Who then is my customer?

Two weeks ago I had the privilege of taking part in the IAIDQ’s Ask the Expert Webinar for World Quality Day (or as it will now be know, World Information Quality Day).

The general format of the event was that a few of the IAIDQ Directors shared stories from their personal experiences or professional insights and extrapolated out what the landscape might be like in 2014 (the 10th anniversary of the IAIDQ).

A key factor in all of the stories that were shared was the need to focus on the needs of your information customer, and the fact that the information customer may not be the person who you think they are. More often than not, failing to consider the needs of your information customers can result in outcomes that are significantly below expectations.

One of my favourite legal maxims is Lord Atkin’s definition of who your ‘neighbour’ is who you owe legal duties of care to. He describes your ‘neighbour’ as being anyone who you should reasonably have in your mind when undertaking any action, or deciding not to take any action. While this defines a ‘neighbour’ from the point of view of litigation, I think it is also a very good definition of your “customer” in any process.

Recently I had the misfortune to witness first hand what happens when one part of an organisation institutes a change in a process without ensuring that the people who they should have reasonably had in their mind when instituting the change were aware that the change was coming.

My wife had a surgical procedure and a drain was inserted for a few days. After about 2 days, the drain was full and needed to be changed. The nurses on the ward couldn’t figure out how to change my wife’s drain because the drain that had been inserted was a new type which the surgical teams had elected to go with but which the ward nurses had never seen before.

For a further full day my wife suffered the indignity of various medical staff attempting to figure out how to change the drain.

  1. There was no replacement drain of that type available on the ward. The connections were incompatible with the standard drain that was readily available to staff on the ward and which they were familiar with.
  2. When a replacement drain was sourced and fitted, no-one could figure out how to actually activate the magic vacuum function of it that made it work. The instructions on the device itself were incomplete.

When the mystery of the drain fitting was eventually solved, the puzzle of how to actually read the amount of fluid being drained presented itself, which was only of importance as the surgeon had left instructions that the drain was to be removed once the output had dropped below a certain amount. The device itself presented misleading information, appearing to be filled to one level but when emptied out in fact containing a lesser amount (an information presentation quality problem one might say).

The impacts of all this were:

  • A distressed and disturbed patient increasingly worried about the quality of care she was receiving.
  • Wasted time and resources pulling medical staff from other duties to try and solve the mystery of the drain
  • A very peeved and increasingly irate quality management blogger growing more annoyed at the whole situation.
  • Medical staff feeling and looking incompetent in front of a patient (and the patient’s family)

Eventually the issues were sorted out and the drain was removed, but the outcome was a decidedly sub-optimal one for all involved. And it could have been easily avoided had there been proper communication about the change to the ward nurses and the doctors in the department from the surgical teams when they changed their standard. Had the surgical teams asked the question of who should they have in their minds to communicate with when taking an action, surely the post-op nurses should have featured in there somewhere?

I would be tempted to say “silly Health Service” if I hadn’t seen exactly this type of scenario play out in day to day operations and flagship IT projects during the course of my career. Whether it is changing the format of a spreadsheet report so it can’t be loaded into a database or filtered, changing a reporting standard, changing meta-data or reference data, or changing process steps, each of these can result in poor quality information outcomes and irate information customers.

So, while information quality is defined from the perspective of your information customers, you should take the time to step back and ask yourself who those information customers actually are before making changes that impact on the downstream ability of those customers to meet the needs of their customers.

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