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Paz Using CX Concepts for Better Respiratory Protection Outcomes · Tim Paz, CIH 2021 Chesapeake...
Transcript of Paz Using CX Concepts for Better Respiratory Protection Outcomes · Tim Paz, CIH 2021 Chesapeake...
Using CX Concepts to Optimize Desired Respiratory Protection Outcomes
Tim Paz, CIH 2021 Chesapeake Health and Safety Educational Seminar April 15, 2021
Disclosure
I, Tim Paz, will present information describing my various experiences as a certified industrial hygienist and respiratory protection program administrator in the public and private sector. Ideas, opinions, and comments described in these slides and mind maps and during this presentation are my own and do not represent the views of my current employment affiliation, the Architect of the Capitol. I am here on my own behalf, as a Full Member of the AIHA.
This presentation is intended for educational purposes only. Any mention of trade, firm, or product names is for descriptive purposes only and does not imply endorsement by the presenter nor the U.S. Government.
Public Disclosure Date: April 15, 2021 2April 15, 2021Using CX Concepts to Achieve Better Outcomes
Agenda
01. Introduction
02. Respiratory Protection – Current State
03. CX Fundamentals
04. Establishing Desired Outcomes
05. CX Applied
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My Goals…
Think Differently
Keep an open mind
Take off your IH/OEHS hat
Embrace empathy and understanding!
Explore self-awareness
Up your empathy game!
People Working Together
You can’t do it alone
Worker participation is key
Engage with key stakeholders
Develop a Group Strategy to Improve the Respiratory Protection Program
Call to Action: Become a CX Champion
Think of the employees you serve as customers
Treat your customers right
Create legendary service
Learn more about CX
Create Customer Personas & Journey Maps
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Using CX Concepts to Achieve Better Outcomes
• CIH - 1994
• Respiratory Protection Program Administrator• Boeing, DOE Superfund Cleanup Project, Dept of Veterans Affairs
• Committed to Self-Awareness
• Personal Mission, Vision, and Core Values Established
01. Introduction
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A compelling vision tells you who you are (your purpose), where you’re going, (your preferred picture of the future), and what will drive your journey (your values).
Vision
Using CX Concept for Better Outcomes
Using CX Concept for Better Outcomes
April 15, 2021Using CX Concepts to Achieve Better Outcomes
Self-awareness is, at its core, the ability to see ourselves clearly—to understand who we are, how others see us, and how we fit into the world. Self-awareness sets the upper limit for the skills that make us stronger team players, superior leaders, and better relationship builders.
Self-Awareness
April 15, 2021Using CX Concepts to Achieve Better OutcomesEurich, Tasha. Insight . The Crown Publishing Group. Kindle Edition.
TP
The art of stepping imaginatively into the shoes of another person, understanding their feelings and perspectives, and using that understanding to guide your actions.
Empathy
April 15, 2021Using CX Concepts to Achieve Better OutcomesKrznaric, Roman. Empathy: Why It Matters, and How to Get It . Penguin Publishing Group. Kindle Edition.
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If I had to name the secret ingredient to the
success I’ve enjoyed, I would say it all boils down
to a commitment to self-awareness.
– Alan Mullaly
Former CEO, Ford Motor Co.
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• Respiratory Protection Still a Top 10 OSHA Violation
• 5 Million U.S. Workers Required to Wear Respirators
• COVID-19 Pandemic Has Increased Awareness
• OSHA NEP – Coronavirus Disease 2019 (Mar 2021)
• NIOSH Created PAPR100 Class of Respirators (Apr 2020)
02. Respiratory Protection: Current State
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• NIOSH approved first-of-its-kind elastomeric respirators without an exhalation valve (Nov 2020) ...3 companies so far
• Still No Accreditation Program for Respirator Fit Test Administrators (in the U.S.)
• Supply & Availability of NIOSH-Approved Respirators Improving – CDC (Apr 09, 2021)
• Counterfeit Respirators
02. Respiratory Protection: Current State (continued)
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• Barrier Face Coverings (BFCs) – New
• ASTM F3502 Standard Specification for BFCs (Feb 2021)
• ASTM F3407 Standard Test Method for Respirator Fit Test Capability for Negative –Pressure Half-Facepiece Particulate Respirators (Oct 2020)
• ASTM F3387 Standard Practice for Respiratory Protection (Aug 2019)
02. Respiratory Protection: Current State (continued)
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Respirator Use in the United States
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Respirators used in 619,000 workplaces
45% of these required for protection against workplace hazards
53% - very small businesses (<10 employees)
3.3 million (3% of all private sector employment) required to wear respirators
Largest fraction of employees required to wear respirators were employed in manufacturing
APRs were the most commonly used respirators
Doney, Brent C., et al. "A survey of private sector respirator use in the United States: an overview of findings."Journal of occupational and environmental hygiene2.5 (2005): 267-276.
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Many Businesses Have Inadequate Respirator Programs
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66% had no written program
51% did not conduct medical evaluation
43% did not provide fit testing
41% did not conduct employee training
Source: A Survey of Private Sector Respirator Use in the United States: An Overview of Findings (2005)April 15, 2021Using CX Concepts to Achieve Better Outcomes
Federal OSHA Data Through January 14, 2021
Total Number of Inspections 310
Total Initial Penalties $4,034,288
Highest Initial Penalty $32,965
Average Initial Penalty $13,013
Most Commonly Cited Standards Respiratory Protection
Hazard Assessment (PPE)
Recordkeeping/Recording
Reporting
COVID-19 Inspection Statistics
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OSHA Top Violations (By FY)
FY 2014
FY 2015
FY 2016
FY 2017
FY 2018
FY 2019
FY 2020
FallProtection
1st 1st 1st 1st 1st 1st 1st
Hazard Communication
2nd 2nd 2nd 2nd 2nd 2nd 2nd
Respiratory Protection
4th 4th 4th 4th 4th 5th 3rd
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Top Sections Cited – 1910.134
Medical Evaluation Voluntary Use
1910.134 (c)(2)
302 Violations
Fit Testing
1910.134 (f)2 – Initial Use, Annually1910.134 (f)1 – TFFR pass QLTF or QNFT
258 Violations188 Violations
Not required for Voluntary Users or Escape-Only Respirators
QLFT may be used to fit test negative pressure APRs if they will only be used in atmospheres less than 10x PEL, since existing evidence only validates the QLFT protocols listed in App A to identify respirators that achieve a FF of 100.
Written Program
1910.134 (c)(1)
449 Violations
1910.134 (e)(1)
518 Violations
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Assigned Protection Factors
Assigned protection factor (APF) means the workplace level of respiratory protection that a respirator or class of respirators is expected to provide to employees when the employer implements a continuing, effective respiratory protection program as specified by this section.
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Effectiveness of Respiratory Protection
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Adequate protection from workplace hazards using respiratory Protection requires:
1. Well-fitting respirators 2. Very accurate fit test methods
Respirators that fit well on a wide range of facial sizes contribute to lower program costs, less administrative time and more effective respirator programs. [ASTM F3407 should help with this!]
D.L. Campbell,C.C. Coffey &S.W. Lenhart. “Respiratory Protection as a Function of Respirator Fitting Characteristics and Fit-Test Accuracy”AIHAJ; American Industrial Hygiene Association 62.1 (2001)
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Importance of Fit Testing
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“98 percent of fit tested workers exceeded the minimum protection level compared to only 55 percent of non-fit tested workers.”
TSI “Why Should Respirator Users be Fit Tested Report” (2007)
Fit Test Training and Accreditation Programs
New Zealand
Commit2Fit
Training
Fit Testing Accreditation Scheme
Fit Test Provider register
United States
None
Australia
Resp-Fit
December 2020 Kick-Off
Training
Stage 1 – Theoretical Assessment
Stage 2 – Practical Assessment by Video
United Kingdom
Fit 2 Fit
2015
Training (Pre-requisite)
Mentored Fit Testing
Examination
Practical Assessment
Good for 3 Years
Reassessment and Retaking the Examination (Until year 6)
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03. CX Fundamentals
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What is CX?
Create solutions for my business“Wow” when it matters
Recognize my loyaltyBe proactive on my behalf
Save me money
Don’t transfer me aroundMake self-service easy
Use language that I understandBe available
Solve my problem, completelyRespect meBe accurate
Don’t waste my time
Differentiate
Make it Easy
Accurately and Quickly Address my Issue
Increasing sophistication of delivering a
compelling customer
experience
Customer Experience is how clients perceive their interactions with the organization
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Customer Experience
Customer Service & CX
Customer Service
Sum of all interactions in different places, via different channels, and over time.
How customers feel about your business, agency or department.
At a specific time, place, or channel. It’s the help you get. It’s reactive.
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34%
35%
36%
39%
47%
48%
0 0.1 0.2 0.3 0.4 0.5 0.6
OTHER
TEXT
SOCIAL MEDIA
WEB
ONLINE CHAT
PHONE
Less than 50% of customers find any channel easy to use
Human Assisted Channels Are Easiest Today
25Digital Disconnect in Customer Engagement –Accenture 2018
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0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
Online Chat Chatbots Face-to-face Phone Apps Social Media Web Form Email Letter
Instant Response
Response Time by Communication Channel
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How soon would you expect to get a response on each of these channels?
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This means…
1.Put the human and physical elements back into customer services.
2.Make it easier for customers to switch channels to get the experiences they want.
3.Root out toxicity – Identify the most difficult customer experiences across all channels and use them to guide your strategy.
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83% of U.S. consumers prefer dealing with human beings over digital channels to solve customer services issues.
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Customer Engagement ChannelsChannel CX Best Practice Agency/Organization - Current State
Support is web and mobile-accessible; intuitive interface for requests any time/where; operational automation
Email is an option when customers prefer; response within 4 business hours
Chat/text available and integrated for support staff; all contact captured for continuous flow of info
Phone support available during operating hours; service levels at 80% in 20”; high First Call Resolution
Social media channels available and monitored for customer feedback; timely response and action
Facebook and Twitter in use; no clear process for managing inbound activity or reporting
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Coaching & Hiring on Behaviors that Matter
What drives customer experience and business results at the same time?
What is the benchmark set by your most successful reps? Why are they great?
Flexible to drive personalized service and care
Drives the coaching discussion – talks about the “how”
Motivates continuous learning and aspiration to deliver an even better experience the next time
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Highly motivational quality programs frame the behaviors/competencies in the positive, creating a “yes we can” and “will do” mindset that drives CX performance.
Make a personal connection Discovery and active listening
Customer Advocacy
Business Acumen
Taking OwnershipMake it Easy for the Customer
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Customers Understanding our customers’ needs, requirements and expectations; mechanisms to collect feedback; the Customer Service and Experience metrics and customer insights that we gather and analyze.
People Roles and responsibilities, hiring (numbers and skill); training and developing; Setting performance expectations for all personnel (employees and contractors). Rewarding excellent customer service.
Process The programs and processes we put in place to serve our customers; SOPs; the communication channels and protocols that we follow; operational “business vitals”.
Technology The tools that we use to manage our customer activities and processes.
Build a CX Roadmap: Define the Priorities
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CX Roadmap (example)
Formation of CX Champions Group/
Community of Practice
• Monthly meetings by customer group
• Quarterly Meetings as an organization-wide team
• Sharing tips & insights
Enhanced Customer
Satisfaction Surveys
• Updating enterprise level surveys to better assess customer sentiment and cover the factors that are most important to customers
Enhanced CX Metrics
• Operational metrics to deliver more actionable insight to continuously improve service delivery
CX Training
• Training tailored by position type and customer group
FY22 Q1 FY22 Q1-2 FY22 Q1-2 FY22 Q3-4
Seamless Service Delivery
• Personalized• Frictionless• Anticipatory
Link to report
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Forrester CX Index Score…measures how successfully a company delivers customer experiences that create and sustain customer loyalty.
Compliance
Likelihood of following directives/procedures
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TP
CX Quality
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Effectiveness: the experience delivers value to the customers.
Ease: It is not difficult to get value from the experience. For example, your SOPs are easy to understand. Scheduling fit testing is a snap. It’s easy to order respirator supplies.
Emotion: Customers feel good about their experience. They have good things to say about the respirator program.
TP
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Who are your customers?
Respirator Wearers Trainees
New Employees – Initial
Existing Employees –Annual
Asbestos and Lead Workers who get “respirator training” as part of other courses(have you audited that course)
Others?
Contractors
Voluntary Users
Employees Undergoing Medical surveillance
Fit Test Subjects
QLFT Subjects
QNFT Subjects
New Employees
Experienced Employees
Asbestos Workers
Lead Workers
Carpenters
Stone Mason
Spray Painters
Emergency Response Team Members
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Clearly identify who you’re serving!
Understanding our Customers: Personas
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Representative description that includes…
• Objectives and needs• Patterns and traits• Emotive – motivations & values• Preferences – communication, likes, dislikes
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What do personas tell us?
What our customer thinks is important Values
What motivates our customer Goals and objectives
What our customer knows Experience, education
What our customer needs from us Basic products and services, priorities
Who our customer talks to and influences Influencers and impact
What is a Customer Persona?
September 3, 20XXAnnual Review 37
How will you use a Customer Persona?
Help the organization understand who the customer is and what he/she wants and needs.
Design service/support processes
Design programs customers want
Communicate in the way that helps customers learn/listen
Build staff empathy skills
What is the purpose of a Customer Persona?
September 3, 20XXAnnual Review 38
What is a Journey Map?
September 3, 20XXAnnual Review 39
Attributes
Doing What actions are they taking? Touch points?
Thinking What is the customer thinking at each step?
Feeling How is the customer feeling at each step?
Pain Points What are the drivers of effort, friction, or rework?
Expectations What does your customer want and need?
Moments of Truth How and where is satisfaction created (or lost)?
Research Evaluate Acquire Use Renew Advocate
Journey map are living documents that drive customer insights, areas of focus, and measurements. They tell the story of the customers’ experience.
04. Establishing Desired Outcomes
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ISO 45001
5.4 Consultation and participation of workersThe organization shall establish, implement andmaintain a process(es) for consultation andparticipation of workers at all applicable levels andfunctions, and, where they exist, workers’representatives, in the development, planning,implementation, performance evaluation andactions for improvement of the OH&Smanagement system.
April 15, 2021Using CX Concepts to Achieve Better Outcomes
Respiratory Protection Improvement Team
Ana
HR Manager
Larissa
Procurement Specialist
Roman
Asbestos Crew Supervisor
Federico
Fit Test Administrator
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Others: Occupational Health Specialist/Nurse; EHS Trainer, Respirator Users, Respiratory Protection Program Manager, etc.
April 15, 2021Using CX Concepts to Achieve Better Outcomes
Using CX Concepts to Achieve Better Outcomes
Respiratory Protection Program Improvement Strategy
Mission------------------Core Values
Outcomes(What do we want?)
Behaviors(What should we do to accomplish the
outcomes?)
Assets(What do we have?)
Question #1: Are the assets sufficient for the outcomes?
Question #2: Are the assets enough for the required behaviors?
Question #3: Will the behaviors accomplish the desired outcomes?
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Prevent occupationally-related lung disease and other regulatory-system related illnesses & injury.
Model respirator fit test program
Employees are issued properly fitted respirators
Only fit test administrators with “appropriate knowledge” and “experience” conduct fit tests
Respirators are of high quality
Scheduling fit tests are easy and convenient
Develop compliant written procedures for fit testing.
Ensure that individuals conducting fit testing have the appropriate knowledge and experience.
Provide training to fit testers.
Audit fit test operators.
Develop a robust Facial Hair Policy that incorporates the new NIOSH Facial Hair Position.
Work with HR to determine what measures can be implemented to ensure that employees who are required to wear respirators are clean shaven during use and at the time of fit testing (enforcement). This should include provisions for Position Descriptions (conditions of employment) and disciplinary actions if employees refuse to be clean shaven when wearing tight‐fitting respirators).
Education, experience and knowledge
Fit testing equipment
Written program with SOPs
Facial hair policy
Budge for respirators and other supplies
Full time EHS trainer
Respiratory Protection Program Improvements
Outcomes (What do we want?)
Assets (What do we have?)
Behaviors(What should we do to accomplish the outcomes?)
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Respiratory Protection Improvement Program Strategic Plan (1 Year)
1st Quarter
Medical Evaluation
2nd Quarter
Written ProgramChangeout Schedules
3rd Quarter
Voluntary Use
4th Quarter
Fit Testing including Facial Hair
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Objectives: Strategize, Harmonize, and Prioritize
Periodic Maintenance of Respiratory Protection Program
Question #1: What is working well?
Question #3:What can we do as a team to make the things that are not working well, work?
Question #2: What is not working well?
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05. CX Applied
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• Make them relevant
• Less is more (frequency and content)
• Ask the right questions (use open-ended questions)
• Have a goal in mind
• Use the results wisely
Surveys
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• 2nd Largest VA Hospital
• Feb – Oct 2010 (After 8 Months On-the-job)
• End of Fiscal Year Input on Performance
• Sent to Wide Range of Customers
• Had spent much of my time helping to shore up Haz Com – New Electronic MSDS System
• Helped identify chemicals (smartphone photos), create inventories, enter products into the MSDS system, print hard copies, set up reminders to refresh MSDSs, etc.
Survey – VA Haz Com Project
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• Quality of Work
• Dependability
• Team Work
• Communication
• [1-10, 10 being the highest score]
• [Option to send anonymously; and to provide comments]
Survey – VA Haz Com Project
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Survey – VA Haz Com Project
• Surveyed workers who I had good interactions with and some who I didn’t
• Next time, I would add questions like…“How could I have been more dependable”“How could I have communicated better?”
Survey – VA Haz Com Project
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Anything that compromises the form, fit or function of a respirator is strictly prohibited.
Add this simple statement to your written program
TP
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Who is going to take the responsibility of ensuring that the respirator use will not create a hazard, the voluntary user is provided the information in Appendix D, and document that the instruction has been provided? This is for an organization for which has no mandatory wearers (and therefore no respiratory protection program administrator).
Voluntary Use Program Administrator
DRM
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Develop a method to ensure that fit test administrators have the “appropriate knowledge” and “experience” through training, mentoring, and proficiency by way of examination and practicum to provide respirator fit testing. In other words, create your own way to “accredit” or “certify” that individuals can perform respirator fit testing. Use the Fit2Fit accreditation scheme as a guide.
Validate the proficiency of your fit test administrators
TP
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• Calibrate equipment as needed
• Perform tests properly, including preparation and any calculations
• Recognize invalid tests
• Ensure that test equipment is in proper working order
Fit test administrators must know how to...
TP
April 15, 2021Using CX Concepts to Achieve Better Outcomes
Focus Groups
New RespiratorWearers (within first six months)
Ask them about their experience with:
Training
Medical Evaluation
Fit Test
Respirator wearers who just got fit tested (within a week)
Ask them about their experiences.
Did the fit test administrator ask them to undergo a 5 minute comfort assessment period?
Did they explain the purpose of the fit test?
Respirator wearers who use a particular class of respiratory protection
Filtering Facepiece Respirators
PAPRS
Full facepiece air-purifying respirators
Escape hoods
Respirator wearers by job class
Healthcare workers
Asbestos workers
Lead workers
Spray painters
Carpenters
Stone masons
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TP
Sit them down over breakfast, lunch or afternoon of refreshments and light snacks
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Demonstration
Mind Map for Respiratory Protection Program Improvements
Mind Map for Face Coverings
Customer Personas Focus Group Questionnaire
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TP
April 15, 2021Using CX Concepts to Achieve Better Outcomes
There is only one boss. The customer. And he
can fire everybody in the company from the
chairman on down, simply by spending his
money somewhere else.
– Sam Walton
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Summary
Become a CX Champion. Treat the employees you serve as customers.
•Identify who you are serving
•Bring customers to life with personas
•Map the entire customer journey
•Analyze and act on data
•Identify common questions (FAQs)
New way of thinking: we should measure success in other ways (not just typical EHS metrics)
Establish desired outcomes (as a group, not just from an EHS perspective)
Work together to identify outcomes, assets & behaviors.
Roll up your sleeves and work towards identifying what is working well, what is not working well, and what improvements are needed.
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References: Books
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Resources: Respiratory Protection
AIHA Respiratory Protection Committee
AIHA Technical Framework: A Resource for Respiratory Protection Programs (to be updated – later in 2021 or early 2022)
ISRP – International Society of Respiratory Protection
National Personal Protective Technology Laboratory (NPPTL) - NIOSH
NIOSH eNews
Facial Hair Guidance
Dr. Roy McKay Newsletter (Univ of Cincinnati)
QLFT Guidance – Dr. Roy McKay (YouTube)
Social Media – Twitter & LinkedIn
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Resources: Customer Experience (CX)
Customer Experience Toolkit
The State of Federal CX (A webinar)
Solving the CX Puzzle (an article)
Qualtrics
Heart of the Customer
CX for Dummies
CX Journey
Forrester
The Northridge Group
Deloitte Center for Government Insights’ Government Trends 2021
Tim’s Drop Box with reference materials, samples, etc. (will expire by 05/15/2021)
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Thank you!
Feel free to contact me if you have questions or ideas for improving this session.
Tim Paz, CIH
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