09 August 2005

Technology Triage

How do you prioritise your work?

The Technical Services Unit is developing a draft Service Level Agreement to discuss with the Division so that there can be a clear understanding of the role of the TSU.

As a part of the internal discussions within the TSU in relation the proposed SLA, how requests are prioritised has received quite a lot of attention.

Under ITIL (Information Technology Infrastructure Library) Service Management practice, there are ‘incidents’ [“Any event which is not part of the standard operation of a system that causes, or may cause, an interruption to, or a reduction in, the quality of service.” Remedy Implementing ITIL Best Practices http://www.remedy.com/solutions/documents/white_papers/wp_itil.pdf accessed 9 Aug 2005], and there are ‘change’ requests [“The addition, modification or removal of approved, supported or baselined hardware, network, software, application, environment, system, desktop build or associated documentation.” ibid.]. During one of our discussions, a TSU staff member came up with the suggestion that hospital triage procedures might inform us of how better to assess ‘incidents’ in order to more effectively deal with them in the context of the Division’s needs to keep its processes operating.

According to wikipedia, the word triage comes from the French word trier, "to sort". Much of the credit for modern day triage has been attributed to Dominique Jean Larrey, a famous French surgeon in Napoleon's army who devised a method to quickly evaluate and categorize the wounded in battle and then evacuate those requiring the most urgent medical attention. He instituted these practises while battle was in progress and triaged patients with no regard to rank.

After the 9/11 destruction of the World Trade Centre buildings in New York, the term Technology Triage came into use in relation to dealing with getting companies that relied on technology back into business, asking such questions as what is mission-critical for your organization? And what technology supports those functions?

The TSU is now looking at both medical and technology triage practices to help it develop an agreed way to classify incidents as they arise, based at least initially on the START (Simple Triage and Rapid Treatment) system developed at Hoag Hospital in Newport Beach, California.

So far we have come up with five categories of incidents with some associated signifying colours:





Send elsewhere: not our responsibility (although the TSU will manage the transfer).


Has to be dealt with now.


Can be dealt with later.


Can be dealt with now or may be delayed.


Minor injuries; first aid and home care are sufficient, a doctor's care is not required.

The TSU is currently working out how to determine which incidents fall into which category: quite an educational experience for the members of the group. There may be a need to change the nomenclature, especially in communication with a client, to ensure that the client feels that their request is being dealt with properly, but as a point of departure for the TSU the technology triage concept is proving enormously successful.

Managing requests for change is yet another matter, but if we improve incident management we can then move on to managing change.