Using Voice of the Customer to Align Processes                    in Service Industries                              Do yo...
problem with Cp is a process may have a high Cp but is producing many defects since the       actual spread does not coinc...
be used in place of the Upper and Lower Control Limits for specifications in calculatingCp and Cpk.The questions to ask a ...
designed that will regularly track and record the wants and needs of our customer baseand alert us to any changes that res...
ConclusionsOrganizations must integrate VoP with VoC so processes are robust, and meet cost andquality requirements. The V...
About John W. Moran and Grace L. Duffy               Grace L. Duffy, CMQ/OE, CQA, CQIA, CSSGB, CLSSMBB provides           ...
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Using Voice Of The Customer To Align Processes In Service Industries

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Using Voice Of The Customer To Align Processes In Service Industries

  1. 1. Using Voice of the Customer to Align Processes in Service Industries Do you know how well your processes meet customer expectations? Many organizations dont, 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 dont care about.IntroductionThe Voice of the Process (VOP) is how the process communicates with the organizationon performance against customer needs and expectations. This communication takesplace through process measures which are descriptors of how the process is performingin its current state. It is critical to understand how the current state is operating to definea baseline before attempting any change or improvement activities. It is important not tochange a process before understanding where performance is centered or the amount ofvariation 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. Acapability study measures the number of standard deviations between the process meanand the nearest specification limit in sigma units. In general, as a process’s standarddeviation 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 ofitems 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 causesof variation have been removed from the process. The only variation of performance forthe process is that which is expected within normal operation. Performance measuresare centered on the average of outcome values reflecting the expectations of thecustomer.Organizations must develop a reliable process to collect regular and timely data for theperformance of its most important processes. It is imperative to the survival of theorganization that these processes are satisfying both internal and external customerneeds. 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 isperforming through intuition. Intuition is not good enough however. We need facts.To determine if a process is capable of satisfying its customers, two most commonlyused 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. 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 capabilityindices are only as good as the specifications being used. The concept of processcapability only holds meaning for processes that are in a state of statistical control andnormally distributed. Process capability indices measure how much "natural variation" aprocess experiences relative to its specification limits and allows different processes tobe compared with respect to how well an organization controls them [3]. Dr. Demingdescribes the benefits of a stable process as one where a process has an identity and itsperformance 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 beoutside the specification. A literature review places an acceptable value range of C p for aprocess somewhere between 1.33 to a high of 2.0. When a C pk is less than 1.0 theprocess is considered incapable but when the value is 1.0 or greater it is consideredcapable. In general, Cpk values should range from 1.33 (minimal industry standardacceptable level to satisfy customers) to a 2.0 for six sigma processes. Theseacceptable ranges for Cp and Cpk indices have been well vetted for manufacturingprocesses but do they apply to service industry processes where specifications are notwell established?Determining What the Customer Will AcceptTo provide an example: a study was conducted of a health clinic’s service wait time for afour week period. The data collected for a process capability study indicates how theprocess is centered and its variability. The clinic study showed that the service processhad a mean wait time of 8 minutes with a standard deviation of 1 minute for deliveringthe service under study.How well does this process meet customer expectations? This is a question mostorganizations cannot answer. Unless we know what the customer will tolerate as anupper and lower time boundary while waiting for a service, we have nothing againstwhich to compare our performance. Organizations can spend a lot of time and resourcestrying 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 customerexpectations? This is a question most service organizations cannot answer since they donot know what their customer will tolerate as an upper or lower boundary for the deliveryof service.In the service industries, healthcare, and public health, many processes do not havedefined customer specifications. It is important to develop acceptable limits for processeswithout defined customer specifications. This tolerable variation must be identified by theactual customers of the process The authors propose developing an Upper TolerationLimit (UTL) and Lower Toleration Limit (LTL) [4] to allow the use of either Run Charts orControl Charts. This Upper Toleration Limit (UTL) and Lower Toleration Limit (LTL) will
  3. 3. be used in place of the Upper and Lower Control Limits for specifications in calculatingCp and Cpk.The questions to ask a customer might be “How long are you willing to wait for thedoctor, for a flu shot, to get through registration at a hospital, to get service in a WICclinic, 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 anaverage 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 ofresources can be expended trying to get wait time to zero, which may not be expectedby the customer. We need to focus our scarce resources on improving our processes toalign with customer expectations.Recent research [5] demonstrates that simply showing people why it is taking so longhelps customers tolerate wait times more easily. If the customer understands what workis 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 customerunderstand 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 customersusing a specific process during a one month period. The survey data indicated thecustomers would accept an average wait time to get that service of an Upper TolerateLimit 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 asfollows: Cp = (UTL-LTL)/6 = (15-5)/6(1) = 1.67. As stated earlier, the larger the index, themore stable the process is, and the less likely any item will be outside the specificationlimits. The Cpk = min (CpU, CpL) for this process thus would be equal to a CpU* of 2.33or a CpL of 1. For this process the minimum value would be a C pk= 1.0. This Cpk wouldindicate that the process is barely capable of meeting its customer’s needs and requiresimprovement and centering.The Voice of the CustomerTo obtain the VoP we must obtain the Voice of the Customer (VoC) first so weunderstand 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 tounderstand who the customers are for our service and then separate the total customerpopulation into a number of categories such as:  Internal customer  External customer  Primary customer  Secondary customer  Ultimate purchaserOnce we have a clear understanding of who our customers are, we need to develop amethodology to obtain the VOC. This is not an easy process. A methodology must be
  4. 4. designed that will regularly track and record the wants and needs of our customer baseand alert us to any changes that result. Some organizations use surveys, telephoneinterviews, or person to person questionnaires at the touch points in the process. Othersuse market firms to survey their customers. It is beyond the scope of this article todiscuss all the potential ways to capture the Voice of the Customer. It is imperative thateach organization use one or more of these ways to capture its VoC in a regular andtimely manner since we depend on our customers and their satisfaction for ourexistence. Quality Function Deployment [6] has many unique features that can be usedto capture the VoC. Organizations are encouraged to use customer touch points [7] intheir 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’swords their required:  Wants  Needs  Satisfiers  Dis-satisfiers  Future needs  ExpectationsThe 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] shownin 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
  5. 5. ConclusionsOrganizations must integrate VoP with VoC so processes are robust, and meet cost andquality requirements. The VoP is an indicator of how capable a process is in meetingcustomer requirements. In service industries we must constantly monitor customerexpectations and requirements to keep our processes aligned with their needs. C p andCpk are values that help us monitor that alignment. Plotting the data using Run andControl charts keep the data visible, easy to interpret, and help focus improvementefforts. We must establish upper and lower tolerate limits with the customer for theprocesses they are using.In our example, although the process is right at 1.0 on C pk, there is still need forimprovement to allow breathing room for the expected variation in the highly behavioralnature of most service transactions. The organization in this study is functioning well forjust beginning their quality journey. Now that they have the data, they can focus on coreprocess improvement based on fact rather than intuition.Organizations with service processes can use Cp and Cpk indices based on customertolerate limits for subjective performance, such as wait time, to guide processimprovement efforts. Over time, performance management systems will develop reliablemethods for establishing levels of both indices for service oriented processes rather thanthe levels established for manufacturing processes. Is a Cpk of 1.33 to 2.0 an effectiverange for customer acceptance of a service process? The answer will come fromaccurate data gathering and validation with service customers. The authors inviteadditional papers documenting effective methods for measuring and improving serviceprocess performance.REFERENCES[1] http://corpslakes.usace.army.mil/employees/perform/quotes.cfm, accessed 7/1/2011[2] USL = Upper Specification Limit and LSL = Lower Specification Limit[3] Wikipedia, the free encyclopedia, http://en.wikipedia.org/wiki/Process_capability_index, accessed June 24, 2011[4] Modular kaizen: Dealing with Disruptions, G. Duffy and J. Moran, Public Health Foundation, 2011, pp. 73, http://www.phf.org/resourcestools/Pages/Modular_kaizen_Dealing_with_Disruptions.aspx, accessed 6/26/11[5] The Gist, US Airways Magazine, June 2011, PP16-18. www.usairwaysmag.com, accessed 6/14/2011 *CpU = upper limit of Cp value, CpL = lower limit of Cp value.[6] Quality Function Deployment and Lean Six Sigma in Public Health, G. Duffy, J. Moran., and W. Riley, ASQ Quality Press, 2010, pp.[7] Public Health Quality Improvement Handbook, Ron Bialek Grace Duffy, and John W. Moran, ASQ Quality Press, © 2008[8] The QFD Handbook, J. ReVelle, J. Moran, and C. Cox, John Wiley & Sons, ©1998, pp. 360[9] The QFD Handbook, J. ReVelle, J. Moran, and C. Cox, John Wiley & Sons, ©1998, pp 359 – 365.
  6. 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 presidentof ASQ. Duffy can be reached at grace683@embarqmail.com.John W. Moran, MBA, Ph.D., CMC, CMQ/OE, CQIA, is senior quality advisor to thePublic Health Foundation. He has over 30 years of quality improvement expertise indeveloping tools and training programs, implementing and evaluating QI programs, andwriting articles and books on QI methods. Dr. Moran is a retired senior vice president ofinformation systems, administrative and diagnostic services at New England BaptistHospital. He was previously chief operating officer of Changing Healthcare, Inc. Dr.Moran was employed for 21 years by Polaroid where he held various seniormanagement positions. His last position was director of worldwide quality and systems.jmoran@phf.org.I invite you to join as a member of the PEX Network Group http://tinyurl.com/3hwakem,you will have access to Key Leaders Globally, Events, Webinars, Presentations, Articles,Case Studies, Blog Discussions, White Papers, and Tools and Templates. To accessthis free content please take 2 minutes for a 1 time FREE registration athttp://tiny.cc/tpkd0PEX Network, a division of IQPC, facilitates access to a wealth of relevant content forProcess Excellence, Lean, and Six Sigma practitioners. Further enhanced with an onlinecommunity of your peers, we will provide you with the tools and resources to help youperform more effective and efficiently, while enhancing the quality operations within yourorganization. As our industry becomes more and more dependent on the Web forinformation, PEXNetwork.com has been developed to provide Six Sigma professionalswith instant access to information. Leveraging our strength and foundation in education,IQPC and the Process Excellence Network are uniquely positioned to provide acomprehensive library of webcasts gathered from our events, as well as exclusivecontent from leaders in the industry.

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