By Linda Sinisi

Here are some service expectations and goals I developed for my new IT team at Pennsylvania Hospital as part of a larger drive to create a service-oriented IT culture.

Service excellence starts with listening. When someone takes the time to explain what they need, the first step I take is to repeat what they said to confirm that I understand. Immediately afterward I send a note with next steps and a realistic timeframe for addressing their request.

Service excellence also means anticipating the needs of your clients. At Pennsylvania Hospital we recognize that clinicians don't always have time to call the Help Desk. So we developed two other ways to reach tech support.

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First, a user can complete a short form on our intranet and get a response within 24 hours. Second, they can use a customized post-it note with check off boxes to define the problem and post it on the device. Every application is listed as well as hardware components. An IT service coordinator rounds the floors daily and assigns technicians to resolve problems.

Another way to anticipate your clients' needs is to take precautions before they ask for help. A new CIO should try to minimize opportunities for potential failures through strong virus protection, user education, and reliable and supportable applications.

Another prevention effort we undertook is our "table top drill." Our patient safety officer, medical department heads, and members of my department and I played out scenarios of potential system disasters to ensure that the policies and procedures we have in place will support our recovery effort.

As we all know in healthcare IT, interfaces proliferate and in some areas hospital operations are triggered by electronic requisitions, for example, requests for lab and radiology orders.

What's challenging is that an interface engine failure can confuse staff and slow the patient flow. To inform folks of a system outage, we use email. Because email is not enough and overhead pages are not popular with patients, who would prefer a quiet stay, our preferred method for communication during an unscheduled outage is as follows: an electronic message on PC screens; an IS Help Desk greeting to inform callers of an outage; and a representative and senior managers from each department in the hospital is notified via cell phone.

In the event of an extended outage at night or on the weekend, a hospital command center would be opened and specific individuals would be called in to manage technical and operational communication throughout the hospital.

A formalized, systematic communication process, similar to a process we already have in place for weather emergencies, provides the oversight and communication need to avoid confusion and to ensure that folks have whatever tools they need to take care of patients during the outage.

Planning and orchestrating a table top exercise, could be viewed as a daunting task, though it pays back many times over. Work with key stakeholders in a round table discussion, and offer everyone a chance to provide input on the process.

Planning ahead with tabletop exercises offers many benefits. Department leaders are "practiced" so during a real disaster, they understand what role they need to play. With a trial run, you can discover best practices ahead of time rather than only after a true disaster. A practice session will give you the luxury of thinking outside the box--something you won't have in a real emergency.

Editor's note: Linda Sinisi is CIO of Pennsylvania Hospital, a 519-bed acute care facility in Philadelphia, which is part of the University of Pennsylvania Health System. A major teaching and clinical research institution today, when it was founded by Benjamin Franklin in 1751, Pennsylvania Hospital became the nation's first hospital.

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