INDUCTION | Recruiting, Inducting and Socializing New Employees

Most organizations deliver in-house initial basic training for advisers for three reasons:

1. No external solutions appear to be available.
2. It is the most cost-effective solution.
3. It enables employees to be trained in systems, products/offerings and customer service approach

In 2003 the average duration for the induction of agents was 36 working days; however, this reduced significantly to 21 days in 2004. Dimension Data suggested that this might have contributed to the decreases in customer satisfaction and first-contact resolution, and increases in call abandonment and staff attrition during the same period.

The reduction in induction training can be attributed to three main reasons. First, there is pressure to minimize costs and when people are being trained they are not available to generate income for the organization. Secondly, many employees leave before the contact centre has financially recouped its investment in recruitment, training and development. The third reason for reducing the period of induction is that this speeds up the provision of new agents into the workplace.

The average length of induction training for new supervisors and managers is 14 to 15 days. However, many key competency areas are not strongly included, eg management skills, coaching, telephone communication skills, team building skills, call analysis skills, and monitoring/use of statistics.

However, training is not just a cost, it is also an investment in the future production potential of the person. Dimension Data observed that contact centre complexity was increasing with multiple channels, different functions, processes and systems, and increased demands for improved performance. To achieve this it argued that 21 days induction was insufficient for all but the simplest contact centre and suggested a minimum of six weeks induction plus ongoing support in the form of an apprenticeship or buddying system.

To be a nurse adviser in NHS Direct, nurses are required to have five years’ post-qualification experience. To assist nurses to take on their new roles they undergo a fairly lengthy period of training, for example, in the early days of NHS Direct induction training for nurse advisers varied between five and 12 weeks depending on the region. The areas covered included clinical assessment, clinical protocols, ethical issues, accountability, IT skills and telephony. However, at Health-Info CLSC in Quebec, the duration of training was only five or six days and this was believed to be because, ‘The practice of nursing over the phone is therefore a continuity of pre-existing lines and embedded in a nursing methodology central to the education of Quebecois nurses.

In an Australian telecommunications company, new employees had a 10-week full-time training programme followed by up to six months of support at the end of which they were expected to be fully competent. Similarly, in Flightco, an airline booking organization, induction training lasted between eight and 10 weeks and focused on computer and technical skills, products and services, and customer service areas. Following this there were two-monthly performance reviews, which continued for about six to eight months until the agents reached the desired level of proficiency.

Market analysts ContactBabel, also identified that induction courses in most industries lasted approximately three to four weeks. In the utilities sector induction training tends to be approximately five weeks because of the cross-selling and up-selling that are expected.

There would also appear to be a degree of correlation between the size of the contact centre and the length of training. Larger centres tend to have a dedicated training department and the average length of induction is four weeks. Those contact centres with less than 50 agent positions average only 14 days.

Some agents receive only a minimum degree of training. Research by CallNorthWest described a situation where the training was rushed, there were no hand-outs and no opportunities to ask questions, which resulted in one agent feeling like she knew very li le. Furthermore, one agent who had not received induction training and had to teach herself, contemplated resigning and stated, ‘I actually walked out at one point after three days because it was so bad. I used to dread coming in, but they came after me and persuaded me to stay’.

The ability of the trainer also has an impact on the motivation of the agents and the perception of the organization: ‘If you have a bad trainer, especially at induction, it puts you off. Especially the induction phase, you can gauge the quality of the organization through that first induction period’.

In larger organizations with high attrition there can be a permanent demand for new agents, leading to a continuous flow of people passing through induction. In general, there appears to be a common structure for induction training:

• classroom training on skills, systems, knowledge, etc;
• practice on systems/computers, etc;
• listening in on calls;
• answering calls under supervision;
• a ‘paddling pool’ or ‘nursery’ where people are under close supervision;
• placement close to an experienced member of staff or a buddy;
• regular supervision and frequent checks;
• normal supervision and assessment.

After induction, training is usually less frequent or even voluntary; however, where there is poor performance training is compulsory. Also, induction training is largely the responsibility of the training department, but after that it is largely the responsibility of the team leader or supervisor.

Induction as assessment

The induction period is used to develop the knowledge, skills and attitudes necessary to work in the contact centre. During this period close attention is given to the inductees so that any areas of weakness can be addressed and improved. Those whose abilities match the necessary standards will be signed off and work alongside more experienced colleagues or buddies. Where people do not come up to standard they may be given additional support and training or, if this is not effective, they may be released. Contracts of employment normally contain the specification that permanent contracts will only be issued to those who reach certain standards during induction or the probationary period.

NHS DIRECT WEST COUNTRY

Background

The 1997 White Paper, The New NHS: Modern, Dependable announced the planned introduction of NHS Direct. First-wave sites began operations in March 1998 and the NHS Direct Special Health Authority was established in April 2004 with five regions consisting of 22 NHS Direct sites employing approximately 4,000 people. Together they handle around 6.5 million calls per year.

NHS Direct West Country began in March 1999 and originally had responsibility for the counties of Cornwall, Devon, Somerset and Dorset. It had a main site in Exeter and satellites in Truro, Plymouth, St Leonards and Taunton. It served a widely dispersed population of 2.8 million people in rural and urban areas and employed approximately 164 people (123 full-time equivalents). At the time of the research there were 70 nurse advisers, 33 call operators, three health information advisers, seven operational nurse managers, four call operator supervisors, 3.4 senior management team, and 10.2 operational and administrative support staff. During 2004/5 there were approximately 400,000 calls of which 96.4 per cent were triaged by a nurse within 20 minutes. Subsequently, an Intelligent Call Management system was introduced and calls were routed around the country. The Clinical Assessment System is operated nationally and so too is the call-back queue.

The training and development process

Calls made by a patient or on behalf of a patient are first received by a health adviser or operator who gathers demographic information. An onscreen algorithm is then used to ask a number of questions designed to prioritize the urgency of the call. Emergencies are immediately directed to 999, and the remaining calls are prioritized and nurse advisers return the calls.

Induction for operators/health advisers lasts four weeks and includes computer systems, keyboard skills, physiology and anatomy. Trainee operators progress from listening in to calls taken by experienced advisers and then gradually take calls themselves. Each month there are two call reviews that evaluate performance. Additional training may include mandatory areas ie, the introduction of new databases.

Nurse advisers are required to have five years’ post-registration experience, have good communication skills and personality. They are supported by a clinical decision support system (Clinical Assessment System) which guides them and also provides information during the patient consultation.

Nurse adviser training has become more nationally standardized and has the flexibility to respond to local requirements. The six-week induction programme is a competency-based programme using a knowledge and skills framework. This is then followed by a transitional week in which they answer calls using a buddy or nursery system. The training includes: call review guidance, NHS Direct, accountability and professional issues, performance management, paediatric issues, confidentiality, health and safety, vulnerable adults; customer care issues, the Clinical Advice System, algorithm familiarization, Microsoft Outlook, history-taking skills, critical thinking skills, and reflective practice.

In general, there are numerous opportunities for ongoing education and training, both internally and externally. There is work-based training with a half-day training every three weeks, study for professional qualifications including National Vocational Qualifications and modular programmes at universities. Moreover, there are shut-down days with calls diverted to other sites, and staff also have protected time for training.

One of the main means for developing staff is through the quality system. To comply with national standards sites are required to audit 2 per cent of calls per day and these are carried out by trained call reviewers. The software can provide feedback on the performance of nurse advisers and all calls are recorded. The performance can be assessed through self-evaluation, one-to-one, peer review, and supervisor review of live calls. Feedback about triage and telephone consultation tends to use Pendleton’s rules of feedback. The challenge is to balance operational demands and educational needs of staff.

Nurse advisers report that their general knowledge is sometimes broader and more up-to-date because the range of cases they deal with is often larger than they might otherwise come into contact with during traditional working. On the other hand, lack of direct patient interaction may lead to de-registration, eg midwives need to assist at a certain number of births.

In summary, the role of training in NHS Direct is very central to the maintenance of high standards and the avoidance of adverse events.

Induction programme content

A number of guidelines have been published to support the public sector in establishing contact centres. The Scottish Executive recommended that comprehensive induction programmes should address at a minimum level:

• aims and structure of the organization and the role and purpose of the contact centre;
• relevant work processes;
• knowledge of the particular services;
• customer service techniques across appropriate channels, in other words, telephone, letter, e-mail, etc;
• IT systems;
• health and safety;
• organizational policies and procedures;
• team building.

Similar guidelines by the Central Office of Information advised government call centres to include the following in induction programmes:

• aims and structure of the department/organization as a whole, and the role and purpose of the contact centre and how it fits into the rest of the organization;
• knowledge of particular service(s) as appropriate, the subject matter and the business process of the service;
• customer service skills, in general terms and specific techniques that can be used across all channels eg, telephone, letter, e-mail;
• familiarity with IT systems;
• health and safety;
• organizational policies and procedures;
• team building
• stress management;
• management training for team leaders.