Customer Satisfaction Project

Capturing the Voice of the Consumer

Early in 2004, leaders in the Missouri Department of Mental Health decided to take an in-depth look at customer satisfaction. Through a contract with the Change and Innovation Agency of Jefferson City, Mo., more than 600 face-to-face interviews were conducted with people across the state who access services of the divisions of Comprehensive Psychiatric Services and Alcohol and Drug Abuse for themselves or others. The feedback provided through these interviews during the year resulted in the document Capturing the Voice of the Customer. The department will use the information in the report to make customer-centered improvements and Monitor customer satisfaction in real time through the use of appropriate performance measurements and Customer Satisfaction Survey tools. Following is the Executive Summary of this report.

Executive Summary

The Change and Innovation Agency believes that at the heart of any world-class organization is a concern and a passion for its customers. The leadership team at the Missouri Department of Mental Health agrees, and therefore, embarked on a massive effort to speak with customers face-to-face in order to uncover the true drivers of customer satisfaction. This report contains information from over 600 consumers and stakeholders, and will enable DMH to:

1. Continuously monitor performance regarding customer satisfaction
2. Annually survey customers with a proven and effective survey tool
3. Strategically plan to satisfy customers

The PowerPoint slides serve as a summary of the customer segments. You will understand the desired outcomes and attributes of each group regarding DMH services and programs as you review. Also included are representative comments from each segment which will provide a better understanding of the outcomes and attributes. The actual focus group notes are also included in this report and provide detailed, word-for-word notes of each meeting.

Six system-wide issues emerged from the focus groups, meaning that we heard the same themes in both ADA and CPS. The themes were:

• After Care - Clients feel that there is a lack of follow-up treatment upon completing a program or leaving in-patient care. They often do not feel prepared to move on without some kind of support (i.e. counseling, life skills training, housing assistance, job assistance, etc.)
  
  
• Repeat Clients - Clients want services and programming that are effective, meaning that they only go through once. It seems as though DMH puts clients through the same exact treatment although it may not have been effective the first time - there is no alternative route specialized for the repeat client.
  
  
• One-on-one time with the counselor - Youth and adults alike, outpatients and inpatients overwhelmingly wanted more time with their counselor. They want to sit down and discuss an issue without getting a prescription handed to them. Clients also want to talk to somebody on an "as-needed" basis. Counselors that "have been in my shoes" are in high demand, as well.
  
  
• Quality of Information - Clients especially in ADA complained about the age of their educational materials - videos, hand-outs, etc. Their major complaint was about the age and usefulness of the materials. They complained that the videos seemed like they were 15 years old, and that the materials were often things they already knew - not challenging. While the age and usefulness of materials are dissatisfiers, the satisfying way to handle this issue is to provide motivational learning experiences such as trips to hospitals to see people affected by their actions, speakers who have been in their shoes and succeeded, etc.

CPS in-patients complained about going through the same information over and over, especially if they were long-term clients. There was a real sense that they are not getting anything out of programming once they have been there for a significant length of time.

• Inpatient Quality of Life - Many in-patients seem bored. They spent many focus groups making a case for doing more activities, getting outside for fresh air, and being able to work out and get rid of some of their energy. Unfortunately, many activities are cancelled or avoided from the apparent feeling that there aren't enough staff to allow clients these opportunities.
  
  
• Speed and Access to the System - Referral sources were very vocal about the fact that it is difficult to get a client into the DMH System for anything beyond an assessment. This was very obvious in CPS, as we heard about the long waits for services, lack of available beds and the inability of the Access Crisis System to carry out all of the prior Mental Health Coordinator duties. Response times are slow, and beds are very difficult to locate. In some cases, located beds disappear while filling out all of the paperwork that is required. The presence of a Crisis Intervention Team in Lee's Summit seems to eliminate many of the complaints we heard elsewhere. Lee's Summit uses a system that was developed by the Memphis, Tennessee Police Department.
  
  
• Staff Attitudes - We heard many comments about poor staff attitudes towards clients. In the Methadone program, we heard of staff treating clients like they were criminals, not clients - with little respect. Many in-patients discussed how they were held to rules that the staff don't even follow, such as cursing, smoking, etc. There was a general feeling that the staff have a direct impact on the client's satisfaction or dissatisfaction level.

As you review the report, we urge you to be thinking about your next steps. We recommend the following:

• Prioritize the cross-cutting Department issues - which issues are most important to work on first? Another way to think about prioritization is to decide if any of the cross-cutting issues affect the others. When you find one issue that you feel is driving multiple others, it should be a priority.
  
  
• Identify and Prioritize Program / Division-Specific Activities - Within the focus group notes, you will find issues that are specific to a program or Division. Each Division should prioritize these issues and make decisions about where and when to focus attention.
  
  
• Create the measurement system for the Department and each Division - Based on the focus group feedback, there are many specific expectations that clients shared. For example, law enforcement wants a returned call within 15 minutes, and an available bed located within an hour. We will work with each division to pull out these measures. There are also expectations that may best be measured through survey instruments. We recommend a meeting as soon as possible with each division to begin developing measurement methodologies.

The Department holds a very powerful piece of information in this report. It is a comprehensive look at the divisions of ADA and CPS, as well as MRDD feedback from two years ago. It tells you in real words what your clients expect, want, and in many cases, what they've been receiving. If DMH focuses on what they want, their desired outcomes, and even follows some of the client recommendations, you will go a long way towards improving satisfaction with the system on behalf of all customer groups.