When it's customer-driven, I wish I could say it was a simple as firing the customer.

Now that I'm in a not-for-profit healthcare organization with one key funder for the bulk of our business, we do not have the luxury of distancing ourselves from their business.
What we can do is attempt to educate them on the lack of alignment between their targets and the amount of business that comes our way.
For example, we have a contractual target of 0.05% for a particular aspect of our business, Missed Care. This is essential when we agree to do the visit in the Client's home, however we fail to arrive to provide care - with some exceptions - and fail to reschedule the visit per the service plan. I'd share the exact definition with you, but it would make many of you go cross-eyed.
Now some of our market areas are low in volume while being large in geographic coverage, yet the target is the same across the board. If this area has 300 scheduled visits per week, we are allowed to miss 0.15 visit...essentially 0. No one is allowed to get sick or have a car breakdown or get lost. No one is allowed to be...well...human. These low volume, large geography areas also pose a struggle in finding qualified and competent staff (especially as hospitals pay better and have better working conditions than working out in the community).
When we receiving a nonconformance regarding failure to meet the contractual target, there are often things we can do on our end, but part of our response includes re-communicating the concerns with the mandated target.
We have not lost business...they give us the nonconformance, we address it to the best of our ability, the eventually close it and the cycle repeats. They'd be able to do their job more effectively if they would understand the merits of capacity and capability and smart statistics, but until then...
