MONEYBALL: An Incident Reduction Approach. Dave Wilson Advocate Health Care

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1 MONEYBALL: An Incident Reduction Approach Dave Wilson Advocate Health Care

2 About Advocate Health Care Largest health system in Illinois 250+ sites of care including 12 hospitals 35,000+ associates Top ten largest employer in Chicago Future growth potential in merger with NorthShore

35,000+ associates Top ten largest employer in

3 About Me Information technology professional for 28 years Started in PC support Managed just about every type of group in IT Love of help desk and statistics Service activist

4 About This Presentation aka Incident Reduction at AHC Not following ITIL, although we refer to it regularly Improve the Help Desk value proposition Improve ITSSM requirements and design for later this year

regularly Improve the Help Desk value proposition

7 In 2012, 66% of technology support organizations saw an increase in support ticket volumes. In 2013, 66% saw an increase. In 2014, 57%. HDI Support Center Practices & Salary Report, 2012, 2013, 2014

8 Advocate also saw growth in contacts

9 but no growth in staffing

11 Top Ten Reasons for Ticket Growth What does the Help Desk have control of? HDI Support Center Practices & Salary Report, 2014

12 LET S MAKE THEM STOP!

13 ITIL Problem Management Prevent problems and resulting incidents from happening Eliminate recurring incidents Minimize the impact of unavoidable incidents Source: ITIL Service Operation

14 Source: Problem Management in Technical Support, April 2014

15 ITIL Problem Management Process

17 Problem Detection Help Desk Critical Incident Executive Inquiry Raising questions due to complaints or volume Root cause analysis Raising questions due to visibility OGC recommends frequent and regular analysis of incident and problem data must be performed to identify any trends as they become discernable

due to visibility OGC recommends frequent and regular analysis of incident

18 Problem Detection = Data Retrieval Sorry - specific data not shared online

19 Problem Logging Source: Victor Kapella, A Framework for Incident and Problem Management

20 Problem Logging SharePoint List

21 Problem Categorization

22 Problem Categorization New Taxonomy Vertical Summarization - Ability to roll-up data and summarize at meaningful levels. Horizontal Comparison - Ability to compare ticket volumes by discrete issues across the enterprise.

23 Problem Prioritization Weighs all the open problems against common criteria and places importance on the most valuable opportunities. The criteria can be based on cost, resources required, length of time to fix or complexity really whatever criteria is most relevant for the business.

24 Problem Prioritization By Total Volume Rank Subject 2013-Q Q Q Q Q Q Q Q Q1 Grand Total 1 Workspace Password Reset Outlook Allegra Password Reset CareConnection IDX Misc Software OWA Sorry - specific subject data not shared online INCIDENT VOLUME BY SUBJECT, BY QUARTER 8 Outlook Desktop Client Account Look Ups/Form Request Password Reset Active Directory Allscripts HomeCare Password Reset CliniCare Desktop Settings Orders & Docs / Power Chart CliniCare - Other Password Reset Workspace Referred to Non-IT Resource CliniCare - Account Management Windows Error Response Issues/Freezing Active Directory Password Reset APP Home Page Printer Connectivity

25 Problem Prioritization By Growth Rate INCIDENT VOLUME BY SUBJECT, BY QUARTER QUARTER BY QUARTER GROWTH (vs Q1 BASELINE) 2014 GROWTH (vs BASELINE) Rank Subject 2013-Q Q Q Q Q Q Q Q % increase 2014 # increase 1 Workspace -28% -18% 74% -9% -19% 22% -4% -8% 5% Password Reset Outlook -32% 31% -3% 25% -19% 22% 1% 3% 19% Allegra -10% 14% 14% 1% 12% -3% -7% -6% 22% Password Reset CareConnection -12% -1% -4% 2% 17% -9% -3% 2% 1% 51 5 IDX -28% -9% -29% 2% 2% 9% -32% -11% -35% Misc Software 29% -2% 17% -2% 50% -27% 5% -32% 37% OWA 2% 25% 25% 31% -16% 39% -35% 4% 60% Outlook Desktop Client 8% 1% 38% 24% -10% 17% -16% -3% 53% Account Look Ups/Form Request -24% 12% 14% 18% -3% 9% -29% 11% 20% Password Reset Active Directory -32% 28% 2% 1% 0% 10% -10% 8% 7% 197 Sorry - specific subject data not shared online 11 Allscripts HomeCare 29% 2% 34% 5% -2% 40% -22% -8% 53% Password Reset CliniCare -1% 30% -4% 20% 12% 12% -15% -5% 44% Desktop Settings -6% 14% 10% -1% 8% 6% -17% -18% 16% Orders & Docs / Power Chart -5% -5% 10% -21% 22% 1% -10% -9% -7% CliniCare - Other -39% 39% -32% 27% 14% 7% -19% -35% 5% Password Reset Workspace -32% 31% -4% 9% -15% 9% 4% 6% 3% Referred to Non-IT Resource -6% 63% -19% 10% 8% -13% 36% -23% 24% CliniCare - Account Management -15% 18% 6% 29% -6% 14% -38% 4% 28% Windows Error 35% -7% 30% 0% 1% 4% 11% -19% 31% Response Issues/Freezing -8% 9% 16% -13% -9% -8% 7% -22% -9% Active Directory -23% 36% 3% 7% -5% 5% 0% -19% 17% Password Reset APP Home Page 3% 8% 27% 80% -61% 40% 112% -48% 73% Printer Connectivity 27% 33% -33% 8% -6% -11% 27% 11% -8% CareConnection System Access 16% 6% -15% 10% 3% 25% -13% -8% 15% Referred to HR Direct -14% 59% 4% 30% -11% 6% 12% -15% 55% 664

26 Problem Prioritization

27 Problem Investigation & Diagnosis Chronological Pain Value Brainstorming Kepner & Tregoe Ishikawa Pareto

28 Problem Investigation & Diagnosis Sorry - specific subject data not shared online

29 Problem Investigation & Diagnosis Sorry - specific subject data not shared online

30 Problem Investigation & Diagnosis LEVEL 1 Sorry - specific subject data not shared online L1 = the volume of tickets resolved at the Help Desk L2 = the volume of tickets resolved by second level Cost is based on fully loaded Help Desk analyst rate Note: User time not costed

Problem Investigation & Diagnosis LEVEL 2 Sorry - specific subject data not shared online L1 = the volume of tickets resolved at the Help Desk L2 = the volume

31 Problem Investigation & Diagnosis LEVEL 2 Sorry - specific subject data not shared online L1 = the volume of tickets resolved at the Help Desk L2 = the volume of tickets resolved by second level Cost is based on fully loaded Help Desk analyst rate and fully loaded second level analyst rate Note: User time not costed

32 Problem Investigation & Diagnosis DETERMINING VALUE BY DOLLARS Sorry - specific subject data not shared online

33 Problem Investigation & Diagnosis DETERMINING VALUE BY HOURS LOST Sorry - specific subject data not shared online

Problem Review Meeting Successful process sets aside the common practice of blaming people for problems and failures, but instead focuses on how things can be done in a better way.

34 Problem Review Meeting Successful process sets aside the common practice of blaming people for problems and failures, but instead focuses on how things can be done in a better way. Improvement in a process is accomplished by seeking to learn what causes things to happen in a process and to use this knowledge to reduce varation, remove activities that contribute no value to the product or service produced and improve customer satisfaction. Lord Kelvin once said, If you cannot measure it, you cannot improve it. In problem management, establishing a set of measurable goals and objectives is crucial. Metrics are the key to any successful program and process. Subsequently, breaking down high level organizational goals and objectives into smaller, team level goals and objectives so that they can be distributed and understood by individual team members as a part of their daily operation of the process. 5. Follow-up on Workarounds and Resolutions 6. Review Data and Log Savings 4. Gain Agreement on Issues to Address 1. Introduction Meeting 3. Execute the Meeting 2. Summarize the Quarterly Data Source: Handbook for Basic Process Improvement & Cisco Problem Management White Paper

35 Roles & Responsibilities Source: Problem Management in Technical Support, April 2014

36 Risks DATA lack of sufficient data, or an incapability to collect data, ACCOUNTABILITY the process is used to assign blame instead of identifying root causes; or management doesn t want to hear about bad news or weaknesses in systems or people, DISCIPLINE lack of effort or resources to carry out the process, or a failure to build and maintain a useful knowledge base, IMPACT an inability to determine business impact of incidents. Source: Effective IT Service Management: To ITIL and Beyond

37 Conclusion Use Data (PDCA) Assign Cost & Effort Focus with 80/20 Partner, don t Blame Track Your Savings

38 MONEYBALL: An Incident Management Approach Q&A THANK YOU! Contact Info:

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