Great Ormond Street Hospital for Children NHS Foundation Trust (GOSH) is a national centre of excellence in the provision of specialist children's health care, delivering the widest range of specialist care of any children's hospital in the UK. It is the only specialist Biomedical Research Centre for paediatrics, the largest centre in the UK for children with heart or brain problems, and the largest centre in Europe for children with cancer. GOSH receives over 260,000 patient visits and carries out approximately 18,800 operations each year. Many of the children and young people on its’ wards require high dependency care and one-to-one nursing. With around 60 paediatric specialties, the broadest range of any hospital in the UK, GOSH is uniquely enabled to diagnose and pioneer treatments for children with highly complex, rare or multiple conditions.
IT pivotal to GOSH digital strategy
The hospital is going through an exciting period of transformational change, with a large-scale redevelopment programme bringing world-class facilities to clinicians and patients. With extensive strategic investment in the digital footprint of the Trust, the role of IT is pivotal to the success of the hospital’s digital strategy.
When Greg Fellowes applied for the role of IT Service Support Manager at GOSH, the IT Service Desk function was outsourced to a third-party, and Greg was tasked with building the new, in-house Service Desk function from scratch. Greg explains, “It doesn’t matter how good your IT teams are, if your Service Desk isn’t excellent, the reputation of the entire IT organization suffers. During my interview, I learned that I would be implementing a new ITSM tool to ensure that our service delivery was the best it could be. I was excited by the challenge but disappointed to learn that the tool had already been selected. I had used Supportworks in another role, and although it’s a good tool, it’s designed for on-premise deployment, which didn’t align with the hospital’s digital strategy.” Fortunately, by Sept 2016, when Greg started working at GOSH, this was open to debate, so he decided to review the decision to install Supportworks.
The business case for Hornbill Service Manager
The GOSH ICT team had looked at the latest versions of several ITSM tools, including Sunrise, ServiceNow, Cherwell and IT Custodian, Greg thought that Hornbill Service Manager was the most innovative solution. However, he needed buy-in from his teams, and especially from his colleague, Hayley Gordon, who would be responsible for configuring the tool. Greg explains, “I encouraged my teams to look at the online videos and demonstrations of Hornbill Service Manager. After watching the videos, most people were on-board. Hayley was confident that she could configure the tool, and we were both convinced that this was the right product for GOSH. We just had to have it. The business case to our Deputy Director of IT explained that Hornbill Service Manager is delivered as a service, so it’s much easier to deploy, maintain and update. We could have to tool up and running within 30-days, and during the switch-on process, Hornbill would transfer all the knowledge our staff needed to be self-sufficient going forwards. In the end, it was an easy decision. We wanted to be a digital hospital, using the best technology we could get our hands on, and for the Service Desk, that was Hornbill Service Manager.”
A service-centric approach makes ITSM simpler and more effective
Although switching to Hornbill Service Manager was the right decision, it presented several challenges. GOSH IT teams had defined their requirements based on implementing Supportworks, and the approach was process-centric. Greg explains, “I realized that setting up Hornbill Service Manager would be a real challenge. The approach is service-centric, so you need a decent understanding of your services. Over the course of my career I’ve been through several new tool implementations, but this approach was very different. With Hornbill’s 30-day switch-on fast approaching, we had to go back to our teams and redefine things from a service perspective. By the time switch-on started those requirements were still coming in. However, it was the right approach, because when you understand your services, it’s so much easier to see how your processes support them. The whole thing flows and works together, so your ITSM becomes simpler and far more effective.”
A fast switch-on
Despite the late change of product and incomplete requirements, a fast deployment was planned. The 30-day switch-on started in December 2016 when Hornbill’s Product Specialists worked with Hayley to configure the tool. Hayley explains, “The training and knowledge transfer during switch-on was great, and I took to configuring Hornbill Service Manager immediately. I instantly became comfortable configuring business processes and using progressive capture. That was relatively easy, but it was a much bigger challenge getting information from our teams about how they wanted the software to work for them. Our Service Desk analysts support around 500 clinical applications, and they can’t be masters in all of them. Progressive capture enables us to prompt analysts to ask different questions, depending on the service they’re supporting. During switch-on, I didn’t have all this information, but I knew that when switch-on was complete, we wouldn’t be stuck with the initial setup, and I could easily change things as requirements came in.”
As the service desk function was outsourced, and the contract with the Managed Service Provider (MSP) had come to an end, there was no help available to transfer data, or export tickets. Greg realised that this presented an opportunity to allow staff to familiarise themselves with the new solution, by getting them to transfer data from the outsourced partner’s ITSM tool. Over a single weekend, 30 members of the GOSH IT team, transferred 800 open tickets from the MSP’s ServiceNow instance into Hornbill Service Manager, ready for go-live on 27th January 2017.
Service Improvement is a marathon, not a sprint
Although it’s challenging to deploy a tool without complete requirements from each IT team, Greg suggests that it can have its advantages. “People often think they’re finished once they’ve stood the tool up, but that’s just the start of the journey. Over a year from go-live, we’re still getting requirements in from different teams, and Hayley is kept busy configuring the tool for different groups, so we’re improving how our teams deliver service on a daily basis. We’ve tailored Services, so that each team is presented with only the information they need to progress their requests. They get a clean interface, with the right information, presented to the right teams, so there are fewer reassignments, and they are working more efficiently. It’s a marathon, not a sprint, but we’re taking service improvement seriously, and other teams want a piece of the action.”
So many departments have asked to use Hornbill Service Manager, that Hayley is swamped with requests. “Procurement, Electronic Patient Records (EPR) and Information Services teams all want to use the tool, so we’re are adding new things every day at present, as well as making process improvements for the 34 different teams that are using Hornbill Service Manager”, said Hayley. “I love to be challenged, and every week, I uncover the tiniest things that I can easily deploy to simplify and improve how we deliver service. When other teams ask- Can we use your system to do this? - it’s great to say, Yes you can! And If I’m ever stuck, I ask the Hornbill Community and Hornbill’s support and development teams, and other customers immediately pitch in to help.”
Huge improvements in the first year
Prior to January 2017, GOSH had been using their partner’s ServiceNow instance, which Greg describes as a powerful tool, but not user friendly, or easy to work with. The Service Desk was receiving 3,500 – 4,000 emails and around 4,000 phone calls per month. Teams were under-resourced, worked in silos, and were poorly organised. Although Greg admits that there’s still a long way to go, since going live with Hornbill Service Manager over a year ago, there have been huge improvements.
According to Greg, Hornbill Service Manager has revolutionised their Change Advisory Board (CAB). “Previously, around ten IT staff would meet in a stuffy room for 90 minutes every week, discussing planned changes. Now, we have a virtual CAB, with a board that allows everyone can see the change backlog and the status every change. People can comment and provide information in the workspaces in Hornbill Service Manager, so 90% of our changes are done before the CAB meeting. Our last CAB meeting was done within 11 minutes flat; so, in total, we’re saving around 80 working days per year, and our change process is more agile.”
According to Greg, the biggest benefit is that Hornbill Service Manager has changed the way people work. “People are really taking ownership and our teams are working together closely”, said Greg. “We are better organised. We use Hornbill Document Manager to store our Standard Operating Procedures and system documentation, so we can easily find useful knowledge and information. We’re using review dates and audit trails to ensure that knowledge stays up to date. We have everything in one place, so it’s easier for everyone in IT to do their jobs, and we’re consistently improving.”
Supporting the values of Great Ormond Street Hospital
GOSH’s values are; to work as one team, and to be Always expert, welcoming and helpful. Greg explains that these values had been gathering dust within the IT organisation, but now, IT is beginning to shine. “To implement Hornbill Service Manager and set up our services correctly, we had to work together. It was a big challenge at first, but people stepped up, and as it has gathered momentum, a new service-centric culture has emerged. Our teams are now focused on the bigger picture, and our people are serious about service improvement. Hornbill Service Manager has enabled IT to establish a digital workplace. I am now truly confident that we can deliver services to support the hospital’s digital strategy, and improve those services daily, so the hospital can ensure that “The Child is First and Always.”