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Author: Elyse, PMP, CPHIMS
July 23, 2009


You know what I really hate - Demand Management by Meteor Shower. One walks the halls, goes to the cafeteria or even in the restroom and receives work requests. It is not the customer's fault. Often, they just recognize you, have a conversation, and then ask for you to follow up on this or would you mind checking this out for me? They are simply desperate and have no standard way to request work from the IT department, so the customer tries everyone and everyway. This missing in action work authorization process is a key characteristic of a chaotic project management culture.

Just to clarify I am referring to enhancements, upgrades, or implementation work requests. Production problems fall into an incident categorization. The process is standardized and you can adopt variations. However, before I layout the process, I want to assure you have two components.

First, there needs to be a business leadership authorization of the work requested. These authorizers should be either Directors, or Associate Vice Presidents in a hospital or health system - lower on the management hierarchy, greater the gap in business alignment. In hospital's or health systems, commonly AVPs or directors have insights into strategy that have not been communicated to the manager, supervisor or staffing levels. This authorization responsibility should not delegated. It brings the gap into play and trivializes the work efforts. I do not like it, but I haven't seen this delegation not cause the problem.

The second point is that just because an item is approved, does not mean work begins immediately on the item. With your dashboard, it has been conveyed the department is very busy with items already in work. If an approved item needs to start immediately, something else has to be dropped from the active in work process. This thought process needs to be clear in the rollout of the demand management process.

Without further ado, here are the basic steps in a IT Request Process.


  1. Initiate Request anyone

  2. Authorize and Approve Request

  3. Assign request for Assessment

  4. Assess work effort for the Request

  5. Have Work Request in inventory queue

  6. With the Authorizor use the prioritization criteria as a guide to prioritize work inventory

  7. Have the top X prioritized items in the staged queue

  8. When the IT team has resource availability move the staged request to active

The best technique to adopt this process, is to have the C-suite to agree to a process improvement effort around demand management. Have your PMO manager lead a cross organizational process improvement team with financial and clinical leadership. Suggestions and input will help assure buy-in and rollout. It also positions an enterprise planning process for capital investments with information technology.

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