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ITIL best practices: Wellness at your service

Cincinnati Children's Hospital's Karen Maas is turning a creaky help desk into a well-oiled ITIL-based service desk. Now nurses and doctors can focus on making children better.

Karen Maas catches herself midsentence, referring to the new IT support system at Cincinnati Children's Hospital Medical Center as the help desk. "We call it the service desk now," said Maas, director of information services, customer services, at the 423-bed hospital and research center.

Run on customized service desk management software from iET Solutions LLC, a Framingham, Mass.-based provider, the medical center's once understaffed (and oft-maligned) help desk is fast becoming command central for the hospital's computing and medical equipment systems.

Customer satisfaction has gone from 82% to 90%. The rate of abandonment -- when the hospital staff simply gives up on the system -- has shrunk from 11% to less than 3%. The time from request to resolution has been cut by 65%. And hospital staff is "chomping at the bit" to add new applications to the system. "We still have a long way to go to make our customers happy," Maas said, "but the kudos we are getting are amazing."

A year in the making, Cincinnati Children's service desk now offers doctors and nurses a single point of contact for their IT requests. The upgrade, which went live in late 2004, required major changes in people, processes and tools, said Maas, who oversees 33 of the hospital's approximately 200 IT personnel.

Unlike the creaky old help desk, where technicians handled requests from 7:30 a.m. to 5:30 p.m. and called it a day, the new service desk is manned 24/7 all year round. The team went from four people and a lead help desk analyst to 18 people and two leads. The service desk also joined hands with the hospital's clinical engineers, who service and repair all the medical devices in the hospital, from IV pumps to kidney dialysis machines and heart and lung machines, as well as with a clinical systems support team that focuses strictly on "how to" for Children's clinical applications. A clinical integration team was also added within the information services department, serving as a hybrid of networking, application and desk-side technical support for clinical areas. Doctors now call one number when then they have a problem with the medical or computing equipment and applications.

The beefed-up service desk also means that hospital's doctors and nurses can now get personal service -- literally. When a call comes in, for example, from a physician or nurse unable to use an application, someone from the service desk's clinical system support team is dispatched to that person's side. The change was welcomed on both sides of the technology divide, Maas said.

"Prior to our new system, nurses and physicians were spending a long time on the phone with the help desk, trying to explain what was wrong. You'd be on the phone asking him or her what the problem was and they'd say, 'I dunno, I just can't use it.' They don't have time to be troubleshooting on the phone, and the service desk analyst was frustrated because they weren't able to help," Maas said. If the issue turns out to be training, a refresher course is provided. If the application has a glitch, an expert is on the spot.

"You need to watch out for people having conflicting priorities. ... With each of these processes being discrete, you have to make sure there are rules of engagement between the different groups."

Chip Gliedman, analyst, Forrester Research Inc.

The new iET services management software is based on best practices defined by the IT Infrastructure Library (ITIL), the British-born framework for standardizing the delivery and management of IT services. Duties had to be segregated, processes redefined, service levels established and the service desk has to ride herd on IT experts in order to meet those service levels. Clinical engineers accustomed to working 24/7 on high alert adapted soonest, Maas said.

Chip Gliedman, an analyst at Cambridge, Mass.-based Forrester Research Inc., said communication between the various IT groups is key, as service desk processes are expanded and cut into discrete chunks. "You need to watch out for people having conflicting priorities. You can't just say, 'We'll pass it along to the network group, unless the network group has signed off on an agreement to deal with it in a reasonable amount of time.' With each of these processes being discrete, you have to make sure there are rules of engagement between the different groups," Gliedman said.

Then there are the bruised feelings to take seriously. In any reorganization, oftentimes there is the perception that someone is winning or losing, Gliedman said. "Organizations have to be very careful that egos are properly massaged, or else that person can in fact torpedo the project through overt or covert actions, or inactions."

Maas agreed. "We had to shepherd people through that change, applying a lot of Band-Aids along the way," she said. "You talk, you talk, you talk, you tell people what has happened and what will happen. You keep talking."

Still, the benefits of the overhaul have been worth the pain. The ticketing system also helps drives workflow. If a user calls in and is having a problem with the hospital's computerized order entry (COE) application, the service desk person will go into the service tree, click on COE, and use the tool to ask a bunch of questions. "It guides the analysts through a series of thoughts, so they can narrow it down as much as possible and dispatch it to the right person or fix it themselves. That is all customized to our environment, including every medical device we touch," Maas said.

For CIOs contemplating an overhaul of their help desks, she recommends they insist that the person who has the equivalent of her job meet with the IT department's customers to understand their needs and expectations. "Do the assessment up front. If you don't know what is going to satisfy your customers, how can you satisfy them?"

Let us know what you think about the story; e-mail: Linda Tucci, Senior News Writer.

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