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A service management office improves service delivery in a busy hospital

A healthcare service management office can be a force for change

March 1, 2018

By Scott Wieder

In an era of increasing consumer choice in hospitals, healthcare service managers hold a lot of power. From Leapfrog scoring to consumer review sites, patient service matters more than ever: It matters to patients and it matters to hospitals, which lose revenue when patients choose to go elsewhere.

And service managers already have a big job. What other position holds such a range of responsibility, from helping keep vital diagnostic tools running to making sure patients are checked in quickly and effectively?

Some days the job probably feels impossible. Ever find yourself stymied in making lasting improvements because your team is busy putting out fires? For many healthcare providers—especially large and complex ones—implementing a service management office (SMO) can help you make headway on improving service delivery and the metrics that matter.

Service management office: Overcoming organizational resistance

An SMO can help eliminate redundancies and create efficiencies in service delivery, build measurable services that you can improve, and tame the complexity of mergers and acquisitions activity. The main benefit of an SMO is your ability to build a cohesive, standardized and measurable process to deliver services, and then continually work toward lasting improvements in them.

In short, an SMO, combined with an organizational change approach, enables your service organization to achieve a level of delivery maturity your peers will envy.

But setting up an SMO isn’t for the faint of heart. You need to invest a lot of time and resources upfront to building the office and infrastructure around it and modifying the culture of how work gets done in your organization.

The most significant challenge you’ll encounter is resistance from change-weary employees. When I’ve helped organizations set up service management offices, I’ve often encountered this sentiment: “Nice to meet you, I understand what you’re trying to do, but please go away and let me do my job.” That type of resistance reflects lack of awareness of the value of the change and change fatigue.

It’s natural for employees to feel put out when you’re radically changing the structure in which they perform their work. They’re anxious about using new tools, reporting to a new manager and working against different standards. Unless you manage change effectively, that organizational resistance will cause your SMO to under-perform.

The most effective component of a successful organizational change management strategy is to have effective, active and visible change sponsorship. Senior leaders at your organization have to be committed to long-term success of your project, or that initial enthusiasm bubble you get from managers will evaporate over time and create additional change resistance.

Effective sponsorship extends from the executive sponsor all the way down to first-line supervisors who must model the behavior change. Until a service management mindset becomes part of your cultural DNA, it can’t sustain itself.

A service management office reduces bureaucracy (you read that right)

Partnering with healthcare providers takes flexibility and industry expertise. After all, you don’t want to install an update that takes down key equipment in the middle of peak patient periods. And you certainly don’t want to implement technology that doesn’t effectively support the workflows of busy nurses.

Flipping from a technology-focused team to a solution-focused provider makes service agility and responsiveness possible. It means service delivery drives solutions and technology becomes an enabler, instead of people having to work around technology. An SMO is a starting point in getting your organization to become a responsive and proactive provider, which means aligning your staff from technology-focused roles to business-focused ones.

What does a business-focused delivery model look like in action? You assign some of your organizational team members as service asset owners so they can take ownership of understanding the service needs of the unit in which they’re embedded. That will help the service owner make informed decisions when negotiating a tech stack with IT. It means understanding their peak times and lulls so you can perform maintenance without causing undue disruptions.

All this takes time. For instance, when we worked with Penn State Hershey Medical Center to improve service delivery, it took us almost a year to map out effective service delivery models for only four services. We used that time to fully understand how systems interact, update change management processes, design a service level agreement process with key metrics, train service owners and design a steering process. We also oversaw implementation of the ServiceNow tool. This upfront investment game them a roadmap for improving all their services and reap real benefits in patient satisfaction.

First step: Setting goals, "Rules before tools"

Before you try to build an SMO, you need to know why you’re doing it. If you don’t carefully define the ‘why’ behind the work, it will sputter out.

After you’ve identified the service value you want  the SMO to deliver, you can define the appropriate goals and objectives to hold service owners accountable to. That allows you to figure out what you need to change and add from a people, process and technology perspective to hit your desired goals and increase the level of service excellence.

For Hershey Medical Center the ‘why’ was their desire to be become a top-10 member of the University Health System Consortium, an organization comprising leading academic medical centers across the country. Doing that would help drive patient preference and revenue, but it required the medical center to perform exceptionally well in satisfaction surveys and ratings administered by Leapfrog Group and Hospital Consumer Assessment of Healthcare Providers and Systems. This clear, tangible goal helped the SMO gain support, and it justified the investment.

Next steps

After defining a clear reason for a service management transition, you can move on to people, technology and process. But remember that technology is just a tool; buying a platform like ServiceNow won’t magically make you a service management organization. You have to get the process and change management piece right or the technology will simply speed up the delivery of bad service.

A key step in setting up an effective SMO is to formalize key roles, such as creating change manager and continuous improvement manager positions, to bring clarity and accountability to your project. Instituting a quarterly review board will also help drive and sustain change. Establishing a rhythm to evaluate metrics and improvement will help you maintain people’s feeling of accountability for driving improvements. The conversation changes from talking about efforts to discussing results.

Interested in learning more about how a service management office can help your organization make lasting progress in service delivery? Contact us to learn more about IT service management and healthcare services.

Explore ITSM and healthcare IT case studies, or read about our ITSM services.

Scott Wieder leads Organizational Change Management Services at TEKsystems.

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