Looking for suggestions for setting Incident priorities for a Healthcare organzation

[Denise11]

we need to re look at the way we set the priority of Incidents.  How do others set the priorities so that non patient related tickets can be a priority ticket?

[James Wright]

Denise - having a focus on patient care is always important and you dont have to lose that.  However, I've seen that end-users can easily tie back most issues to affecting the clinical environment and patient care. This leads to every issue being a P1 issue. That is likely why some of these other issues such as payroll fall through the cracks.

In my experience, questions are great to feed judging Urgency of an issue (similar to your survey).  Customers tend to gravitate to standard best practices (ITIL) that covers a diverse hospital environment.  Focus on pivoting off this formula: Impact + Urgency = Priority will help.  Lets unpack this:

-Impact: IT typically is the deciding factor on the Impact, not always end-users.  Impact can be determined by the type of service that is being interupted (Payroll, EMR, etc).  Therefore an Impact of 1 can be associated to the EMR Service.

-Urgency: Customer can decide on this based on any factors or by guiding them with similiar survey questions (is this just you or the entire floor?).

-Priority: Running the above two (impact and urgency) through the matrix IT prioritize its work and populate a static field of PRIORITY.

Here is an example that can tie it all together. Left column is Urgency.  Top Row is Impact. I hope this helps!

Best Regards,

James Wright | Sr. Healthcare Solution Consultant | ITIL 2011, PSM®, CPHIMS

[Quan Truong]

James, one thing I'm interested in is how you've seen other organizations actually operationalize this. Do they train their help desk to use this matrix to decide the priority? What about tickets that users enter themselves?

[James Wright]

I think at first pass, I've seen organizations in general train the Service Desk on the matrix and how it works.  However, the next level from that is removing the subjective nature of this approach.  You can do that for example by:

-End User Portal > Create Incident (something broken) > Required field of URGENCY, without numbers - but with "This is only affecting me" vs "This is affecting a small group" vs "This is affecting the entire floor".

-Backend/IT view > Review Incident > select a Service that is tied to a Tier of Support (Critical Services-Payroll, EMR) > which then populate the IMPACT field.  The matrix above then gives IT the priority.

Hope this helps!

[Mike B_ Fisher1]

We are a healthcare organization and have used an Urgency + Impact = Priority matrix similar to what James posted.

It has been a challenge for all parts of IT to think along these lines, and we are still working out the factors for the Urgency and Impact axes to include language for both clinical and non-clinical. We have trained our help desk staff to use the matrix, but it's still a work in progress. When end users enter an Incident via the portal, we set it by default to P4.

Here's our current guidance for Impact:

High Impact
Core Application
Gold Application
Clinical care for multiple patients
Mission-critical Clinical service, Business service or Enterprise Infrastructure
Medium Impact
Silver Application
Clinical care for an individual patient
Documenting patient care
Low Impact
Bronze Application
How to questions / training
Requests for information

So we can have an Incident be a High Impact for non-clinical issue. For example, generating a payroll would be considered a "mission-critical business service" and if that service was down then the Impact would be High.

Mike Fisher

Service Management Office

University of Vermont Medical Center