Author: Ross Pope
Date: 2011-01-24

Mid-Michigan District Health Dept.
(MMDHD)
84 employees
3 Branch Offices, Main Office located in Stanton
Serving a population of ~174,000

“Q-Tip” Team Members:
Wendy Currie– CHED Supervisor
Rex Hoyt– Data Specialist
Ross Pope– Data Specialist
Jamie Sorgenfrei– PH Representative II
Bonnie Waterman– Accounting Clerk II
Mark Weber– MIS Specialist II

Quality Improvement Story Board
Improving Customer
Satisfaction with the
Automated Phone System

Act

Plan

Study

Do

Plan
Identify an Opportunity and Plan for Improvement

Our Baseline data was obtained from a checksheet that was developed for use by our Public Health Representatives (PHR’s) to further determine the root causes for misrouted calls dealing with MMDHD’s phone system.

Study
Use Data to Study Results of the Test

1. Getting Started

7. Study the Results

MMDHD initiated our QI efforts by identifying an area for improvement at the health department dealing with customer satisfaction. To find the most appropriate need to be addressed, MMDHD staff members reviewed the collected data from the last several years of the Client Satisfaction Surveys. After reviewing our Client Satisfaction Surveys, it became apparent that measures needed to be taken to improve the quality of service received by our clients, as it pertained to our phone system.

Below are the results of the changes MMDHD made to the auto attendant to improve customer satisfaction when contacting the Health Department. (includes both baseline and final data measurements)

Results from Clients Satisfaction Surveys

The findings for our baseline data are stated below in the following charts:

Most Frequent Programs with Misrouted Calls (356 Total Calls)
Program/Service	Misrouted	% Misrouted
WIC	58	16.3%
EH (all services)	50	14.0%
Imms	41	11.5%
CD	33	9.3%
DHS	32	9.0%
MMHP	30	8.4%
FP	28	7.9%
Unknown	20	5.6%
BCCCP	16	4.5%
Other Agencies	13	3.7%
Wrong #	8	2.2%
Dental	7	2.0%
MCIR	7	2.0%
Hearing/Vision	7	2.0%
Sports/DOT Physicals	6	1.7%

Most Frequent Phone Menu Issue for Client (356 Total Calls)
Menu Option Issue	Misrouted	% Misrouted
Options Didn't Apply	130	36.5%
Dialed auto option # (primarily for "all other services")	68	19.1%
Stayed on the line (timed out)	56	15.7%
Wanted a Person	44	12.4%
Unknown	24	6.7%
Dialed # Directly (typically dialed wrong ext.)	14	3.9%
Didn't hear options	8	2.2%
Pushed wrong button	7	2.0%
Spell-by-name incorrectly	2	0.6%
Call transferred	0	0.0%

Root causes identified for misrouted calls by clients:
Phone menu options are unclear or do not fit caller’s need
There is no phone menu option to directly talk to a person for clients with questions
Insufficient call groups
Need for additional staff education/training dealing with the phone system

4. Identify Possible Solutions

After analyzing the baseline data the following actions are recommended:
Clarify phone menu options
Expand phone menu options
Expand call groups
Educate staff on the phone system and its capabilities
Standardized the auto attendant throughout district

Note: The GBO WIC/FP final data is higher due to an unforeseen communication error with the relaying of incoming phone calls, and the MBO EH final data is higher due to clients being given the wrong phone number which accounts for 8 of the 9 misrouted calls. These problems have since been corrected and we feel that there should be no further problems when a client is contacting the GBO WIC/FP or MBO EH department.

2. Assemble the Team

MMDHD assembled the QI team together with the mindset that all members would have a different insight and therefore have many different vantage points from which to address the problem from both a customer service and technical point of view. The team members assembled committed their time and efforts on a weekly basis over the full duration of the QI project. A Pareto chart was developed to identify key problematic issues as stated by the clients in the customer satisfaction surveys to which the QI team used as a starting point to address these issues and concerns. (charts below depict specific problematic issues clients identified).

Aim Statement:
In order to optimize the performance of the automated telephone system for clients calling the health department, we will reduce misrouted calls originating from the auto attendant by 25% by February of 2011(version #4)

5. Develop an Improvement Theory

MMDHD Predictions:
IF we expand the menu options for the Family Planning, WIC, Immunization programs by separating callers who want to schedule an appointment from those callers who want to speak to someone to ask a question or clarify information… THEN this should accomplish two things: a) remove calls from the central scheduling queue that were not intended to go there, and b) provide the caller with a more direct route to the program/service they need.
2) IF we enlarge the call group size in the branch office by routing the “timed-out” calls and the “all other” calls to a single call group where two people are available to take calls (rather than one person for each)... THEN the larger single call group should enhance coverage to the client.
3) IF we increase the number of times the phone menu options cycle (from once to twice) before the caller is timed-out… THEN the caller will have sufficient opportunity to hear the menu options and correctly make a selection.
4) IF we clarify the Environmental Health menu script to more clearly identify EH-specific programs… THEN callers wanting EH-related services are more likely to select this menu option and non-EH (CHED) callers will be less likely to select this menu option.
5) IF we add to our phone menu the Mid Michigan Health Plan (MMHP) as a menu option… THEN callers in need of this service will have a means of reaching the program staff directly.

Note:
The goal was to decrease misrouted calls by 25%

Act
Standardize the Improvement and Establish Future Plans

8. Standardize the Improvement or Develop New Theory

MMDHD has standardized the automated phone system throughout all three branch offices. We believe that customer satisfaction will increase, as well as staff efficiency with this new streamlined approach, as both get acclimated to the new phone system. MMDHD was able to surpass our original goal of reducing misrouted calls by 25%, and in fact were able to accomplish a 33% reduction of misrouted calls originating from the auto attendant. (the chart below illustrates the improvements made to the auto attendant throughout MMDHD district-wide).

3. Examine the Current Approach

MMDHD decided to use flowcharts to depict the phone system throughout the district. Below is an example of the Gratiot Branch Office (GBO) auto attendant. Each branch office has a similar auto attendant setup.

Do
Test the Theory for Improvement

6. Test the Theory

MMDHD tested its theory by implementing two separate Rapid Cycle Improvements and multiple data collection periods.
RCI #1
1.) Expanding CHED menu options to a two tier system (schedule an
appointment or questions)
2.) Create new call group that captures “all others” and “timed
out” auto attendant options
RCI #2
1.) Refining EH menu message for callers
2.) Add MMHP to main menu options
3.) Allow main menu options to cycle twice, rather than once
After the RCI’s were analyzed and the outcomes proved positive, the changes were standardized and implemented district-wide on all three branch office auto attendants. A final data collection was then administered and the data was complied and analyzed. (Client Satisfaction Surveys will be used as normal to obtain future data)

9. Establish Future Plans

MMDHD will celebrate our accomplishments and continue to monitor their progress with the newly-formatted telephone system and auto attendant. Client Satisfaction Surveys will be gathered and analyzed on a quarterly basis to identify the impact these changes have made towards the overall improvement of customer service. These surveys will be used to help determine future quality improvements that may be necessary.

Multi-State Learning Collaborative 3 - Funded by the Robert Wood Johnson Foundation.