"This requires no IT involvement"

Have you ever heard:
  • “We are changing this unit to an observation unit.”
  • “Medicare has just released new requirements.”
  • “We need more specialty content.”
  •  “We are acquiring a new ambulatory practice.”
  • “We are marketing a new service line to our diabetes patients.”
  • “It is time for our yearly audit.”
All of these are often followed by, “There is no need to worry, this requires no IT Involvement.”  For a CIO, this is a phrase they dread hearing.  Usually, this means there will be an immense amount of work with tight timelines and seemingly unrealistic expectations. Many times, they will need to ask their teams to lay aside other priorities to focus on this new request. For a CIO and their application team, there are never enough hours in the day to keep up with new regulatory requirements, maintain system health, and manage all of the daily requests.  What is the solution? It really comes down to 3 things: capacity planning, an empowered governance structure, and transparency.

Capacity Planning

Let’s discuss capacity planning first. Capacity planning is a term that is used regularly in the manufacturing world. By definition, capacity planning is the process of determining the production capacity needed by an organization to meet changing demands for its products. In the context of capacity planning, design capacity is the maximum amount of work that an organization is capable of completing in a given period. Hospital operations understands a hybrid concept of capacity planning because of productivity planning. Productivity planning assumes the ability to quickly flex staffing up or down based on volume. For IT departments, the ability to quickly flex staffing up or down based on needs is much more challenging and is not budget friendly. In addition, many healthcare IT organizations do not have a system in place where they are regularly tracking the work products of their FTE’s. This leaves both the CIO and the team in a constant predicament of saying they do not have enough resources to complete these requests without real data to back up the claims. 

Ultimately, the first step in capacity planning is gaining an understanding of what the team is currently doing. So, what Is the team working on?  This sounds easy enough when you say it. They are working on upgrades, standard service requests, some big projects, and some maintenance tasks. Generally, all of these together take up roughly 105% to 120% of a regular work week. You might think: 120%? How is that even possible? The majority of IT application support staff work more than the standard 40-hour work week just to keep up with the demand. Over a prolonged period of time, the unrelenting demand can create a disengaged and dissatisfied workforce. (A different topic we will discuss in a later post.)

Step 2 is understanding how many hours each team member works per year. 2,080 hours, right? Not quite. Basically, all team members should work about 260 days per year less vacation, sick days, and holidays. After those are subtracted, it really leaves only about 235 true work days per year. With the math, that means each team member has about 1,880 hours they can commit to work with the standard 8- hour day. 

Step 3 is common definitions and discovery across all the application teams. What defines a maintenance task as opposed to a small service request as opposed to a project? What items are necessary for the health of the system and how much time do these require on a daily, weekly, or monthly schedule? How is time allocated to strategic initiatives as opposed to departmental requests? In theory, teams allocate what they are doing to buckets of time usually defined by the following: Maintenance tasks also known as “keep the lights on” activities, small service requests, projects, and administrative time. Administrative time is a much larger bucket than is usually realized. Administrative time is made up of meetings, answering e-mails, meetings, following up with the end users, and did I mention meetings? There are so many meetings. Usually about 2.5 hours per day are made up of administrative time. Back to our math, that means approximately 590 hours per year are used just for administrative tasks. That leaves each team member with about 1,300 hours per year to work on the other areas such as the small service requests, the projects, and the maintenance tasks. 

Do you have any thoughts? Let us know by posting in the comments below!

Next up: Putting all of the data together to build the capacity plan.

Sincerely,

Stephanie McDonell | Vice President, HIT
Cell: 404.788.8690 | [email protected]

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Editor's Note: Stephanie McDonell will be speaking at the 2nd Annual Becker's CIO/HIT + Revenue Cycle Conference on July 27-28 at the Fairmont Hotel in Chicago. Mrs. McDonell will be on a panel, Getting the Most Out of Epic in the International Ballroom on Thursday, July 28 at 1pm CST. She is also the Epic Program Director at Spartanburg Regional in Spartanburg, SC. 

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