Moving Past Active Listening to Facilitate Communication: Shifting the Paradigm

GearsIn several previous professional positions, especially those in call centers, there has been considerable time spent training people to actively listen.  The problem; active listening can be faked, and fake active listening is as useful as a shower without soap or shampoo.  You might get wet, but you do not feel clean.

Listening has four distinct levels, these are:

  • Inactive listening – Hearing words, seeing written communication, zero impact mentally. Mostly because your internal voices drown out the possibility for communication.
  • Selective listening – Hearing only that which confirms your own voices, opinions, and biases. While others are speaking, you are already forming your response.
  • Active listening – Show the other person you are paying attention, engage with meaning in a reply. Focused upon removing barriers to get your point across.
  • Reflective listening – Paying attention to intent and content, reducing emotion, two-direction as both parties are engaged in achieving mutual understanding.

Tools for listening effectively, which for all intents and purposes, means listening reflectively, requires several tools, along with considerable experience in using these tools.  Customer service focus – not sales in disguise, not having a hidden agenda, and not covertly looking for opportunities to turn the conversation back to you.  The attitude of service – is all about what your intention is after listening.  Sales are all about attitude and winning over someone else; however, how many sales require first being able to reflectively listen; every single one.  Desire – desire determines your choices, your choices form decisions, and decisions determine destiny!

ElectionConsider the press conferences at the White House.  A room is full of people who would claim they are professional listeners, who then report what is being said.  Yet, how many times do you see questions asked with an agenda, personal opinions warping what is said into what they desired to hear, and then reporting what they erroneously heard to satisfy their desires politically; every single time.  Hence, the problems with active listening and how active listening can be faked.  Desire and attitude of service are not being applied to improve customer service focus.

Communication occurs in two different modalities, verbal and non-verbal.  Good communicators adapt their message to the audience.  Adapting the message requires first a choice, determining who the primary and secondary audience is, then focus the message onto the primary audience.  Next, adaptation requires prior planning, which includes mental preparation, practice, and channels for feedback.  Finally, adaptation requires listening to achieve mutual understanding, careful observation, asking questions designed to lead to mutual understanding, and clarifying what is being said to achieve mutual understanding.

Too often, those labeled as “good communicators” cannot listen reflectively.  They have never learned how to use the tools of desire and attitude of service, in a manner that builds customer service focus into reflectively listening.

Leadership CartoonConsider two people the media has proclaimed as great communicators, Presidents Reagan (R) and Obama (D).  President Reagan was listened reflectively, asked good questions, listened to the answers, asked more questions, and then listened some more.  In listening and asking questions, President Reagan built people (customer service focus) and was respected by enemies and friends for his ability to communicate (personal desire determined destiny).  President Obama has been labeled by the media as a good communicator; but by all accounts, he never listened, his questions showed he desired to be heard, and his focus was all on him as the smartest person in the room.  Desire builds an attitude of service, which then forms the customer service focus, which then reflects a desire to reflectively listen and achieve mutual understanding with those being communicated with.

One of the most despicable problems in customer service today is a theme established by Stephen Covey, “Most people do not listen with the intent to understand; they listen with the intent to reply.”  On a recent issue, a letter was sent to Senator Martha McSally (D) of Arizona, the response has formed the epitome for not listening in written communication as the response had nothing of the original issue even discussed.  The response was a form letter, on a different topic, and lacked any response that the sender had been heard; but, the letter advertised Sen. Martha McSally and her commitment to listening to her constituents.  But, you might say, a Senator is too busy to respond to every communication delivered, a few other examples of both verbal and non-verbal communication failures.

  • Two lieutenants, representing the Department of Veterans Affairs, Federal Police Service, stationed at the Phoenix VA Hospital. Engage a person not wearing a mask.  Body language clearly states they are the authority and will broker no resistance.  The officers spend 45-minutes haranguing the patient before cuffing and frog-marching the patient to a holding cell, where the patient who was seeking services in the emergency room, waits for an additional 60-minutes before being forced off Federal Property.  The patient informed the officers multiple times of their pre-existing condition and inability to physically wear a mask.  The hospital mask policy allowed for a face shield to be worn instead of a mask, and after the patient put the face shield on, the officers continued to verbally engage without listening, until the foregone conclusion of arresting the patient could be justified.  The patient was fined $360.00 (USD) for “disorderly conduct” by refusing to wear a mask.
  • Calling a major cellular phone provider (AT&T) with questions about the price plan. The representative answered every question but needed to make a sale, and their focus was on making that sale, not on assisting the customer.  Not the agent’s fault, the policy of the call center is to up-sale on every call.  If the agent does not up-sale, the call is automatically downgraded in quality assurance and the agent gets in trouble.  Hence policy dictates that the customer not be listened too reflectively as the sale must come before the customer.
  • Hotel check-in, online registration was made specifically for a particular sized bed, but due to late check-in, the customer is not provided what was asked for, and the attitude of the clerk is one of disgust at being bothered. Verbal and nonverbal cues are sending messages that the customer is the problem and is interrupting the life of the clerk.
  • A patient receives a call to make an urgent appointment with a VA medical provider in general surgery. The medical provider has demanded the patient be seen in the clinic, thus negating a phone or video styled appointment.  The patient’s record clearly states the patient has trouble complying with mandatory masking for patients seen in the clinic.  The provider arrives 20+ minutes late to the appointment, and because the patient is not wearing a mask immediately refuses to see the patient, wasting 90-minutes of the patient’s day.  The provider gets off in 10-minutes, and seeing the patient will make the provider late getting off.  Was the mask really the problem; not likely.

Social Justice Warrior 2Not listening is probably the largest social problem in the world today.  Everywhere fake active listening is observed, along with copious amounts of observable inactive, selective, and active refusals to listen.  Some of the problems in improving listening are policies and procedures that do not allow for individual adaptation or situational understanding.  However, too often, the individual choices to grab power, exercise authority, and pass along inconvenience are the real problems in not listening.  Harvey Mackay is reported to have said, “Easy listening is a style of music, not an attribute of communication.”  Proving again that listening is a choice, a personal choice, borne from desire, bred on attitude and reflected in verbal and non-verbal patterns of communication.

The following are some launch points for improving listening in society:

  1. Understand your desire.  Know that your desire choices are determining your destiny.  If your destiny is not one, you appreciate, return to the desire and make different choices.
  2. Practice mental preparation, based upon previous situations, to make different choices. Listening is a voyage of discovery to reach a mutual understanding, but mental preparation is key to safely reach the destination.  Prepare, use a mirror, practice until what currently feels alien becomes familiar.
  3. Reduce emotion. The principle of empathy and sympathy are destroying listening and only reflect the internal voices.  The volume of internal voices is silencing the ability to reflectively listen, necessitating the need to fake actively listening for employment’s sake.
  4. Listen as you would have others listen to you. This is an adaptation of the “Golden Rule” and remains applicable as a personal choice.  How you choose to listen will determine your destiny.
  5. Listening remains the number one tool you control and has application to written communication and verbal communication channels. Body language is a non-verbal communication channel that can be heard as well as seen.  How are you communicating non-verbally, which is interfering with your written and verbal communication attempts?

Listening is a choice.  Listening is hard.  Yet, many people have pointed out that we have two ears and one mouth so we can listen twice as often as we speak.  Choose to reflectively listen, choose to reach a mutual understanding, watch your destiny change.

© Copyright 2020 – M. Dave Salisbury

The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/

Realities and Uncertainties – The Paradigm at the VA

I-CareThe Department of Veterans Affairs – Office of Inspector General (VA-OIG) reports they are returning to a more regular schedule of release for the inspection reports with the Department of Veterans Affairs (VA) recovering from COVID-19.  Congratulations are in order, to the VA, as they begin returning to normal operations and procedures.  The reality is that standard operating procedures (SOP) are regularly missing at the VA, this absence causes uncertainty, and forms the crux of this report. A question for the VA-OIG, “How can you assess employee competency without SOPs?”  To the VA VISN leaders, “How can your directors and supervisors, conduct employee evaluations without written SOPs?”  The short answer is you cannot!

Congratulations are in order, for the Marion VA Medical Center (VAMC) in Illinois.  The Marion VAMC experienced a “comprehensive healthcare inspection” and were generally praised for the excellent work being conducted, the happiness of the patients, and the overall condition of the facilities.  While there were recommendations made by the VA-OIG (29 in 8 different areas), the overall report was satisfactory, and this is mentionable.  Hence, my heartfelt congratulations for your success in this inspection.

VA SealThe Marion VAMC VA-OIG report raises a common theme, and this is a reality the VA appears to be incapable of addressing training and two-directional communication.  From the hospital director to the patient-facing staff, training always appears as a significant issue in VA operations.  Having experienced the training provided by the VA for employees, and as an adult educator, I know the uselessness of the training program and have several suggestions.  Perhaps the problem would be best addressed if more evidence was provided of a systemic failure in training employees at the VA.

In 2017 Congress mandated a change in research operations for the VA, specifically where canine research was concerned.

The OIG found VHA conducted eight studies without the former or current Secretary’s direct approval, resulting in the unauthorized use of $393,606 in appropriated funds.VA continued research using canines after the passage of the funding restrictions, in part, because VHA executives perceived that then VA Secretary David Shulkin had approved the continuation of the studies before his departure.”

The cause of the problem, the VA-OIG discovered was, “Unclear communication, inadequate recordkeeping, and failure to ensure approval decisions were accurately recorded and verified all contributing to VHA’s noncompliance.”  The researchers and executives relied upon two leading causes for not following regulations, designed incompetence, and a lack of training through clear and concise communications.

Congress mandated the documentation to assure approval was obtained before research commenced; yet, the researchers and administrative staff collectively failed to do their jobs and were able to hide behind the bureaucracy they established to excuse their poor behavior.  Loopholes for designed incompetence and lack of training need closed; but, two incidents do not clearly illustrate the reality of the problem.

ProblemsThe VA Southern Nevada Healthcare System in North Las Vegas, in response to a referral from the U.S. Office of Special Counsel (OSC), was investigated by the VA-OIG after a community healthcare worker was attacked.  The VA-OIG findings are appalling, but the reasons for the problem are worse.

The OIG determined that facility managers failed to timely respond after the social worker reported an assault during a home visit and did not address the social worker’s health needs after the assault. The social worker’s supervisor failed to immediately report the incident to the community and VA police. The facility’s policies lacked specific guidance regarding employee emotional and mental health injuries. Further, the OIG substantiated that the social worker was not informed by a supervisor of a homicidal threat, occurring subsequent to the assault, until two weeks after facility leaders became aware of the threat.”

The facility leaders knew there was a problem, yet did nothing before or after the event, that could have cost this healthcare worker their life!  VA-OIG recommendations boil down to a need for clear communication and staff training.  The recommendations highlighted another issue entirely that forms the reality and creates uncertainty at the VA, communication is not a two-directional opportunity to share information.  Single directional communication is useless, and those leaders supporting the bureaucracy to only allow communication to flow in, need immediate removal from the VA.  During my time at the VA as an employee on the front-lines, facing patients, I regularly experienced the lack of communication, and this issue is systemic to the entire VA as witnessed and observed at VA Medical Centers across the United States.

The Nevada incident is deplorable, reprehensible, and the potential for loss of life cannot be overlooked by VA leadership in Washington, at the VISN, or at the Medical Center any longer!  The problems of communication cannot explain this incident, and failure for training cannot excuse this behavior!  Since the OSC initiated the complaint, I am left to wonder, did the employee reporting this incident get fired and needed to appeal to the OSC for remediation?  I ask because the knee-jerk reaction to problems at the VA is to fire the person reporting the issue, as previously observed and personally experienced, and as described to Congressional representatives during televised hearings.  A more thorough investigation into causation needs to be concluded and reported to Congress for this incident reeks of politics and CYA.

Leadership CartoonThe Harry S. Truman Memorial Veterans’ Hospital in Columbia, Missouri, and multiple outpatient clinics was recently provided a comprehensive healthcare inspection, and the leadership team provided 14 recommendations in 7 different areas for improvement.  While congratulations are in order, for the patient scores, the employee scores, and the overall conditions discovered.  Yet, again staff competency, e.g., training and communication, remain critical articles requiring targeted improvement.  Is the pattern emerging discernable; in Nevada, an employee is assaulted and training and communication are blamed, comprehensive healthcare inspections are conducted in three different geographic areas and the same causation factors discovered; training and communication are systemically failing at the VA.  But, the evidence continues.

The John J. Pershing VA Medical Center in Poplar Bluff, Missouri, recently underwent a comprehensive healthcare inspection.  The VA-OIG issued 17 recommendations in 6 fundamental areas, including staff competency assessments, e.g., training and communication, as well as the inadequate written standard operating procedures.  When discussing designed incompetence, the first step to correcting this problem is writing down the standards, operating methods, and procedures.  Then the medical center leaders can begin training to those standards.  Barring written instructions and published standards, employees are left to ask, “What is my job? and “How do I perform my job to a standard?”

The Oscar G. Johnson VA medical center, and multiple outpatient clinics in Michigan and Wisconsin recently underwent a comprehensive healthcare inspection, 11 recommendations in 3 critical areas.  As did the Tomah VA Medical Center and multiple outpatient clinics in Wisconsin, 4 recommendations in 3 crucial areas.  Both facilities are to be congratulated for their continual improvement and their success during the inspections.  In case you were wondering, staff competency assessments, e.g. training and communication, are vital findings and variables in improving further for both facilities.

The VA has what it calls “S.A.I.L” metrics that form the core standard for performance.  S.A.I.L. stands for Strategic Analytic (sic) for Improvement and Learning.  Learning is a critical component in how the facility is measured and yet remains a constant theme in the struggles for improvement.  Thus, not only is two-directional communication a systemic failure, but so is the poor training results found on all the comprehensive healthcare inspections performed by the VA-OIG.  Poor communication almost cost a healthcare worker their life, and staff training was a key component for recovering from this incident in Nevada.  How can the VA consistently fail at two-directional communication and training, designed incompetence?  Those in charge require an excuse for not doing their jobs, and the most common excuse provided is a lack of training and poor communication.

I-CareIt is time for these petulant and puerile excuses to be banished and extinguished.  The following are suggestions to beginning to address the problems.

  1. Easy listening is a musical style, not an action in communication.  By this, it is meant that the VA needs to stop faking active listening and engage reflective listening.  Reflective listening requires reaching a mutual understanding and is critical to two-directional communications.  In the world of technology, not responding to email, not responding to text messages, and untimely responses to staff communication are inexcusable on the part of the leaders.
  2. Staff training remains a core concept, but before staff can be properly and adequately trained, standards for performance, operational guidelines, and procedural actions must be clearly written down. The first question I asked upon hire was, “Where are the SOPs for this position?”  I was told, “Do not mention SOPs as the director hates them and prefers to work without them.”  Do you know why that director preferred to work at the VA without SOPs because she used it as an excuse to get out of trouble, to fire those she deemed trouble makers, and to escape with her pension and cushy job to another VA medical center?  A repeatable pattern for poor leaders to spread their infamy.  Shame on the VA Leaders for promoting this director to a level beyond her incompetence.  Worse, shame on you for creating an environment where many like her have excelled and done damage to the VA reputation, mission, and patients, including killing them while they awaited care.
  3. From the VA Secretary to the front-line patient-facing employee, cease accepting excuses. The private sector cannot hide behind immunity from litigation and act in a more responsible manner.  Thus, the VA needs to benchmark what private hospitals do where staff training and SOP’s are concerned.  Benchmark from the best and the worst hospitals for an average, then implement that average as the standard.  One thing discovered in writing SOPs for the NMVAMC, the committee for approving SOPs, and the process for writing SOPs were so convoluted and time-intensive that the SOP was outdated by the time it could be implemented.  Shame on you VA leadership for creating this environment!
  4. Training should be an extension of an organizational effort and university. The VA is not properly training the next generation of leaders; thus, the problems multiply and exponentially grow from generation to generation.  Launch the VA Learning University concept, staff that university with adult educators, and allow lessons learned from the university to trickle into operational excellence.
  5. Form an independent tiger team in the VA Secretary’s Office who has the authority to travel anywhere in the VA System to conduct investigations with the ability to enact change and demand obeisance. The Nevada incident was a failure of leadership and needs a thorough reporting and cleansing of the bad actors who allowed that situation to occur.  Worse, in my travels, I have heard many similar stories.  I heard of a patient getting their ear chopped off when a veteran assaulted another veteran after becoming irate at waiting times in the VA ER.  I have heard and witnessed multiple incidents of furniture being thrown, employees being assaulted, employees harassing and assaulting patients, staff property trashed, and so much more.  These incidents need direct intervention and investigation by a party not affiliated with that affected VAMC and the leadership’s political policies.

Carl T. Hayden04 October 2016, the VA-OIG released a report on dead veterans after the comprehensive investigation into the Carl T. Hayden VAMC in Phoenix, Arizona.  The same event occurred in 2014, at the same hospital, with the same causes and the same conclusions.  The core causes for the dead veterans, no written procedures, poor to no training, and reprehensible communication practices.  The Phoenix VAMC went out of their way to fire all the employees who reported problems at the Phoenix VAMC before the veterans began dying in 2014, I can only speculate that the same occurred in 2016.  Staff was frightened in 2014; they are demoralized in 2020.  Nothing has changed at the Carl T. Hayden VAMC in Phoenix, Arizona, after two successive hospital directors, if anything the problems have worsened.  The problems worsened because leadership failed to act, failed to write down SOPs, failed to communicate, and failed to train.  The hospital directors since 2014 have been appointed from the same pool of candidates who created dead veterans in the first place, and that is a central failure of the VA Secretary and Congressionally elected representatives’ failure to act!

How many more veterans or staff must die before the VA is willing to act?

© Copyright 2020 – M. Dave Salisbury

The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/

Dane-Geld: A Warning to the Mayors and Governors of America

Dane-GeldDane-Geld is “a land tax levied in medieval England, originally to raise funds for protection against Danish invaders.”  The 11th Century saw many frightened landowners who wanted peace raised money to pay-off the warring tribes of the north, called Danes.  From across the land, the rulers gathered penny and pound to buy protection from these warring tribes.  When the Dane’s saw how easy it was to obtain gold, they moved in and took the lands, and whole civilizations dropped into barbarianism, and the only reason we know these stories today, were the warring tribes of the Dane’s met cold steel in a furious fist and were beaten back.

Rudyard Kipling wrote a poem on this topic, called coincidently enough, “Dane-Geld.”

“It is always a temptation to an armed and agile nation
To call upon a neighbour and to say: —
“We invaded you last night–we are quite prepared to fight,
Unless you pay us cash to go away.”

And that is called asking for Dane-geld,
And the people who ask it explain
That you’ve only to pay ’em the Dane-geld
And then you’ll get rid of the Dane!

It is always a temptation for a rich and lazy nation,
To puff and look important and to say: —
“Though we know we should defeat you, we have not the time to meet you.
We will therefore pay you cash to go away.”

And that is called paying the Dane-geld;
But we’ve proved it again and again,
That if once you have paid him the Dane-geld
You never get rid of the Dane.

It is wrong to put temptation in the path of any nation,
For fear they should succumb and go astray;
So, when you are requested to pay up or be molested,
You will find it better policy to say: —

“We never pay any-one Dane-geld,
No matter how trifling the cost;
For the end of that game is oppression and shame,
And the nation that pays it is lost!”

Who, pray tell, is the modern Dane’s?  We currently call them Black Lives Matter (BLM), Antifa, and other extremist factions in American Society.  We call them ISIS, we call them terrorists.  For terrorists they are, and terrorist history has called them from day one.  Requiring a fearful reputation for violence, these people come to disrupt society, damage business, destroy goods, and wreak untold havoc and destruction.

Gadsden FlagMayors, Governors, you have a choice, to pay the Dane his pound of gold, or to fight the terror in society and be remembered.  The Mayor in Philadelphia during the riots past gave up entire city blocks for the Dane’s of her city to destroy, the Dane’s were not appeased, they moved in, and now control larger sections of the city than ever before.  Seattle’s mayor recently paid the Dane’s and has become the laughingstock of America over CHAZ.  Minneapolis, Detroit, Chicago, and so many other cities across America have bent the knee, paid the gold, and will never be rid of the Dane.

You can try and appease a mob.  You can fight a mob.  These are your only two options.  There is not third selection possible, for the mob, you fear today will be your rulers in captivity tomorrow.  Ask the city of Philadelphia if they like their new rulers.  Ask the community of Watts in LA if they like their rulers post LA Riots.  You can break a mob into individuals and hold them accountable, and you can try to pay off a mob, but you cannot do both, and you will lose short-term or long when you act against the mob.  Better to lose short term and win, then appease and lose everything to the rule of a mob.

For those city councils crying to appease the mob with defunding the police, I would that you would take a hard look at the closing stanza from Kipling.

“We never pay any-one Dane-geld,
No matter how trifling the cost;
For the end of that game is oppression and shame,
And the nation that pays it is lost!”


If you replace the word “nation” with city and county, you will understand the stakes you are suffering under currently.  I cannot stress enough the need for you to rise up, put some backbone on, tie on your work boots, and go to war against the powers of oppression and tyranny.  Call in the National Guard, the State Militias, we the sheepdogs of war will respond.  Do not allow America to fall on your watch because you think paying Dane-Geld is easier and more respectable.  For I promise you, if you do not stand against the tyrants today, the rest of America will have to stand against a stronger and more violent tyrant tomorrow!

The mobs, the rioters, and the looters currently rampaging are domestic terrorists, and make no mistake their sole aim is to destroy your town, your city, your county, your state, and your country!  Quoting from President Roosevelt, “We, too, born to freedom, and believing in freedom, are willing to fight to maintain freedom. We, and all others who believe as deeply as we do, would rather die on our feet than [to] live on our knees.

National GuardJoin us, ye politicians, who tremble!  Military Crests

 

© Copyright 2020 – M. Dave Salisbury

The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/

Plasticization of Words and the American Political Left – Shifting the Paradigm

Non Sequitur - Plasticity of LanguageI love words; I was taught from a young age three invaluable lessons:

  1. Speak the King’s English with exactness.
  2. Correctly pronounce and enunciate your words.
  3. If you do not know what a word means, and misuse it, you are wrong and must correct your mistake immediately.

Growing up, these rules were inviolable.  You could use any word you knew the definition of; but, you had better pronounce that word, enunciate, and be able to defend yourself when asked.  Since 1990, I have become detested with two things the American Political Left has chosen to do that is atrocious and worthy of the vilest condemnation, racism, and the plasticization of words.

As a student of history, the American Political Left has, from the inception of political parties, been telling lies to hide political skullduggery and shenanigans, to obfuscate issues, and derail issues.  The plasticization of words has shamed many a person, has cast doubts that have ruined elections, and been exercised tirelessly to tear America apart.

Pentagon BureaucracyConsider a term oft used to describe the political left, “Social-Justice Warriors.”  Long have I asked my political left-leaning colleagues what this term means, how it applies, and the veracity of the term as a description of societal action.  Breaking down the term, we find three definitions taken from Dictionary.com:

Social: Adjective – relating to society and its organization; Noun – informal social gathering

Justice: Noun – just behavior or treatment; administration of law or authority

Warrior: Noun – an experienced soldier or fighter

Social Justice WarriorThus, to extrapolate meaning from the definitions, one would conclude a social justice warrior is “a person in society, looking for the social administration of law, who has experience fighting for the proper administration of law.”  Yet, the definition from the dictionary for this term is 180-degrees different and is termed derogatory, “a person who expresses or promotes socially progressive views.”  Those rioting and looting in the streets got there because a social justice warrior enraged the community on an issue that is racist, one-sided, and emotionally driven.  Lest it is forgotten, the term being applied to the people driven by emotion to launch protests that become mob violence is derogatory in nature, critically disrespectful of the person calling themselves a social justice warrior.  But, the social justice warrior carries this title as if it were a compliment and a badge of the highest esteem.

Thus, language is plasticized to confuse, interfere, and claim moral superiority, while at the same time damaging the basic fiber of America, destroying small businesses, and ruining commerce.  In reviewing the historical records of riots in America, the term social justice warrior appears to have cropped up as a neutral or possibly positive term in the 1990s, but by 2011 the term had gained its derogatory connotations with the rise of social media.  Many victims of social justice warriors claim they have been “thought policed,” “word policed,” attacked for not being appropriately centered on progressive politics.  The social justice warrior is often extremely biased, self-aggrandizing, sanctimonious, but first, last, and always puerilely unreasonable!

Social Just Warriors 5A recent attack by a social justice warrior regarded the inability of poor black people to have government-issued photo ID, and that without that photo ID, the poor black person would be disenfranchised in exercising voting rights.  My response was that holding any person down by race was racist, and the social just warrior preceded to become unhinged.  Let us be clear, anytime a person’s race is the sole reason that person, or group of people, cannot take part in something, is racism, and the person espousing that opinionated garbage is racist.

In fourth grade, shortly after the Christmas Break, Governor Anderson Elementary School, Belfast Maine.  The teacher is Mrs. Ohlund, I am repeating fourth grade because I was accused of being socially unprepared for fifth grade.  I express doubts about Martin Luther King and a negative opinion regarding “Black History Month.”  Then I am falsely accused, for the first of many times, of being racist.  I lost three recesses, had to write a paper by way of apology, and was forced to spend the rest of “Black History Month” not participating in the events planned and scheduled.

Social Justice Warriors 4From that day to this, I have been attacked for not seeing race, not being sensitive to the race of others, and refusing to allow a person’s race to be an excuse for poor performance, bad language, and infantile public and private behavior.  I remain unapologetic; I am not a racist!  I hold myself to the highest standards publicly and privately as my first obligation to society.  Without regard to race, color, creed, etc. I hold others to the same standards.  I am willing to teach and remain willing to learn as my second obligation to society.

Senior Chief Cloud (DCCS) gave me a tongue lashing in the US Navy because I could not understand the verbal interlocution of a second-class petty officer.  The second-class petty officer used “Ebonics,” while on duty as a form of speech, and I had no idea what he was saying.  Off-duty, this same second-class petty officer spoke differently and I was able to understand him, just fine.  I was accused of being racist, disrespectful, and obstinate for not understanding the intentional speech patterns of a higher-ranking person.

Social Justice Warrior 2I quickly learned that if any other race of person employed “Ebonics” they were told to speak properly, but there was a pass for black people.  When I pointed out this was racism, I was sent up on charges for being disrespectful to see the Commanding Officer.  In the US Army, I was the only white person in my squad in S. Korea.  I was never invited to squad parties, social get-togethers, or allowed into training.  I asked why I was being excluded and was told it was because the squad leader did not understand white people.  The command structure supported the exclusion, and I was left without support as a new soldier in the US Army.

When white people treat black people in a manner that segregates, separates, or allows lower standards based upon race, this is considered racism, and rightly so.  Yet, when black people reflect the exact same behaviors, the socially progressive elements in America rush to defend this behavior, and it is still racism.  The term racism sees no colors, understands no race, and cannot distinguish between people.  The term racism has been plasticized and forced into seeing colors and races, but only when directed in one direction towards black people; and, this is wrong!

In S. Korea, I met some of the most amazing people, gifted, talented, intellectually brilliant.  In S. Korea, I never felt I was a foreigner; the people accepted my small gestures to learn the language and were very kind.  Yet, in South Chicago, South Detroit, Bakersfield, Palisades, and other traditionally black neighborhoods, I am a foreigner, and the people not only treated me like scum on their blocks but insisted I did not belong.  How is it, I can feel more welcome in a foreign country, than on American soil, simply because of my race; this is racism!  The same is true when I visited Bahrain, and the Rock of Gibraltar, highly integrated societies, where I was the foreigner but was never treated as a foreigner or an outsider.  But, travel to Jersey City, Burlington, or Baychester and I was told to wear armor because I was going to be shot.  As a point of interest, Bruce Willis has this same problem in the movie Die Hard 3, and Hollywood treated that overt racism as a movie plot; this is wrong!

Social Justice Warrior 3In the name of racial equality, America has been taught since the early 1980s that words create problems, and some words cannot be used by “white people.”  This behavior is inherently racist and spreads the problems of race, not improving racial relationships.  During President Obama’s reign, America learned that peanut butter and jelly sandwiches are racist.  Fluffernutter sandwiches are racist.  But, this is not so, they are sandwiches, food, and delicious.  Yet, through plasticization and a social justice warrior, suddenly, a staple of millions of people is now “off-limits” and cannot be consumed.  My local sandwich shop had to stop selling a peanut butter honey spread on bagels as a sandwich option because the owners feared being picketed.

It is time for Americans to stand together against the tyranny of plastic words.  Terms see no race, color, creed, and can do nothing but form expressions in communicating ideas.  People see colors, race, creeds, handicaps, and more, words do not.  The plastic words employed by the political left need to be called out every single time a new term arises, and the following are some suggestions for reducing plastic words.

  1. Get to know words and their definitions. It is okay to look up new words and use them in daily vocabulary.  It is okay to have a vocabulary to fall upon to describe, detail, and inform your communication.
  2. When in doubt, ask for clear definitions for terms. If this is the second or more instance, compare definitions from previous explanations, and every time the definitions do not match the intent, call that person out.
  3. Insist upon pronunciation and proper annunciation of words. The English language is beautiful when properly used, and the proper usage of language improves the world.  Be the speaker that makes flowers bloom in another person’s mind through language.
  4. Swearing, cursing, and vile imprecations do nothing but degrade the speaker and lower the speaker’s intelligence. Insist that speakers improve their language usage before speaking as a sign of respect.  I show my respect to you by guarding my tongue, you show your appreciation and respect to me by guarding your tongue, and communication advances both of us.
  5. Plastic words are a social disease and a tool of weak and untested minds. Remember, emotional outbursts are not tolerated by parents from children, and are even less tolerated by adults towards other adults.  Teenagers should be able to get away with back-talking and emotional hyperbole, why do we allow these same outbursts from adults?

Words DefinedImproving communication is all about knowing and using language succinctly and precisely, and then supporting proper social behaviors through courage and tenacity.  There is no reason the grocery store, the restaurant, and other social and community gatherings should be an atmosphere of foul deprecations, excuses for small minds to emotionally lose control, or for adults to imitate the worst childish behaviors.  Standards promote freedom, and the US Republic is all about personal freedom through responsibility and accountability for one’s self.

© Copyright 2020 – M. Dave Salisbury

The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/

Communication: The Devil is in the details – Shifting the VA Paradigm

I-Care23 January 2020, I wrote about how a medical support assistant (MSA) was negatively influencing communication between my primary care provider and myself.  Today, I discovered the Department of Veterans Affairs – Office of the Inspector General (VA-OIG) is reporting the same problems in several other VA Medical Centers across the country.  One veteran waited 36-calendar days for a positive test result notification; yet, because there were no “adverse patient events as a result,” the lack of communication is not considered an issue.  Another example involves a patient and do not resuscitate (DNR) orders, along with family concerns and end-of-life home hospice care.  The VA physician/hospitalist in charge had four incidents raising concerns the VA-OIG investigated, where the need to improve communication is the problem with no solution, support, or quality controls.

I guarantee, if there is a 36-day lag in a positive test result notification to me, there would be an adverse patient reaction.  While the VA-OIG made communication recommendations, I would bet dollars to doughnuts that the problems in communicating remain a significant customer service issue.  Why, because the majority of comprehensive inspections the VA-OIG conducts include failures in communication, and the amount of communications issues resemble bunny rabbits in a field with no predators.

The “I-Care” customer service program at the VA reports the following in every I-Care class:

“How we treat veterans today determines if the veterans choose the VA tomorrow.”

On the I-Care Patient Experience Map, how communication is used influences how the veteran feels about choosing the VA for their needs.  Yet, the VA continues to communicate like the veteran has no choice, no options, and does not matter.  Here are some communication tips, tailored specifically to the VA; may they find application quickly in VA customer operations.

  1. The VA claims that the primary care provider, the nurse, the MSA, and the patient are a healthcare team.  If this is the case, then the first step in improving communication is a technical fix opening as many channels of two-directional communication as possible.  Including email, voicemail, text messaging, telephone, fax, and instant messaging.  If the patient has all these channels, and they do; why can’t the nurse, the doctor, and the MSA use all the same technology to communicate?
  2. The VA has improved on this issue, but there is considerable improvement still to make; when test results come out, copy the patient on the results, automatically. But, where the patient’s results are concerned, explain the results.  Have the nurse or a physician assistant write some comments about the results, before sending them onto the patient.  Currently, I receive bloodwork results and have to Google/Bing my way through the results and guess when discussing the results with my spouse.  I received bloodwork results from UNM, the results came in digitally to my email box, with hyperlinks to explanations by doctors in the UNM system.  I received X-Ray and MRI results that claimed “all normal;” this does not tell me anything and increases the problems in understanding what was observed in the X-Ray and MRI.
  3. Face-to-face customer service is a skill that requires training, quality assurance, and monitoring. Yet, the MSA’s at the VA, who do the most customer influencing communication, are not trained, monitored, or quality assured.  The result, patients are treated horribly or are treated amazingly well, based solely upon the individual.  Unfortunately, the leadership in charge of customer service are often the worst offenders for poor customer service.  This must change; implementing a quality assurance program is not difficult, or expensive, and provided the quality assurance does not become the stick to beat people into submission, will provide positive fruit.  But, everyone who communicates with a veteran needs training and needs methods for improvement.
  4. Stop active listening as the standard for communication. In a hospital environment, especially, the standard should be reflective listening to achieve mutual understanding.  Active listening skills can be faked, thus inhibiting proper communication.  As an example, review the physician hospitalist who was able to fake care for patients sufficiently to fool the VA-OIG, but the patients and their families were left without feeling they had communicated sufficiently to act with confidence.
  5. “I-Care” is a good program; why has it not become the standard for all customer interactions? There is no reason for this program to not be a mandatory baseline standard of employee behavior from Secretary Wilkie to the newest new hire.  Yet, hospital directors can dismiss “I-Care,” refuse to implement “I-Care,” and disregard “I-Care.”  To grow the “I-Care” culture, every employee needs to onboard and commit; where is this being insisted upon?

Too often, the root cause analysis is either poor communication as the issue, or a substantial sub-issue; yet, even with the insistence of the VA-OIG, communication failures remain.  No more!  The VA must implement “I-Care” for every employee, implement a quality assurance program for communication, hold communication training, and design communication goals for every classification of employee.  Most importantly, every single leader must exemplify the customer standards they want to see in their employees.  There are no valid excuses for failing to communicate!

 

© 2020 M. Dave Salisbury

All Rights Reserved

The images used herein were obtained in the public domain, this author holds no copyright to the images displayed.

Uncomfortable Truths – More News from Albuquerque Public Schools

Some friends discovered I was attempting, again, to work as a substitute teacher for Albuquerque Public Schools (APS) and told me to not waste my time and talents.  They then shared with me some of the recent changes and more issues at APS that shocked and horrified me.  I do not have a student in the APS school district; thus, all I can do is relate their stories here in the hopes of generating enough angst that someone in the Department of Education will rip the scab off the injury called APS, and begin some sunshine disinfectant.

Government Largess 2An Educational Assistant (EA; Teacher’s Aide) was called upon to be a substitute teacher in Seventh Grade math; because APS is bereft of substitute teachers and is experiencing a teacher drought.  The EA is not a licensed substitute teacher; thus, when asked how this is legal, to have an EA substituting outside her regular work and expertise, she said she “didn’t know” and then acknowledged this is standard practice.  The EA went on to further elaborate saying that when she has asked for a substitute teacher because her teacher was out or off, she had a very low probability of ever getting a licensed substitute teacher and generally had to teach the class, with no extra money for doing extra work.  Why does the NM Professional Licensure classify licenses, and charge horrendous fees for licensure, if EA’s can be “regularly called upon to substitute teach?”  My friend has worked in four other states in the US as an Educational Assistant/Teacher’s Aide, and has never been licensed to be a substitute teacher; yet, somehow in APS, she can be regularly called upon to substitute teach.

While discussing teacher performance, another classic APS child abuse issue was uncovered, all while a good teacher is being forced out of her position.  Because of the teacher drought, APS is experiencing, and due to reduced registrations in a Bi-Lingual education school, an illiterate teacher in both Spanish and English, who had to pass a state-mandated test to get the license to teach bilingual students, is going to keep her job for another year.  This intellectually challenged teacher has been reported to APS more than a dozen times for swearing, insulting, and not being able to teach; but this teacher was just offered a full-time position teaching bilingual students, when she cannot speak/read/write in either English or Spanish at an academically acceptable level to teach others.  Due to falling registrations, a Kindergarten teacher, who was the last one hired at this school, is being laid-off.  The teacher, being terminated is a stellar teacher, works hard, is well-liked by staff, parents, and students.  Since joining APS, this phenomenal teacher has been assigned to “catch” those students from the most impoverished homes and get them up to speed academically.  Reported by all who know this teacher, she is exemplary in her assigned duties; fully 180-degrees separate from the illiterate teacher who landed her job under shady circumstances or nepotism.  Yet the bad teacher is being kept and the good discharged.  APS, and by extension, the NM Professional Licensure board, are committing child abuse on such a scale, there should be criminal charges.

I have been in business a long time, and one of the fundamental rules of business is if people are assigned to work, and mandatorily required to put in extra time, those people must be paid for their extra time.  In discussing job mandates and requirements with more than forty-different full-time, substitute, and EA instructional staff members of APS, a regular theme arises; if the school mandates the instructional staff is required to work, they will not be paid for their extra time.  For example, the EA discussed above, was called to substitute teach, spent 90-minutes after work writing notes to the regular teacher, and will not be reimbursed for her extra time.  Please note, this is 90-minutes on top of her regularly scheduled, non-paid, mandatory overtime.  Thus, every day, this EA loses 90-minutes of pay at the end of the day and between 60 and 90 minutes at the start of the day, with no reimbursement to cover this employer-mandated time.  With a regular school year average of 38-weeks, 5-days per week average worked, and roughly 150-minutes per day unpaid, an average EA salary of $15,116.50 ($9.95 per hour), this EA is losing approximately $2,836.70 each school year.  Where is the NM Department of Labor?  Where is the NM Legislature?  Where is the NM Public Education Department (NM PED), who also happens to be in charge of overseeing licensure?  As I understand this is a widespread general practice for all teaching staff, but I can attest that the administrators leave promptly on time and arrive on time, and if they must work late they are reimbursed for their time.  Why is the teaching staff treated differently?

Government Largess 4With a total grant budget of $1.6 Billion, no numbers have been found for the amount of tax revenue APS is handed, the school district is certainly well funded.  From the 2018-2019 school survey on APS performance, we find a common theme from the citizens to the APS school district, reduce administration costs.  The answer from APS school administrators was to, “Increase Counselors, Social Workers, Security and other staff to support our student’s mental and physical health … Increase Custodians across the schools [sic].”  The Albuquerque Journal reports that APS is the lead agency for taking tax dollar revenues.  With Bernalillo County and City of Albuquerque, plus property taxes, all being collected at ridiculous rates, APS must be getting a significant chunk of revenue; still, APS demands more money “For the children.”

Understanding checkpoint, we have more than one instance of a teacher unable to perform their duties, and verbally abusing students.  We have a functionally illiterate teacher who landed her position based on either shady circumstances, or through nepotism, and we have a recorded phenomenal teacher being summarily discharged during a teacher drought.  We have citizens, parents, and a concerned community begging for reduced administration, where APS then responds they are increasing administration.  Then we have non-licensed staff forced to work outside their licensure because the administration cannot obtain substitute teachers, and teaching staff forced to work extra hours without proper compensation.  Where is the public outrage?  Where are the lawyers?  Where are the politicians demanding answers?  These problems are not new to APS; why the silence?

You're FiredDuring the summer of 2019, for the first time in 15-years, APS full-time licensed teachers received a pay raise.  Not for the first time in 15-years, the teachers saw a slew of additional requirements, mandates, and reductions in alternative licensure to “pay” for the teacher pay raise.  All while the school board received yet another pay increase.  The voters have already told APS NO on a slew of tax increases and bond sale schemes; however, in November 2019, APS is trying again to raise taxes, raise money, and raise administrator salaries.  Albuquerque, the next time Bernalillo County, City of Albuquerque, or APS asks you for more money, ask them when they will deliver education to students, a reduced administration, and fix the teacher drought?  It is blatantly apparent to me that when APS, City of Albuquerque, or Bernalillo County claim, “It’s for the children,” they really mean they want a pay raise on your blood, sweat, and tears; tell them no!

© 2019 M. Dave Salisbury

All Rights Reserved

The images used herein were obtained in the public domain, this author holds no copyright to the images displayed.

Experience + Education + Time + Reflection = Knowledge: The Knowledge Transfer Process

The Rule of 7-P’s can be expressed two different ways, that then communicate two significantly different outcomes; yet, both expressions are intertwined and cannot be separately employed.

Proper Prior Planning Produces Potentially Positive Performance

or

Proper Prior Planning Prevents Purely Poor Performance

When discussing the Rule of 7-P’s and knowledge transfer, both methods of communicating the rule remains continuously applicable. For example, a toddler takes a table knife and starts to insert the table knife into an electric outlet. The adults, knowing that a discussion about electricity, the potential electricity has for causing burns, shocks, and fires will be lost on the toddler; thus the adult simply takes the knife, shouts NO!, and maybe smacks the child. What knowledge was transferred; the lack of a plan in this knowledge transfer opportunity has resulted in poor performance. However, the argument remains, what will a toddler learn without experiential knowledge? For a potentially positive knowledge transfer process, why not create a plan and turn a negative into a positive?

Providing the next variable in knowledge transfer, KISS, or “Keeping (IT) Supremely Simple.” The “IT” here can be the plan needing to be simple, the words employed, the method of knowledge transfer, etc.; all of these are variables in the knowledge transfer process. The principle is the requirement to transfer knowledge simply. Whether the audience is a toddler, a teenager, or an adult, the principle remains, keep (IT) supremely simple. Now, I have been reprimanded for insisting that adults need simple knowledge transfer; I continue to disagree. How many adults enter a training opportunity with nothing else on their minds than the coming learning? How many adults have shut down their lives for the training to enable full concentration for knowledge transfer success? Hence the need to communicate simply even for adults.

Agency; in all the world, there is no variable more powerful. Agency, as defined by Aristotle, is an agent in action. The agent is a body with the power to choose, the action is choosing, and natural consequences follow. Agency is a binary solution, act or do not act. Both choices possess consequences that will be valued by the individual through choice, who will then follow the logic of past choices and valuations into a determined destiny.

Communication, or knowledge transfer, provides a sender and a receiver in interaction the opportunity to act and will share both individual and combined natural consequences. Consider the toddler and the adult; the adult wants to keep the toddler safe. The toddler wants to discover. Connected the toddler and the adult share an experience (table knife and an electric outlet) with consequences, and individually, they will enjoy or suffer consequences as well as collectively they will have consequences. A consequence is neutral, the value of the consequence e.g., good or bad, positive or negative, relies upon the individual to choose, or exercise agency as an empowered agent. Every agent possessing the power to choose will exercise that power, and cannot escape the consequence.

Self-determination is often confused with agency, even sometimes used synonymously for agency, but self-determination is not agency. Keeping these two items, separate and distinct, remains imperative. Self-determination is defined as “the process by which a person controls their own life.” Thus, agency is a binary solution and not a process. Self-determination is a process, or a logical movement from one instance of an agent acting to another in a continuous chain of events, or cycles, of perception, choosing, evaluating, consequence, leading back to a new choice opportunity. Knowledge transfer relies upon self-determination as the sender cannot dictate how the knowledge sent will be employed. Only the receiver can determine the usefulness, the value, and the application. To blame the sender for knowledge transfer failing is mentally disingenuous at best, since the sender and the receiver share conjoined responsibility for the knowledge transfer process, the consequences of agentic action, and individual effects that are stemming from the knowledge transfer interaction.

Sine Qua Non a Latin phrase meaning “an indispensable and essential action, condition, or ingredient.” Trust is the Sine Qua Non in knowledge transfer opportunities. Trust is always playing a role, but the sender will generally not know if they are a trusted source. Trust remains an essential ingredient in all knowledge transfer opportunities. With trust between agents, knowledge transfer occurs almost effortlessly. Without trust between agents, knowledge is always doubted, efforts to transfer knowledge are more difficult, and the consequences of the lack of trust might not be realized immediately. Trust is based upon experience, time, and contains many different degrees, or shades. For example, the toddler might not convey they trust the adult, but the toddler will remember their interactions with the adult, and these remembered interactions build over time and experiences. One day that toddler will be able to vocalize trust, and the adult in that situation will then be faced with knowledge for good or ill.

Realtors have a saying, a rule, an aphorism, “Location, Location, Location.” Knowledge transfer is also contingent upon location, many times, this variable is conveyed as the environment. Regardless, where knowledge is transferred remains an aspect of prior planning that determines positive or poor performance. Just as realtors often overlook location, the knowledge transfer process, without a plan, will stumble over the location. Consider the following, while serving in the US Navy, an officer was observed attempting to transfer knowledge while a sailor used a pneumatic needle gun to chip paint. Chipping paint on steel requires ear protection, many times there is a desire for dual-ear protection, earplugs, and a set of over the ear, foam insulated, muffs. The officer was then observed holding the sailor accountable for the knowledge transferred, to the sailor’s detriment. Other times this same officer was observed transferring knowledge in engine spaces, with running machinery in the background; with the same result, the sailor was held accountable for not receiving the knowledge the officer was sending. Time after time, the same lesson is available, proper prior planning produces potentially positive performance, provided the plan understands location, location, location.

Knowledge transfer relies upon A Priori and A Posteriori knowledge to understand and onboard what is being provided. Humans are creatures that build, and experience builds knowledge, and education combined with experience, builds knowledge. The valuation of developed knowledge is personally known and evaluated continuously then compared with present situations and available experiential knowledge. The human brain will always be trying and testing A Posteriori knowledge, A Priori knowledge, against explicit, tacit, procedural, descriptive/declarative knowledge bases to build new knowledge from current experience. With this retesting will come the natural consequence of new valuations, where something highly valued suddenly becomes less valued or even rejected outright. Thus, the oft-repeated need for proper prior planning in transferring knowledge; without a plan, or with a poor plan, potentially positive performance is not obtainable.

Murphy’s Law states, “No plan survives first contact intact.” Some people take this law and then refuse to plan. Other people take this law and plan redundancies Ad Infinitum, but never carry out a single plan. The most effective people take this law, realize the potential, and will create plans flexible enough to accommodate reality, while confidently moving forward with the plan to achieve the desired end goal. An agent in action will choose who they are where planning is concerned, and the resulting consequences thus create societies, learners, communities, and other collections of empowered agents that are drawn to those with similar choice and valuation cycles — providing the variable in knowledge transfer second to agency, peers.

A peer group, as mentioned, forms around a group of agents that follow similar thought patterns and valuation cycles. For example, smokers know the dangers of smoking, but continue to smoke, and quitting requires choosing a different peer group before the smoker can quit. While other smokers surround the smoker, quitting is either a “pie crust promise, easily made and easily broken,” or an unfulfilled wish, due to the peers chosen with which to associate. The choice and perceived valuation cycle prevent peer reevaluation; thus, the smoker will continue to smoke. Knowledge transfer is dependent upon peer influence. Consider, if the sender is not trusted by one member of the peer group, the entire peer group will be influenced, and knowledge transfer will suffer accordingly. Even if the individual has a different evaluation of the sender through experience.

Consider the following example, while serving in the US Navy, an officer was charged to teach a class on handgun safety. The officer began the class by pointing a handgun at the audience. The officer was trying to teach a basic rule of handgun safety: “if you do not personally know a handgun is loaded, all handguns are presumed loaded.” However, this lesson failed horribly! Everyone in the class had a different perception of the lesson and related their experience to their peers. Thus, trust for this officer plummeted and interfered with every lesson this officer taught throughout his career. The officer was a subject matter expert, had tremendous insight, and could impact people for good. This single incident followed him from ship-to-ship, and doubt in their capability to teach was sown, all through peer-to-peer communication, and the influence of peer groups.

The importance of understanding the Rule of 7-P’s, KISS, agency, trust, location/environment, Murphy’s Laws, peer groups, and self-determination, forms foundational knowledge needed to build a training program, improve teaching and training, and enhance the process of knowledge transfer. Thus, it behooves all agents to have this information to enhance learning and improve teaching performance. The cycle is clear, “we teach that we may learn more perfectly, so we may teach more correctly, and then learn more perfectly.”

© 2019 M. Dave Salisbury

All Rights Reserved

The images used herein were obtained in the public domain, this author holds no copyright to the images displayed.

Defining Customer Service: Some Examples – Shifting the Paradigms

Gitomer’s, “Customer Service is Worthless: Customer Loyalty is Priceless (1998),” customer service has changed in ways that motivate me to investigate, cheer when found, and when negatives are experienced I want to help fix the problems. Several books and research papers in my library confirm every point Gitomer makes; thus, the following four interactions are compared to Gitomer’s text to supply solutions that can be benchmarked as Gitomer is much easier to read. The intent of this article is to power enthusiasm for change in how customer service is found and improved to inspire customer loyalty.

The Chase bank app delivered an error that made no sense. I called the “Mobile Banking Line,” and then was transferred to another department with “tech-savvy people who could assist me further.” Those representatives were not only unable to aid, but they also could not understand the problem as described, and offered a “local branch.” Upon learning that I lived 264 miles to the nearest Chase bank branch in El Paso, Texas, the representative had no other solution, offered no additional explanation, and for being a senior, tech-savvy representative, was less useful than the first representative I spoke with. Thus, I drove the four hours to El Paso, to be at the Chase Bank branch by opening. Not only was the teller having difficulty performing the transaction, the Chase Bank “Customer Service Star” desktop guide posted where I could see and evaluate performance. I was correctly greeted, in the standard big bank demanded-greeting that means nothing and has no humanity, good-job. Everything after that went downhill. When the teller was told that the El Paso branch is the “local” branch for Albuquerque, NM., there was no response. Eventually, the transaction was finally completed, and I was offered a big corporate bank, no humanity farewell, good-job. For a transaction that I can normally complete on my phone, to take 25-minutes in the branch, after a four-hour drive, you would think the teller would have cared, responded, or simply had humanity.

Gitomer offers several suggestions that a customer needs; I offer the most critical customer need, “Response!” When the customer begins a conversation about having to drive from another state to your location, respond. Show an attitude of gratitude, express amazement, ask about the trip, but to ignore the customer and only focus on the transaction, I could have stayed in Albuquerque and gotten that response from the telephone line. Gitomer claims the best customer variable is loyalty. Washington Mutual was my bank; I was loyal from the first thing in the morning to the last thing at night, I told everyone to change to Washington Mutual. Chase acquired Washington Mutual during the banking crisis, and I have been provided a reason to be loyal to Chase to date. I have not been presented a reason to enjoy banking with Chase. Why; because every transaction is ruled by the corporate thinking and inflexibility of big banks who consider themselves “Too big to fail.” Well, lose some more customers, keep ignoring the customers you still have, and another merger to an even bigger corporate bank will be the future.

AT&T, there are several issues in the following story of recent customer service. Frequent readers of my articles will see a common trend, training. Here is another matter where training wins customers. February, I called AT&T looking for a solution; I got a larger price plan and thought all is well. March, I am introduced to the mouse print and discover that “Unlimited Data” has several limits; who knew, obviously not the AT&T telephone representative, or the online Chat representative, I had to visit a local store for an explanation. April more calls to the telephone line, more guesses to close the call. Another visit to the local store for help. Like the shampoo bottle’s instructions, “Wash, Rinse, Repeat” May, June, July, and August will see me going into the local store again on Monday. I promise, my trips to the store are not because I am finding customer service, especially since I must keep dodging sales to get questions answered. AT&T, what is your company training philosophy, procedures, and strategical and tactical reasons for conducting employee training? The current results are not satisfactory, and that problem is not improving.

Gitomer discusses how converted employees become loyal employees. I was a converted and loyal customer to Cingular Wireless, which was bought by AT&T. I was a converted customer of Alltel, which was merged into Verizon and AT&T. I was converted to these companies for the service, clarity, and the lack of mouse-print conditions that the employees do not even know or can explain. Banking and Cellphones have something in common, the product is remarkably similar, and the service provided by employees is the only separating variable between your company and your competition. Chase, AT&T, where is the employee training on distinguishing service and building customer loyalty?

“#6 WOW! Variable: Truthful – Customers want the truth! The customer will find out eventually, so you may as well start with the truth – [especially] if [the truth] hurts” (Gitomer, 1998, p. 97; emphasis mine). AT&T, please heed! Chase, you might want to have the same conversation in your call center as well. When customers start with the telephone line looking for information and receive a lie, you are building a customer event that will cost your company customers! Lying loses customers; this equation should be the number one discussion with every employee. I have spent hours on the phone receiving one piece of information, only to walk into the AT&T store and get handed more mouse print. Thus, when training, emphasize the need for clear, concise, truth; served openly and with conviction.

Like many US Military Veterans, I am regularly stuck between two bureaucracies in dealing with the Veterans Administration. However, there is nothing more frustrating than getting the same issues in non-government health administrations. Corporate medicine began in the late 1980s in America, and since then community hospitals have become giant behemoths where bureaucracies reign.  These establishments have yet to understand they must pay attention to the customer/patient, not the insurance company, and indeed not the voices in their heads. Hospital directors, leaders, and providers, what do you do when a patient/customer walks in with cash and asks for service? I walked into the University of New Mexico, Orthopedics Department, plopped $2000.00 in cash down and asked for 60-minutes of time with any provider who was available for a letter I need. Records were available, x-rays, MRI’s, and a host of data. The letter would take less than 60-minutes, and I do not know anyone who would turn down cash and a payday of $2000.00 for an hour or less of work. Yet, not only was I turned away by the bureaucracy, I was informed I would have to travel an hour to another location instead of where I was, because I had been treated there two-years prior. But, I would still not be able to obtain the letter I needed as the other department is neurology. To receive treatment at the specialist demanded by the VA bureaucracy, I must first find a primary care provider who would refer me to a specific provider in orthopedics, before I could finally discuss the potential to fill my need.

Gitomer talks about this principle. The customer does not care about your processes, procedures, policies, and propaganda. The customer cares about what they need, what they offer, and how to obtain what they need. When I called AT&T this week, the third person I spoke with started every answer with “I apologize.” The UNM representative did the same thing in refusing my money and their services. The UNM representative also pulled the “Let me check” run out the office, reappear, helpless, act, to attempt actually to be helpful. The same act is done by telephone representatives who place a customer on hold to “check with a supervisor.” The customer knows what you are doing, and I, for one, am not impressed! Gitomer emphasizes on this point, and if the apology does not come with a solution that gets the customer to what they need, the apology is an excuse that is lame, weak, and useless.

03 August 2019 email messages were sent to three Federally elected representatives of New Mexico, Congresswoman Debra Haaland (D), Senator Tom Udall (D), Senator Martin Heinrich (D). I asked them if they were interested or cared about the veterans in their districts and what is occurring in the Albuquerque VA Medical Center. Their silence testifies to their disregard to their constituents. Unfortunately, this treatment or abuse of their constituents is not limited to the few representatives from New Mexico. Friday, I received a boilerplate email response from Senator Tom Udall’s staff, auto signed, with wording that clearly claims, I do not care about you or your issue, leave me alone, and stop bothering me. As the sole respondent in three elected officials, as the customer, voter, and citizen, I am not pleased!

Each of the above situations breeds a question; “Why should I remain a customer, patient, voter?”

The solutions are clear:

  1. Train employees. Encourage employees to walk customers through different solutions using the truth mentally. Apologize only when you have a solution and mean you are sorry. False apologies are as useful as a blunt needle, you might get the job done, but you are going to drive yourself and everyone else crazy doing the job. Show why training is occurring. State the strategy, so the tactical actions requested make sense to those being trained.
  2. Respond to the customer. Active listening is only half the communication effort, forming proper responses means building upon what the customer said with your response. Failure to respond appropriately, and the customer situation is worsened for the next person to communicate with this customer.
  3. Gitomer asks the following question, “What will it take to end measuring ‘[customer] satisfaction’ in your business” (Gitomer, 1998, p. 257)? I guarantee that the answer to this question is going to cause significant angst in why and how you communicate with customers. I am fairly certain, the answer to this question is going to disrupt every communication channel’s operations and daily tactical actions requiring a review of operational strategy. Business leaders, do you dare to ask the question? Are you prepared for the answer?
  4. Gitomer, Chapter 16 (p. 234-248) details change and how to make the change effective in your operations. The 10.5 points are useful, but what comes next is the best plan for moving forward successfully.

Leading to the final question:

“What will you do now?”

 

Reference

Gitomer, J. (1998). Customer Satisfaction is Worthless, Customer Loyalty is Priceless: How to Make Customers Love You, Keep Them Coming Back and Tell Everyone They Know. Atlanta, GA: Bard Press.

 

© 2019 M. Dave Salisbury

All Rights Reserved

The images used herein were obtained in the public domain, this author holds no copyright to the images displayed.

Uncomfortable Truths – An Open Letter to the Department of Veterans Affairs and the Congressional and Senatorial Representatives of the United States of America

I-Care

I write by way of greeting; I write by way of exhortation to action, as the current status quo is reprehensible and unacceptable.  Uncomfortable truths are those realities where bureaucracy has superseded logic and leadership, creating situations where the harm of the patient/customer is the first and only business.  There are good people at the Department of Veterans Affairs; but, these people are being crushed by the bureaucracy, the stifling mental inertia, and the lack of actionable leaders to propel change at the Veterans Benefits Administration (VBA), the Veterans Health Administration (VHA), and the National Cemetery.

An example of uncomfortable truths: I witnessed a veteran enter the emergency room of the VA Medical Center, and be actively, but passively, abused.  Because he was a regular, and sometimes came in and was obstinate, and because he was homeless, he had a history with this emergency room and staff.  The staff actively overlooked him, they talked bad about him, they cussed him out behind his back, and his service was suboptimal at best when he was finally treated.  As this veteran was not the only one being treated in this manner, this was brought to the attention of hospital leadership; the person reporting the abuse was terminated without cause.  This is a leadership issue, a process problem, and an excuse not to change.

Another example of uncomfortable truths: the VBA needs/wants “New and Material Evidence” to process/review/correct a claim.  The Primary Care Provider and all specialty clinics at the VA cannot provide “New and Material Evidence,” as they are not diagnosticians.  Thus, the veteran is left stuck between two bureaucracies that refuse to help, because the rules do not allow the providers to help; this a leadership problem and a process issue.  How can the veteran afford outside insurance to obtain the “New and material evidence?”

Earlier this month, the OIG sent out a report over death at the VA due to leadership inefficiencies and can be found here, VA-OIG report.  Over the last week, three more incident reports have been discharged from the VA-OIG.  Report 1: Has a veteran dying of suicide, because the decision-making process, a process designed specifically to improve communication to aid high-risk patients were not implemented, tracked, and reported properly.  The decision-making process is expected to employ a full patient-care team (PACT) in evaluating and making decisions that affect the patient’s care.  The process was not followed, and the veteran who is already at high-risk for suicide and known to the PACT was deactivated, leading to a veteran’s death.  The VA-OIG made a recommendation to improve the process, the same process that was disabled, leading to a dead veteran.  How does this make sense?

The uncomfortable truth is multi-faceted in this case.  Leadership does not do record audits to ensure the deactivation of high-risk patients does not become “lost” in the bureaucracy.  Leadership is not flagged when the PACT disagrees with the treatment of a patient.  Finally, the VA-OIG has no teeth to reprimand, insist, and improve compliance; they can only make recommendations after the fact.  Congressional representatives and Senators, you allowed the VA to have its own dedicated inspector general, why?  What will you do to enhance the leadership at the VA?  Do not tell me again; we will hold “Committee Meetings.”  These committee meetings have been, and continue to be a feckless waste of taxpayer time, money, and never addresses the core issues apparent.

Report 2: Covers a veteran needing an appendectomy and had to wait for three hours for the surgeon to become available to perform the surgery.  The VA-OIG confirmed the delay in care, but essentially settled for, “Well, the patient lived, so no problem here.”  If that statement seems overly simplified of the process, tell me why the patient had to wait.  Why pay records and timekeeping records were messed up for a single month (May 2018), and how pay and timekeeping records got messed up in the first place.  The VA uses a national system for reporting time worked, but not all employees use the same payment system.  If true, why aren’t all employees, to include residents, surgeons, and staff using the same pay system?  The wait is blamed on poor communication, communication in scheduling surgery, communication between resident and surgeons, and communication because the “appropriate documentation” was insufficiently maintained.

I know from sad experience that there are nurses and doctors who write things down in notebooks, on scrap paper, and on paper charts, when the computer on wheels (COWS) is readily available.  The excuse is always, “I am too busy to use that thing.”  I know the VA has spent an excessive amount of money to get digital records, installing digital records, getting digital records to work when needed, and delivering the digital record available to mobile stations to document what is happening with the patient.  I have some grave concerns for checkbox medicine; but, blaming a surgical delay on improperly maintained documentation remains a wholly inexcusable and unacceptable statement in an official investigation.  Why was this lame excuse allowed to stand?

Report 2, exemplifies a multi-faceted problem presenting a need for a multi-faceted approach to correction.  Leadership at the hospital must be actively engaged, ensuring processes and procedures are optimized to deliver the “I-CARE” customer promise.  Communication chains are a leadership tool, and when broken, correction demands accountability and responsibility to resolve correctly.  Reporting is a leadership function to ensure liability and corrective action as a normal operating procedure.  Did anyone ask why the documentation was not maintained?  Was this lack of documentation maintenance a design flaw to hide what happened during this incident as an extension of designed incompetence?

Report 2, demands answers on two distinct issues double-dipping, and the continued practice of collective design incompetence. Double-dipping by providers working for the VA at the same time they are working at other medical institutions, is this occurring?  Why?  I understand there is a provider shortage at the VA.  I know doctors need to make money, and doctors make money by seeing patients, surgeons make money performing surgery.  The VA-OIG report appears to gloss over the practice of double-dipping e.g., on-call from one hospital while working at another, or working at another hospital while the VA expects you to be at their hospital.  Senators and Congressional representatives, are you investigating the potential for double-dipping?  Will it take a dead veteran before you even care about double-dipping occurring?  I make no accusations; I am asking honest questions on this issue in an attempt to learn more.  Will you do the same?

One of the most egregious problems at the VA is designed incompetence to allow a malefactor the ability to hide behind bureaucracy to avoid accountability and responsibility.  Designed incompetence remains a significant problem and I do not see any of the mid-level managers, leaders, supervisors, trainers, etc. acting to eliminate designed incompetence to the improvement of the Department of Veterans Affairs.  During President Obama’s Administration, I watched a Congressional Committee meeting where whistle-blowers were invited and testified about the designed incompetence that allows for an individual to pass the buck, duck responsibility, and protect their jobs and power at the VA.  I keep discussing design incompetence, because the mid-level managers, directors, and supervisors at the VA refuse to address and correct this issue.  Senators and Congressional Representatives, why do you allow this practice to continue?  Did you know that this is the primary method for discriminating and harming whistle-blowers?  Of course, you did.  I have seen several committee meetings where this exact issue was discussed, and the bloviation from the committee does nothing.  You are the leaders in our Republican Society, when are you going to act, in concert with Secretary Wilkie (who’s doing an exceptional job), correcting and insist these practices cease?

Report 3: Involves 60,000+ veterans, is this number sufficient to warrant permanent action on the proper billing of insurance companies and veterans, or does this number need to exceed some other level before it warrants your attention.  If a different level is required, what is that magical number?  I guarantee that veterans from all states and territories are involved here, as their representatives, what will you do?

Directly from the VA Website, we find two different uses for funds collected:

  • “VA is required by Public Law 87–693; 42 USC. 2651, commonly known as the Federal Medical Care Recovery Act, to bill the health insurance carrier that provides health care coverage for Veterans to include policies held by their spouse. The money collected goes back to VA medical centers to support health care costs provided to all Veterans.
  • Funds that VA receives from third party health insurance carriers go directly back to VA Medical Center’s operational budget.”

You, the elected officials of the Republic of the United States of America, enacted these laws and improper billing of veterans and insurance companies, causes financial harm and distress; this is your problem!  Do you understand that even if money is returned to a veteran, the financial injury has been done?  Those veterans who have paid a bill, or the insurance company that paid a statement, they didn’t need to pay is an interest-free loan to the government, and this is wrong!

There are literally tons of money at stake here; I know my local VA Hospital said, “The funds collected when we bill insurance companies come directly to this hospital for construction projects, renovations, new equipment, and so forth.”  Report 3 is but one of how many VA-OIG reports where improper billing is occurring. Incorrect billing drives the cost of healthcare up.  Hence, Obamacare costs more because the VA is not accurately billing.  Medicare costs more because of improper billing.  You the elected officials are directly responsible for ensuring proper billing occurs as an aid in reducing the costs of healthcare.

Where are you? Will you act?

 

© 2019 M. Dave Salisbury

All Rights Reserved

The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

Leadership and the Department of Veterans Affairs – Shifting the Paradigm on Killing Veterans

I-Care

Since the beginning of 2019, a running theme in the Department of Veterans Affairs Office of Inspector General (VA-OIG) reports, that I have delivered via email, has been the lack of leadership.  Today’s VA-OIG report is a perfect example of discussion and remains significant due to a veteran being killed by the Spinal Cord Unit in San Diego, CA.  I fully submit that VA Secretary Wilkie is trying to reform the Department of Veterans Affairs.  I fully offer that the nurses and providers, as well as other front-level employees at the Department of Veterans Affairs, are trying to do a difficult job in a bureaucratic nightmare.  I contend that the mid-level managers between the supervisors and Secretary Wilkie need removed and processes redesigned.

Using today’s report, we find causation for removing mid-level managers to streamline leadership effectiveness and potentially save patients.  The VA-OIG claimed, “At the time of the patient’s death, the SCI unit used an outdated nurse call system that required the use of a splitter to connect the ventilator to the call system, none of the respiratory therapy staff had training or competency assessments related to PMV use, staff failed to report the patient’s ventilator tubing disconnections through the Patient Safety reporting system, and SCI leaders failed to follow the standard operating procedure for the management of clinical alarms.”

Outdated technology is inexcusable, especially for all the money continually pumped into the Department of Veterans Affairs to update technology.  Who are the mid-level managers in charge of procurement that have failed to do their job and improve technology effectively?  VA-OIG, was the role of technology procurement included in this investigation?  If not, why?  If so, where is that report?  I have personally witnessed 10+-year-old technology used for patient care due to inadequate leadership efforts and procurement people wasting time, as well as other resources.  If a root cause in a patient dying is old technology, why are we not holding those in procurement an IT accountable?

Training at the Department of Veterans Affairs is a colossal joke; either the training is bloated, and the user cannot identify which parts are valuable to their job duties specifically, or the training is so shallow that the topics are considered a waste of time.  But, there is also a third option for training; training only applies to managers due to the labor union collective bargaining agreement.  Thus, the front-line worker could use the knowledge, but the union is preventing that knowledge from spreading as that policy has not been approved.  The leaders in charge of training cannot answer basic questions regarding applicability, usefulness, or point to policies and procedures that govern why certain topics are required to specific audiences.  The lines of communication breakdown in training have reached monumental proportions, and as witnessed, is killing patients.  Worse, the training at the VA is governed by third-party LMS software that can quickly be completed without ever influencing the actions of the individual.  Classroom training is a rehash of the LMS training and does not cover the gaps or explain why.  Front-line supervisors cannot answer basic questions about the why behind a process or procedure, nor can they point to a resource where the information can be discovered.

The VA-OIG noted a root cause in their investigation, “The OIG could not determine what the ventilator settings were at the time of the patient’s death, because facility staff who inspected the ventilator immediately thereafter changed the settings to check whether alarms were functional and then reportedly returned the settings to the previous levels.”  If the setting on a piece of equipment is required for a patient safety report, why are there not digital pictures taken?  I find the VA-OIG being unable to ascertain equipment settings to be a complete failure of current technology.  How many smartphones are possessed by patients, staff, providers, etc. that could snap a picture of a piece of equipment for an official record?  Does not the VA issue phones to mid-level managers?  One of the most egregious problems at the VA is designed incompetence to allow a malefactor the ability to hide behind bureaucracy to avoid accountability and responsibility.  Designed incompetence is the problem and I do not see any of the mid-level managers, leaders, supervisors, trainers, etc. acting to eliminate designed incompetence to the improvement of the Department of Veterans Affairs.  Consider for a moment the hundreds of millions of dollars lost in bloated construction projects.  The project leader has vague, inaccurate, old, etc. processes and procedures to blame the failures upon; this is an example of systemic designed incompetence, that protects a lazy employee and costs the taxpayers resources, and the Department of Veterans Affairs reputation.

The VA-OIG reported more root causes in the death of a patient to include, “… the facility did not implement risk mitigation strategies for the use of the in-line Passy-Muir® Valve (PMV) on ventilated patients. The facility did not have a backup monitoring plan when the ventilator alarms were off, patient criteria to determine when the valve should be removed, policies for facility staff and patient/family education on the use of the PMV, policies or procedures for monitoring and documenting ventilator and alarm settings while using the PMV, or a policy to use anti-disconnect devices.”  Risk mitigation is everyone’s job in a VA Medical Center.  Risk mitigation is a facet of every post and included in the third-party software training programs for providers, nursing staff, and clerical staff.  Why did this patient die from a lack of risk mitigation?  What are the tactical risk mitigation actions that support risk reduction strategies?  I have asked this exact question, as an employee and a patient, in two separate VA Medical Facilities and never received an answer beyond simple platitudes.  A root cause in a patient dying was risk mitigation strategies; VA-OIG, there is a bigger problem here that merely making a recommendation to leadership can resolve.  If a strategy is not supported with tactical action, there are no strategies; simply wishful thinking and hope statements.  Are the mid-level managers going to be held accountable for dropping the tactical ball here and letting a patient die from systemic designed incompetence?

The US Military believes in redundancy; every mechanical system has a backup, that backup has a backup, and there is a manual backup for when all else fails.  How can the Department of Veterans Affairs claim to serve America’s military veterans without redundancies?  Without training on redundancies?  Without education and real-life training scenarios, to prod thinking before an emergency occurs?  The simple answer, the VA cannot represent, serve, or support America’s veterans without these core competencies built into the processes and procedures that power a learning organization.

I am sick and tired of seeing veterans harmed, abused, and killed at the hands of bureaucratic ineptitude and systemic incompetence that protects the lazy and useless at the expense of veterans.  I am beyond disgusted that mid-level managers, supervisors, directors, etc. have the power to arbitrarily pick winners and losers based solely upon the worship that employee does to the boss when the employee cannot do the job they were hired to accomplish.  It is beyond inexcusable to see no job-specific duties, processes, and procedures that provide tactical action for strategic aims at every workstation where training is held daily to meet the strategic goals of the medical facility.  The Department of Veterans Affairs needs to begin cleaning house of the criminals, the incompetent, and the lazy that are supporting a reputation of killing veterans through designed incompetence, as they masquerade as supervisors, directors, managers, etc.; there is no excuse for killing another veteran!

© 2019 M. Dave Salisbury

All Rights Reserved

The images used herein were obtained in the public domain, this author holds no copyright to the images displayed.