Structuring Cross-Departmental Teams

by | Oct 10, 2011

[Welcome back from the holidays! I am back as well and we are continuing our Healthcare Implementation Roadmap Series. If you have feedback on this series or related stories you can share, I encourage you to put them in the comments below.]

As a department, IT always has a vested interest in system implementations because, well, they are responsible for technology. But there are few systems in a hospital that IT and only IT cares about and is responsible for. Except for applications like enterprise email and technology support tools, IT simply should not be the system owner because you don’t want IT making business decisions that drive your hospital.

 IT should drive what it is good at – technology. Beyond that, IT should be a partner with the business owner to make sure that the technology solution is being implemented, utilized, and supported as best as possible. The business owner is the one who has the vested interest in how the technology solution should work and, in conjunction with input from their IT partner, is the one best suited to make the decisions on how the system and processes are designed to work.

This principle applies across all industries but we see it in healthcare with more typical situations – Finance owns the financial applications like AP, GL, and Payroll – as well as in healthcare-specific systems like an EHR, which is owned by the clinical practice.

Clinical system implementations are the best example of IT partnering with the business for a technology solution. The following are a few factors on why that partnership happens so strongly for a clinical implementation:


  • Advanced clinical systems are complex, both from a technology perspective and in how instrumental they are to patient care.
  • Clinical practitioners do not have the advanced technological knowledge required and must rely on IT for the complex system requirements.
  • IT is not clinical and can only support the technology, relying on the clinical practitioners to make the decisions expected from the user owners.

For those of us who have been around clinical system implementations, either on the IT side or the clinical side, these are all completely obvious factors. However, I think it is important to point them because these exact same factors relate directly to scheduling systems.

Scheduling systems often, by default, fall to IT to own (because it is a “system”). While that department definitely needs to be involved, that can’t be it – Nursing, Finance, and HR need to be involved as well.

Here is how each department has a vested interest in scheduling:


As we’ve previously mentioned in this blog, employee scheduling is the operational heartbeat of the hospital. The scheduling system is the labor management tool that enables a hospital to put their staff in a position to provide the best possible patient care. That is the domain of nursing management.


There is the direct relationship to the timekeeping system, which Finance should own as a part of the Payroll umbrella. But in addition to that, the scheduling system is the only place where the labor budgets are translated from dollars to hours to actual shifts. Managing these proactively has an identifiable impact on the bottom line.

Human Resources

It is easy to overlook the importance that scheduling has to HR, but they are just as much of a stakeholder as Finance. Compliance with labor laws and union contracts, the domain of HR, is enabled (or violated) right within the scheduling system. And, parallel to Finance, the schedule is the only place where the employee contracts and position management are turned from requirements into actual shifts.

Information Technology

Because the scheduling system is a “system,” IT needs to be involved to select, implement, and support the system. But there is no additional business reason for IT to have a vested interest in scheduling.

What can we draw from that? Three big conclusions jump out at me right away:


  1. The stakeholders for a scheduling system are more diverse than other system implementations in a hospital. Unlike other systems which have a clear business owner and responsible party, scheduling has the ability to affect many (seemingly) disparate areas.
  2. IT is the worst choice as the business owner of scheduling, since they have no vested interest in the operations. But they are a critical stakeholder given the interaction that the scheduling system needs to have with other clinical and business applications.
  3. The best choice for the business owner of the scheduling system is Nursing, as they are responsible for operations and patient care. Finance and HR both have critical input into the scheduling process, but, just as it is without a scheduling system, that should be “input” only and not ownership of the process.

That brings me back to the partnership that goes on between IT and the clinical side of the house for a clinical system implementation. When it comes to a scheduling implementation, it should be thought of and treated like a clinical system implementation, with the same model of close partnership. The only added variable is that both Finance and HR need to be involved in the decision-making process, given how critical the system is to all parties.

Unfortunately, scheduling implementations don’t always happen that way. There tends to be one department who decides, on their own, “We are going to implement a scheduling system!” The result is a disjointed experience that is sometimes painful and always falls short of the potential. Everyone needs to be involved.

That is why we are laying out this roadmap: To help you see the all of the different paths so you can decide to take the ones that get you to the best possible destination!

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