Service Design in Government How Design Thinking Principles Can Bolster Mission Effectiveness, Productivity, and Customer Satisfaction

FEATURE

Service design in government How design thinking principles can bolster mission effectiveness, productivity, and customer satisfaction

Jeneanne Rae, Tiffany Dovey Fishman, Bruce Chew, Adriana Teran Doyle, and Claire Nelson

DELOITTE CENTER FOR GOVERNMENT INSIGHTS Service design in government

Service design combines principles of customer experience and business process design to help public sector agencies improve three critical tasks: mission effectiveness, productivity, and customer satisfaction.

HEN PATIENTS BEGAN trickling away to monitored wait times on their computers and commercial drug stores, a government attempted to reduce them. But it wasn’t enough. Wpharmacy network tried a customer experience cure. But the trickle continued, then Patients continued voting with their feet. grew to a steady flow. The network was hemorrhaging money. The pharmacy network’s customer experience needed drastic improvement, and the root causes The pharmacies were paying upwards of 50 percent for patients’ pain appeared to run deeper than more for every prescription filled outside their pharmacy checkout counters. So, network leaders network. Even when patients were buying their kicked off a full-scale pharmacy service redesign. medicine elsewhere, the network still had to pay It began with a broad study of patients’ habits, for their pharmacy network staff and real estate. motivations, and expectations and examined how they moved end-to-end through pharmacy services. Pharmacy operating costs were swallowing a Researchers surveyed 1,000+ patients and a broad quarter of the medical budget that had to cover a range of health care providers, conducting direct full range of medical care for their patients. interviews with patients in waiting rooms and with pharmacy staff. Drug spending outside the network had to come down. The results caught the pharmacy team by surprise. It wasn’t waiting for prescriptions that most It wasn’t as though the pharmacies hadn’t tried irritated patients. It was that at the end of the wait, to entice customers back. They added displays in the pharmacies often didn’t have the medications waiting rooms showing time estimates for checking they needed. in and for filling prescriptions. Pharmacy staff The network had been treating the wrong problem.

2 How design thinking principles can bolster mission effectiveness, productivity, and customer satisfaction

Rx for the real problem Beyond customer experience

The pharmacy team’s prescription for curing Many companies and government agencies have patients’ real complaint—unavailable medications undertaken customer experience (CX) improve- —took effect far from the waiting areas. Treating it ments.1 Until recently, however, these efforts have meant recombining and improving data streams so focused purely on the customer interactions. Few staff could track drug availability, view historical have combined CX with business process reengi- and real-time prescription demand data, and track neering to design—or, as is more often the case in supply performance. the world of government legacy systems, redesign— services more broadly. Using a new inventory data tool, pharmacy staff aligned the amounts and types of medication Service design uniquely considers how the “front- they keep on hand with actual patient demand. stage” experience of the patient, traveler, business Now they are able to prepare for seasonal shifts partner, or other end user is orchestrated with the and changes in available medicines, so they have “back-stage” capabilities and sequencing of activi- enough of the right drugs on hand even when ties to enable and enhance that experience (figure demand peaks. 1). It is an inherently holistic and systems-oriented approach to problem-solving Service design uniquely considers how that involves planning and organizing people, processes, the “front-stage” experience of the and technologies, along with patient, traveler, business partner, or the infrastructure to improve the quality of interactions other end user is orchestrated with the between organizations and the “back-stage” capabilities and sequencing audience they are serving. of activities to enhance that experience. CX-minded providers often envision the “optimal experi- At the pilot test sites, medication availability ence” for their customers, but unless the ecosystem increased 25 percent. It led to a 46 percent of supporting processes and systems is optimized increase in patients served within 30 minutes at to deliver that experience, any plans for improve- one pharmacy, and lifted service quality scores by ment will ultimately fail. 22 percent at another.

Pharmacy staff no longer over-order drugs that A mandate for service design sit on shelves beyond their expiration dates or underorder them, driving empty-handed patients Service design isn’t just a promising practice for to retail drug stores. Adding effective drug data and improving mission delivery, productivity, and logistics to a positive interaction at the pharmacy customer satisfaction. It’s highlighted in the counter ensures their prescriptions are filled and President’s Management Agenda, which calls keeps pharmacy customers coming back. it out as a tool for pursuing more effective customer interaction and engagement. The agenda includes a cross-agency priority goal, “improving customer experience with federal services,” that

3 Service design in government

What is service design Service design is oistic roc tt considers te endtoend service eerience cross cnnes nd tocoints rom cstomer nd orgnition ersective Service design is rt cstomer eerience ront stge nd rt siness design c stge

Custoer Service Business experience design design C

Sorces eoitte nsis eloitte nsights deloittecominsights

4 How design thinking principles can bolster mission effectiveness, productivity, and customer satisfaction

interact with government and how government delivers services—in short, to redesign the delivery of its services.

Remaking poorly performing services doesn’t just help a government program or agency reap effectiveness and efficiency dividends and improve customer satisfaction; it also helps it comply with White House mandates. HISPs, especially, must meet customer experience metrics, which are then publicly reported. Service design is one of the tools to help these programs meet their goals.

Public service redesign in action

The pharmacy initiative described earlier displays the hallmarks of service design:

• It made impactful improvements in customer covers more than two dozen high-impact service experience through informed, deep understand- provider (HISP) programs in more than a dozen ing of users and of the current state of the departments.2 service provided.

A new section in the Office of Management and • It mapped the immediate and supporting pro- Budget Circular A-11 includes service design in cesses and systems to demonstrate how they a list of core functions to be used by HISPs in influenced and potentially limited current capa- managing customer experience: bilities and could be changed to enable potential improvements. Service design: Adopting a customer- focused approach to the implementation of services, involving and engaging custom- • It thoroughly accounted for and analyzed staff, ers in iterative development, leveraging manager, stakeholder, and customer points of digital technologies and leading practices view to reimagine the service. to deliver more efficient and effective touchpoints, and sharing lessons learned across government.3 • It shifted the focus from delivering on time to delivering value. The White House Government Effectiveness Advanced Research Center aims to be an incubator All this involved redesigning pharmacies’ structure, for innovative solutions to government’s biggest metrics, culture, and processes. The pharmacies’ problems. Among its charges is to create holistic experience illustrates the importance of examining and systems-oriented solutions by bringing first- and second-order processes when attempting together experts in economics, computer science, to transform customer experience. Often, the fix is and design thinking to reimagine how citizens far removed from the customer, and nothing truly

5 Service design in government

will change until the processes and technologies the right forms on USPTO.gov. These customers creating poor experiences are addressed. were the most likely to give up on the application process, depriving themselves of protection and FURTHERING USPTO’S CORE MISSION the agency of fees. They also were the biggest users of the call center, which added significant cost for Service design can help heal other government USPTO.5 The struggles of do-it-yourselfers were ills, too. For example, when the constituencies not unknown, but until the customer journey of served change or one segment grows faster than the novice user was analyzed using service design another, an organization might lose track of users’ methods and tools, it was difficult for USPTO to needs. Service design dives into the demographics see clearly how those struggles were impacting the and experiences of new or changing customers, agency’s mission goals and bottom line or how best identifies the root causes of service shortcomings, to improve on an underoptimized system. and prescribes integrated front-end and back-end solutions that support an optimal experience USPTO applied service design, backtracking to for users. learn more about every step of new users’ experience. Those lessons led the agency to reorganize its website and hire writers to Citizens all too often find themselves simplify and clarify its language. It adopted quick, easy fixes, such frustrated because they must navigate as a cheat sheet on how to fill disconnected, inconvenient systems to forms, cluing in users on form idiosyncrasies and how to handle access government services. them. And, to mimic a more YouTube-like experience that Case in point: the US Patent and Trademark customers were accustomed to, it corralled all its Office (USPTO). As Jill Leyden Wolf, customer how-to videos in one place. experience administrator for trademarks at USPTO, explains, “We have a growing segment of REDIRECTING RESOURCES WHERE THEY do-it-yourselfers. About 30 to 40 percent of our BELONG MOST applicants are coming to access our services on the trademark side without attorneys. That could be a Citizens all too often find themselves frustrated mom-and-pop shop; it could be a startup without because they must navigate disconnected, incon- legal counsel yet coming to us to access our ser- venient systems to access government services. vices, but they don’t have a baseline understanding Employees resent being pulled from their work of what trademarks really are.”4 The same could be to assist users of these poorly designed processes. said for new users of the even more complex patent That’s exactly what was happening in the US process. Customs and Border Protection’s (CBP) Global Entry Program. Accountable for much of the country’s job growth and innovation, this group of mostly first-time ap- Global Entry was designed to speed prevetted plicants arguably have the greatest need for patent international fliers through airports, both saving and trademark protection. Without lawyers to trusted travelers precious time at the airport while show them the ropes, most first-timers didn’t know freeing the time of security and customs officers to how to begin the complex trademark or patent focus more on screening higher-risk passengers. It application processes or how to find or fill out seemed like a customer-service slam-dunk. But it

6 How design thinking principles can bolster mission effectiveness, productivity, and customer satisfaction

wasn’t taking off. Service design prompted traveler duplicative reviews, unclear authority, and and employee listening sessions that showed mountains of conflicting edits, leading to delays while the Global Entry service at airports was in the issuance of examination reports. According enticing, the Global Entry enrollment centers were to CFPB’s inspector general: “[T]he CFPB had not chokepoints. met its goals for the timely issuance of examination reports, and a considerable number of draft ex- Provisionally approved Global Entry applicants amination reports had not been issued,” resulting had to travel to an enrollment center for an in “delays in the issuance of examination reports in-person interview to complete the process. But that can leave supervised institutions uncertain making interview appointments often took months about the CFPB’s feedback on the effectiveness of and getting to them could entail a trip of hundreds the institutions’ compliance programs or processes, of miles. which could delay the implementation of required corrective actions.”8 To smoothen the process, CBP designed Enrollment on Arrival (EOA), an alternative Unsticking exams and reports proved relatively interview process conducted at airport customs inexpensive—as often is true with service design booths when customers were returning to the projects—but it wasn’t easy. CFPB had to delicately United States. realign final decision-making power from key stakeholders and delegate it to fewer that were Since its inception in 2017, EOA has expanded closer to the frontlines. A new triage function to 47 major international airports, with over expedited reviews for lower-risk examinations. 70,000 enrollments in FY18, resulting in added Templates made reports faster to write and convenience for Global Entry applicants and saving improved quality. Setting time limits and en- CBP thousands of officer hours over each traveler’s forcing them for each step in the examination and five-year Global Entry membership.6 reporting process made expectations and responsi- bility clear.9 REDUCING BACKLOGS By realigning front- and back-end processes, CFPB Regulatory agencies don’t have direct customers was able to improve the effectiveness and ef- in the commercial sense, but they, and the citizens ficiency of the exam process. The number of exams they protect, have as much to gain from service exceeding time limits stopped increasing. A rising design as commercial organizations. Take the proportion of exams qualified for expedited re- Consumer Financial Protection Bureau (CFPB), gional and headquarters review, leaving extra time which supervises financial institutions to help to focus on higher-risk and more complex cases. ensure they don’t engage in risky practices. Relations between field examiners and leadership also improved. When the bureau came under scrutiny from its inspector general in 2014, improving the operational efficiency of supervision was flagged as a manage- Targeting the biggest service ment challenge that, left unaddressed, would most design returns likely hinder the bureau’s ability to achieve its strategic objectives.7 Backlogs are just one ubiquitous government problem that service design addresses. One could At the time, CFPB’s examination process was argue that it’s hard to come up with a government bogged down under the weight of multiple, service that wouldn’t benefit significantly from

7 Service design in government

service design. Widespread public sector adop- 4. Inadequate digital platforms. Underlying tion of customer experience initiatives shows digital platforms can hamper an agency’s efforts that government program leaders are willing to to deliver an excellent customer experience. embrace techniques to improve service to citizens. Outdated, disjointed, and limited digital ser- Service design can help accomplish that while also vices make effective service provision delivering efficiency gains and increased mission nearly impossible. effectiveness to ensure better experiences will stick. 5. Unresponsive customer service. Many Public sector organizations should target programs government organizations fail to consider how where service design will deliver the biggest return back-end systems impact their ability to pro- on investment. Deloitte’s Government and Public vide responsive customer service. A poor Services Customer Strategy and Applied Design customer experience can lead to embarrassing team reviewed 39 case studies of successful govern- news coverage, congressional inquiries, and a ment service design projects to develop indicators loss of funding. of service design opportunities (see sidebar, “Self-assessment: Identifying which services could 6. Complex regulatory environment. Govern- benefit from service design”). Six showed up again ment agencies are often burdened with complex and again: legal and political demands. Service design helps prevent regulatory complexity from trans- 1. Limited knowledge of end user. Many gov- lating into confusing back-end systems and a ernment agencies lack detailed demographic frustrating customer experience. and behavioral knowledge of the citizens and organizations they serve. Without dedicated systems that gather, analyze, and share cus- Looking ahead tomer knowledge, delivering a positive customer experience is difficult. Service design projects, by their very nature, require leaders to embark on a journey of discovery, 2. Disconnected services. Poor communica- leaving behind preconceived notions about why tion between different agencies and limited things are the way they are, and seeing things consolidation of processes and systems within anew from the customer’s perspective. To be able the same agency can lead to disjointed service to succeed, leaders must embrace the process and, provision. As a result, agencies often face frus- through it, the opportunities it reveals. trated citizens who have been asked to navigate multiple, disconnected systems to access As more agencies embrace service design—both to related services. comply with the OMB mandate and as a means of furthering their own mission objectives and orga- 3. Unique end-user challenges. Services for nizational performance—project designs and/or customers with specific challenges such as procurement approaches will need to be revisited homelessness, mental or physical illness, and and updated to reflect the inherent uncertainty unemployment require a particularly high level about the nature of the solutions that will emerge of service design to understand and incorporate from the process. needs that may fall outside the common experience.

8 How design thinking principles can bolster mission effectiveness, productivity, and customer satisfaction

SELF-ASSESSMENT: IDENTIFYING WHICH SERVICES COULD BENEFIT FROM SERVICE DESIGN The Government and Public Services Customer Strategy and Applied Design team analyzed case studies featuring service design in the public sector to identify indicators that suggest that a project represents a strong opportunity for service design. Through the analysis of the case studies, the team identified six service design indicators that point to a potential opportunity for service design.

Self-assessment: Identifying which services could beneﬁt from service design

. Inadequate digital . Limited knowledge of platforms end user 56% 54%

. Disconnected services . Unresponsive customer service 44% 21% Complex . Unique . end-user regulatory challenges7% environment 28% 28%

Sorces eoitte nsis eloitte nsights deloittecominsights

Is service design right for your project? Take the quiz to learn more. Answer the questions below to see if your organization could benefit from service design.

1. Limited knowledge of end user Many government agencies lack detailed demographic and behavioral knowledge of the citizens and organizations they serve as they lack dedicated systems that gather and share customer knowledge. This absence makes delivering a positive customer experience difficult. continued >

9 Service design in government

1. Limited knowledge of end user, cont.

I have a detailed understanding of who is using my organization’s services.