Mount Sinai Medical Center

🚨 Incident vs Problem vs Change — Explained in Simple Words (Finally!) Let’s be honest… Most people in ITSM say: 👉 “This is an incident” 👉 “Raise a problem record” 👉 “We need a change” But ask them to explain the difference clearly… and things get confusing 😅 So let’s break it down in simple, real-life language — no jargon. 🔥 1. What is an Incident? 👉 An Incident = Something is broken RIGHT NOW It’s any issue that is affecting users or business operations. 🧾 Examples: Email not working 📧 VPN down 🌐 System is slow 🐢 Application crashed 💻 👉 Goal: Fix it as fast as possible 💡 Think of it like: Your car stops in the middle of the road → You just want it running again ASAP. 🧠 2. What is a Problem? 👉 A Problem = The ROOT CAUSE behind incidents If incidents keep happening again and again, there’s a deeper issue. 🧾 Examples: Server crashes every Monday Network slowness at peak hours Same error reported by multiple users 👉 Goal: Find and fix the root cause permanently 💡 Think of it like: Your car keeps overheating → The real problem could be a faulty radiator. 🔄 3. What is a Change? 👉 A Change = A planned fix or improvement Once you know the problem, you implement a controlled fix. 🧾 Examples: Patching a server Upgrading software Replacing faulty hardware Deploying a new feature 👉 Goal: Fix or improve without causing new issues 💡 Think of it like: Taking your car to the garage to replace the faulty part safely. 🔗 How They All Connect (Simple Flow) 👉 Incident happens ➡️ Fix it quickly 👉 Same incident repeats ➡️ Create a Problem 👉 Root cause identified ➡️ Implement a Change 👉 Change implemented ➡️ Incidents reduce or stop 🎯 ⚠️ Where Most Teams Go Wrong ❌ Treating every issue as just an incident ❌ Ignoring recurring issues ❌ Skipping root cause analysis ❌ Making changes without proper planning 👉 Result: More tickets, more chaos, more stress 😓 ✅ What High-Performing Teams Do Differently ✔️ Resolve incidents quickly ✔️ Investigate recurring issues ✔️ Focus on root cause ✔️ Implement well-planned changes 👉 Result: Fewer incidents, happier users, and a calmer team 🙌 📊 One-Line Summary 👉 Incident = Fix now 👉 Problem = Find why 👉 Change = Fix forever 💬 Real Question for You In your organization… 👉 Are you just fixing incidents? 👉 Or actually solving problems? #ITSM #ServiceDesk #IncidentManagement #ProblemManagement #ChangeManagement #ITIL #ServiceDelivery #ITOperations #ContinuousImprovement #Leadership #CustomerExperience

🚀 How I Reduced MTTR by 50% — Without Burning Out the Team Let me be honest… Our MTTR (Mean Time to Resolution) was not great. Tickets were dragging. Users were frustrated. And the team? Constantly firefighting 😓 👉 Issues taking too long to resolve 👉 Endless follow-ups 👉 Escalations piling up 👉 Pressure from all sides Something had to change. Within a few months, we cut MTTR by almost 50%. No extra hiring. No fancy tools. Just fixing how we worked. Here’s exactly what worked 👇 🔍 1. We Identified Where Time Was Actually Going Earlier, we only looked at total resolution time. But that didn’t tell the real story. So we broke it down: ✔ Time to first response ✔ Time waiting on user ✔ Time stuck in escalation ✔ Time in reassignment 💡 Reality check: Most delay was not solving time — it was waiting time 🧠 2. We Standardized the First Response Every ticket was handled differently. Some agents asked the right questions… others didn’t. So we fixed this: ✔ Created standard probing questions ✔ Built response templates ✔ Collected key info upfront 👉 Result: Fewer back-and-forths = Faster resolution 🎯 3. We Focused on “Right Assignment First Time” Big hidden problem. Tickets were: ❌ Assigned wrong ❌ Bounced between teams ❌ Delayed unnecessarily So we improved routing: ✔ Clear categorization ✔ Defined ownership ✔ Better triage at L1 💡 Result: Less ping-pong = Faster MTTR 🛠️ 4. We Reduced Dependency on L2/L3 Earlier mindset: 👉 “Escalate to solve faster” Reality: 👉 Escalations were slowing things down So we: ✔ Trained L1 on top recurring issues ✔ Gave access to tools & knowledge ✔ Created resolution playbooks 👉 Result: More tickets solved at Level 1 📊 5. We Started Tracking the Right Metrics Not just MTTR overall. We tracked: ✔ MTTR by issue type ✔ MTTR by team ✔ Escalation turnaround time ✔ Aging tickets 👉 This helped us fix specific delays, not guess blindly 💬 6. We Fixed User Dependency Delays A lot of tickets were stuck because: 👉 Waiting for user response 👉 Incomplete information 👉 No follow-ups So we improved: ✔ Clear instructions to users ✔ Defined follow-up timelines ✔ Auto-reminders 💡 Result: Less waiting = Faster closure 🔄 7. We Built a Daily Review Habit Game changer. Every day: ✔ Reviewed aging tickets ✔ Highlighted blockers ✔ Took quick actions Every week: ✔ Analyzed delayed tickets ✔ Fixed root causes 👉 Small daily actions = Huge MTTR improvement 📈 Final Outcome ✅ MTTR reduced by ~50% ✅ Faster issue resolution ✅ Fewer escalations ✅ Happier users ✅ Less team stress 💡 Key Lesson Reducing MTTR is not about: ❌ Working faster ❌ Pushing harder It’s about: ✔ Removing delays ✔ Fixing handoffs ✔ Solving smarter 🚀 If You Manage a Service Desk, Start Here: 👉 Fix ticket routing 👉 Empower L1 👉 Eliminate waiting time Everything else will follow. #ServiceDesk #ITSM #MTTR #IncidentManagement #ITSupport #ServiceDelivery #Leadership #ContinuousImprovement #ITOperations #CustomerExperience

This week, I attended the Coalition for Health AI (CHAI) Leadership Summit in Dana Point, California, and interacted with other healthcare leaders who are navigating the ever-changing AI landscape. I got to chat with some old colleagues and met some new ones! Tom Gillette Michael B.

Compliance isn’t lost in big decisions — it’s lost in small exceptions. In Facilities, we make hundreds of decisions every day—and sometimes they’re shaped by “just this once”, “it’s quicker this way”, or “I’ll update it later.” The problem is those small flexibilities add up. A missed work order. An asset not properly tagged. A bypassed process during a busy day. Individually, they seem harmless. Together, they erode the reliability of our systems, the quality of our work, and ultimately, patient safety. Strong programs are not built on perfection — they’re built on consistency. The challenge isn’t knowing the standards. It’s having the discipline to follow them—every single time. What’s one “small exception” you’ve seen turn into a bigger issue?