How we create and deliver value
Most organisations have a way of hearing from the people they serve, and a number that says how it is going. Surveys, complaints, satisfaction scores, a report with a figure on the front.
The number tells you what came out. It does not tell you what it cost to produce, or whether it can be produced again next year.
This is the only one of the eight dimensions that looks outward.
The other seven ask people about the organisation they are standing inside - how it feels, how it works, where it is heading. Service asks them about somebody else: the people the organisation exists to serve. Every organisation calls them something different, so the assessment uses your word. Residents. Customers. Patients. Clients. Members. Students. Whoever it is that the work is ultimately for.
The dimension reads a loop. Does what those people need get into the organisation - properly, currently, in a form that shapes decisions rather than decorating them? And does the organisation get better as a result - not perfect, but better, with problems fixed at the cause rather than smoothed over?
A loop can break in either direction. It can also stall for want of anyone having the hours to turn it, which is the fifth statement, and often the one that matters most.
A good outcome can be produced two ways.
It can come out of a system that works - where what people need is understood, the understanding reaches the decisions, problems get fixed at the cause, and there is time to make things better. Or it can be carried: produced by people going round the system rather than through it. Working late. Chasing another team for something that should have arrived. Keeping a private spreadsheet because the official one is wrong. Doing the job twice because the first way was the way the process wanted.
From the outside, the two are indistinguishable. The satisfaction score is the same. The complaint volumes are the same. Everything the organisation measures says the same thing.
From the inside, everybody knows exactly which one they are living in.
That is the case for asking a workforce about service, and it is a different question from asking the people being served. Ask the customer and you learn the outcome. Ask the workforce and you learn what produced it - and whether it can go on producing it. A carried service is not a failing service. It is frequently an excellent one, delivered by people who care a great deal, at a cost that does not appear in any of the numbers the organisation looks at.
This is where the eight dimensions do something a single measure cannot. Service high, Flow low is a specific and readable pattern. It says the outcome is holding and the system is not - that the gap between the two is being closed by people, and that the closing of it is being paid for somewhere. Service high, Flow high says something else entirely: the system is producing the result, and the result is likely to survive the people who happen to be delivering it today.
The rest of the eight fill in the picture. If what users need is not reaching decisions, the question may be whether the organisation's information travels at all - which is Connection. If people can see what is going wrong and do not raise it, the question is whether it is safe to - which is Culture. And if the improvement never happens despite everybody knowing what is needed, the answer is often that there were no hours in which to do it - which is Flow again, from the other side.
The Service score is the mean of five statements. Two read whether the outside gets in. Two read whether the organisation gets better. The fifth reads whether there is any room to do either.
Whether what is delivered is built around what the people served need.
Most organisations believe they understand the people they serve. The question is whether that understanding is current, tested, and doing any work - or whether it is an assumption, formed some time ago, that nobody has had cause to revisit. Where this is reported as less true, the organisation is building around what it thinks people need. It may well be right. It has no reliable way of knowing, and no way of noticing when it stops being right.
Whether the voice of the people served comes through in how the organisation runs.
Not whether the organisation collects their views, but whether those views survive the journey inward. The front line meets these people daily. The decisions get made somewhere else. This dynamic reads whether anything of them makes it across that distance intact - whether you can hear them in the room even when they are not in it, or whether what reaches the decision is a number with the person taken out of it.
Whether what the organisation delivers keeps getting better over time.
Not whether the service is good, which is a question about a level. Whether it is improving, which is a question about a direction - and a more useful one, because the direction is what tells you where you will be in a year. Where this is reported as less true, people are not necessarily describing a bad service. They may well be describing one being held together: maintained, defended, kept at the same place by steady effort, with nobody able to point to anything that is meaningfully better than it was.
Whether problems for the people served get fixed at the cause, not the symptom.
Something goes wrong for someone the organisation serves. It gets dealt with. The question is whether it gets dealt with in a way that stops it happening to the next person - or whether the individual case is closed and the cause is left where it was. This dynamic separates good complaint-handling from actual learning, and the two are easy to confuse: an organisation can be excellent at the first while doing very little of the second. It will have good response times, and the same problem, indefinitely.
Whether there is time and space to improve how work is done, not just to keep up.
The statement that decides whether the other four are possible. Improvement takes hours, and in a great many organisations every hour is already spoken for by the work itself. Where this is reported as less true, people are not usually failing to improve things because they do not know what to improve. They often know exactly. There is simply no room in the week in which to do it, so it gets deferred - and deferred again - and the organisation stays busy running to stand still.
The assessment asks how often each statement is true. Below is what each end of that scale describes. Neither column is a judgement - both are descriptions of what people report.
Alongside the five scored statements, everyone is asked one open question about service:
What one thing would most improve what we deliver to the people we serve?
The organisation supplies its own word for those people, so the question arrives in the workforce's own language - what would most improve what we deliver to residents, or to patients, or to customers.
It is the question that reaches knowledge nobody has asked for. People on the front line often know the answer in specifics, and are rarely in the room where it would be useful. The responses are not scored, summarised or averaged. They appear in the dashboard as written.
Where Service sits against the other seven dimensions - and in particular against Flow, because the two read together tell you whether the service is being produced by the system or carried in spite of it.
Whether the loop is breaking on the way in, on the way out, or stalling for want of time. Which of the five the score rests on, and which sit further from it.
Service is a dimension where the front line and the centre are likely to answer differently - not because either is mistaken, but because they are standing at different points in the loop. One meets the people being served every day. The other sees a summary. The dashboard shows that split rather than resolving it into one number.
In their own words, unsummarised - and on this question, that usually means specifics.
Five statements, each answered on the same five-point frequency scale: almost always, often, sometimes, occasionally, rarely. The prompt is how true is this in your experience?
That prompt is a deliberate choice. Agreement scales measure opinion - whether someone endorses a proposition about the organisation. Frequency scales measure observation - how often a person reports seeing something happen. Opinion tells you what people think about the organisation. Frequency tells you what they encounter in it.
The dimension score is the mean of the five. It is reported on the 1-5 scale rather than converted to a percentage, and it carries the language of the scale with it - a Service score of 3.6 reads often true, and means the average respondent reported these five conditions as often true, not that the organisation scored 72%.
Alongside the mean, the dashboard shows the spread, which on Service is worth reading closely. Two organisations can return the same score with very different distributions underneath - one where the outside gets in but nothing improves, one where the organisation is improving hard against an out-of-date idea of what people need. Both are broken loops. They are broken at opposite ends, and there is very little in common between what each should do next.
A note on what this dimension does not do. Service measures what an organisation's own people report about how it serves. It does not measure satisfaction, and it is not a substitute for asking the people being served directly.
The two answer different questions, and both are worth having. A satisfaction score tells you what came out. It is silent on what produced it - whether the outcome came from a system that works, or from people working around one that does not. That is the question this dimension is built to answer, and it is one only the workforce can.
Service is one of eight dimensions States of Vitality reads across a whole workforce. We can talk through what an assessment would look like - scope, timing and price.