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All for the Want of a Plan . . .
Anonymous
This account centers on an information system, MedCare, installed in several public hospitals in 1999 under pressure to achieve year 2000 (Y2K) compliance. MedCare had been developed in another country; thus, the corporate office was overseas, and a small regional office (in a state separate from the sites) managed the product locally. The stage was set for conflict by all the usual factors accompanying a rushed information system implementation, including poor planning, ambiguous contracts, and insufficient training. It took the entrance of a new player on the scene, Ms. Black, to ignite the esca- lating conflict. The “sparks” involved two fairly trivial administrative tasks—preparing an enhancement estimate and completing a questionnaire.
Background
Ms. Black was hired by the state Department of Health Services (DHS). She was responsible for all information systems throughout the state. She did not personally use MedCare, or work in a hospital, but was politically powerful. The position was created subsequent to MedCare being installed, so she was not involved at the begin- ning of the process. Each hospital had a system supervisor who managed MedCare at each individual hospital site and acted as the point of contact between that hospital and MedCare’s regional office. Mr. Brown was employed by the MedCare regional office to manage the system. He was the contact between the local hospitals and the MedCare overseas corporate office where all the development took place.
Conflict Flashpoints
The Enhancements Procedure
The enhancements procedure was the method by which the sites, in theory, could incor- porate changes into the software. Written into the contract with the state was MedCare’s commitment to provide twenty-five “free development days” annually to be used for adding enhancements to MedCare. This meant that enhancement requests had to be agreed on and prioritized among all the sites and approved by MedCare.
The enhancement procedure included the following steps:
1. Each site’s system supervisor completes an enhancement request template for each enhancement they would like.
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2. The request is sent to the MedCare corporate office where it is entered into the enhancement database and assigned a unique number.
3. The request is either declined (and removed from the enhancement database with the reasons communicated to the system supervisor concerned) or accepted.
4. The twenty-five free development days belong to the sites collectively, however. A report listing all the accepted enhancement requests is distributed annually to the system supervisors of each hospital, providing the opportunity for these requests to be reviewed and discussed. This report includes a “prioritization table” providing the following:
a. The identification number of the enhancement b. The enhancement title
c. An estimate of the amount of development time required given in a range of days, i.e., 1 to 5 days for relatively straightforward enhancements, 5 to 10 days for moderately complex enhancements, 10 to 20 days for complex enhancements, etc.
d. A field in which the system supervisor can assign a priority to the enhancement by awarding it a number of points.
5. The system supervisors have 4 weeks to return the list of requests to MedCare, pri- oritized by importance to their hospital site.
6. MedCare totals the points and ranks the requests in order. The corporate office schedules the enhancement work, beginning with the highest-priority enhance- ments, and goes down the list until the twenty-five free development days have been used.
This enhancement procedure had been accepted at other MedCare client sites, and had worked at these hospital sites without serious problems as well, until Ms. Black was appointed. She wanted an estimate quoted in number of days (-/+10 percent) on the prioritization table—not in a range of days. To quote Ms. Black: “It simply is not feasible to quote between 10 to 20 days, and even when providing these numbers to call them estimates. I really can’t see what the problem is with providing a more accurate account of the provision of service requested as it is considered standard procedure.”
In response MedCare argued that (1) to estimate with this degree of accuracy for all the enhancements, the 25 days of development time would be used up preparing esti- mates, leaving no time to develop and test any of the enhancements, and (2) prioriti- zation of the enhancements should be largely based on functionality, with the time estimate used as a guide. MedCare would thus only agree to a tentative target, and quote a range of days for the enhancement report.
Because the estimation process had not been described and recorded in detail and had been approved by Ms. Black’s predecessors, both parties stuck to their idea of how things should be done. There was no process in place for managing changes in the enhancement estimation process—resulting in an impasse with Ms. Black refusing to allow her system supervisors to take part in the enhancements procedure.
MedCare decided they had to continue with the existing enhancements procedure for that year at least, to fulfill their commitments to their other clients, who were satisfied with the range-of-days estimation offered by MedCare used to prioritize enhancements. This provoked Ms. Black further, and she stated in a memo:
As I had mentioned in several earlier correspondences, we have not voted on these enhancements due to not being supplied an accurate number of programming days. It is disappointing to see MedCare proceed with the enhancements when we have asked on numerous occasions for an accurate amount to be provided on programming days. I reiterate that these enhancements may 27. All for the Want of a Plan . . . 243 LTF27 10/11/2004 9:18 AM Page 243
have been selected by other clients, but that we have not endorsed them, and as such, we will not relinquish our entitlement to our allocation of development resources.
This stance created contract problems, as MedCare had agreed to provide Ms.
Black’s hospitals with enhancements but unfortunately had not documented exactly how this was going to be done. If only it had been realized that “once all project stake- holders agree to the estimation procedure, one can engage in rational negotiations about the inputs to the estimate (feature set and resources) rather than irrational argu- ments about the outputs (budget and schedule).”1A written and agreed-on estimation procedure within the enhancement procedure could have prevented these problems between MedCare and Ms. Black.
The Questionnaire
MedCare sent out an annual questionnaire entitled “System Supervisor Satisfaction Questionnaire” to gain qualitative feedback from users about the MedCare product and services. The system supervisors usually completed the document and e-mailed it back to the regional office for compiling.
Ms. Black’s feelings about this were stated as follows: “Please note that I have asked sites to delay completion of the user satisfaction survey, as it should be discussed at the next state meeting. I have concerns with some of the questions as they are very sub- jective rather than objective.”
MedCare argued that (1) this was a MedCare questionnaire, not a DHS question- naire, and so MedCare should administer it, and (2) MedCare was canvassing the indi- vidual opinions of the actual users (system supervisors), not the collective opinion of users.
The end result was that MedCare’s questionnaire was sent to Ms. Black, who dis- tributed it to her sites and then collected and correlated the responses on her own.
MedCare felt, rightly or wrongly, that the motive behind this action was to prevent any
“good feedback” from the actual users reaching the regional office that could then be used to argue their case with Ms. Black and DHS.
With Hindsight . . .
The first step on the road to these conflicts was insufficient planning. A robust, agreed- on, and therefore enforceable enhancement procedure would have been a good start.
If this had been coupled with an agreed-on change control process detailing how to make changes to the enhancement procedure if the need arose, the conflict regarding the estimation process could have been better managed. Similarly, if there had been a documented, agreed-on process for gathering feedback from the end users, it would have been easier for MedCare to maintain this line of communication.
Conclusion
The root causes of these conflicts, like most conflicts were:
• Poor planning. Exactly how MedCare was going to be managed within the sites had not been given enough thought. The hierarchies and work practices of the clients, and the contracts signed with them, were very different.
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• Poor documentation. Documentation was almost universally poor, starting with the original contracts and going on to include the enhancements procedure.
• Poor adherence to the procedures in place. Even where procedures existed, they were unclear and often ignored.
• Poor communication. The distances and time zones involved should have made those involved focus on setting up clear, formal, regular communication paths. Instead it was a case of good luck rather than good management if a message got through.
If the above bases had been covered, the chances of anyone being able to derail the enhancements procedure or a satisfaction survey would have been reduced and the working environment of all involved improved.
Reference
1. McConnell S. Software Project Survival Guide. New York: Microsoft Press, 1998.
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