Overheard earlier this year while on holidays:
“TQM, ISO, KPIs, I tried all that. They’re all shit.”
After I had a little chuckle to myself for the coincidence that I would overhear something like this while on holidays after just starting my own business, I really wanted to go over and speak to this person and find out how I could help. Unfortunately, I didn’t, but here is what I would have like to have said.
Firstly, all of those are totally different things. TQM (Total Quality Management) I consider a ‘style’, if you like, for quality management. I believe by saying ‘ISO’ this person was referring to the 9001:2008 standards. And KPIs are indicators, of course, used for measuring how well we’re doing something.
I see this an awful lot—businesses jumping from quality management hot topic to another, usually so rapidly that they never really embed anything and therefore don’t allow any system to be successful. If you do this, I’m not surprised you would think they’re all shit! It would feel like a lot of time and effort spent on nothing but the same results you were getting before. So, is there any way we can make quality management less crap? Here are my top three tips! But, before that, a little secret:
There is no magic formula for quality management, and no catch-phrase system that will make your organisation immediately and suddenly perform better. Quality management is really simple—identify your processes, assess their risk, measure them, control them, evaluate them. This does take time, but if you start small and begin with the end in mind, it is achievable without exhausting your resources.
1. Take the time to design your system well—this includes all elements, but especially if you are using software or the intranet. Begin with the end in mind is a phrase I cannot use often enough! Mind mapping is great for this exercise, start off with your idea of the perfect system and work your way back to how you can achieve it. This is still possible if you already have a system in place but you want to improve it. Your system isn’t stone—it might take a bit longer to change, but you can still do it.
2. Don’t overload your system with documents—by this I mean if you have one line policies or four-point procedures, you really need to ask yourself if this is useful or merely in place because you want to say you have one. Ask yourself if you really need separate policies and procedures or could you combine them into one document? Remember—if you don’t use it, lose it. And a smaller number of documents makes reviewing them much quicker.
3. Prioritise—take the top three things you want to improve. Through whatever exercise you choose, identify what you’ll do to improve them. Now, this is the really important bit, what will they look like after you make these changes? Will you go from being able to do client reviews in three hours to 30
minutes? Will your wait list times reduce? Give the change some breathing space, then go and see what happened. Okay, if it worked, great, you can move onto something else. If it didn’t, that’s cool too—now you know, and you can try something else.
Sometimes issues are complex and require complex thinking, longer timeframes, and more work to solve. But I believe every issue can be handled by sticking to a ‘simple is bliss’ philosophy.
Are you finding something in your Quality Management System really challenging? Please feel free to comment or drop me an email.
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I can talk about Quality Management until the cows come home, but I would like to write about the things that are important to you. So, I would love to hear your feedback on what to write and what your particular issues are. Please feel free to send me an email or leave a comment.
Quality control is not a term used or heard often in human services. It’s a term that, perhaps, we would identify more readily with organisations that produce things; I think we can all agree that controlling how a plane is made is a very good thing. However, ensuring quality control over processes should be important for any type of business.
I often hear that control is difficult in human services because we are working with people and our aim is to be flexible. And things can change quickly and sometimes things go wrong. But it is precisely because we work with people in a client-centred environment that “control” should be paramount. Because what we
are controlling is risk.
Human service quality standards are generally non-prescriptive and flexible when it comes to how service processes are defined and delivered, recognising the diversity of the sector’s client groups and the uniqueness of individuals. However, there are requirements—contractual, legislative. You may not like the word “control”, but you should be concerned about client (and staff) safety and wellbeing, and ensuring their rights are protected. The best way to ensure this is by controlling your processes, so that everyone is aware of their expectations, management has a way of monitoring what's happening, and you have something to work from to improve.
Documenting (or video-taping, or drawing, etc) your processes is the best way to demonstrate control. Personally, I love a good process flowchart as I think they help keep processes succinct and clear. Once you have your control, don’t just let it go stale—commit to a review timeframe so you know it’s still working. Next week I'll talk a little more about how to write procedures that make sense.
Remember that control is not about restricting the individual way you deliver your services—it’s about ensuring that those services are delivered consistently in the best way.
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Every quality management framework for human services in Australia has a standard / indicator / expected outcome relating to feedback. Organisations will generally realise this through a compliments and complaints system, and, of course, through surveys. Surveys can occur during any stage of the service delivery process; usually clients are surveyed when they exit, and at timed intervals during their service, e.g. annually.
But a common complaint about surveys is that nothing ever comes of them—management might give an overview of results, but there is often little action or change. In an environment where clients are continually (and increasingly) asked for feedback (both internally and for external audits too), being able to demonstrate that you really care about what they have to say is a vital part of a customer service culture.
Being able to get results from surveys that you can action goes back to how the survey is written. All too often, management will write or release a survey without knowing what they will, or can, do with the results. Before you start, first ask "what exactly do we want from this survey?" Here are some guidelines I use when designing a survey:
1. A targeted survey is more valuable than a generic, broad one. Look at your strategic and/or operational plan for inspiration on where to target your survey. Complaints or other feedback data can also be helpful.
2. Ask yourself what you really want to know—do you want to know if your service is achieving its purpose? If clients are happy with service times or how long they have to wait on the phone? Asking something like "do you feel that the service has helped you maintain your independence" (and following up with "if no, what could we do better") will get you a more useful response than "are you satisfied with your services".
3. Make sure you know your critical limits—or, what is a "good" response to you? If you're asking satisfaction questions, is a 70% satisfaction rate good? Or is 85% what you really want? What is the most important question, and what is the least? Defining this as you design your survey will help you respond to what is really important. Make sure you document this: "if the satisfaction rate for question x is below 85%, management will initiate a review of the x process".
4. Get a good sample—if you have 200 clients and 30 respond, you don't really have a good enough sample to be assured of the results. Remember that you have to factor in outliers (people who feel strongly either way and can skew averages) and incomplete or incorrect surveys. If you're not getting a good response, extend the survey and follow up personally.
Our clients and staff time is precious, and I do not believe in surveying for the sake of meeting a quality standard or any other reason besides a genuine desire to learn, engage, and change. Doing something with your survey results is a sign of respect. And (nerd alert) a beautifully designed survey that gets you results that you can actually action? Well, it's truly an exciting and invigorating thing.
I would love to hear about good or bad surveys and what you've learned; please drop me a line or comment.
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Quality management, for me, exists to help organisations consistently deliver their product / service, and to provide a framework for improvement. And the best way it works is through the process approach. For service organisations, we need to know that we are meeting our clients’ needs. We also need to be sure that we are meeting those needs in a time-efficient and organisationally effective way (that is, right number of
staff, resources and support).
In human services, as we move towards client-directed service models (such as the NDIS and Consumer Directed Care for Home Care Packages), knowing that we are delivering a high-quality service is vital. So what do you do if you notice that things aren’t going so well? Maybe an increase in complaints, a budget going in the wrong direction, or, worst of all, your clients start leaving. You need to be able to clearly identify where things have gone wrong, and improve on it—and quality management can help you with that.
So, if you have already set up your system, hopefully you will have done so using a process approach. It should be fairly simple to identify where things are going wrong—take a look at your complaints / incident data, budget, and staff and client improvement suggestions. Once you’ve got your process:
1. Map or flowchart it. Use a whiteboard, post-its, Visio…it doesn't matter what you use, just take the time to get it down thoroughly. Always get the help of a team who actually ‘do’ the process.
2. From your process map, and from asking staff, can you see where the pressure points are? What parts are messy, duplicated, onerous? Highlight these.
3. Look for linkages with other processes—are there other factors influencing how well the process is working?
4. Suggest improvements! Now that you can see the process in front of you, and those pressure points, what can you do about it?
And now here’s the most important step:
5. Make sure that you articulate what change you want / expect to see, develop a way to
measure it, and come back to the process later to evaluate whether or not your change worked.
Now that bit above in bold is probably the step that doesn’t happen the most, yet it’s the most important. Do not change for change sake. If you don’t know what improvement you want to see, and then you don’t go back and check that you’ve actually improved, you are missing a huge part of the puzzle. Check if it works! That’s the bottom line.
If you have any questions about process mapping or improvement, please don’t hesitate to ask! Suggest a blog topic or send me an email with your question.
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No matter the size and scope of your organisation, or your internal audit program, at some point you will have to interview staff and provide feedback (to both staff and management) about your findings.
Being able to pick up non-verbal and verbal cues from people is a vital part of being an internal auditor. From the moment you walk into a service or department, you should be able to "sense" how the audit will go. It's not just about the findings, it is how you deliver the message and how that message is received that counts. Reading non-verbal and verbal cues is also very useful when interviewing staff—many people are nervous about audits, and knowing when to change your interview technique can make a huge difference to the interview outcome.
Some of the basic cues I've picked up over the years include:
1. Eye contact and posture - if people are receptive and engaged, they will look at you and position their bodies to face you. If someone is turning their head away from you and or only looking down at their notebook, it is a sign that they are not interested.
2. Dressing up negative comments and jokes - if you walk into a department and the manager says to you "look out, better hide" or "oh no, weren't you just here?" and then laughs or says "just kidding", you need to ignore the laugh. In my experience, people that are genuinely accepting of the audit process don't feel the need to make comments like this.
3. Defensive comments - these are usually pretty obvious. It is natural for someone to take their work or the work of their staff personally; how you respond will determine your ongoing relationship with that person.
So what can you do if you notice these types of cues?
1. Maintain your professionalism - relax your face and keep a neutral expression (no brow furrowing or lip pursing), and do not respond with sarcasm or negativity of your own.
2. Change your line of questioning or feedback - switching the talk to something positive can relax the other person, particularly if they are nervous. See if you can move the topic onto something neutral or discuss a strength before steering the conversation back to what you were previously discussing.
3. If you really feel like you're losing your audience, sometimes the best thing to do is stop and ask if everything's okay. Invite their feedback on what you're saying—people do have the right to respond and it shows professional integrity on your part.
For further reading about body language, I recently found this comprehensive website, Business Balls (love the name too!).
Thanks for reading,
The Quality Nerd loves all things Quality Management and Internal Audit...too much is never enough!