Transforming a Health Organisation: Learnings from the Agile Transformation of the CDHB's Information Services Group

1. Transforming a Health Organisation:
Learnings from Lean Agile transformation of the CDHB’s
Information Services Group
Lynn Davies
Process Improvement Leader– Canterbury District Health Board
Joe Kearns
Principal Agile Consultant– Assurity

2. TRANSFORMING A HEALTH ORGANISATION

3. A connected system
Centred around people
That aims not to waste their
time
Our Vision

5. HealthOne Success

6. WHAT IS ISG?
 Provides and maintains hardware/software, telecommunications, infrastructure and applications support
to our health services
 CDHB (all facilities) and Regional services
 107 FTE
 Delivers on National IT programmes
 Consists of:
 Operations Teams
 Project Teams
 Service Desk
 Applications support
 Training

7. WHAT’S THE PROBLEM?
▪ ISG looking for ways to improve
▪ Despite (because of?) success, Canterbury Health System and Region placing ever increasing
demands
▪ eMeds Programme
▪ Regional PAS Programme
▪ Regional HCS Programme
▪ Digital Hospital – rebuild
▪ Realisation: Needed external support to respond to system needs

8. OUR BLUEPRINT
1. KNOW YOUR CURRENT STATE

9. Discovery Phase
GOAL
29 May 2015
23 February 2015

10. Findings - opportunities
Process
maturity
Strategy and
Alignment
Customer
relationships
Project
Prioritisation
Service
Offerings
Communication
Workflow
maturity
Service
Delivery

11. OUR BLUEPRINT
1. KNOW YOUR CURRENT STATE
2. DEVELOP A (ROUGH) PLAN

12. The Roadmap at a Glance
Develop
Management
Systems
Validate and
Communicate
Strategy
Prioritise
Against
Strategy
People,
Process &
Framework
Engagement and
External
Communication
Develop
Internal
Communication
Looking Toward
the
Region
Systems,
Applications &
Infrastructure
ISG Stand Alone Activities
Develop
Service
Catalogue
ISG Policies at
Governance
Level
Benchmarking
Against Health
& Other IT
Innovation Time /
Mini
Programme
Enterprise PMO &
Alignment
with Region
Risk
Management
Strategies
Activities External to ISG
Establish and
Document
Processes
Enterprise &
Regional Strategic
Alignment
Enterprise-wide
Change
Management

13. People, Process and
Framework
Develop
Management
Systems
Validate and
Communicate
Strategy
Prioritise
Against
Strategy
Engagement and
External
Communication
Develop
Internal
Communication
Looking Toward
the
Region
Systems,
Applications &
Infrastructure
• Development of “delivery frameworks”
• (Further) definition of projects and business as usual
• Team building - understanding roles and work
• Definition and description of roles and the delivery of
strategy
• Introducing product ownership
• Visibility and transparency of process
• Development of metrics – internal and in
terms of customer value
• Standardised units of work and time
• Methods to estimate time
• Address resourcing considerations
People,
Process &
Framework
Why?
38% of ISG staff members engaged
during the assessment raised concerns
about the level of process maturity within
ISG. In addition, skill growth and
development was raised by 22% of staff
as a problem, and 39% of ISG staff
members considered resourcing as a
major issue.

14. THE LEAN GROUP
▪ Framework to deliver on the roadmap
▪ Lean Group to implement change
▪ Senior Managers and Team Leads (14 people!)
▪ Scrum – monthly sprints, twice weekly stands up etc.
▪ Dedicate 8 hours/week to Lean Group

15. OUR BLUEPRINT
1. KNOW YOUR CURRENT STATE
2. DEVELOP A PLAN
3. SET YOUR KEY METRICS

16. MEASUREMENTS
▪ Metrics developed:
▪ Opex budget vs actual
▪ Service desk abandoned calls
▪ Application uptime
▪ Incident resolution time
▪ Recurring sustain tasks not done
▪ Staff utilisation
▪ Progress against roadmap

20. OUR BLUEPRINT
1. KNOW YOUR CURRENT STATE
2. DEVELOP A PLAN
3. SET YOUR KEY METRICS
4. GET STARTED

21. SAM

23. UNDERSTANDING WORKFLOWS
BREAK FIX
SUSTAIN
ENHANCE
Service Desk
28%
Email
60%
telephone call, Lync
message or text
12%
Which one is most important?
Which is the right one to do first?

24. OUR BLUEPRINT
1. KNOW YOUR CURRENT STATE
2. DEVELOP A PLAN
3. SET YOUR KEY METRICS
4. GET STARTED
5. UNDERSTAND WHAT’S WORKING

25. OTHER SUCCESSES
▪ Prioritisation reference group - PRG
▪ Problem Management Team – Network Account Lockouts
▪ Staff Engagement

27. 1st Gate 2nd Gate
Enhance
Team
Sustain
Team
EPIC
Stories
Priority
by
Value
Project
Or
Request
28/11/2016

29. NETWORK ACCOUNT LOCKOUTS
▪ Reminders sent to change password in advance
▪ Easy to self correct through portal
▪ Cross functional problem to solve
▪ Problem management team formed
Reduced from 15% to 10% of calls
= 250 less calls/mth

30. STAFF ENGAGEMENT SURVEY
• Performance Management (PD review)
• Career Path - guidelines
• Internal Communication
Team Manager/ Team Leader
Planned Completion Date Fixed Completion Date
Agreement from
Manager – T/L
Goals written
Initial meeting
with each staff
member
Agreed goals recorded in
Sonar6
1st Interim review meeting
with each staff member
Management Team Chris Dever
15/06/2016 15/07/2016 31/07/2016 16/12/2016
Project Services Matt Long
15/06/2016 15/07/2016 31/07/2016 16/12/2016
Application Support John Hawkins
15/06/2016 15/07/2016 31/07/2016 16/12/2016
BSA Team Leader Leon Scott
15/06/2016 15/07/2016 31/07/2016 16/12/2016
BSA Team Leader
Jess Munro
15/06/2016 15/07/2016 31/07/2016 16/12/2016
BSA Team Leader
Stuart Wakerley
15/06/2016 15/07/2016 31/07/2016 16/12/2016
Service Operations Mohammed Sayeed
15/06/2016 15/07/2016 31/07/2016 16/12/2016
Service Desk Julie McGing
15/06/2016 15/07/2016 31/07/2016 16/12/2016
SAM Team Julie McGing
15/06/2016 15/07/2016 31/07/2016 16/12/2016
NTT Team Peter O’Callaghan
15/06/2016 15/07/2016 31/07/2016 16/12/2016
Core Systems Team Jon Sammonds
15/06/2016 15/07/2016 31/07/2016 16/12/2016
Technical Team Paul Pilgrim
15/06/2016 15/07/2016 31/07/2016 16/12/2016
Tech Support Team Stacey Wolland
15/06/2016 15/07/2016 31/07/2016 16/12/2016
Support & Training Elizabeth Spooner
15/06/2016 15/07/2016 31/07/2016 16/12/2016 Yes

31. INTERNAL COMMS - WHO AM I?
▪ Internal comms group set up
▪ Briefed to be a conduit

32. OTHER SUCCESSES
▪ Outages Process
▪ Duty Manager and communications
▪ Senior Management working better as a team
▪ Teams engaged/self-organising

33. OUR BLUEPRINT
1. KNOW YOUR CURRENT STATE
2. DEVELOP A PLAN
3. SET YOUR KEY METRICS
4. GET STARTED
5. UNDERSTAND WHAT’S WORKING
6. CHANGE WHAT ISN’T WORKING

34. LESSONS LEARNT
▪ Keep your lean group lean (too many people)
▪With a system to engage team leaders
▪Involve staff as well
▪ Outside business support is critical
• Keeps aligned to organisational vision
• Flags blind spots to the business

35. LESSONS LEARNT
▪ Train your people to fill the roles
▪ Continuity of people is crucial
▪ You’ve got to find your rhythm, and keep it
▪ Learn and improve as you go - retros
▪Ensure work from sprints ends up implemented in the business

36. LESSONS LEARNT
▪ Get buy-in and ownership to the vision
▪ Ensure it is not seen as ‘on top of current work’
▪ Transformation needs to be driven and role modelled by senior management
▪ It starts at the top (Exec? Board?)
▪ Review early (external review after 6 months)

37. LESSONS LEARNT
▪ Transformation is hard
▪ People are the hardest to transform
▪ Ownership of transformation is crucial
▪ Leadership is crucial

38. THE FUTURE

39. NEXT STEPS
▪ Inspecting and adapting as we go
▪ Currently revising the Roadmap based on what we now know
▪ Focusing on Senior Management improvements – these trickle down
▪ Looking for an exit strategy

40. OUR BLUEPRINT
1. KNOW YOUR CURRENT STATE
2. DEVELOP A PLAN
3. SET YOUR KEY METRICS
4. GET STARTED
5. UNDERSTAND WHAT’S WORKING
6. CHANGE WHAT ISN’T WORKING

41. Thanks for listening
Any Questions?