This article summarizes my understanding of ITIL implementation at Queensland Health.
Queensland Health (QH) is the functional organization of the Australian government in Queensland state to provide overall public health. QH ensures public health accessibility by managing the hospital system in Queensland, monitoring the health services, and creating public awareness of a healthy life. QH manages 122 public hospitals and employs around 90,000 staff, being the largest government department in Queensland. To operate all its services, QH uses various technologies and IT services to deliver quality healthcare services. In 2004, QH started a project to restructure its IT services to centralize its five independent IT units and followed Information Technology Infrastructure Library (ITIL) framework during the process. The case of ITIL implementation by QH is analysed in this article.
What IT services do QH provides?
To efficiently manage QHâs large service operation, its IT department, also known as QHâs Information Directorate (QHID) operates the integrated services network across 20 Health Service Districts and Mater Hospitals. QHID provides 24 hours IT service in providing system support and information management. The baseline IT service provided by QHID ensures the operation of all the clinical, medical, and emergency services. Similarly, community health services like aged care, public health awareness and mental health services are also dependent on the QHID integrated network. Research and Innovation are also supported by the IT services provided by QHID. The Table below highlights some important IT services and their values to the end users.
Service Desk: In QHID, the service desk resolves incidents related to the different software systems and other supportive IT services. The service desk of QHID also supports the technological infrastructure by providing real-time IT support when conducting highly technical surgeries.
Hospital management system: QH has its customized Enterprise Resource Planning (ERP) system which consolidates the management of the financial, operational, human resource and customer service functions of QH. This ERP system also integrates with the database management of patientsâ medical information which helps in the overall hospital management system. QHID is responsible for providing the Provides baseline technical support for this system.
Patientsâ portal: QHID provides an online self-service portal for patients known as âyourHQâ which helps the patients to manage their appointments, find various information and access their medical history. This is an efficient platform for patients and saves their time. QHID also ensures the operation of the customer service desk and resolves the incidents related to the âyourHQâ portal.
E-Prescribing Software: The clinicians use electronic prescribing software which is connected across hospitals and pharmacies across Queensland. QHID maintains the software operation and provides the network infrastructure to the system.
Why was the centralized (integrated) system required?
Before deciding on the project to integrate its systems, QH conducted a survey in 2004. The survey reports and usersâ reviews outlined that the QH was not able to deliver the expected IT services. The solutions to these problems were possible after overcoming the inefficient IT services provided by QH. The QH decided on the âtransformation programâ to improve the service delivery from a centralized organization structure, and one effective way to restructure the organization was to implement the ITIL framework.
Issues before ITIL implementation
The issues before the ITIL implementation are discussed below.
i) Longer waiting time at the service desk: The QHID decentralized service desk was inefficient and took a longer response time causing an increasing waiting list.
ii) Poor service quality: The IT service quality was not meeting the standards causing the poor level of IT services and causing many complaints.
iii) IT capabilities inability to perform major functions: The major functions of IT services including hospital management systems were not capable to deliver the results in the desired timeframes.
iv) Lack of IT service coverage and staff shortage: Chegg website claims that the IT support system was inadequate to support all the hospital networks of the districts. Also, the staff shortages were another major problem before ITIL implementation.
v) High operational demand for IT services: QH had a high dependency on IT services on delivering values, but the services were decentralized and had low capacity. Experts used the term âtail wagging the dogâ to describe the relationship between QH and IT services before the transformation program started.
ITIL implementation at Queensland Health
QHâs transformation program is considered one successful example of Information Technology Services Management (ITSM) using the ITIL framework and there were some critical success factors behind this projectâs success. The critical success factors were the support from senior management and a motivated workforce; positive vendor relationships; effective change management and project governance; a clear vision of transformation. ITIL implementation also created some positive changes in organizational culture and business processes. The biggest technical achievement for QH was an ITSM toolset which integrates with all systems within the organization and with the vendorâs system.
The ITIL implementation failed the first two attempts
There were several issues and challenges that QH faced before and during the process of ITIL implementation. The ITIL implementation in QH failed two times before getting success. The first reason for failure is that the ITIL implementation project wasnât taken as a special project. The project started as a usual project without any specific project team but with the ambition to finish on time. Also, there were no experts hired for the project-oriented tasks. Secondly, change management was not taken seriously. External factors like high health services demand and media controversy distracted the senior managementâs interest in the project. Additional resources were required during the project which were overlooked. Although continual service improvement is an important step before and after the service transition in ITIL implementation, the QHID management failed to continue with that process. That was another reason for failure.
Successful ITIL implementation
When ITIL implementation started, QHID focused on setting up the incident management, change management and configuration management process. By the end of 2006, these processes were established creating grounds for the next stage: a centralized service desk establishment. The establishment of a centralized service desk brought all the eleven independent services desks under a single umbrella which solved most of the problems related to the internal staff. The release management and problem management process were parallelly developed in this stage.
After the consolidated service desk, the third stage was the service operation which included the service level management, customer engagement and asset management that helped in solving the problems from the customerâs end. This added to the assistance in incident management. The final stage was developing the process of continual service improvement.
The process diagram below summarizes the ITIL implementation process followed by the QH which led to the success.
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Benefits after ITIL implementation
After establishing the integrated system using the ITIL framework, most of the issues described above were solved with some added benefits which are discussed below.
i) A centralized service desk solved the longer waiting time in hospitals: The service desk designed using the ITIL framework serves as a centralized contact point among customers, end-users and the service provider. After QHID operated the service desk from a centralized location, the hospital management system was efficient. The appointments, schedule, patient flow and other operations in hospitals were organized which solved the problem of long waiting lists both in the hospital and at the service desk.
ii) Service desk improved the quality of service: The implementation of ITIL includes the various aspects of service delivery including the incident response. Shortening the time of incident response improves service quality. Customers claimed that the quality of health service was improved by the effective incident response at the service desk after ITIL implementation in QH.
iii) Communication channels with vendors and customers improved customer service: ITL framework includes setting up the communication framework with internal and external stakeholders which makes a more transparent environment in an organization. The communication in QH from senior management with the employees and vendors was easy after the integrated service desk.
iv) Improved IT service capabilities and wider coverage: The problem of the systemâs inability to cope with the IT service operation was solved after the implementation of ITIL. The centralized system designed using ITIL was able to run ERP systems which also extended the IT service coverage with the functionalities like customer relationship management, patient portal, and vendor management software.
v) Relieved the staff shortages: ITIL framework suggests the automation of some tasks in service level management and incident management. The automated tools used in QH during the ITIL implementation helped in knowledge transfer among the staff and the vendors. Automation solved the staff shortage issues in delivering IT services to some extent.
Conclusion
Queensland ITIL implementation case study reflects the effectiveness of the framework in ITSM to manage a large organization which requires huge IT services operation. With a major objective to deliver public health in Queensland, QH used its technical capabilities and restructured its IT services using the ITIL framework. After two prior failed attempts, the successful ITIL implementation and efficient service operation from QH set an example to all large organizations about the reliability of the ITIL framework. This case study also gives a lesson that change management is an important aspect of the ITIL implementation process.
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