Situation
The Shock Trauma Air Rescue Society (STARS) is a community based not for profit organization in Alberta, Canada. Their mission as an emergency medical response organization is to provide expedited transportation services for critically injured or ill patients via their specialized fleet of helicopters. After their formation in 1985, the organization quickly grew with funding through private donations and partnerships with community and government agencies.
According to STARS Governance And Financial Report 2010, STARS’ average net revenues over the past three years were $28. 9 million from all sources — operations, fundraising and investments. Over the same period, average expenditures were $29. 7 million. Average net revenues over average expenditures were $(0. 8) million. With such budgeting shortfalls, the organization has to find ways to cut costs. Led by Dr. Greg Powell, a former emergency room physician now CEO, the STARS mission is to “find patients, take care of patients, and transport patients. The organization employs approximately 250 full and part time staff in addition to the hundreds of volunteers from the medical community. STARS has an average of 3. 4 missions per day, and more than 1,000 each year.
Strategy
The current organizational purpose is simple; to provide “a safe and rapid, highly specialized emergency medical transport system for the critically ill and injured. ” The STARS work environment is made up of professionals working in a cohesive, team oriented model.
The air medical crew (AMC) is well staffed and always prepared for a mission. Once a call for an airlift comes in, the crews quickly and efficiently evaluate the situation and are airborne within eight minutes of notification. The current technical strategy is the use of the Emergency Link Center as the central location for communication between the AMC and other medical professionals waiting at incident locations or the hospital. While the ELC is a significant role in the organization’s business model, the technical foundation is not sound or secure.
This includes a weather check, ensuring safety checks and special equipment is on board. Upon takeoff, the pilot continually communicates with air traffic towers as well as with the Emergency Link Center (ELC). The ELC is a central communication hub that communicates with the AMC, hospitals, ground ambulance services and other emergency responders. It can be thought of as the messenger between the air crew and others. During the flight, the ELC informs the crew of patient data and landing zone information.
When a mission is completed, the helicopter is brought back to the base where it is cleaned, re-fueled and re-stocked for the next mission. STARS relies heavily on Information and Communications Technology, from providing services, maintaining communications between all parties, monitoring weather patterns etc. Dr. Sharaz Kahn the recently appointed Chief Information Officer for the organization in 2008, inherited a fractured system that had no central oversight.
Issues
The new IT Director, Sharaz Khan, is faced with an array of challenges when started his role with STARS. The most prominent of which is the disjointed nature of the department that he now heads. It consists of seven full-time employees, one manager and several consultants. The organization has utilized a type of outsourcing by irregularly employing outside consultants to tackle some projects and “in sourcing” by allowing other non-IT departments in the organization to perform tasks that otherwise would be IT functions. Other departments also hired their own IT staff or outside contractors, often costing the company much more money.
This has led to what the author calls “Distributed Information Services” making it difficult for Kahn to determine initially the full scope of IT at STARS as well as determining IT operating expenses. In addition to being a distributed model with multiple IS “silos,” the outsourcing model STARS used was incredibly expensive and had little oversight over the contractors who had somewhat free rein to determine what their priorities were. In the case of internal employees, he determined that there were no clear definitions of roles with the staff, nor were there any clear work plans for managing multiple projects.
Eventually, Kahn was able to identify 24 projects underway and each one was marked as “critical. ” Unfortunately, project planning (i. e. prioritizing tasks, identifying appropriate human resources) was unheard of. On the contrary, projects were started as a result of a problem or issue that would need to be resolved. The system was almost purely reactive, which did little proactively to contain issues or costs. He also made note that IT services even for routine tasks were often routed by end users and not by the internal process.
The other immediate issue facing Kahn is his recognition that infrastructure was in need of updating as well as cutting out redundant technologies. For instance, STARS had many more servers than were needed. Additionally, many of the IT components were well passed their warranty period, and all maintenance and repair incurred exorbitant costs. There was no regimented way to handle security issues or any preventative maintenance to the network. When security breaches would occur, repairs would involve contractors with more high fees.
Finally, to further complicate the situation it appeared that after presenting the state of IT to the CEO and other executive leadership, Kahn was expected to revamp the entire system as well as cut costs by 10% to free capital for the purchase of additional helicopters.
Analysis & Recommendations
The entire STARS IT group was disjointed and was not aware of the scope of IT within their organization. The first time the IT group was truly aware of the scope of their systems was when Kahn displayed a visual of all the systems they (should have been) manage at an Executive presentation.
Based on Kahn’s fact-finding, he presented the STARS Technology Environment (as shown in Appendix A), which gave an overview of what servers supported various aspects of the organization. This was really the first time IT garnered visibility within the organization. The presentation identified the IT staff as a unified, organized team for the first time. Unfortunately, Kahn’s predecessors never took keen interest in the IT group, resulting in the lack of direction and purpose. As a result, they felt taken advantage of by other Department heads and powerless to do their jobs.
Kahn made clear that he was the individual responsible for all IT activities and the person with whom other managers should speak to for IT matters. He established the IT hierarchy, which is the first step in creating a unified IS. Our analysis of the issues above is that more ‘process’ needs to be established in IT decision making and project implementation. The IT group has lacked a great deal of structure and direction, which has led to inefficient decisions, and unnecessary and excessive spending.
We recommend the following items be taken into consideration to support STARS mission and budgetary concerns: From a human resource perspective, Kahn needs to identify the IT staff’s professional capabilities (for both the STARS and consulting staff) and define clear work functions for all parts. Employees need well-defined tasks and responsibilities, not only to provide guidance in their everyday work, but also for Kahn to be able to monitor the IT department and hold individuals accountable. Furthermore, it needs to be determined if there are gaps in staffing. Are there, for example, backup employees for key IT functions?
In addition to this, a clear hierarchy needs to be established so that all IT projects and information makes its way up to Kahn. Regarding project planning, structure needs to be imposed. The 24 projects should be prioritized as High, Medium and Low. Further, budgeting for each project should be created and a project manager and other key staff (STARS and consulting) should be identified for each project with each head reporting to Kahn. From an IT perspective, we recommend conducting a comprehensive inventory of all equipment and corresponding warranties and maintenance information.
Moreover, instead of operating in a reactionary mode, the department needs to be more proactive with network and security work. Redundant and outdated hardware and software should be updated with a system put in place for regular maintenance and replacement. Other departments need to give up their IT functions to Kahn and his staff as they create a unified system.
Maintenance Protocols for equipment and software are needed in order to stay up-to-date and avoid interruptions, computer crashes, time waste and ultimately losing money. Additionally, a “Change Process” that allows other Departments to submit IT requests ranging from new computers to new software installations should be established. This will, first of all, ensure that tasks are being delegated to the appropriate staff members; and secondly, it will become easier to keep track of the IT labor, and thus operating expenses of the IT department. Lastly, we recommend allocating as much work as possible to STARS staff to avoid costly consulting fees.
Reference
- http://www. stars. ca/data/1/rec_docs/297_STARS_2010_FINANCIALS_F1_web. pdf
