paz using cx concepts for better respiratory protection outcomes · tim paz, cih 2021 chesapeake...

Using CX Concepts to Optimize Desired Respiratory Protection Outcomes

Tim Paz, CIH 2021 Chesapeake Health and Safety Educational Seminar April 15, 2021

Disclosure

I, Tim Paz, will present information describing my various experiences as a certified industrial hygienist and respiratory protection program administrator in the public and private sector. Ideas, opinions, and comments described in these slides and mind maps and during this presentation are my own and do not represent the views of my current employment affiliation, the Architect of the Capitol. I am here on my own behalf, as a Full Member of the AIHA.

This presentation is intended for educational purposes only. Any mention of trade, firm, or product names is for descriptive purposes only and does not imply endorsement by the presenter nor the U.S. Government.

Public Disclosure Date: April 15, 2021 2April 15, 2021Using CX Concepts to Achieve Better Outcomes

Agenda

01. Introduction

02. Respiratory Protection – Current State

03. CX Fundamentals

04. Establishing Desired Outcomes

05. CX Applied

3April 15, 2021Using CX Concepts to Achieve Better Outcomes

My Goals…

Think Differently

Keep an open mind

Take off your IH/OEHS hat

Embrace empathy and understanding!

Explore self-awareness

Up your empathy game!

People Working Together

You can’t do it alone

Worker participation is key

Engage with key stakeholders

Develop a Group Strategy to Improve the Respiratory Protection Program

Call to Action: Become a CX Champion

Think of the employees you serve as customers

Treat your customers right

Create legendary service

Learn more about CX

Create Customer Personas & Journey Maps


Using CX Concepts to Achieve Better Outcomes

• CIH - 1994

• Respiratory Protection Program Administrator• Boeing, DOE Superfund Cleanup Project, Dept of Veterans Affairs

• Committed to Self-Awareness

• Personal Mission, Vision, and Core Values Established

01. Introduction


A compelling vision tells you who you are (your purpose), where you’re going, (your preferred picture of the future), and what will drive your journey (your values).

Vision

Using CX Concept for Better Outcomes

Using CX Concept for Better Outcomes

April 15, 2021Using CX Concepts to Achieve Better Outcomes

Self-awareness is, at its core, the ability to see ourselves clearly—to understand who we are, how others see us, and how we fit into the world. Self-awareness sets the upper limit for the skills that make us stronger team players, superior leaders, and better relationship builders.

Self-Awareness

April 15, 2021Using CX Concepts to Achieve Better OutcomesEurich, Tasha. Insight . The Crown Publishing Group. Kindle Edition.

TP

The art of stepping imaginatively into the shoes of another person, understanding their feelings and perspectives, and using that understanding to guide your actions.

Empathy

April 15, 2021Using CX Concepts to Achieve Better OutcomesKrznaric, Roman. Empathy: Why It Matters, and How to Get It . Penguin Publishing Group. Kindle Edition.

TP

If I had to name the secret ingredient to the

success I’ve enjoyed, I would say it all boils down

to a commitment to self-awareness.

– Alan Mullaly

Former CEO, Ford Motor Co.


• Respiratory Protection Still a Top 10 OSHA Violation

• 5 Million U.S. Workers Required to Wear Respirators

• COVID-19 Pandemic Has Increased Awareness

• OSHA NEP – Coronavirus Disease 2019 (Mar 2021)

• NIOSH Created PAPR100 Class of Respirators (Apr 2020)

02. Respiratory Protection: Current State


• NIOSH approved first-of-its-kind elastomeric respirators without an exhalation valve (Nov 2020) ...3 companies so far

• Still No Accreditation Program for Respirator Fit Test Administrators (in the U.S.)

• Supply & Availability of NIOSH-Approved Respirators Improving – CDC (Apr 09, 2021)

• Counterfeit Respirators

02. Respiratory Protection: Current State (continued)


• Barrier Face Coverings (BFCs) – New

• ASTM F3502 Standard Specification for BFCs (Feb 2021)

• ASTM F3407 Standard Test Method for Respirator Fit Test Capability for Negative –Pressure Half-Facepiece Particulate Respirators (Oct 2020)

• ASTM F3387 Standard Practice for Respiratory Protection (Aug 2019)

02. Respiratory Protection: Current State (continued)


Respirator Use in the United States

13

Respirators used in 619,000 workplaces

45% of these required for protection against workplace hazards

53% - very small businesses (<10 employees)

3.3 million (3% of all private sector employment) required to wear respirators

Largest fraction of employees required to wear respirators were employed in manufacturing

APRs were the most commonly used respirators

Doney, Brent C., et al. "A survey of private sector respirator use in the United States: an overview of findings."Journal of occupational and environmental hygiene2.5 (2005): 267-276.


Many Businesses Have Inadequate Respirator Programs

14

66% had no written program

51% did not conduct medical evaluation

43% did not provide fit testing

41% did not conduct employee training

Source: A Survey of Private Sector Respirator Use in the United States: An Overview of Findings (2005)April 15, 2021Using CX Concepts to Achieve Better Outcomes

Federal OSHA Data Through January 14, 2021

Total Number of Inspections 310

Total Initial Penalties $4,034,288

Highest Initial Penalty $32,965

Average Initial Penalty $13,013

Most Commonly Cited Standards Respiratory Protection

Hazard Assessment (PPE)

Recordkeeping/Recording

Reporting

COVID-19 Inspection Statistics


OSHA Top Violations (By FY)

FY 2014

FY 2015

FY 2016

FY 2017

FY 2018

FY 2019

FY 2020

FallProtection

1st 1st 1st 1st 1st 1st 1st

Hazard Communication

2nd 2nd 2nd 2nd 2nd 2nd 2nd

Respiratory Protection

4th 4th 4th 4th 4th 5th 3rd


Top Sections Cited – 1910.134

Medical Evaluation Voluntary Use

1910.134 (c)(2)

302 Violations

Fit Testing

1910.134 (f)2 – Initial Use, Annually1910.134 (f)1 – TFFR pass QLTF or QNFT

258 Violations188 Violations

Not required for Voluntary Users or Escape-Only Respirators

QLFT may be used to fit test negative pressure APRs if they will only be used in atmospheres less than 10x PEL, since existing evidence only validates the QLFT protocols listed in App A to identify respirators that achieve a FF of 100.

Written Program

1910.134 (c)(1)

449 Violations

1910.134 (e)(1)

518 Violations


Assigned Protection Factors

Assigned protection factor (APF) means the workplace level of respiratory protection that a respirator or class of respirators is expected to provide to employees when the employer implements a continuing, effective respiratory protection program as specified by this section.


Effectiveness of Respiratory Protection

19

Adequate protection from workplace hazards using respiratory Protection requires:

1. Well-fitting respirators 2. Very accurate fit test methods

Respirators that fit well on a wide range of facial sizes contribute to lower program costs, less administrative time and more effective respirator programs. [ASTM F3407 should help with this!]

D.L. Campbell,C.C. Coffey &S.W. Lenhart. “Respiratory Protection as a Function of Respirator Fitting Characteristics and Fit-Test Accuracy”AIHAJ; American Industrial Hygiene Association 62.1 (2001)


Importance of Fit Testing


“98 percent of fit tested workers exceeded the minimum protection level compared to only 55 percent of non-fit tested workers.”

TSI “Why Should Respirator Users be Fit Tested Report” (2007)

Fit Test Training and Accreditation Programs

New Zealand

Commit2Fit

Training

Fit Testing Accreditation Scheme

Fit Test Provider register

United States

None

Australia

Resp-Fit

December 2020 Kick-Off

Training

Stage 1 – Theoretical Assessment

Stage 2 – Practical Assessment by Video

United Kingdom

Fit 2 Fit

2015

Training (Pre-requisite)

Mentored Fit Testing

Examination

Practical Assessment

Good for 3 Years

Reassessment and Retaking the Examination (Until year 6)


03. CX Fundamentals


What is CX?

Create solutions for my business“Wow” when it matters

Recognize my loyaltyBe proactive on my behalf

Save me money

Don’t transfer me aroundMake self-service easy

Use language that I understandBe available

Solve my problem, completelyRespect meBe accurate

Don’t waste my time

Differentiate

Make it Easy

Accurately and Quickly Address my Issue

Increasing sophistication of delivering a

compelling customer

experience

Customer Experience is how clients perceive their interactions with the organization


Customer Experience

Customer Service & CX

Customer Service

Sum of all interactions in different places, via different channels, and over time.

How customers feel about your business, agency or department.

At a specific time, place, or channel. It’s the help you get. It’s reactive.


34%

35%

36%

39%

47%

48%

0 0.1 0.2 0.3 0.4 0.5 0.6

OTHER

TEXT

SOCIAL MEDIA

WEB

ONLINE CHAT

PHONE

Less than 50% of customers find any channel easy to use

Human Assisted Channels Are Easiest Today

25Digital Disconnect in Customer Engagement –Accenture 2018


0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

Online Chat Chatbots Face-to-face Phone Apps Social Media Web Form Email Letter

Instant Response

Response Time by Communication Channel

26

How soon would you expect to get a response on each of these channels?


This means…

1.Put the human and physical elements back into customer services.

2.Make it easier for customers to switch channels to get the experiences they want.

3.Root out toxicity – Identify the most difficult customer experiences across all channels and use them to guide your strategy.

27

83% of U.S. consumers prefer dealing with human beings over digital channels to solve customer services issues.


Customer Engagement ChannelsChannel CX Best Practice Agency/Organization - Current State

Support is web and mobile-accessible; intuitive interface for requests any time/where; operational automation

Email is an option when customers prefer; response within 4 business hours

Chat/text available and integrated for support staff; all contact captured for continuous flow of info

Phone support available during operating hours; service levels at 80% in 20”; high First Call Resolution

Social media channels available and monitored for customer feedback; timely response and action

Facebook and Twitter in use; no clear process for managing inbound activity or reporting


Coaching & Hiring on Behaviors that Matter

What drives customer experience and business results at the same time?

What is the benchmark set by your most successful reps? Why are they great?

Flexible to drive personalized service and care

Drives the coaching discussion – talks about the “how”

Motivates continuous learning and aspiration to deliver an even better experience the next time

29

Highly motivational quality programs frame the behaviors/competencies in the positive, creating a “yes we can” and “will do” mindset that drives CX performance.

Make a personal connection Discovery and active listening

Customer Advocacy

Business Acumen

Taking OwnershipMake it Easy for the Customer


Customers Understanding our customers’ needs, requirements and expectations; mechanisms to collect feedback; the Customer Service and Experience metrics and customer insights that we gather and analyze.

People Roles and responsibilities, hiring (numbers and skill); training and developing; Setting performance expectations for all personnel (employees and contractors). Rewarding excellent customer service.

Process The programs and processes we put in place to serve our customers; SOPs; the communication channels and protocols that we follow; operational “business vitals”.

Technology The tools that we use to manage our customer activities and processes.

Build a CX Roadmap: Define the Priorities


CX Roadmap (example)

Formation of CX Champions Group/

Community of Practice

• Monthly meetings by customer group

• Quarterly Meetings as an organization-wide team

• Sharing tips & insights

Enhanced Customer

Satisfaction Surveys

• Updating enterprise level surveys to better assess customer sentiment and cover the factors that are most important to customers

Enhanced CX Metrics

• Operational metrics to deliver more actionable insight to continuously improve service delivery

CX Training

• Training tailored by position type and customer group

FY22 Q1 FY22 Q1-2 FY22 Q1-2 FY22 Q3-4

Seamless Service Delivery

• Personalized• Frictionless• Anticipatory

Link to report


Forrester CX Index Score…measures how successfully a company delivers customer experiences that create and sustain customer loyalty.

Compliance

Likelihood of following directives/procedures


TP

CX Quality

34

Effectiveness: the experience delivers value to the customers.

Ease: It is not difficult to get value from the experience. For example, your SOPs are easy to understand. Scheduling fit testing is a snap. It’s easy to order respirator supplies.

Emotion: Customers feel good about their experience. They have good things to say about the respirator program.

TP


Who are your customers?

Respirator Wearers Trainees

New Employees – Initial

Existing Employees –Annual

Asbestos and Lead Workers who get “respirator training” as part of other courses(have you audited that course)

Others?

Contractors

Voluntary Users

Employees Undergoing Medical surveillance

Fit Test Subjects

QLFT Subjects

QNFT Subjects

New Employees

Experienced Employees

Asbestos Workers

Lead Workers

Carpenters

Stone Mason

Spray Painters

Emergency Response Team Members


Clearly identify who you’re serving!

Understanding our Customers: Personas

36

Representative description that includes…

• Objectives and needs• Patterns and traits• Emotive – motivations & values• Preferences – communication, likes, dislikes


What do personas tell us?

What our customer thinks is important Values

What motivates our customer Goals and objectives

What our customer knows Experience, education

What our customer needs from us Basic products and services, priorities

Who our customer talks to and influences Influencers and impact

What is a Customer Persona?

September 3, 20XXAnnual Review 37

How will you use a Customer Persona?

Help the organization understand who the customer is and what he/she wants and needs.

Design service/support processes

Design programs customers want

Communicate in the way that helps customers learn/listen

Build staff empathy skills

What is the purpose of a Customer Persona?


What is a Journey Map?


Attributes

Doing What actions are they taking? Touch points?

Thinking What is the customer thinking at each step?

Feeling How is the customer feeling at each step?

Pain Points What are the drivers of effort, friction, or rework?

Expectations What does your customer want and need?

Moments of Truth How and where is satisfaction created (or lost)?

Research Evaluate Acquire Use Renew Advocate

Journey map are living documents that drive customer insights, areas of focus, and measurements. They tell the story of the customers’ experience.

04. Establishing Desired Outcomes


ISO 45001

5.4 Consultation and participation of workersThe organization shall establish, implement andmaintain a process(es) for consultation andparticipation of workers at all applicable levels andfunctions, and, where they exist, workers’representatives, in the development, planning,implementation, performance evaluation andactions for improvement of the OH&Smanagement system.


Respiratory Protection Improvement Team

Ana

HR Manager

Larissa

Procurement Specialist

Roman

Asbestos Crew Supervisor

Federico

Fit Test Administrator

44

Others: Occupational Health Specialist/Nurse; EHS Trainer, Respirator Users, Respiratory Protection Program Manager, etc.


Using CX Concepts to Achieve Better Outcomes

Respiratory Protection Program Improvement Strategy

Mission------------------Core Values

Outcomes(What do we want?)

Behaviors(What should we do to accomplish the

outcomes?)

Assets(What do we have?)

Question #1: Are the assets sufficient for the outcomes?

Question #2: Are the assets enough for the required behaviors?

Question #3: Will the behaviors accomplish the desired outcomes?

April 15, 2021

Prevent occupationally-related lung disease and other regulatory-system related illnesses & injury.

Model respirator fit test program

Employees are issued properly fitted respirators

Only fit test administrators with “appropriate knowledge” and “experience” conduct fit tests

Respirators are of high quality

Scheduling fit tests are easy and convenient

Develop compliant written procedures for fit testing.

Ensure that individuals conducting fit testing have the appropriate knowledge and experience.

Provide training to fit testers.

Audit fit test operators.

Develop a robust Facial Hair Policy that incorporates the new NIOSH Facial Hair Position.

Work with HR to determine what measures can be implemented to ensure that employees who are required to wear respirators are clean shaven during use and at the time of fit testing (enforcement). This should include provisions for Position Descriptions (conditions of employment) and disciplinary actions if employees refuse to be clean shaven when wearing tight‐fitting respirators).

Education, experience and knowledge

Fit testing equipment

Written program with SOPs

Facial hair policy

Budge for respirators and other supplies

Full time EHS trainer

Respiratory Protection Program Improvements

Outcomes (What do we want?)

Assets (What do we have?)

Behaviors(What should we do to accomplish the outcomes?)


Respiratory Protection Improvement Program Strategic Plan (1 Year)

1st Quarter

Medical Evaluation

2nd Quarter

Written ProgramChangeout Schedules

3rd Quarter

Voluntary Use

4th Quarter

Fit Testing including Facial Hair


Objectives: Strategize, Harmonize, and Prioritize

Periodic Maintenance of Respiratory Protection Program

Question #1: What is working well?

Question #3:What can we do as a team to make the things that are not working well, work?

Question #2: What is not working well?


05. CX Applied


• Make them relevant

• Less is more (frequency and content)

• Ask the right questions (use open-ended questions)

• Have a goal in mind

• Use the results wisely

Surveys


• 2nd Largest VA Hospital

• Feb – Oct 2010 (After 8 Months On-the-job)

• End of Fiscal Year Input on Performance

• Sent to Wide Range of Customers

• Had spent much of my time helping to shore up Haz Com – New Electronic MSDS System

• Helped identify chemicals (smartphone photos), create inventories, enter products into the MSDS system, print hard copies, set up reminders to refresh MSDSs, etc.

Survey – VA Haz Com Project


• Quality of Work

• Dependability

• Team Work

• Communication

• [1-10, 10 being the highest score]

• [Option to send anonymously; and to provide comments]



• Surveyed workers who I had good interactions with and some who I didn’t

• Next time, I would add questions like…“How could I have been more dependable”“How could I have communicated better?”



Anything that compromises the form, fit or function of a respirator is strictly prohibited.

Add this simple statement to your written program

TP


Who is going to take the responsibility of ensuring that the respirator use will not create a hazard, the voluntary user is provided the information in Appendix D, and document that the instruction has been provided? This is for an organization for which has no mandatory wearers (and therefore no respiratory protection program administrator).

Voluntary Use Program Administrator

DRM


Develop a method to ensure that fit test administrators have the “appropriate knowledge” and “experience” through training, mentoring, and proficiency by way of examination and practicum to provide respirator fit testing. In other words, create your own way to “accredit” or “certify” that individuals can perform respirator fit testing. Use the Fit2Fit accreditation scheme as a guide.

Validate the proficiency of your fit test administrators

TP


• Calibrate equipment as needed

• Perform tests properly, including preparation and any calculations

• Recognize invalid tests

• Ensure that test equipment is in proper working order

Fit test administrators must know how to...

TP


Focus Groups

New RespiratorWearers (within first six months)

Ask them about their experience with:

Training

Medical Evaluation

Fit Test

Respirator wearers who just got fit tested (within a week)

Ask them about their experiences.

Did the fit test administrator ask them to undergo a 5 minute comfort assessment period?

Did they explain the purpose of the fit test?

Respirator wearers who use a particular class of respiratory protection

Filtering Facepiece Respirators

PAPRS

Full facepiece air-purifying respirators

Escape hoods

Respirator wearers by job class

Healthcare workers

Asbestos workers

Lead workers

Spray painters

Carpenters

Stone masons

60

TP

Sit them down over breakfast, lunch or afternoon of refreshments and light snacks


Demonstration

Mind Map for Respiratory Protection Program Improvements

Mind Map for Face Coverings

Customer Personas Focus Group Questionnaire

61

TP


There is only one boss. The customer. And he

can fire everybody in the company from the

chairman on down, simply by spending his

money somewhere else.

– Sam Walton


Summary

Become a CX Champion. Treat the employees you serve as customers.

•Identify who you are serving

•Bring customers to life with personas

•Map the entire customer journey

•Analyze and act on data

•Identify common questions (FAQs)

New way of thinking: we should measure success in other ways (not just typical EHS metrics)

Establish desired outcomes (as a group, not just from an EHS perspective)

Work together to identify outcomes, assets & behaviors.

Roll up your sleeves and work towards identifying what is working well, what is not working well, and what improvements are needed.


References: Books


Resources: Respiratory Protection

AIHA Respiratory Protection Committee

AIHA Technical Framework: A Resource for Respiratory Protection Programs (to be updated – later in 2021 or early 2022)

ISRP – International Society of Respiratory Protection

National Personal Protective Technology Laboratory (NPPTL) - NIOSH

NIOSH eNews

Facial Hair Guidance

Dr. Roy McKay Newsletter (Univ of Cincinnati)

QLFT Guidance – Dr. Roy McKay (YouTube)

Social Media – Twitter & LinkedIn


Resources: Customer Experience (CX)

Customer Experience Toolkit

The State of Federal CX (A webinar)

Solving the CX Puzzle (an article)

Qualtrics

Heart of the Customer

CX for Dummies

CX Journey

Forrester

The Northridge Group

Deloitte Center for Government Insights’ Government Trends 2021

Tim’s Drop Box with reference materials, samples, etc. (will expire by 05/15/2021)


Thank you!

Feel free to contact me if you have questions or ideas for improving this session.

Tim Paz, CIH

[email protected]


paz using cx concepts for better respiratory protection outcomes · tim paz, cih 2021 chesapeake...

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