# Presentation: 085263

## National Immunization Conference 	

- Conference Goal
- “The goals of the Conference are to provide information that will help participants provide comprehensive immunization coverage for all age groups and explore innovative strategies for developing programs, policy, and research to promote immunization coverage for all age groups.”
**McKesson Specialty’s Objective:**
***To communicate the results we have achieved to date as well as our continued commitment to ensure you are able to execute on promoting immunization coverage for all age groups.***

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## Quality Performance - DC

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**Notes:**
	                              Jan-08	Feb-08	Mar-08	
# OF LINES SHIPPED	     88,361 	88,181 	22,831 	
# OF PACKAGES SHIPPED    26,688 	23,087 	6,253 	
Returns	                       218 	35 	         4 	

As many of you have heard, there has been a problem with some vaccine shipments arriving frozen.  In January, 71 of 20,166 boxes arrived with the temperature monitor indicating "frozen."  This compared with 25 of 16,721 boxes in December, a change from 0.015% to 0.035% of shipment boxes.  The increase in cold chain problems happened on Sunday shipments.

McKesson traced the problem to a difference in the handoff of packed vaccine from McKesson to Federal Express on Sundays compared with weekdays.  On Sundays, the packed boxes were outside of the controlled environment of McKesson's warehouse for a longer period of time than on weekdays.  The colder temperatures in January, therefore, exposed the packed boxes to temperatures they were not designed to handle.  The temperature probe picked up this temperature excursion, preventing frozen vaccine from being used.

McKesson has suspended Sunday shipments temporarily until they can establish a cold chain between their warehouse and Federal Express that assures ambient temperatures in the range that the boxes can handle.  Once this procedure is established, McKesson will resume their Sunday shipments.

## Cold Monitor Instances

| December 2007
 |  | January 2008 *
 |  |
| --- | --- | --- | --- |
| # Packages | 16,721 | # Packages | 20,166 |
| Monitor Instances | 25 | Monitor Instances | 71 |
| Accuracy % | 99.84451
 | Accuracy % | 99.64793
 |

**** Estimated Point in Time***

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## Customer Service Calls

***Combined 1/21 & 1/22 due to MLK holiday***

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## Instances by Ship Date

***Red bars confirmed picked up on Sunday***

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**Notes:**
No longer ship via FedEx on Sundays to avoid delay such as those experienced in January
Temperature scanners added to verify temperature range on orders and ice  
Refrigerated storage added for each pack station to ensure proper handling of product and monitors

## Quality Measures - DC

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## 48 hour rescue product process

- The objective of this process is to save as much vaccine for the program as possible
- Proactively track delivery status of every order
- At the 48 hour mark, intercept product and bring safely home (re-route to DC)
- Follow up with outbound call to Grantee communicating events
- Place replacement order, remove delivery challenge and get viable vaccine to provider

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## Over $750K in rescued product

_*Over $750K in rescued product*_

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## New Packing List

**Provider Pin #**

**Number of**
**Containers**

**Container**
**Numbers**

**Doses by**
**Presentation**

**Presentation**

**Manufacturer**

**Vaccine Price**

**Ship Date**

**Lot #**

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## Sacramento Update

- Live with second distribution center
- Orders – 1,241
- Containers – 1,282
- Doses – 267,073
- Boxes/Order – 1.03
- Comprehensive transition schedule

- Sacramento
- Service

**AK**
**AZ**
**CA**
**HI**
**ID**
**KS**

**MN**
**MT**
**NE**
**NM**
**NV**
**OK**

**OR**
**TX**
**UT**
**WA**
**WY**
**Pacific Islands**

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## Customer Operations Overview

“Customer Service is the ability of an organization to constantly and consistently exceed the customer’s expectations”

***“******Customer Service is the ability of an organization to constantly and consistently exceed the customer’s expectations”***

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## Where have we been?

- Project Ambassadors:
- Designed and implemented as administrative staff to track and escalate the disposition of packages en route.
- Take Phone calls, voice mail and email and escalate to DC for resolution
- No single point of contact (SPOC)
- No clear escalation path
- Lack of responsiveness
- Little to no follow up

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## Verbatim Experience Quotes 

**“****I have sent 3 previous request to have their wasted vaccine picked up.  Clinic is upset that it has been sitting in their office waiting for pick up since early Sept.”**
**“****We need to be notified of these type of instances immediately.  It is a poor reflection on all of us, when basically the only reason we find out about the lack of stock is because a provider called McKesson and found out--or because I've called McKesson due to the provider calls I am receiving and that's how I find out.  This situation has to change.”**
**“****I have not received a response regarding this shipment.  Is there a time frame that I can expect a response within?  I sent this Wednesday and then again Thursday. “**
**“****Vaccine delivery service to our state has not been going well.”**

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**Notes:**
 Shelby A Tooze, Oregon
 Jonna Goosetree, Tennessee
 Eric Pennington, Nevada 
 Lisa Harris, Minnesota 

## Where are we now?

- Customer Service:
- Empowered with tools, SOP’s and authority to resolve issues for Grantees on the very first telephone call when possible
- Training our agents to act as the advocate for the Grantee and Provider, owning issues from inception to resolution

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## Customer Operations Key Developments – Technology and Customer Service Alignment

- Technology
- All Calls logged in Storm as of Mid-December
- Capable of Delivering Key Customer Operations Metrics by November 5th
- Issues by Category; by CSR; by Project; Created over Date Range
- Escalation Tracking; Time to Resolution; 1st Call Resolution; Re-Open Rate; Temp Monitor Reporting
- Internet Protocol Call Center Manager
- Average Wait Time
- Abandon Rate
- Speed of Answer
- Talk Time

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## Key Metrics

| Service Level (Average Speed of Answer) | Dec  | Jan  | Feb |
| --- | --- | --- | --- |
| >=80% calls answered in 30 seconds or less | 85% | 83% | 81% |

| Answer Rate | Dec | Jan 
 | Feb |
| --- | --- | --- | --- |
| >=95% calls answered | 83% | 73% | 72% |

| First Call Resolution | Dec  | Jan  | Feb |
| --- | --- | --- | --- |
| >=98% of total tickets logged | 60% | 63% | 66% |

| Time to Resolution | Dec | Jan  | Feb |
| --- | --- | --- | --- |
| Issues not resolved on first call | 1.52 D
 | 2 D | 0.9 D |

| Total Call Volume (email & telephone) | Dec | Jan  | Feb |
| --- | --- | --- | --- |
|  | 822 | 1.099 | 882 |

| Capture Rate | Dec  | Jan 
 | Feb |
| --- | --- | --- | --- |
| >=96% of total Telephone Calls and Emails | 70% | 83% | 85% |

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**Notes:**
We know you get what you measure, having said that, as we transition from an administrative group to a true customer care organization allows us to measure and focus on the key metrics that support improving responsiveness, such as Service level, time to resolution......

## Verbatim Experience Quotes

***“******Yes, it has been an excruciating month for us, and I am sure you are tired of seeing the daily e-mail’s from me, and I know that those of you I talked to in customer service got tired of hearing my croaky, laryngitis stricken voice.  I am very thankful and appreciative of all of your hard work.  You truly have been partners with us during this challenging time.”***
***“******I hope you know you are helping us a great deal by moving these on through.  It saves us a great deal of time and energy.  Thanks for doing such a good job.”***
***“******Thank you for your help, you are doing a great job for (our) providers, and we appreciate it...”***
***“******Thank you, thank you!!! I have contacted the Provider they are willing and ready to accept the delivery tomorrow!!  All three of my concerns have been resolved by you and I appreciate it so very much!!!”***

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**Notes:**
 Jan Hicks-Thomson, Washington State
 Marsha Rippetoe, Texas
 Jan Hicks-Thomson, Washington
 David Oliver, Maryland

## Issue Escalation

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## Customer Experience Advisory Board

## Objective

***Form and cultivate an organization that includes McKesson, CDC and Grantees focused on sustainable solutions that bring value to VMBIP empowering all of us to meet or exceed the expectations of providers***

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## Charter

- General function
- The function of the VMBIP Customer Experience Advisory Board will be to advise and make non-binding recommendations to the VMBIP Leadership team
- Membership
- The VMBIP Customer Experience Advisory Board will be co-chaired by Tom Hart, MCK and Brad Prescott, CDC
- Members will contain 3 CDC members, 3 MCK members and 15 Grantees
- Mode of operation
- The VMBIP Customer Experience Advisory Board will meet 4 times a year (1 time each quarter)
- The VMBIP Customer Experience Advisory Board will communicate updates to all grantees following each meeting
- A member of the VMBIP Customer Experience Advisory Board will provide a progress report at group conferences such as AIM or NIC

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## Process to engage	

- Membership:
- Selection and notification will be provided to the advisory board as to those participating, via AIM
- Time Frame:
- All members should be selected by May 15th
- Kick off meeting
- Location TBD
- Date: June 3rd, 2008

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## Rules of engagement

- Real life examples
- Though anecdotal information abounds us, it is critical that those participating in the board collect detailed examples of those issues driving challenges for all
- Be part of the solution
- As an active member of the board, we will be looking to you to provide solutions and positively engage in communicating results
- Voice of the customer
- Come as a voice for those you represent.  We all should be advocates and remember why the program was created:
*Many parents can't afford to pay for vaccines on their own. When large groups of children go without vaccines, it leaves them unprotected and disease outbreaks can happen. This program allows everyone to stay healthy by getting his or her vaccines on time. **(Ref: Mar. 10**th**, http://www.cdc.gov/vaccines/programs/vfc/providers/faq-parents.htm)*

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## 

THANK YOU!  

*THANK YOU!**  *
* *

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