Putting customer focus into practice

This section guides you through the key steps that public health agencies and programs can take to attain a better customer focus and use it daily in programs and services. It explains what each step is and how to complete it, and includes links to key tools.

Identify customers
Prioritize customer focus efforts
Determine customer needs and requirements
Collect and analyze customer feedback
Take action: Use and share customer information and feedback

Identifying customers is one of the first steps to achieving a customer focus in a public health program or agency. It is important to identify who your customers are for each program/service/product you provide because different customers want and need different things. The more specific you can be when identifying your customers, the easier it will be to determine their wants and needs and the more successful your agency or program will be at achieving a customer focus.

Customers [define: customer] are the direct recipients or users of the programs, services, and products provided. They can be both internal and external (see examples below) to your agency or program. Another term you may use to describe customers is stakeholders. However, in a customer-focused agency or program, stakeholders and customers want or care about different things and therefore, need to be distinguished. Stakeholders [define: stakeholder] care about and are interested in the programs/services/products provided but, unlike customers, stakeholders do not necessarily use them.

Examples:

Program, product, service	Customer	Stakeholder
Conduct restaurant inspections	Restaurant owners	People who dine at restaurants
Give immunizations	Patients receiving immunizations	Immunization advisory board
Develop and maintain website	Website users/audience	General public
Provide new employee orientation	New employees	Employer
Manage grants	Your grantees	Your funding agency
Process time cards	Employee	Employer
Write reports	Other health agencies	Program manager

To begin to identify your customers, create a list or table (like the one above) and ask yourself the following questions:

1. What programs/services/products do I provide? What do I do?
2. Who is the direct recipient of my programs/services/products? Who is the intended audience/user?

You may also choose to identify stakeholders in order to help you narrow down your customers appropriately. A customer identification worksheet is available for identifying customers that you may find helpful to use.

Due to capacity and resources, it may be necessary to limit your customer focus activities to certain programs/services/products. If you need to limit what programs/services/products you focus on, here are some criteria to help you prioritize them (in no specific order):

• Largest number of people served
• Largest program/service/product, in terms of budget or staff
• There are clear opportunities for improvement (e.g., programs/services/ products with known complaints or issues)
• Highest strategic priority
• High profile programs/services/products, or programs/services/products with known controversy

Source: Measuring Customer Satisfaction (PDF), King County WA

Another step in achieving a customer focus is to identify your customers' needs and requirements for the programs/services/products you plan to focus on. Customer needs and requirements [define: customer requirements] are the qualities that make customers satisfied with a program/product/service, also known as wants, key drivers, or expectations. They are also referred to as the voice of the customer (VOC) [define: voice of the customer]. Examples include, but are not limited to, things like:

• End result: Service/product quality
• Timeliness: Speed of service/product delivery
• Information: Quality and completeness of information
• Staff competence: Professionalism, expertise
• Reliability: Performance of service, products, staff
• Staff attitude: Courtesy, politeness, friendliness
• Fairness: Honesty, justice, and fairness of the system
• Access: Availability of staff, services, products
• Look and feel: Appearance, comfort of environment, facilities, staff
• Safety and security: Customer safety and confidentiality
• Convenience: Ease of obtaining product/service
• Value and cost: Value of service/product compared to cost

Source: Measuring customer satisfaction (PDF), King County WA

Customer requirements are important to know; they can:

• Help you understand what causes customer satisfaction or dissatisfaction, including what influences satisfaction more
• Lead to the development of customer satisfaction surveys/questions
• Lead to improvements that are important to the customer rather than ones the agency believes are important (i.e., challenge your assumptions)
• Lead to the development of customer-focused performance measures

To understand what your customer needs and requirements are, you must ask them. Basic methods to gather this information include:

• Review existing data (complaints, previous feedback surveys, etc.)
• Customer interviews
• Customer surveys
• Focus groups with customers
• Customer observations
• Talking to staff who provide the programs/products/services directly to the customers
• Mapping the customer journey/process

Ultimately, you want to understand what customers like and do not like about a program/product/service, and if possible, why they like/dislike it. The method used to gather it will depend on the resources and capacity you have available.

Once you know your customers' needs/requirements, the next step is to prioritize them. You could use one of the methods above to help prioritize (e.g., if you could group complaints into a few categories, the largest group could be top priority). You could use survey questions to ask customers to rank things in order of importance, or rate things on a Likert scale (from "must have/critical/extremely important" to "unnecessary/not needed/not important")

It is important to gather this information regularly because customer needs and requirements change over time. You will use this information to inform how you measure what satisfies your customers and to understand what has changed.

Some tools to help determine and prioritize customer needs and requirements include:

• Critical to quality (CTQ) tree: The CTQ Tree is a tool used to translate broad customer needs and requirements into specific, measurable performance requirements.
• Kano model: The Kano Model is a tool that helps prioritize customer needs and requirements by grouping them into three categories: Expected Quality (must haves), Normal or Performance Quality, and Exciting Quality.

After determining customer needs and requirements, the next step in achieving a customer focus is to regularly collect and analyze customer feedback. The customer feedback collected and analyzed here, as opposed to customer information gathered in the previous step, is used to inform you about customer satisfaction [define: customer satisfaction] and whether or not you are meeting your customer needs and requirements.

The collection and analysis of customer feedback can be as simple or complex as you want to make it. The important thing is to collect feedback you will use. If you are not going to use it, why use resources and take the time to collect it?

The most common methods used to collect and analyze customer feedback are:

• Survey
• Focus group
• Interview
• Comments/complaints

Survey
Advantages	Quick Inexpensive Large sample sizes (more representative and generalizable) Provide quantitative and qualitative data
Disadvantages	Need well-written questions Low response rates
Best practices	Include: Likert Scale questions (with an additional N/A or Do Not Know option) Open-ended question(s) Demographic questions Questions related to customer needs/requirements Length: as short as possible
Analysis	Likert scale: median and range Open-ended: categorization or themes, if possible
Focus group
Advantages	Deeper conversation Specific information Can read body language, if in-person Group dynamics
Disadvantages	Time consuming Need a good facilitator and recorder Qualitative data only Not everyone is comfortable speaking up in a group setting
Best practices	Use focus groups in addition to a quantitative method. For example, can be used to help interpret results of the other method.
Analysis	Categorization or themes
Interview
Advantages	Deeper conversation Specific information Can read body language, if in-person One-on-one
Disadvantages	Time-consuming Qualitative data only
Analysis	Categorization or themes
Comments/complaints
Advantages	Specific, detailed information about likes/dislikes Repeat comments/complaints confirms customer need/requirement
Disadvantages	Most people do not complain; they just go somewhere else or stop using the program/ product/service Low rates of completion
Analysis	Categorization or themes

While many of these methods will not provide you with statistical validity or generalizability (i.e., you will not get research-level, statistically sound data), that level of rigor is not always necessary--especially when you are just beginning to focus on customers. Choose the method(s) that will work for your agency or program based on your capacity and use of the feedback.

For example, a smaller change, like the addition of signage, could be made based on a less rigorous and a smaller amount of customer feedback. A larger change, like the reallocation of resources, or design and development of a new program/product/service, would require higher quality and a larger amount of customer input.

Once you determine the method(s) you will use to collect and analyze customer feedback, you will need to develop the following components, which will help with consistency and accountability:

• Data collection tool: The data collection tool contains the questions, instructions, and guidance that become the method(s) you use to regularly collect customer information and feedback.
• Data collection plan: The data collection plan outlines the process you use to collect customer information and feedback. It includes the purpose for collecting the information, frequency of collection, the tool used to collect it, where and how the collected information is stored, and the person(s) responsible for collecting it.
• Data analysis plan: The data analysis plan outlines the process you use to analyze the customer information and feedback you collect. It includes the frequency of analysis, where the information to be analyzed is stored, the person(s) responsible for the doing the analysis, and the type of analysis performed. It could also include any specific performance measures [define: performance measures] and their respected targets, if appropriate. You may choose to combine the customer feedback collection and analysis plans into one document, if that makes more sense for your agency or program.

For more detailed books, tools, and websites related to measurement, analysis, and reporting, visit customer focus resources.

Taking action and using the customer information and feedback you collect and analyze is the most important part of a customer-focused agency or program. Taking action both starts and ends with sharing customer information and feedback with the appropriate stakeholders and customers. You will want to share the customer information and feedback you gathered and analyzed with decision-makers for use in making their decisions. You will also want to share the decisions made and actions taken with those impacted by the decisions.

To ensure customer information and feedback is shared consistently and regularly, it is important to develop a plan for sharing customer information and feedback (a plan like this is also known as a communication or reporting plan). This plan will include who receives the information, why they receive it, the frequency they receive it, how they receive it, and the specific information they receive. It should also include who is responsible for carrying out the plan.

With whom and when you share customer information and feedback will depend on the purpose for sharing it. Consider sharing customer information and feedback with:

• Agency/program leadership
• Agency/program staff
• Governing board, elected officials, or advisory board
• Customers
• General public or other stakeholders

Reasons to share customer information and feedback include:

• To demonstrate transparency
• To show customers that their feedback is being looked at and acted on
• As a means to promote the customer focus of your agency or program
• To encourage use of the feedback for making decisions
• To inform your agency or program on how to meet your customers' expectations and increase customer satisfaction

As part of your plan for sharing customer information and feedback, you will want to create templates for each audience you choose to share the information with. Creating templates will help with consistency and ease of regularly sharing the information. Templates used to share customer information and feedback can be as simple or complex as you would like to make them, and will look different depending on your audience and purpose.

Again, taking action and using the customer information and feedback you collect and analyze is the most important part of a customer-focused agency or program.

Examples of decisions and actions resulting from customer information and feedback include:

• Adding evening hours to immunization clinics, so more patients are able to attend
• Creating a mobile version of the agency website, so users can view it on their mobile devices
• Sending email reminders a few days before time cards are due, so that employees do not forget to submit them and have their paychecks delayed
• Including a summary of key points and next steps with restaurant inspection reports, so that restaurant owners can more easily understand the inspection results.