Category Archives: Strategy

Are Clinical People more Patient Care Sensitive than Non Clinical Staff ??

From The Crucibles of JPS Customer Value Academy

                             Just Plain & Simple                       

                             ….. Helping Create Customer Value

Just a hypothesis that I recently developed during my visits to one of the most premium and top end hospitals of South Delhi. A few months month back, my father had to be hospitalized and operated upon due to an emergency. The few weeks of pre and post-operative stay at this hospital brought up so many dimensions of patient care …..

Interaction with the diagnostics staff in laboratories was really nice and comforting, I must say. From guiding around the place, to being extra caring while taking samples/conducting tests ….. everything was very efficient and smooth. One was full of admiration, for the courtesy, skill and professionalism of everyone involved in the diagnostic labs.

The difference, however, was so stark and glaring when I went to pick up some test reports at the pre-scheduled time. No reports were available at the ‘delivery desk’ and they had no information about when they would come. ‘You can go and check in the X-ray lab ?’, I was told. So much for all the premium charges and service levels that are promised. On checking at the X-ray lab, I was told that they had already sent the report to the ‘central dispatch’ section. So I went to the ‘central dispatch’ section, where I was told to wait till they ‘searched’ for the report …..

On the other hand, for sure, our experience with paramedical staff and doctors was really good. Not only did they carry out their own functions nicely and courteously, they actually went beyond their normal routine role and tried to guide us even regarding administrative issues.

A total contrast, however, were the inpatient admissions, billing and discharge sections. The waiting time was not due to any length of queued up patients, but due to total apathy and lack of interest to speed up and ‘make it easy’ for patients. On the contrary, they were actually trying to ‘make it difficult’ for the patients and attendants. Needlessly slow paperwork, long delays in ‘photocopying’, absence of staff from the counter ….. all that one would expect at a third rate government hospital (and I had actually taken my father to this hospital to avoid all these issues).

On one occasion, I was shuttled ‘to and fro’ between two counters thrice. One counter was having some ‘maintenance repairs’ and the other one ‘did not have the specific department under its jurisdiction’ ????? I had to finally go to the supervisor, to seek her intervention in sorting out which counter would finally process our papers !!!!!

Then there were these super priced ‘private rooms’ with rates higher than the rooms at the adjoining five star hotel (surgery and procedure charges vary with room rental by the way). The ‘call bell’ in the room, however, did not work and the request for food, water, tea or medicines would take anything from 45 minutes to one hour (after several reminders) ….. and when I approached the attending floor staff to point out that there were too many delays in service, there was a general amusing and mocking exchange of glances amongst the staff, as if to say ‘why is this guy getting agitated ??’.

One could have actually stayed at the neighbouring five star (right next door) at lower room rates and come in daily for checkups at much lower ‘related’ procedure’ charges, with better service and comfort !!

At the time of discharge, they make it a point to tell you that the process can take anything up to three hours (?????), as if to prepare you for further systemic inefficiencies. One learnt though, that their estimate was not wrong, because the staff had to actually grapple with issues like ‘so and so is not in his seat’ and ‘the printer is not working’ and ‘the system is down’. These are not cooked up, but actual reasons given out one by one, ‘sequentially’, at the time of discharge. Hence the ‘promised’ three hours did elapse, at the end of which the nursing superintendent came to take ‘our feedback’ on the hospital’s service levels !!

But yet again, this was the difference I want to highlight. The nursing staff again was very efficient, courteous and professional. Immediately after I gave the superintendent a download of our experience and my strong comparisons on the five star parameters, I could see her having a session at the nursing station and genuine concern on the faces of all nurses.

Is it that the ‘clinical’ people have been closer to human suffering and can therefore understand and feel human pain a lot more. Being involved in the actual healing process probably makes their approach  different from the so called administrative staff ?

I am sure the administrative staff at this premium and most expensive hospital would be getting sufficient compensation and training to enable them to deliver great patient care. But somehow, the salary levels and training and development inputs seemed ineffective. Maybe, at the most, there was a superficial generation of patient care related awareness. But what the system definitely failed in creating, was an awakening, realisation, internalisation, motivation (desire) and action to be sensitive to genuine patient care.

This is where design and methodology of development programmes need to be built on strong experiential foundations, so as to be able to ignite the requisite passion and awakening. Probably what the management missed is to establish a connect and a holistic appeal to the senses through aesthetics, storytelling, empathy, feelings, pleasure, creativity and meaning …..

J.P.Singh,

Justplainandsimple Consulting Pvt. Ltd.

Website : www.justplainandsimple.com

Twitter : @jpsingh55

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Healthcare and Aviation ….. Cross Learnings

From the Crucibles of JPS Customer Value Academy
Just Plain & Simple
….. Helping Create Customer Value
14th Issue of HEALTH BIZ INDIA magazine, October, 2011

Recently I came across a very interesting article on the net. It was titled ‘Why Patient Safety is harder than aviation safety and five practices to borrow from aviation’. The author argues that there are a lot of learnings that the health care industry could draw from aviation safety and the rigour and discipline that goes into the same. He also mentions that he does not want to oversimplify the comparison and realizes that healthcare is a lot ‘harder’. The basic reason given for this is related to ‘scale’ ….. number of patients vs passengers, number of pilots vs nurses and types of aircraft vs diseases. The practices listed, that play a role in aviation safety and the ones that healthcare could learn from are ….. usability and safety of technology, crew management, simulation, prediction and root cause analysis (and hence open and transparent exchange of data).

While it is true that there is a difference in ‘scale’ and ‘complexity’ in the two cases, the discipline and learnings can and should definitely flow into ‘speciality/superspeciality/critical care’, where the gap of scale reduces and ‘seriousness’ and ‘speed of response’ maybe equally significant ….. It is ironical that aviation is taking lessons from hospitals and hospitality on aspects of care though !!

However, just stepping back to first principles for a moment and correlating the fundamental dimensions where there may be similarities and differences between the two that we can build on, let us look at the following :

  • Core Deliverables :
    • Healthcare : Good clinical/surgical outcomes
    • Aviation : On time and comfortable trips
  • Essentials to build on :
    • Healthcare : Patient Care; course/accuracy of treatment; Doctors and staff
    • Aviation : Speed/turnaround time; speed of response; Stringent Processes/technology
  • Performance Metrics :
    • Healthcare : Surplus/sq. ft. or Surplus/bed
    • Aviation : Surplus/trip

With ‘cost/trip’ more or less ‘fixed’, there is a concerted effort in aviation, to build on passenger numbers and revenue/passenger (Needless to say, there should obviously be no compromise on speed of response and safety).

If healthcare is to come out of this trap (no matter who pays for the treatments) of chasing numbers and revenues to fulfill a ‘fixed cost or unabsorbed capacity’, the answer lies in (Needless to say, with no compromise on clinical/surgical outcomes and patient safety) :

1) Scale to be achieved through creating reach and accessability to broaden the base (and much needed in the Indian context), alongwith

2)‘Disruptive Technologies’ to reduce cost/sq. ft. or cost/bed.

These answers are available in development/deployment of ‘appropriate technology’ (Innovation) and spreading the cost of technology and doctors (per patient or per bed or per sq.ft.) through initiatives like telemedicine (the doctors deserve to be paid competitively, but the cost implication on the ‘metrics’ per unit of patient or sq.ft. or bed gets enormously spread out)

Having said that, the learnings from aviation can and should be very appropriately and immediately applied in all aspects of healthcare where safety and speed of response is critical. There are examples even in healthcare where such rigour and discipline is followed. As the scale, accessability and reach of healthcare increases, learnings, processes and skils from these centres of excellence in health care and for sure even from aviation, should be weaved into the genetic code of patient care at all levels as the wave spreads over time.

Aviation is definitely a good learning ground as the source article I mentioned, says, but even otherwise, a similar discipline is needed in any field, in the evolution from being a novice to eminence ….. and it will be very helpful to the evolving Indian Healthcare industry to adopt the following practices and catch the wave on the high !!

  • Taking feedback continuously ….. it is said that ‘feedback is the breakfast of champions’.
  • Priority Setting ….. allows effective and efficient utilization of scarce resources.
  • Sharing ‘The Technique/Method’ with trust and openness ….. for any new entrant, learning from scratch and building up a code from first principle is like re-inventing the wheel.
  • Coaching Ability and Coachability ….. To reach high levels of expertise, inputs from a good coach are extremely helpful
  • Practice, Practice, Practice ….. there is no substitute to this ingredient
  • Simulation, ‘Rehearsals’ and Performance ….. this is a practice followed wherever ‘expertise’ is reached ….. sports, dance, science …..
  • Root Cause Analysis ….. to be able to search for, hit and face the truth boldly and correct it

These are very much woven into the DNA of the aviation industry as well. No wonder we are able to see the beauty of aircraft flying in a formation ….. with a shared vision, speed, trust, constant communication, safety, teamwork, and grace …..

J.P.Singh,

Justplainandsimple Consulting Pvt. Ltd.

Website : www.justplainandsimple.com

Twitter : @jpsingh55

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The Branding Kaleidoscope

From the Crucibles of JPSConsulting
Just Plain & Simple
….. Helping Realise Potential
What’s in a name ? Nothing ….. Or is it everything ? Shakespeare captures a perspective, so beautifully reflected in the following exchange between Romeo and Juliet :

Juliet.

O Romeo, Romeo! wherefore art thou Romeo, Deny thy father and refuse thy name; ‘Tis but thy name that is my enemy; Thou art thyself, though not a Montague.

What’s Montague? It is nor hand, nor foot, Nor arm, nor face, nor any other part; Belonging to a man. O, be some other name !

What’s in a name? that which we call a rose

By any other name would smell as sweet;

So Romeo would, were he not Romeo call’d, Retain that dear perfection which he owes; Without that title:–Romeo, doff thy name; And for that name, which is no part of thee, Take all myself.

Romeo.

I take thee at thy word: Call me but love, and I’ll be new baptiz’d; Henceforth I never will be Romeo.

Juliet tries to tell Romeo that a name is a meaningless formality (for the sake of identity ?) and that she loves the person who is called “Montague”, not the Montague name and the Montague family. Romeo, out of his love for Juliet, rejects his family name and vows to be instead “new baptized” as Juliet’s lover.

Juliet meant that she loved Romeo the person, his attitude, his spirit, his nature, his soul and not the name per se ….. little did she realize that the same very name, alongwith her own, would become a strong brand name, which, over the next few centuries, would epitomize love and romance !! So even if Romeo Montague’s  name was changed to ‘Tom, Dick or Harry’, it didn’t really matter to Juliet. No one will ever know, however, whether instead of Romeo, if any one of ‘Tom, Dick or Harry’ were used, would they have still evoked the same feelings and emotions that ‘Romeo’ evokes or capture the same nuances ….. but that is what brand Juliet, in love with brand Romeo thought !!

What a great ‘value add’ an experience, feelings and emotions can do to a name !! Even X, Y, Z and alpha, beta, gamma can start to stand for anything, depending on the ‘surround’ sound created by a brand experience, performance and interaction (referred to variously as brand positioning, personality, personification, style, tonality, image etc., etc.). But whatever it be, should be genuine; as they say, the consumer could be your wife or mother as well.

The word used for ‘identification’ of  any product or service, whether having a dictionary meaning or not, starts acquiring a new meaning, properties and characteristics of its own, sometimes very different from the original meaning (if any), depending on the interactions and experiences ….. and when that happens, that word ‘grows up’ to be ‘A Brand Name’ !!

A classic case in brand experience is the iconic ‘Ambassador’ car seen on Indian roads for many decades now. Dictionary meanings of names, obviously cannot, on their own, rub off qualities on the product or services that use the name (as also, words with no meaning at all, acquire distinct properties based on the experience that the products/services using them create). Ambassador has not been able to ‘encash’ on the ‘class’ that the dictionary meaning of its name brings ….. no Ambassador would have ever taken the Ambassador car as a Brand Ambassador or vice versa, been one for the car !! But ever seen a white Ambassasor car with a red light on top (and maybe a few stars and a flag also), moving on the roads in India ….. this new ‘look and feel’ now acquires very different brand characteristics of ‘political power’.

The concept of branding, initially originated to ‘brand’ cattle for the purpose of identification, has now evolved into an art form working together with the discipline of scientific approach and evokes so many feelings, emotions and thoughts. Brands are valuable assets that need nurturing, protection and maintenance, to be handled very carefully like crystals or to be polished like brass. A little slip and we have examples of how brand equity risks getting shaken up, requiring monumental subsequent efforts to salvage/build it again. How much the ‘feel’ of a brand can be stretched to brand extensions, is also another area of debate and study …..  A Fanta always meant an orange drink to me; I could never ‘digest’ an apple Fanta. Examples and learnings abound for both positive and negative handlings of brand equity …. the Nimuselide controversy, Tiger Woods scandal, Satyam case, Tylenol crisis,  etc., each of which is a case study, but obviously cannot be detailed out here due to lack of space.

Who would have thought that a very unconventional name like ‘Amitabh Bachchan’, carried by a thin, skinny, lanky figure, whose owner’s deep baritone voice was rejected by All India Radio and whose initial attempts in Bollywood were hardly worth talking about, would one day become A ‘BIG Brand’ with probably the largest fan following on this planet. The story of the effort that he genuinely put into his work and the experience, delight and enjoyment this brand name subsequently brought to the world, is what legends are made of ….. as if resonating a dialogue from one of his blockbuster movies, in the same deep baritone voice saying ….. Aaj khush to bahut hoge tum (Today, you must be feeling very happy) ….. A Brand tagline of sorts !!

 J.P.Singh,

Justplainandsimple Consulting Pvt. Ltd.

JPSConsulting

Just Plain & Simple

….. Helping Realise Potential

JPS Customer Value Academy

Just Plain & Simple

….. Helping Create Customer Value

Website : www.justplainandsimple.com

Twitter : @jpsingh55

 (An edited version of this article also appeared in Empowering Times, May, 2011)

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Optimall Solution !?

From the Crucibles of JPS Customer Value Academy 

                                Just Plain & Simple                               

                                ….. Helping Create Customer Value

The Indian Optician, March-April 2011 Issue

The last decade has seen a mushrooming of malls across all city classes in India. It has been a revolution in retailing. Retailers of all types rushed to find their space in these malls and customers thronged them. Results have been mixed though and so are opinions on whether the malls are an alternative to traditional Indian retail.

There sure is a novelty value and an initial surge of visitors leads to quite a substantial footfall. People have rushed in for all sorts of reasons ….. to get a feel of the new ambience, to stay indoors and spend time in cool/dust free environs, to hang around in restaurants/coffee shops, to visit the multiplexes, or for plain window shopping. The initial debate of sales not being commensurate to rentals and/or footfall continues, though in various measures, for different cities and retail types. What is the reality; where will the system reach a dynamic equilibrium !?

As with all other retail categories, so also have our very own optical stores, and rightly so, moved in to occupy their rightful place in such malls. Speculation and debate is very much alive for this category also. But compared to any other category, be it foods and grocery, fashion accessories, shoes, garments or bookshops, the debate on how opticals are faring, or will fare, is probably a little more tricky.

Questions abound ….. the neighbourhood optical store is more convenient; malls have a lighter/fun environment and hence not suitable for an eye check up; when in a mall, frame of mind is different; eye-checkup is more serious stuff; impulse purchase or non serious purchases are OK in a mall; specs are a predecided/pre thought out decision and hence one goes to a predecided regular destination store …..

For various categories, the ambience of malls has broken old habits. One sees foods and groceries and vegetable buying habits also in for a change. Internationally, where mall penetration has been high for quite a long period of time, opticals and even pharmacies have had a decent and profitable presence. The trend is also, in the recent past, towards even medical clinics coming up in malls ….. these, however, will ride on the convenience provided by a pre-existing mall culture/habit. They promise speed, transparency and convenience, though the ‘regular same’ doctor concept may not be fully practiced as yet.

But what does all this bode for opticals in India ? Will it be a tough ride going forward ? Will it be a game changer ? Will serious eye checkups never pick up in malls ? Will only impulse/less ‘serious’/fashion led products like sunglasses do well ?

Whatever be the case, one thing that optical stores will have to gear up for mall presence, beyond ambience (which has been mastered), is staff quality, to be able to match the type, style, spending ability, mood and aspirations of a mall customer. This is one area which leaves a lot to be desired.

While optimism rules and there is every hope and reason that hygienic and clean  ‘mall’ shopping habits should build up, there also is likelihood of a shakeout and as the old saying goes ‘survival of the fittest’. In the meanwhile, it may not be advisable for any multi-store/multi location optical store to miss a presence in the malls ….. lest they miss the rise when the wave sweeps high !!

J.P.Singh,

Justplainandsimple Consulting Pvt. Ltd.

JPSConsulting

Just Plain & Simple                               

….. Helping Realise Potential

JPS Customer Value Academy

Just Plain & Simple                               

….. Helping Create Customer Value

Blog :http://jpsingh.wordpress.com

Website : www.justplainandsimple.com

Twitter : @jpsingh55

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People Power in Retail ….. What, Why and How ?

From the Crucibles of JPS Customer Value Academy

Just Plain & Simple

….. Helping Create Customer Value

Progressive Grocer, March 2011 Issue

Why Right People :

An owner is fully conscious of his roles and responsibilities and why and how he has to do what he does ….. that is why we have a term called ownership. So, I guess, that is the first step in understanding why it is important to have The Right People at each level and what they should do to be like the owner himself, when it comes to key elements of customer service, continuous improvement, team work, integrity and passion !!

Retail in India is clearly poised to grow. The last decade has seen the growth curve take a definite upward swing. With growth, come newer challenges and newer ways of looking at business. New players enter the market, as also, stakeholders from different domains, who, obviously, may not have been, or rather, definitely would not have been exposed to professional retail processes, considering the absence of opportunities to learn from ….. organised retail was not there and hence also, experienced professionals and education programmes to offer know how.

Each stakeholder brings a background and know how and definitely adds valuable contribution to the growth story. Each also has its own perspective and its own strategy on how to ‘create value’. This diversity in skills and knowledge is definitely a good thing as it brings the much needed basic skills and discussions to enable the evolution of a healthy new knowledge/skill base.

With multiplicity of players in retail, there will also be increased competition and that should be, for sure, good for the customer. Hence, Customer Value Offering will necessarily become extremely critical. Survival of the fittest will therefore be linked to whoever is able to master ‘what the customer really wants’ & ‘what adds most value to the customer’.

What is contributed towards a customer’s satisfaction by retail, is essentially through operational efficiency. Most products are sourced and hence, apart from a retailer’s role in sourcing the right type, mix (after having studied customer preferences) and depth of inventory, the biggest value add a retailer can do is through efficient operations i.e. serving according to customer preferences, efficiently. To a large extent, customer preferences at a macro aggregated level, can also be thrown up on an ongoing basis by an operationally efficient system, which ‘tracks’ the same accurately and hence, if the system is sensitive enough, records and adjusts inventory accordingly ….. very much like the dynamic equilibrium in nature, through an efficient feedback loop of an open system !! And if there is a robust enough system, it can provide micro level individual customer preferences at the store ….. allowing the floor executive to mimic the ‘intimate’ understanding of customer preferences, that an individual owner like Kundan Uncle could manage so beautifully !!

What will Right People do :

Strategically, a key differentiator that will emerge therefore, is operational efficiency ….. which includes cost, process efficiency, service cycle times, continuous improvement, width and depth of inventory etc.. This will be an important input towards achieving high levels of customer service/satisfaction/delight.

Technology will be a key element and an accelerator in winning this game to cater to the huge mass of population. And for that matter, there is money to be made at all levels of the income hierarchy and geographic spread. But how does this get unlocked ?

One point which cannot get over-attention in this, is the importance of Right People and Right People Processes. It is people, across all stakeholders and across all domains, functions and levels, who fundamentally drive all the strategies, decisions and operations. Ability to select, develop, retain and grow The Right People will probably emerge as the single most important Success Factor. Any of the players in retail, definitely spends a large percentage of its revenue in people cost. This is probably the biggest expense in the P&L, after cost of goods ….. and just consider how much attention goes behind purchase of inanimate goods compared to selection, development, retention and growth of The Right People !!

Development of skills and talent, specific to retail itself, maybe an investment worth making in the business. This one activity could be the biggest value and profit enhancer, from the top end paying customer to a no frills outlet in rural areas, where also, as they say, there is a lot of fortune lying !!

It is people at all levels who will become critical to success.

Functional skills will and should vary to bring in diversity and different dimensions to the table/organisation. However, a base level of skill sets and behavioural norms is a must and that should be ensured. The key lies in the owner (or Top Management ?) to have confidence that the last person in the last store, will behave, act and serve customers as she would have done if she could be at all locations and with all customers all the time. Hence, is a base level ‘cloning’ good !?

Before you are a leader, success is all about growing yourself. When you become a leader, success is all about growing others.
— Jack Welch

How to get, retain, develop and grow Right People :

However, having said that, there are ways to ensure that uniform levels of ‘operational efficiency’ are maintained. Processes, SOPs and continuous training are important elements. But all these are also decided and run by people/employees at all/different levels and locations in the organisation. Hence, also, what becomes important is evaluation norms that can be used at recruitment and development stages. The first things which have to be checked (and which non negotiable), are alignment to organisational values, Integrity and team work. Everything else follows …..

What then needs to be kept in mind, has three levels, to keep it simple at this point :

1) Skill Set :

  • Functional Skills
  • Customer Orientation
  • Coaching Ability
  • Ability to take tough calls
  • Adequate IQ level

But 1) above is a base qualification. It is a necessary but not sufficient condition. What are to be looked at, alongwith 1) ?

2) Execution Excellence

3) Passion

The guiding success equation is quite simple :

1) = Base Condition

1)+2) = B grade

1)+3) = C grade

1)+2)+3) = A grade

It is only at that A grade that ownership, accountability, trust, customer orientation and motivation, all come into play naturally.

Leadership Challenge is to build bridges into the future …..

For those who think operational efficiency may not be as important, it may be appropriate to share here that “Fielding historically has been seen as a Service Function in cricket for too long, till Jonty Rhodes changed the game and showed that a Fielder can win matches !!”

J.P.Singh

Justplainandsimple Consulting Pvt. Ltd.

JPSConsulting

Just Plain & Simple                               

….. Helping Realise Potential

JPS Customer Value Academy

Just Plain & Simple                               

….. Helping Create Customer Value

Blog :http://jpsingh.wordpress.com

Website : www.justplainandsimple.com

Twitter : @jpsingh55

 

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