November 14, 2023

Healthcare IT Staffing: The Demand – Talent – Team Triangle

by Tamara Pomerantz

The Demand - Talent - Team Triangle  

Forecasting IT staffing needs for today’s & tomorrow’s healthcare system.  

You are not alone if your IT department is struggling to meet the support and project demands of your health care organization.  I’m frequently asked questions like, “How many resources do we need?” and “How do other health systems organize their IT teams?”  

Appropriately determining IT department staffing needs is not as simple as modeling other organizations or sizing staff for specific project needs.  

Consider the grocery needs of two similar families of four.  We do not expect these families to consistently need the same amount or type of food.  Variables need to be  applied, such as the age and development (maturity) of the children, how often, when and where they eat, the types of food preferred, special events (demands and goals), etc. 

Just like these two families, we cannot assume two health systems require the same number of IT staff.  Such comparisons often result in under or overestimating and failing to identify needs.  

Traditional healthcare IT staffing approaches are often ineffective because they don’t take into consideration necessary variables to identify IT staffing needs.

The demand for IT continues growing as the way to solve healthcare challenges such as staffing shortages, burnout, consumer expectations, competition, accreditation, and regulation.  However, IT department models for evaluating and forecasting staffing needs have not been advancing.

73% of organizations do not have enough resources to meet incoming demand” 2

Further, healthcare IT structures often rely on multiple team hand-offs, resulting in increased staffing needs while creating pockets of siloed individualized knowledge and specialization, lack of ownership and accountability, and limited understanding of health information functions and workflows being supported.  All of this contributes to IT’s struggle in meeting the demands of the organization.

A Gartner Strategy Survey found 62% of leaders believe their operating model cannot support current and future strategic objectives and plans1.  Planview also reported that 73% of organizations do not have enough resources to meet incoming demand, and 55% of organizations believe their projects and resources are not well aligned with business goals2

To be sustainable, Healthcare IT departments must plan for support needs and outcomes by evaluating expected service request and talent capabilities.  Therefore, IT staffing models should use demand, talent, and team data to forecast resource needs.

The Demand - Talent - Team Triangle

Determining and developing a modernized IT division structure requires the consideration and continuous monitoring of several variables including:

  • Demand for services -  intake type and volume
  • Maturity of services and technologies
  • Talent capability
  • Professional development programs
  • Team organization
  • HR requirements and organizational/department politics

Figure 1.

These variables are illustrated by the Demand-Talent-Team Triangle  (Figure 1).

The Demand-Talent-Team Triangle incorporates key considerations and variables for an effective Healthcare IT staffing model.  It is through the adjustment of these variables that an equation can be formed to balance demand with resources.

For example, increases in Demand can be addressed by increasing Team sizes or increasing Talent. Depending on the types of demand, the right mix of talent may be able to sufficiently manage the work with fewer teams and resources.  However, if the talent pool is not as experienced, capable, or large, then more resources across teams may be necessary.  Further, if the talent to meet the demand is spread across many teams requiring hand-offs, greater team coordination and resources may be required.

Let’s break down the elements of the Demand-Talent-Team Triangle.

Demand - service intake type and volume

Specific staffing recommendations require evaluation of the existing and expected demand for services that come from day-to-day business needs, as well as operational and strategic goals. 

For example, by looking at a health systems logged work request types, we can determine how many hours they have previously spent on different services; and utilize that data to forecast future demand.  We can also use this information to identify opportunities for process improvement.

Maturity of services – technology alignment with end user adoption

The maturity of the organization’s end users can impact its IT services and staffing needs.  

An organization with well-established, integrated processes and effectively adopted technology may require less day-to-day support.  However, this organization may be more demanding of IT innovation requiring a greater skilled IT department.

While an organization with low end user adoption or proficiency where technology is not well integrated into their processes may need greater day to day support.  This organization is likely less tolerant of information technology change, and therefore may need less skilled IT support but require more personalized attention.

Talent capability

An organization’s IT workforce, its talent, influences the achievement of the organization’s vision and goals.  High skilled and experienced workers generally produce faster.  However, IT teams often include resources with varying levels of experience and skill.  

Think of the times when it seems like 80% of the work is done by only 20% of the team. Or the same people have to be engaged in every project because they have all the knowledge.  

We can improve the lower performers and increase a team’s capacity by focusing on motivating and expanding talent capabilities.

Professional development programs

Have you ever looked at a project team thought “How many people does it take to change this light bulb?”

Resource specialization by function and technical system has often been encouraged by traditional IT division and team structures.  This results in many different resources having to get involved to complete the work. 

Further, this approach can discourage cross-training and cross-functional knowledge, limiting the potential for talent development and agility. 

However, workers motivated to increase their skill and experience are more productive.  A cross-trained worker has greater cross-functional knowledge and can decrease the requirements for hand-off and increase agility - therefore, doing more with less.  This can lead to faster delivery of more integrated products.

Team organization

The number of human resources required to deliver efficiently is also influenced by how IT teams are organized around scope of work (topic/area).

A high degree of knowledge specialization within a team results in more hand-offs requiring more resources to support and complete the work.

IT teams structured by vendor systems, specific technical function, or venue can also create discrepancies in operational processes and practices, increase management overhead, and lead to conflict and duplication.  This is particularly prevalent when organizations utilize multiple systems that provide similar IT functionality, such as multiple registration systems.

When IT teams encourage resources to expand their knowledge, they decrease the need to pull resources from many different teams, increase flexibility in staffing, and limit hand-offs.  Therefore, fewer resources are required to complete work.

IT divisions designed to foster cross-matrix and generalist knowledge approaches lower the “walls” between departments and teams, increase comfort with indirect reporting structures, increase communication, and decrease discrepancies.  All of this leads to more integrated teamwork and more efficient project and service delivery.

HR requirements and office politics

The ability to adjust resource allocation and team structure may have dependencies on HR requirements that must be considered: education and years of experience, salary limits, and legal statutes, etc. 

Additionally, the ability for team members to work well together professionally and personally both directly and indirectly influences how teams should be structured and must be taken into consideration.

How to do it: 

Data driven Staffing using the Demand Talent Team Triangle

As a manager, you may know you need to increase staff, but do you have the data to understand the type of talent you need and justify a new position or additional staff training?

Service and project management system data, if accurately captured, can help you predict your staffing needs. 

Use data from service and project management systems to:

  • Estimate expected volume of requests
  • Determine average work effort required to complete requests
  • Evaluate talent needs and trends

Three Steps to calculating Staffing Needs

Step 1:  Understand IT demand and expected work effort

Review the types of requests your team receives and their turnaround time to better estimate average hours needed per request.

An organization’s operational and strategic expectations, such as expansion of service lines to advance care and consumer areas, or improve quality and revenue often require changes or replacements of technology.  This creates significant IT resource demand (labor, time, and capital) that may not enter through standard IT service intake and project request processes.  Understanding operational initiatives supports IT forecast planning and helps avoid unexpected IT utilization.

Accurate forecasting of service requests requires recognizing trends and patterns through the consistent tracking and accurate service classification of requests across IT.  Reviewing this   data for how it changes over time advances identification of growing or declining service needs.

Consistent use of clearly established classification criteria for common service request types also drives process improvement. For example, a high rate of break/fix requests indicates testing and validation processes may need improvement.  While a high rate for education/adoption support indicates end user education and communication processes may need attention.

Review hours expended by service request type, administrative responsibilities, and time off to improve resource forecasting. 

Use service and project management systems to capture demand and log resource hours. 

Incentivize and encourage teams and individuals to be better with their data entry by showing them their data is utilized to improve staffing.

Analyze the data to forecast and then validate that resources and work effort are aligned to organizational expectations. 

Figure 2 illustrates how resource allocation data and service request data can provide clarity for where resources are spending time compared to organizational demand need.

Figure 2.

Step 2:  Evaluate and forecast staffing and talent need

Break down requests based on type of request and area or topic to understand talent needs and focus professional development and hiring practices.

Identify and establish baselines for existing resources and their skillset and expertise levels, then track growth and improvement so there is a greater awareness and understanding of resource talent.

Compare talent to expected demand.  Ensure the talent expertise matches the areas of current and forecasted demand.  The capabilities of human resources are essential to achieving operational and strategic objectives.  Therefore, human resources must have the ability, and be incentivized, to adapt and expand to expected business need and demand.

Identify opportunities to improve talent agility.  Consider team restructuring, cross training, role/position changes for resetting work expectations to meet expected demand.  Ensure professional development plans align to role levels that guide resources through capability growth.  Establish processes and tools for planning work assignments and estimating time allocations, then monitor plans against actuals.


Step 3:  Select and act

Determine action plans and execute based on data, and continue to review, monitor, and adjust based on changes in demand.  Action plans may cover increasing and tying internal professional development to annual review processes, adjusting team structures to increase cross-functional knowledge and generalist skills, or hiring new resources with specific skills.

How MAKE Solutions can help

MAKE’s Staffing and Talent Need Calculator can help you process historical service request data and expected demands to better predict your IT staffing and talent needs. 

For more information contact
Tamara Pomerantz, VP Client Operations, Tamara.Pomerantz@makesolutionsinc.com.


References
  1. Joanne Kopcho, Monika Sinha, Irving Tyler. A Key to Unlock Execution Success: Align IT and Enterprise Operating Models. ID G00756034. Gartner. September 29, 2022.
  2. Planview, Inc. The Project and Portfolio Management Landscape 2017 Edition. 2017.

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Tamara Pomerantz

About the author

Tamara Pomerantz has spent her career as a trusted advisor to healthcare organizations across the country. Over her 25 years in the industry, Tamara has proven herself to be an experienced leader, mixing innovative solutions with industry best-practices to create change and deliver results. She specializes in Operational Excellence to develop strategic and operational goals, installing process and data-driven performance metrics, motivating operational change, and providing consulting services.

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