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!)
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