Shortening the Queue

Back to Obama again, and The Audacity of Hope. This is one of those rare books I am compelled to underline, flag, and mark. Here's another quote that speaks directly to the original theme of my blog, "I am convinced - although I have no statistical evidence to back it up - that antitax, antigovernment, antiunion sentiments grow anytime people find themselves standing in line at a government office with only one window open and three or four workers chatting among themselves in full view." (p. 73)

I've tested this quote against a few of my friends, and they laugh. They recognize the image. It does make sense. My friend was reminded also of bank lines, where perhaps four or five bank tellers are at their counter, but only one is open. A supervisor perhaps, the receptionist, loans officers and the bank manager also will be busy (or not busy) at their own tasks. No-one takes ownership to shorten that line save the one designated bank teller. For the person standing in line, do they feel valued; is attendance of their needs a priority? Oviously, observably, not. In return, how much loyalty and good-feeling does the customer build for the bank?

I'm reminded also of the business pundits' warning that companies who want to remain competitive should invest their time figuring out what the customer really wants. From Covey's book, "Predictable Results", "Clearly, the App Store is successful because it allows customers to get exactly what they want immediately and in a simple and inexpensive way. " How do you find out what customers really want? The best results aren't from analysing satisfaction ratings or survey results. These may be filtered or distorted by the collection method itself. Find out by walking around.

A great example of customer service is Pike Place Fish. I am re-reading their book, "Catch - A Fishmonger's Guide to Greatness" and I am reminded again that every fishmonger makes a personal intention - every day - to give each customer a memorable experience. I am a head-over heels, starry-eyed fan of these guys. A couple years ago, I went to check them out myself. I was increasingly nervous as I approached their booth in the market. Would they live up to the hype? Why, yes, they did. In a very personal way. I didn't catch any fish. But they did make my visit memorable in many small ways. I have the autographed book to prove it.

Visit the counters and the waiting rooms. See what the customers see. Inspire your front workers to take a personal interest in every customer that comes across their desk. Don't ever let it become routine, dull, "take another number". Let everyone who visits you for services leave feeling they have been heard, understood.

Customers have memories.

Back to my mission - lineups at the Movie Theatre

It's about time I turned back to the reason I started this blog in the first place. Can I make a difference to intake to make it kinder and easier, that is humanize the experience? Everyone would benefit, including me as I head in to retirement.

I despise waiting rooms.

So I asked myself, have we stood in a line lately? And sure enough, we have. I was in the line-up at our discount movie theatre, Movies 12. As is the case in so many places in Alberta, they were short staffed last night. There was one girl on ticket sales and only two on concession. The line to the concession was growing. At some critical point, the counter staff hollered out, "there are two lines!" and the line dutifully split. We flowed naturally, like a creek finding a new path. The only person who was a little upset was a girlfriend, who had briefly left the line. Those of us waiting our turn helpfully told her where to find him. She shook her head at nearly losing him.

Later on in the evening, the management put a sign up at the ticket booth, letting patrons know they could buy their tickets and their concession at the same time....inside.

Efficient and friendly. They made best use of the resources they had. And we were all knew it.

So why is it that in nearly every private example I've looked at, there's a sense of professionalism, of order, of a desire to make the patron as comfortable as possible? Could it be the reason we are there? Cinema wants us to come back. They gain when we have a good experience. We are planning to have a good time.

It's not quite the same thing when we go for hospital testing or apply for a service, is it?

It just makes the world a little less cruel...

The chicadees were waiting for me this morning. They were close enough for me to see their plump grey forms hopping up the bush. It pays to be reliable, especially when little creatures are depending on you.

I got a follow-up e-mail from someone else interested in Homeless Connect, and she twigged me to a YouTube clip on the San Franciso campaign. http://www.youtube.com/watch?v=M1-K0-GC7jM It looks as wonderful as it sounds. The line that really stood out for me on the video was from a volunteer who said, "It just makes the world a little less cruel." Another volunteer noted that these are the same people we pass on the street every day without acknowledging, yet in the connect atmosphere they are "just like everyone else." Isn't that what it is all about, to bring humanity in to every interaction?

On a separate note, I just finished another delightful novel from Alexander McCall Smith. He's the only author whose books I can't wait to come to paperback. I'm beginning to collect an impressive series of hard bound books about the "No. 1 Ladies' Detective Agency", set in Botswana. But this man does a lot more than write delightful detective novels. He is also an expert in the field of bioethics, serving on many national and international bodies. A BBC biography writes of McCall Smith, "If his day job presents its own philosophical complexities and dilemmas, McCall Smith's writing offers an escape to a place that celebrates moral certainty, warmth and compassion. The author considers it "legitimate to write about virtue" and The Detective Agency series, in particular, shows "qualities that are found all over Botswana. People don't go in for distance and insincerity"."

Legitimate to write about virtue. What a delightful turn of phrase. Is it not also legitimate to campaign for virtue and decency, even in a jaded world?

___________________

Update from Elise, on Facebook: "Anyways, I heard really good things from my co-workers about that event (Homeless Connect). They all thought it was very successful. The event expected 1000 people but over 1500 showed up! "

Connecting with the Homeless

I just heard about a program to help the homeless connect to services in the community. Edmonton is hosting a "Homeless Connect" campaign today. Dozens of services will be under one roof at the Shaw Conference centre. The homeless can get a hair cut, clothing, social services, and even photo ID if they need it. Launched by San Franciso in 2004, this approach is recognized in the United States as a national best practice.

The concept is intriguing, and I suspect far less frustrating for the homeless than roving from office to office. Transportation is an issue for street people as well. An errand that would take an urbanite an hour to complete in their car could take a street person two days to fulfill.

I'd love to hear how it went. Were there enough volunteers to help? Were there lineups?

Your call will be taken in the order it was received

You guessed it. I was put on hold... and hold... and hold. I was calling back a woman tasked with booking me for diabetic training. She'd left a pleasant message, giving me a call-back number which I foolishly deleted. I thought, why bother when I have her number displayed on my blackberry? Her failure, in this diva's opinion, is that she did not state the nature of the call. She simply said she was calling from Capital Health link to make an appointment.

(Note to self: Include pictures with every post to liven up the text)

When I called the displayed number back (which varied from her call-back number by one digit, by the way), I was put in to holding hell for about twenty minutes. I didn't dare hang up, because the pleasant automated voice reminded me of the dreaded consequences. I'd lose my place in the queue. So as my husband shouted conversational inanities at me over a Tim Horton's lunch, I listened in succession to health tips, elevator music, and dire warnings not to hang up. I offered to let my husband listen in to the helpful tips, but he declined.

The second failure was an automated message that came on every five minutes or so, advising me that they were experiencing a high number of calls and if I wished, I could "press one" to leave a message. After ten minutes, I gave that "1" a try. It doesn't work! So then I was stuck. Do I hang up and risk a longer wait in the future? I grimly stuck it out.

The receptionist at the general health line was unhelpful. She asked what the appointment was for. When I said I did not know, she told me I would have to wait for the lady to call me back again. (The horror of hours of hold flooded my imagination). In desperation, I mentioned that my doctor was hooking me up for diabetes training. Could this possibly be why they are calling? "Well then, I'll forward your call to Diabetes booking. If I lose the call, here's the number." I made her repeat it two times. She said it too fast to write or memorize.

What was doubly unfortunate is the receptionist bothered to explain how difficult it is to locate the right department, now that they have gone through a major reorganization. She detailed that for me, just in case I was unaware. Like that prig of a psychiatrist years ago, I got the sense she was trying to pull me in to her political reality.

It's not my fight, lady. I want out of hold hell, and I'd pretty please like to set up that appointment.

The woman who originally called me was delighted to hear from me. She was so pleasant and efficient I forgot to tell her that her original voice mail was unclear. But we got through the necessaries and I am booked for my appointment. It was disconcerting that the closest clinics for the Northeast are far West and Central.

Now I am envisioning several "mystery shopper" forms that people could complete to describe their own experience. I'd need one for waiting rooms, queues, and for automated phone systems.

Terror at the Counter

This only happened a few days ago, so perhaps that explains why I haven't posted. It is harder to write when fresh, as I might not come off as so kind. The gloss of time makes all of our memories heroic. Am I avoiding the brutality of writing honestly about myself?

In this incident, I was attending one of my son's psychiactric appointments. It can't be the easiest job in the world to run the front counter for a mental health clinic. It's got to rack right up there with the counter clerks at Money Mart. Harried from before and within, it's got to be an unrewarding job. I could read all of this in the few minutes we had our encounter. I stood less than a foot from the bulletproof glass. She was hunched over and gave me the barest eye contact. It was as if she dearly hoped I had no reason to be there and that I would quickly leave. Behind her, a half-dozen workers were chatting it up.

I told her I was to meet my son at his appointment. I had his name but not the name of his worker. This was a problem, apparently, as her brow furled. She started flipping through her work pad and looking at the computer screen. She asked if I had the worker's name and I said that my son refers to him only as his "therapist". The crowd behind her desk suddenly burst out laughing and left. Was it my comment or some other private funny? In any case, I was not impressed. As the counter clerk continued to shuffle through her papers, I pulled out my Blackberry and called my son on his cell phone. It turns out he was in his therapist's office, and his name was Jim. I relayed this key bit of information. Then I found out my son was on a different floor. I asked if there was a different reception on that floor, and left.

Where my behavior was not the best was that I remained cool and professional. Probably I don't like being eyed as a potential mental patient. Also, I am hypersensitive to how I am treated at counters, and I have a low tolerance for inefficiency. That girl at the front desk should have all the information at her fingertips to do her job well. She didn't, and I was annoyed. She didn't want me to be there, so I was annoyed. What is unfortunate, is she could not know that my annoyance was not at all personal. It was no reflection on her, personally.

Except, darnit, she acts as if she is afraid of her own clients. Her body language screams, "Get me out of here". She flinched when I approached the counter, "Oh, no. Here comes another one." She never knows if the client is going to be kind or frantic. Frantic for the mentally ill can escalate all the way up to calling the paddy wagon.

There was a paddy wagon parked outside the facility that day.

I wonder if there is an unpleasant encounter that escalates to the paddy wagon, if the counter clerk could be spelled off to get a mental break and a chance to recover.

It seems to me that it would help to elevate her floor so that, when seated, she would be eye-to-eye with the client when they approach. I'm thinking this height can be non-threatening if done right. The Pike Place counter is quite high. Would it help also to deepen the counter so that the distance between the client and the glass were more like two and a half feet? I think that is the Canadian cultural norm for appropriate distance. Also, the space behind her should not be open for random social gatherings. It is distracting for both the clerk and the supplicant.

And finally, she needs to be frequently told the value of her job, and be given all the tools to do it. She should be the most informed person in that clinic. If there are two mental health counters in that building, they should have information about each of their appointments that day as well.

What is the great thing that she adds to these people's day? Reassurance that they are heard, and that their concerns are being taken seriously. She can help a mentally ill person feel at peace. On the random days when the paddy wagon gets called anyways, it's not her fault.

An in-line experience

I thought I'd start with some of my own experiences to show what I mean about dehumanizing intake. Perhaps this incident hit home so hard because it was a pharmacy. Though my days may be over for applying for social assistance and helping my children and mentally ill relatives, there will be many, many pharmacy counters in my future. It's mundane, it's routine, and everyone lives through it.

This incident happened several years ago at a Superstore pharmacy, about the same time they came out with that two-station system; receiving and shipping. I started out poorly. I went to the wrong counter. When I got to the the receiving end the clerk helpfully advised that it would be a half-hour wait to pick up my order. I thought, fine, I am in a store, I will do my shopping and come back in thirty minutes. This surely would be a plus, as I don't have to stand around waiting for my order.

When I came back thirty minutes later, there was a line of frustrated customers. After watching the line for a few minutes, I understood why. None of the orders were ready. The pharmacy, besides putting in the entry and exit stations, had instituted a new system. Each order had it's own little basket. So far so good. Those baskets could be in any of a dozen locations. Very, very, bad.

As the clerk received each person in line, she bustled around in the back, checking each of the dozen locations in turn. It was worst for the woman directly in front of me. The clerk came back to the woman in front of me a couple times and told me she could not find the order. Finally she told the woman they were out of stock of the particular medication and she would have to come back.

After seeing what happened to that poor woman, I decided to take a stand. I had my turn with the counter clerk and told her I was cancelling my order, could I please have my prescription back. Her eyes went wide and she disappeared in the back .... for twenty minutes.

She came back with my order. The pharmacist, on hearing my request to cancel, rushed my order instead. They were nearly out of stock of my medication, so they only filled the prescription partially. I would have to come back for the rest.

I was angry. Not only was I required to wait much longer than promised, but my specific request to cancel the order was ignored. I assumed they preferred the days' profit over a small embarrassment. I left and never returned. They can keep the partial order on file forever for all I care.

What were some of the mistakes in this encounter, and how could the pharmacy have improved them? I've ordered the pharmacy errors from most important to least important.

• There was no respect for the customer by the pharmacist. My specific request was bypassed for the sake of interests (profit) that were not my own. I never got to see the pharmacist face-to-face to tell him so myself. He never found out that he permanently lost a regular customer because of his neglect. His vision was appallingly short-sighted. In his interest on not losing a single sale, he permanently lost a customer.
• The counter clerk was neither empowered to make changes or properly oriented to the new system. She was confused, rushed, and utterly intimidated.
• The process sucked. The two counter system is appropriately efficient, and the individual baskets work well. However, there were too many stations where the orders could stack up. There should have been only three. Receiving, filling, and completed. Maybe four. There always seems to be a stack of orders that are picked up days later.
• The intake clerk really did not know how long orders would take. She gave the same answer to all, "thirty minutes". This may be petty, but I hate being misinformed.
• There was no accommodation for newbies. Could they have taken my order at the shipping counter and advised me "for next time"? Perhaps not, but I thought I would mention it. As small as the incident seems, a petitioner is always in the vulnerable position. Don't make us feel any more stupid than we already feel.

Well, that's that. Wouldn't it be great if we had "mystery shopper" questionnaires and customer service cards at places like this? Those of us who speak up would have a place to protest. Rather than resort to sharing our experience by word of mouth and blog.

My list for the holidays. The white-tail deer don't count as birds, but it was pretty cool to see them in the Kootenays and Montana. On the trip I saw the following birds to add to my lifetime list:

• Starlings
• Canada Geese
• Mallards
• Red-Tailed Hawks

All but the hawks are all flocking to fly south for the fall. The hawks waited patiently on fence-posts for unwary gophers. I won't count the terns and gulls yet because I'm not sure which ones I saw.

Investigating the intake experience

Here's my overall framework for investigation. There's big blanks, as I'm getting the big thoughts down before I lose them. In order to improve the intake experience, I've got to understand a few things.

1. What is the psychology that drives the experience...that makes it either unpleasant and demeaning, or significant and helpful?
2. The first contact (receptionist) and the intake worker must be empowered. There's no point in fixing the mechanics of intake, if the people responsible for finalizing the action are miserable.
3. Reviewing the process itself. How many handoffs are there? How much work is put in to verifying, keying? What is the optimum intake criteria for the action? Are we asking too much, too little? Auditors, what do they want to see?

For the rest of this entry, I'll talk about issue one - the primal psychology. These are just ideas. I would like to confirm them against behavioral research. I am coming to realize the way we react to various situtations in our civilized world, has more to do with how our stone-age ancestors would have reacted in an equivalent situation. We aren't so far away from our ancestors as we would like to believe. It's like civilization has given us a veneer, but we are the same primitive construction beneath. So what did drive our ancestors? From Pinker's list, he suggests that we are hard-wired for complex social interactions. We've always been social beings. It seems to me we would have always had the need to negotiate a needed service from a stranger. It becomes a problem if we have nothing to barter. If we have nothing to offer, we beg.

The image that comes to mind of begging is a subservient wolf grovelling with the alpha dog. He'll crawl on his belly, mewling, puppy-like. He'll lick the lips of the alpha. In every way he will try to appear harmless. How does the alpha dog react to this behavior? It seems the successful alpha will be benevolent most of the time. He won't make the subservient dog grovel for extended periods of time.

Getting back to people, what happens to us if we are required to grovel for extended periods of time? Does resentment build? Is there a breaking point, where the subservient stops trying, and becomes a hostile threat to the group?

Another analogy that comes to mind is the petition to the king. It seems that the same behavior applies as described above. Success may depend on the petitioner's ability to appeal to the benevolence of the leader. A complicating factor might be an intermediary, or a gate-keeper, who decides who gets access to the King. Biblical examples are Haman in the book of Ruth, and Absalom who undermined his own father-King when petitioners came to see him (2 Samuel 15:2-6).

And finally, besides the application of complex social interactions, the queue, or line, appears to trigger our primal instinct to protect our "territory" or earned space in line. It is deeply offensive to jump the line. The entire line may jump on a line-breaker, exerting extreme social pressure to conform. I am sure you can think of dozens of examples.

Besides line-jumping, the whole experience of waiting in line for an indeterminate period is stressful. The line-holder has very little status other than his placement in the line. Very often the receptionist or intake worker has no status in the organization either. Both may fiercely maintain any dignity that is offered him. The intake worker's greatest power comes from their near godlike ability to accept or reject based on the rules. The worker's intimate knowledge of the rules, (and the line-holder's ignorance of them) results in a social dance that, for the ignorant, can be humiliating and highly discouraging.

Could this result in the socially inept being denied services they rightfully deserve? Aren't these same people the ones who most desperately need the help? How do we break through the process to allow status to all the participants - intake workers and petitioners alike - so that they can meet on common ground?

The social dynamics of human-to-human contact is so much better. Meeting and conversing with a friend, having them understand you, and receiving needed help, isn't that so much more satisfying than the dynamics of petitioner-granter? It seems to me that the status of both the petitioner and the intake worker has to be raised and acknowledged first, before we can have this kind of significant dialogue.

Retirement Planning and Queues

Mr. Squirrel has discovered the bird feeder. He'll be making many trips a day to his cache, I expect. I do hope his cache is not in my eaves somewhere. So far, Mr. Squirrel, the sparrows, and chickadees have been at the feeder. They will help me with my list.

A great colleague of mine retired this week. He goes back to school to take philosophy. His dream is to resolve the issue of choice over death. Can we choose our own passing, and how can those we love make the best choice for us? Shold they make that choice? He smiles like a chipmunk every time he talks of his retirement. His parting words to me is to not delay in making my own plans.

Now, my own retirement is over a dozen years away, but I've been a good girl and gone for the training. The trainers were excellent. Their first great gift is that they convinced me that, financially, we will be just fine. They also convinced me that I need a vision, mission, and a plan if I am to enjoy retirement. What is my dream?

To make it easier for people in queues. Start an advocacy and consulting non-profit group that helps people get through the intake process as humanely as possible. We should be able to do this without stuffy waiting rooms, sweaty lines, take-a-numbers, triplicate forms, harried receptionists, and surly intake workers. One wonders sometimes if they make it so hard just to keep the numbers low?

You see, I dread the queues in my own future. Pharmacies. Hospitals. Disability applications. Insurance claims. I fear I will become one of the faceless masses, that pairs of dead eyes will stare past as rough hands stamp, "Rejected".

How do we make the whole experience more humanizing? Why can't intake be like Pike Place Fish, where they make everyone's day? For a few moments, there is genuine contact. And we earn this great connection over fish! http://www.pikeplacefish.com/

Anyways, that's my dream. All the things I want to do will take years to set in motion. But I've got the years. And the talent for making it better.