Tutor notes Managing IS project development and implementation London Ambulance Service & news paper article

Lead up to system failure- Vicious cycle of cause and effects Ambulance incidents- pressing wrong buttons, radio blackspots, causing a build up of incorrect vehicle information on system As a result system made incorrect allocations on the basis of the information it had o Multiple vehicles sent to same site o Closest vehicle not chosen for despatch Calls which didnt go through correct protocol were placed on waiting list o Exception generated for incidents which received incorrect status information o As the number of exceptions increased, it became difficult for staff to clear the queue, to attend to messages that had already scrolled off the screen Size of the queue slowed the system With fewer resources to allocate, and problems of dealing with the waiting and exception queues, it took longer to allocate resources to incidents Frustrated patients called LAS HQ to report incidents Increased call volume together with slow system, and insufficient call takers, contributed to a significant delay in phone answering, This lead to further delays for patients. Ambulance crews became frustrated with incorrect allocations, and this could have further exacerbated their errors, such as pressing wrong buttons and taking the wrong vehicles to locations. Crew frustration also lead to a greater volume of voice radio traffic, which created a radio communications bottleneck This caused a general slowing down in radio communications and led to increasing crew frustration.

Key problem areas Software vendor SO underbid and were pressured to complete system quickly LAS had previous bad experience with faulty software LAS provided poor specifications Big band approach to implementation

Project management o Price before quality- call for more finances and longer time scale was supressed by senior managers o Overambitious deadline o SO developers were inexperienced o SO believed apricot was the lead on the contract o Management of project was inadequate- didnt use prince project management method o SW was incomplete and unstable- emergency backup was untested, poor choice of development tools and platform o Inadequate training- incomplete and inconsistent

Stakeholders Mistrust and lack of ownership due to problems with previous failed phases Disorganisation, low staff morale, friction between management and workforce Hostile attitude toward computing systems Control room staff had no previous experience in using computers

Environment Macro- Political and economic influences of NHS o Many IS failures within NHS o No governing body has responsibility for IT in NHS- No unitary power structure within NHS- very autonomous. Actual delivery of healthcare is in hands of very powerful clinical professionals who are naturally concerned with preserving their professional autonomy. Different bodies have different beliefs of IT: region and trust administrative systems, hospital and GP surgery clinical applications, regions- management information systems, trusts- operational systems

o Lack of clear organisation of IT meant the absence of a clear strategic vision for IT. o Conflicting objectives of various stakeholders within NHS. This network placed several constraints on information management at NHS. o NHS staff had become alienated to culture change attempts Micro o LAS was in need of major modernisation and change o LAS was restructured with little consultation of staff, removing senior and middle management. This caused a great deal of anxiety in organisation o Change in structure created a fear of failure within LAS. Management were pressured to succeed. This may have lead to management being pressured to complete project on time and on budget, but disadvantageously led to them neglecting fundamental difficulties with system implementation. o Technological determinism- Management was nave in assuming that introduction of system would change working practices in relation to mobilisation of resources. Crews could accommodate older practices by failing to mobilise, sending a different resource, failing to acknowledge or report status Analysis More of an expectation failure on part of most stakeholder groups, LAS HQ and ambulance drivers Not a termination failure as system is now a success, using a phased implementation approach (incrementally adding features)

Post implementation- political, structural and ideological concerns influence IS trajectory e.g. user resistance

Development issues Poor project management Lack of socio technical methodology Poor software choices No thorough testing Over ambitious

Use issues Prior history of poor relationships with management and workforce Previous history of failed IS Technological determinism- management wanted system to change work practices This led to user resistance, as workforce were not involved In the design and implementation of system Irrational persistence- Decision to pursue a high-risk project (tight budget and time scale) in light of previous failed IS implementations. Major stakeholders are reluctant to withdraw support because of heavy personal investment

Mere technical approaches to making systems safer, not focusing on cognitive and organisation aspects of their real world application result in Only addressing part of the problem May increase risks through their effects on belief s about computer systems

Summary of learning from case This case is highlighted by the newspaper story from the Independent. It focuses on the challenges of delivering complex IS projects that involve both significant technological and organizational change. Key points to be highlighted here: 1. The design and organization of the project encouraged a narrow framing of its scope and objectives emphasizing technological change and not addressing the wider organizational implications (engagement of staff, training, organizational effects). 2. The narrow framing of the project was reflected in the success criteria adopted for implementation the computer system did not fail and unclear responsibilities for organization-level outcomes. 3. The introduction of the new system a big bang approach - was high risk because it prevented the testing of different elements and their interaction . This resulted in a lack of learning, and unforeseen interactions on launch. The paper by Beynon-Davies provides further background on the case, and also relates it to wider debates on project failure in IS. Important issues here include the need to address use failure as well as development failure. Also the importance of managing collaboration the appointed contractor lacked experience and underbid for the project, leading to a poor specification etc. Putting project management into wider context, the editorial paper from Long Range Planning highlights some of the knowledge dimensions of projects which are particularly relevant for more knowledge-intensive settings, e.g computer games development mentioned in the lecture.