Looking at my project load for 2010 and the upcoming requirements to keep our existing applications fresh, as well as trying to address meaningful use (in a meaningful way), has created capacity issues for all of us. While I hear a lot about how vendors may not have enough staff to implement all of the new functionality that is required to meet meaningful use, I still have to keep a few hundred applications up and keep thousands of users happy. WHAT ABOUT THE HOSPITAL IT STAFF? Coming off of a very difficult budget cycle in 2009 and with many people hesitant to add staff, a modified approach to “how much can our existing staff really take on” comes into play.
I realize that you can only get so much done with a team without pushing them “over the limit”, but I continually try to ask the question and push the boundary related to knowing our limits. Do you really know what your capacity is? My team is currently working on more projects at one time than we have since 2001 and we have almost 20% less staff than we did from five years ago. I can say that we are more productive and more successful than we ever have been even though we are fitting more into a day.
There are a few principles that have helped our team achieve the ability to pile more on, successfully.
- Your team needs to know that you are trying to eliminate work that “isn’t smart”. If you look at your programming queue or project requests I can imagine that you can find a few items that you know are not going to pay off for the business in the long run. Instead of plowing through those projects or writing those programs because the end user or governance team approved it I personally go back to the project owners / requestors and have a conversation about workflow, utilization and really challenge them to prove results and quantify the need to expend the effort. We have cancelled some substantial projects and “rush” jobs by our management team in I/S being diligent about our work queues. When we do cancel those or resize them we make that very public to the I/S team.
- Understand and cleary communicate the business need in terms that your team will understand. Because our Hospital is community owned and independent, one of our advantages is being extremely nimble to market conditions. There are requests that we get that really make sense to push through ahead of other tasks and projects. In a formalized structure these tasks can frustrate your I/S team. If they don’t understand, at a fundamental level, why these requests jump ahead in the queue it will be a continual point of frustration that you may not be hearing about. We try to ensure that when these items come up that our managers clearly explain why we are reprioritizing work and how the business will benefit from it. This not only fosters better communication between teams, but creates better outcomes. Information Systems requests can get very transactional and it is easy for your team to become disconnected from how they are really impacting the business.
- I used to work for a CIO that said if you worked 40 hours a week you were considered part time. Times have changed and while almost all of my team puts in more than 40 hours a week the expectation to work longer no longer is the expectation. We are trying to instill a “work smarter” attitude that includes planning your day before you start your day (i.e. don’t answer emails as your first activity of the day), write things down in a journal to ensure you don’t forget anything, and significantly reduce distractions. Working smarter has created good dialogue with my team and has allowed some of them to reprioritize how they looked at their day and are able to “work smarter”.
While these three things won’t allow us to double our workload it does provide a simple framework to accomplish more with less. We all are going to wrestle with achieving meaningful use while providing support to our users and existing applications. I don’t know about you but that doesn’t equate to hiring a lot more staff – you will need to find a way to work smarter, not necessarily harder. (It also helps to have the best team in the world to work with!)
Anthony Guerra says
Hi Steve. Excellent, excellent post. And, as an aside, you will always have the honor of writing the first guest post at healthsystemCIO.com (something to tell your grandchildren :))
Anyway, your post is timely and very helpful. I remember a few years ago interviewing the new CEO of a Wall Street-related company called Omgeo — a massive, global company that is part of the backbone of the financial services industry. Well, she said something that I thought was cliche at the time. She said, “Anthony, we have 1,000 different great things we can do at Omgeo — it’s my job to figure out WHICH of those we need to do at any given time.”
Over the last few years, that has completely and totally resonated with me. I am uber-guarded of my time and bristle when I feel it is being wasted or not put to good use.
Your staff probably feels the same way, so communicating with them WHY they are working (or not working) on any given job at any given time is a great strategy.
I think the bottom line here, and the unspoken theme underpinning your post, is you have to RESPECT your workers. If you approach this from a position of arrogance and say, “Why do I owe them any explanation? They are getting a paycheck,” you will have an unmotivated staff and get less, not more, done.
Always put yourself in the position of your employees and decide what behaviors by management would make YOU want to come to work and do your very best, what behaviors would do the opposite.
I think your strategy is spot on, and I would bet dollars to donuts (love that expression) you have a very motivated staff.
Thanks!
Bonnie Siegel says
Steve, congratulations, your 1st blog is wonderful and so accurate. Many health system CIOs, I speak with, face similar barriers: more projects, less money, less staff. I think finding and retaining qualified IT staff in this competitive environment will be the key to success for CIOs now and in the future. Your team and strategy seems to have met that goal head on. Good luck!
tjtolan says
Great post Steve! This is a common challenge for CIOs and vendors alike in this market. We hear it every day. The really sad part is that many employers continue to ask more from smaller staffs. It’s usually a request to do more work and wear multiple hats. That model will not work as the market forces and stimulus dollars begin to flow. For those that just “don’t get it” it could spell real trouble moving forward.
Steve Huffman says
Thanks for the comments. This is not an easy thing to roll out to staff, or the organization. It has taken a few years for folks to become comfortable with digging into purchasing decisions and questioning, again, the validity of the priority of the project.
Our turnover rate was almost 0% last year which speaks to how well these are working. We still continue to work on the third point related to team members not starting out the day reviewing email and writing things down, but it has been a great process.
Anthony Guerra says
email is an addiction that plagues all of us. it follows us all day and night with the PDAs. it’s a real problem.
Marc Holland says
I couldn’t agree more. Sound governance processes are important, but only go so far. I’m reminded of what my high school Geometry teacher drummed into our heads when describing proofs and theorems — “necessary, but not sufficient”. Sound, effective governance is necessary, but not sufficient, and does not mitigate the need for sound business case analysis. In the ideal world, every request is valid and resource availability is infinite but, hey, who said this is an ideal world?