from this case study Appendix: ITIL Project Implementation at Queensland Health (QH)

Background: QH ITIL Project Queensland Health, as the largest State agency in Queensland, is a highly complex and widely distributed organisation with a staff strength of about 50,000 employees. Its mission is to provide dependable health care and better health to all the communities in the State. The agency accomplishes this by delivering a range of integrated services, including hospital inpatient, outpatient and emergency services, community and mental health services, aged care services and public health and health promotion programs, through a network of 20 Health Service Districts and the Mater Hospitals. The responsibility for building the health information systems lies with QHs Information Directorate (QHID), which is acknowledged as the largest IT operation in Queensland with over 800 staff and 285 networked sites. QHID provides IT services to the entire user base at QH through support systems and information for clinicians use to make critical decisions. These support systems are designed to operate on a 24 x 7 basis right across the State of Queensland, which is seven times the area of Great Britain and two and a half times the size of Texas. In 2004 QHID reorganised and consolidated its IT operations bringing together five previously separate IT functions in response to concerns that a decentralised structure was not meeting the level of IT services that users expected. Shortly after the reorganisation, the Queensland Government commissioned the Queensland Health Systems Review to examine the problems that QH was experiencing and identify a range of reforms.

The Transformation Program: One of the initiatives that emerged from the review is the Transformation Program which has the broad aim of moving QHID to a new service-oriented organisational structure and new mode of operation in terms of both governance and IT service delivery capabilities. To ensure that the longer term gains from the Transformation Program will be less at risk, QH instigated a number of initiatives, one of which calls for the development of a sustainable organisational capability to undertake IT service management more effectively using the ITIL framework. As the ITIL framework was new to QH, established consultants and vendors were engaged during the early stages of the ITIL implementation project. QH senior management further assigned the Manager of Continuous Improvement to the role of overseeing the implementation process, promoting the benefits among QH staff and liaising with the consultants and vendors. The journey so far

As at the end of 2006, QHID had established the processes for incident management, change management and configuration management, and was on the verge of completing processes for release management and problem management. At the same time the existing eleven zonal help desks were consolidated into a single corporate- wide service desk to enhance the ability for QHID to resolve incidents at first point of contact. With the accomplishment of the centralised service desk and all processes within service support, QH reached a significant milestone in its ITIL project. Attention was next turned to service level management and other complementary processes. A mechanism for the continuous improvement of the newly installed processes was also instituted. Senior management level staff were allocated process owner roles to ensure that the project progress was sustained as they were able to deal with change resistors and make quick decisions. As part of project governance, a customer committee named the Operations Board comprising senior customer represen tatives from both corporate and clinical areas was established to review the performance of QHID and provide a customer perspective on any proposed initiatives and changes. Fujitsu Australia was engaged to develop a process design methodology handbook to provide guidance to the implementation team mem bers. At the start of

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the project in 2005 a process maturity assessment was jointly conducted by Fujitsu Australia and QHID to establish the existing state of QHIDs process chain, ascertain the interfaces between the different processes and determine the optimal implementation sequence. The results from the assessment, as depicted in Figure 1, formed part of the project base line and helped to define the initial implementation priorities as well as set targets to raise the maturity levels of the various processes. An important element in the process design methodology developed by QHID is the benefit realisation plan. The purpose of the plan is to identify and manage the realisation of the benefits that are attached to each new process. These benefits, which include both financial and non-financial measures, are recorded in a benefit register and tracked by the project executive team on a monthly basis. Each process is also associated with a set of key performance indicators which are monitored and reported to senior management. To fast track project execution, QHID introduced the timebox approach into the ITIL project. This technique is grounded in the philosophy that dates are not flexible but deliverables are. QHID had previously suffered from a get agreement from everybody on everything syndrome which meant that progress was slow. QHID soon developed a mantra of progress not perfection after recognising that 80 percent completion is a great start and that the other 20 percent can be completed through continuous improvement. This modus operandi resonates with one of Brown and Vesseys [3] success factors concerning the satisficing mindset in which 80 percent solutions are accepted as good enough (p.67). The change management issues faced by the agency are formidable in view of the scope of the Transformation Program which calls for a drastic reduction in the number of position descriptions and operational areas in QHIDs new organisation structure. To alleviate the anxiety of the staff, QHID took pains to build transparency into the project execution by disseminating relevant information through corporate newsletters and the intranet, and team briefings. Senior user managers represented in the Operations Board were also provided with performance reporting on QHIDs accomplishments so that they could relay the results to their departments. Most QHID staff completed the ITIL Foundation training course, some progressing to the advanced level, to provide a common ITSM language of com munication. In terms of benchmarking, QHID commissioned Gartner to conduct annual Customer Satisfaction Surveys to gain better insights into the perceptions of the customers and gauge their level of satisfaction. As shown in Figure 2, the users judged support availability and support responsiveness as the two most important criteria. In the 12 months from 2006 to 2007, the satisfaction level increased for all eight criteria. The complexity and diversity of QHs ITSM requirements rendered it difficult to rely on a single centralised tool to manage all processes. Fortunately, the agency was able to engage the assistance of HP, a major ITSM tool vendor, to customise an integrated and automated toolset that is consistent with the ITIL framework and to advise QHID on the technical implementation.

Challenges and breakthroughs: QHID experienced two failed attempts at the beginning of the ITIL project. To begin with, although the project had strong endorsement from QH senior management, the commitment was not manifest in the project implementation. For instance, process owners were not staffed at the right level but were instead arbitrarily allocated. The project was also conducted on a business as usual approach to the extent that schedule, resource and expertise issues were not given due attention. A com ment from one of the project team members aptly summarises the situation: We just cant do it anymore. Weve got to keep the lights on as well! Furthermore, the initial decision to integrate ITSM and Quality Management System processes blurred the focus of the project and it was abandoned.

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Crucial change management issues arising from the reorganisation of the IT function were not accorded priority and subsequently led to pockets of resistance and an atmosphere of negativity and scepticism. To compound the problem, the effort to obtain buy-in from staff through extensive consensus-seeking proved to be counterproductive as their new roles in the restructured organisation were not resolved. Once the teething issues from the two false starts were addressed and appropriately rectified the project began to show dramatic results.

Task 1: Identifying CSFs of ITIL implementation (4 x 2 = 8 marks)

What are the four (4) most critical factors that have contributed to the successful implementation of ITIL at Queensland Health (QH)? Discuss them in light with the existing literature.

Task 2: Classifying CSFs of ITIL implementation (4 x .25 = 1 mark)

How would you classify those critical factors that have been identified in Task 1? Discuss them in terms of:

source of factors (e.g., internal, external)

type of factor (e.g., technical, managerial, organisational).