnostic services at New England Baptist
Hospital. He was previously chief operating officer of Changing Healthcare, Inc. Dr.
Moran was employed for 21 years by Polaroid where he held various senior
management positions. His last position was director of worldwide quality and systems.
jmoran@phf.org.
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