Targeted Methods for Obtaining Feedback on Your EH&S Program Robert Emery, DrPH, CHP, CIH, CBSP, CSP, CHMM, ARM, CPP Vice President for Safety, Health, Environment & Risk Management The University of Texas Health Science Center at Houston Professor of Occupational Health The University of Texas School of Public Health

Change in Focus EH&S programs have changed in recent years – Originally “command and control”, regulatory driven – Now service oriented, with goal to support the organizational goals

Soliciting Feedback As part of this service orientation, reliance on feedback is crucial Feedback is typically obtained in four ways: – Unsolicited: usually complaints, rarely compliments – Training courses: smile sheets – A few generic questions as part of a larger organizational survey – Passive link on website: “let us know how we did”

Previous Efforts Previous client satisfaction work at UTHSCH focused on routine safety surveillance program Intended to evaluate staff performance in 5 persistently problematic areas – Interruptions, discourteous, – unknowledgeable, not technically proficient, – and waste not picked up Results overwhelmingly positive >90% approval ratings Unanticipated results – written comments: “thanks for asking!” Powerful tool for demonstrating program goodwill value to upper management

Major Challenge Feedback from surveys can be skewed or misleading if client expectations are not understood first The trick is to first understand what client expectation are, and then to conduct operations accordingly

Two Types of Client Expectations Realistic expectations that are perceived as not being achieved – Solution: recalibrate operations to meet expectations Unrealistic expectations that can never be met – Solution: educate client so that expectations can be adjusted

Measuring Expectations and Perceptions SERVQUAL tool Developed by Parasuraman et al. under the auspices of the Marketing Science Institute Research shows that customers evaluate firms by comparing service performance (perceptions) with service expectations

Five Dimensions of Service Quality Tangibles – appearance of staff, facilities Reliability – ability to perform promised service dependably and reliably Responsiveness – willingness to help clients and provide prompt service Assurance – knowledge and courtesy of staff which instills trust and confidence Empathy – caring, individualized attention

SERVQUAL Tool 22 paired statements split into two sections – Expectations – Perceptions Example: “When excellent cable TV companies promise to do something by a certain time, they will do it” Each statement evaluated on a 7 point Leikert scale Data summarized and graphically displayed, comparing expectations versus perceptions

Methods Modified questionnaire developed, consisting of 7 paired statements about EH&S program services – Areas of concentration: reliability, responsiveness, assurance, empathy Distributed to 280 principle investigators in paper form with a personalized, signed cover memo Survey form pre-labeled for return via campus mail

Results By the end of a 3 week period, 32% return rate Data entered into a spreadsheet and displayed graphically Overtly display to various stakeholders!

Benefits Results provide tangible evidence of program meeting the expectations of an excellent EH&S program Powerful leverage tool to gain needed resources Written comments identified other areas of concern Great for staff morale – feedback for work rarely acknowledged

Other Examples Clients of Radiation Safety Program Clients of Chemical Safety Program Clients who interact with Administrative Support Staff Employees and Supervisors Reporting Injuries Clients of Environmental Protection Program Services Determining the Level of Informed Risk

Administrative Support Staff Survey Results Summary distributed to 90 targeted faculty and staff clients across UTHSCH, with 54 responses in 30 days (60% response rate) QuestionsYesNoN/A Phone answered within 3 rings?78%2%20% Timely response to inquiries?93%2%8% Courteous response?94%3% If couldn’t answer, offer suggestions or alternatives? 66%2%34%

Administrative Support Program Client Satisfaction Survey (distributed to 90 targeted faculty and staff clients across UTHSCH, with 54 responses in 30 days (60% response rate) “ 7) Compared to other administrative personnel you interact with across UTHSCH, please indicate your impression of the level of proficiency of the EH&S Administrative Support Staff member demonstrates during your interaction with them”

No Care or Lost Time (18% response rate) Care But No Lost Time (57% response rate) Supervisors (13% response rate) Was this the first time you have reported an injury or exposure at UTHSC-H?67%(Y) 33%(N)62%(Y) 38%(N)37%(Y) 63%(N) Prior to the recent reported injury event were you aware of your obligation to report any injury or exposure?88%(Y) 12%(N) 96%(Y) 4%(N) Did you receive a copy of the completed first report of injury form?70%(Y) 30%(N)62%(Y) 38%(N)96%(Y) 4%(N) To your knowledge has the source of your injury or exposure been addressed?81%(Y) 19%(N)88%(Y) 12%(N) Did you encounter any issues with the reporting process that you didn’t know or anticipate?12%(Y) 88%(N)38%(Y) 62%(N)27%(Y) 73%(N) Our records indicate that you did not receive any health care in response to your injury or exposure. Who made the determination that health care was not needed? 72% Yourself 9% Supervisor 19% Other Have you experienced any residual affects from your injury or exposure?9%(Y) 91%(N)12%(Y) 88%(N) Where did you access health care?53% Employee Health 20% Student Health 27% Other Please indicate your impression of the level of service provided by the health care provider who addressed your injury or exposure? 38% Very Good 44% Good 6% Average 0% Poor 12% Very Poor Were you able to easily access the necessary Supervisor's First Report of Injury form?92%(Y) 8%(N) If any assistance was needed in order to complete and submit the Supervisor's First Report of Injury form, was this assistance readily available? 46% (Y) 8% (N) 46% (none needed) Were you provided with the information needed for you to effectively manage the affected employee?100%(Y) 0%(N) Survey of Employees and Supervisors Filing UTHSC-H First Reports of Injury in 2007 ( based Zoomerang survey for period February 2007 to August 31, 2007) Injured Employees Requiring Care and Lost Time (n = 39): Not Included in survey, as each injured worker that accrues lost time is assigned a case manager to personally assist in the rehabilitation process. Employees requiring care, but no lost time (n = 28) Employees not requiring care, no lost time (n = 179) Employee Population (not reporting any injuries, n = 4,181)

Summary Institutional EH&S programs are service intensive operations Important to understand client expectations before measuring satisfaction Formal surveys quantify intangibles Other possible applications surely exist Great way to capture and display program’s goodwill value!

References Emery, R.J., Sawyer, R.L., Sprau, D.D., "Assessing the Service Provided by an Institutional Radiation Safety Survey Program" Health Physics, 70(5): , Emery, R.J., Savely, S., "The Benefits of Actively Soliciting Worker Concerns During Routine Safety Inspections" Professional Safety, 42(7): 36-38, Emery, R.J., "Adding Value to Your Radiation Protection Program", Chapter in Roessler, C.E. Management and Administration of Radiation Safety Programs, Medical Physics Publishing, Madison, WI Parasuraman, A., Berry, L.L., Zeithaml, V.A., Guidelines for measuring service industry quality. Marketing Research, American Marketing Association., December 1990

UTH EHS