A service health boost for St John of God
Organic growth may be good for business but, as Perth-based St John of God Health Care (SJOG) found out a few years ago, it makes consistent IT management nigh unto impossible. A few years down the track, however, an extensive ITIL (IT Infrastructure Library) based service project has helped SJOG completely redefine its help desk services and process management.
The change came about after a series of acquisitions had grown the organisation to the point where it was operating 11 hospitals in Western Australia and Victoria, making it Australia's third largest private hospital operator and fourth-largest pathology service provider. SJOG now manages 1666 beds in acute, rehabilitation and psychiatric facilities, with over 6600 caregivers.
Several years ago, continuing inefficiencies in the way IT was being delivered across the group led its IT team to embark on a significant effort to streamline operations. -A number of hospitals had small IT departments and were siloed," explains Russel McCarren, IT service manager with SJOG in Perth.
-There was an appreciation that people in IT were delivering to the best of their ability, but we weren't realising any economies of scale. If we had a problem across 11 hospitals we might solve the same problem 11 times, and if we were going to deploy a new piece of software we might go through that deployment process 11 times. With all this duplication of time and effort, it really diluted the services delivered in the end."
Filling the ITIL script
Searching for a more consistent approach, the SJOG team hit upon ITIL, whose design and scope meshed well with the more consistent service that the organisation was trying to provide. Its broad worldwide acceptance and zero cost also helped it stand out above alternative methodologies, says McCarren.
Wary of dropping massive organisational change onto the organisation, SJOG recognised early on that user education was going to be a major part of the ITIL exercise. A large number of staff were pushed through an ITIL foundations training exercise, while a smaller number buckled down and completed the intensive ITIL Master certification.
With employees up to speed with the basics of ITIL, the project team developed an IT service management (ITSM) structure that would address IT support across the entire organisation. All but one ITIL process -- financial management, which will be addressed eventually but was left out of the initial project scope -- was evaluated and organised, supported by the organisation's CA Unicenter Service Desk system.
Although ITIL clearly stated what capabilities SJOG needed to introduce, it was far less clear on the specifics of how that was to happen. This made for some interesting conversations, says McCarren, noting that -implementation of ITIL is actually quite difficult".
Step by step, however, the team mapped and implemented the policies it would need to make ITIL a reality. First off the bat was the service desk and incident management solution, which was well understood conceptually and relatively clear to implement. Phone numbers for the centralised service desk were published across the organisation, with employees advised to ring the newly centralised service desk rather than raising any problems with their local hospital staff.
Better service, every time
Consolidating help calls not only made it easier for the centralised IT staff to serve all employee enquiries, but also allowed for far better tracking of service calls and visibility of service trends.
-This ability to capture and see all the way through the end of an incident or customer request is a fantastic benefit that's much better than the old hand on the shoulder or catching an IT guy in the corridor to ask for help," says McCarren.
-And, because we have statistics such as the number of incidents per station per hospital, we can spot anomalies and spikes -- and take note of when major processes change -- to understand why they happened." For example, a spike in calls after a new application is rolled out could indicate the need for extra training within a specific group.
Continued reinforcement of the ITIL-driven change has produced significant results for SJOG. With a more consistent, efficient way of handling support calls -- and extended operating hours to cater for the two time zones in which it operates -- SJOG has noticed an overall improvement in the group's four front-line support workers' ability to handle support calls. The team is handling around 600 jobs per service desk person per month -- -well over Gartner recognised benchmarks", McCarren adds.
Equally significant: since the ITIL initiative began, continued expansion within the SJOG network has increased the number of networked devices being managed from 1015 to 1600 workstations -- without having to add more support employees.
Tools of the trade
Although process improvements have been a major part of the ITIL implementation, McCarren points out the importance of having a robust tool set to support the rollout. SJOG's CA Unicenter environment provides an integrated network monitoring environment that allows staff to watch and act upon equipment configuration and other issues from the central support desk.
Tools such as remote access, paired with the information stored within the group's CMDB (configuration management database), have proved invaluable in meeting ITSM objectives. The CMDB, however, proved to be a major sticking point throughout the ITIL rollout: although around 95 percent of equipment details are now loaded in the system, with the benefit of hindsight McCarren says he would prefer to have populated the CMDB completely before the system went live.
-We put the processes in place, but didn't have the data in place, and that makes it tough," he explains. -People assume populating the CMDB is easy, but if you really want to manage one of your routers or switches you need to be able to go collect the utilisation data from the device -- then store the data somewhere meaningful, and create relationships between the software that's installed and the workstations it's installed on. The richness of the information comes from the relationships."
Maintaining those relationships has required the establishment of strict policies for handling support requests. For example, employees can't request a change configuration request without having the change in question tagged in the CMDB.
That's a big improvement from the past, says McCarren, when -change has happened without us being precisely aware of the configuration items affected by that change. Understanding the impact of things on what people do is a continuous communications and training exercise."
Richer information about installed assets is proving particularly valuable as SJOG embarks on a comprehensive upgrade of its standard operating environment. As with IT support, process changes can be developed once and rolled across all 11 sites without wasting time on repetition.
ITSM also helped the company immensely when it recently went to negotiate an outsourcing arrangement with an outside provider. Whereas such agreements normally require a significant effort to decide the scope of the contract and key performance indicators (KPIs), SJOG already had those KPIs in its system -- so was able to negotiate with the outsourcer from a much stronger position.
Several years down the track with ITIL, SJOG went about weighing up its progress so far. A comprehensive ITSM benefits realisation report, designed to compare actual versus expected performance, found significant improvements across the organisation's operations: the 22 percent internal rate of return, upon which the ITIL business case was approved, had actually blown past expectations to reach 143 percent.
-The driver for that was that during the implementation of ITSM and the toolset, we acquired more businesses but didn't have any growth in IT support staff numbers," says McCarren. -Before you implement the process, however, you need to have a clear understanding, and be able to define, what it is that you're going to measure -- and have something to measure with -- or you'll just get caught up in following the ritual without actually making improvements. If you don't have a service that's at least as good as what you had before, don't bother; users will just go back to what they had before."
