Using Triage to Manage Process Workloads in Services

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y Mark George

It's something we have all experienced: Walking into a bank and finding we're the sixth person in line. Having a computer go down and discovering that it will take hours or days before someone can come to fix it. Getting an urgent request and having to set aside the 10 other things we were supposed to get done today.

These situations are all the result of the same underlying problem: a process that is overloaded with work. Finding ways to manage workflow and minimize congestion, and the delays it causes, is a common challenge in services. One of the most effective tools for dealing with congestion is triage.

The principle of triage is the same whether you work in a hospital emergency room or office typing pool: Make sure that the most critical cases are dealt with first, and either take longer or use alternative methods for dealing with less-critical cases.

The crux of triage in business is sorting jobs into categories that reflect different levels of effort required. Once you have the categories identified, you can develop different routings, strategies, or resources to deal with each category. Typical sorting schemes include:

• Fast service times/medium service times/slow service times;
• Small/easy problems/serious problems/catastrophic problems;
• Customer-contact issues/non-customer-contact issues.

Response schemes include:

• Focusing all employees on the high-priority tasks.
• Dividing work between different subgroups of employees (e.g., giving complicated work to more experienced employees, always giving similar kinds of work to particular staff, and so on).

Here are a few examples of how triage can work in service environments:

Example 1: The IT Department

The IT department in one company was overloaded with work requests ranging from installing new software to updating virus definitions and fixing email connections. On average, it was taking them more than six working days to respond to requests.

To deal with the situation, they began sorting the requests into three categories:

Class 1 – Emergency: Computer lost or stolen, computer won't boot up, user cannot get to mail servers.
Class 2 – Intermittent problems: Windows locking up frequently (more than two times per day), Microsoft Office/other applications won't open (more than one application), cannot use port features (more than one port disrupted).
Class 3 – Software/hardware additions/changes, wish list items: Software/hardware requests/installs, computer swaps (due to lease end, for example), software preference changes.

Each day, the IT staff would sort requests submitted the previous day, except for Class 1 requests which were dealt with as soon as possible. The staff would address remaining Class 1 problems first before moving on to Class 2, and then on to Class 3. The department even set up an online tracking tool that let everyone see where their requests stood "in queue." The result of this simple system is that the average cycle time for repair completion dropped to just over one day.

When NOT to Triage Triage works well when you're dealing with orders or requests or emails, but does not work when you're dealing with actual customers who are standing in line. Imagine walking into a bank or hotel and asking some customers to stand off to the side while others are moved to the front of the line. In these cases you will need to develop backup capacity. In most cases, that doesn't have to mean hiring extra staff. Instead, try cross-training personnel so you can temporarily increase your "process capacity." One hotel chain, for example, trains office and other staff on registration procedures, and pulls them in whenever there are more than one or two people waiting in line. It's a lot better to let a purchase order sit waiting on a desk than to have a customer growing impatient in line.

Example 2: The Marketing Department

Independent agents for a company needed to get proposal information from the company's marketing department in order to provide quotes for jobs. Originally, it took the marketing department as long as two to three weeks to develop the needed information. That didn't make the agents happy. They wanted their information within two or three days.

A marketing team collected data and determined that in order to make their customers happy, they could only have about 48 requests "in process" at any one time. But they often had two or three times that number waiting to be worked on. So they developed a system where all requests went into a buffer, an in-box of sorts; and then they used triage to determine which ones to work on next.

They knew that some requests represented high-dollar orders that would likely be accepted. Other orders were much less likely to be accepted, represented difficult bids or were for smaller orders. They decided it was most important to work on the highest value potential first, so their triage system was based on scoring each request 1, 2, or 3 for each of three criteria:

• Difficulty to bid (least difficult = 3)
• Competitive advantage (biggest advantage = 3)
• Gross profit dollars (highest profit = 3)

Bid opportunities with the highest rating would be the next to be released into the process -- even if there were other bid opportunities that had been waiting in line longer. Thus a new request that scored a 9 would be released before an older request that scored a 6.

Using this system, the same number of marketing staff booked 70 percent more revenue and 80 percent higher gross profit.

Summary

These two examples demonstrate two different outcomes from triage.

In the first case, the IT department was able to speed up the completion rate for all job types without changing anything else. That is, the department still handles as many requests as before, but is now more organized about it. There is better continuity and the staff is more focused. The guidelines for the order in which jobs are handled are very clear, so the IT staff no longer has to constantly interrupt work on a Class 1 task to respond to someone's demand that they do a Class 2 or Class 3 task.

In the second case, the marketing department made a conscious choice to let some jobs take longer in order to focus on better prospects. The decision was to allow a low-probability, low-dollar-value job stay in the "buffer" longer if it meant that the company could meet customer expectations on the kinds of jobs that were likely to increase revenue and gross margin.

Both of these examples show the benefits to managing work flow, and not just trying to tackle every job as it comes along. A little focus can reduce congestion, lead to greater customer satisfaction, reduce variation in processing time, effectively increase capacity, and generate the kinds of fiscal results every company wants to see on its balance sheet. And it can be used in any service -- from loan processing and underwriting to all kinds of direct customer service.

So look at the stacks of papers or email in-box in your own office, and give triage a try.

About the Author

Mark George is a director at George Group (http://www.georgegroup.com) and has helped deploy Lean Six Sigma programs in financial services, telecommunications, industrial manufacturing and business services. He has delivered training around the world for executives, project sponsors and Green Belts at companies such as Alcan, Geico and Xerox. He may be reached at mageorge@georgegroup.com.

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