IT drives quality services

CIO, service provider focus on data, internal customers in network management overhaul.

KCHC’s Al Porco first established a plan to build and implement a comprehensive management framework designed to enforce process, procedure and workflow, and proactively monitor networks, systems and applications.

When Al Porco arrived as chief information officer in June 2003 for Kings County Hospital Center (KCHC), located in the center of Brooklyn, “There was an opportunity for IT to become a primary driver in elevating the quality of health care services,” he says. “For that to happen, the foundation of the IT department had to be substantially improved.

“We lacked analytical tools to gather data to make strategic recommendations and decisions about our IT infrastructure,” he adds. “Without management technology to get our hands around problems, efforts were misguided and inefficient, and we had zero ability to dispute claims that our network or systems were slow, unavailable or otherwise problematic.”

KCHC is one of the oldest hospitals in the United States, a member of one of the largest municipal healthcare networks in the country, and the largest trauma center in New York state, handling more than one million patient visits per year. With a growing dependence on clinical applications and systems, KCHC’s healthcare professionals increasingly needed more responsive, efficient support from the hospital’s IT department.

Porco inherited a staff of 25, supporting 3,500 users throughout 22 buildings, spanning 42 acres of campus and five remote sites. Customer satisfaction was critically low and internal customers had little confidence in IT’s capability.

Porco first established a plan to build and implement a comprehensive management framework designed to enforce process, procedure and workflow; proactively monitor networks, systems and applications; and empower end-users to help themselves. His agenda included implementing service-level measurement capabilities to ensure greater consistency in the team’s engineering and support efforts. He also set out to acquire analytical tools that would help identify long-term trends in the utilization, performance and capacity of the networks and servers so that intelligent decisions could be made about budgets and deployments.

Porco had hands-on experience deploying elements of Computer Associates’ (CA) Unicenter Enterprise Management framework. He was familiar with CA’s scope of products and knew they could be integrated to meet his needs if deployed with proper planning and execution. He selected many of the core Unicenter products, including Unicenter ServicePlus Service Desk, Unicenter Network and Systems Management, Asset Management, Remote Control, Software Delivery, and Etrust security solutions.

According to Porco, working with a partner that had operational experience with the products was critical, as opposed to only being proficient at implementations. “My staff was stretched as it was. There was no way we could deploy a complex management infrastructure without help. I’ve seen many of these projects fail–even with more sophisticated IT departments that are better funded. We needed a partner that had dealt with the real-world pressures of using the products to meet budgetary and service-level commitments.”

Integrator with ca experience
Porco selected IT services company CompuCom to help him design, implement and manage the new solution. CompuCom uses several of the CA applications to run its own enterprise management center as part of its managed services offering. “That they ran their own business on the core software I had purchased was important to me. Projects of this type are at least 51% operations and determination of workflow. Installation is generally the easier part,” he says.

CompuCom conducted a critical analysis that focused on several important elements, including current customer satisfaction levels and customers’ feedback on areas requiring improvement. The company also assessed the IT staff’s ability to handle issues in a scalable and consistent manner. Lastly, CompuCom staff evaluated the quality of available data used for service-level analysis, budget estimates and capacity planning.

According to Porco, “I wanted to build highly successful and functional silos of implementation, with a focus on integrating the products later. My staff and the healthcare professionals we support needed to start with a strategically selected building block before moving on. We could not have had credibility or success if we had tried to do everything at once.”

The Service Desk system was implemented first, going live in 2004. The majority of the implementation focused on customizing the interfaces, determining workflow and involving the users and operations staff in design decisions. Specialized functionality was added to enhance management control and provide customized service prioritization capability.

While the operations staff worked with the new system, the asset-management and software-delivery applications were implemented. In parallel, the network- and systems-management elements were installed and customized.

Calls, however, were still being abandoned by the overloaded call center. “We wanted to empower users, but knew that announcements and training sessions were an interruption to patient care,” Porco says. “We decided to create grassroots, word-of-mouth capability. We pushed an icon to the users’ desktops using Software Delivery that brought them directly to the Service Desk application.”

The customizations and end-user involvement in the design phase paid off. Within days, dozens of tickets were opened directly by users. Within months, some 1,200 tickets–about 25% of all calls–were opened via the new Web interface.

customer satisfaction improves
Automatically generated surveys have given Porco a tangible measure of customer satisfaction as the project has progressed. In addition to an uncommon 30% response rate, more than 66% of respondents say they are using the new Web-based Service Desk system, and 90% find it to be satisfactory.

Improved customer satisfaction is driven by problem resolution that continues to get faster and more efficient, according to Porco. Browser-based remote control has enabled the engineering team to reduce resolution times by up to 30 minutes per ticket simply by eliminating the time it takes IT staff to travel to users’ desks throughout the 42-acre campus and satellite offices.

Software Delivery provided similar value during the recent deployment of a new version of clinical software to hundreds of systems used to facilitate patient care. When problems occurred within the software’s security settings, a new build was deployed within hours, reducing downtime significantly.

Potential problems are being identified proactively. Unicenter NSM recently saved the network support team a full day of problem analysis and repair time, while saving the pathology department many hours of downtime, when it detected high temperature conditions brought on by fan failures. The network support group performed preventative maintenance without disrupting the clinicians and pathologists.

The new, integrated system also distinguished itself during a deployment of more than 650 new workstations within the hospital. Previous rollouts took weeks to complete, after which no records existed of where the systems were located, how they were configured, or if they had been successfully utilized by end-users. Leveraging ServiceDesk’s Change Management module, IT ensured consistent delivery and detailed tracking of each workstation deployment. Staff also generated a history of each asset from receipt of shipment to desktop deployment.

Moving forward, and guided by concrete data, the team is targeting log-in issues and printer problems, which combine to account for nearly 40% of all calls. “We’re now able to consciously decide what should be fixed, because we know what the impact will be,” Porco says. “We’re providing measurably better service without increasing costs, and our end-users are now involved. They’re talking to us about future needs as opposed to complaining about how much care they aren’t able to provide because of IT.”