Back to portfolio
Healthcare · Program management · Ongoing

20 Days to Go Live. No Way to Track a Single Issue.

“You can’t fix what you can’t see. The tracker came before anything else, then the scope decision that kept the launch honest.”
Joined a self-scheduling rollout two months after implementation had already started, with no issue tracker and 20 days left to go live.
Role
Point of Contact, Self-Scheduling Rollout
Joined
2 months in, 20 days from go-live
Status
Live, scope still expanding
Organization
Mount Sinai
60+
Issues logged and personally resolved
Before and after go-live
115+
ServiceNow tickets behind those issues
Many bundle 2+ issues each
60+
Cost centers live today
2 job categories, on the original date
01

Background

The rollout was already in motion when I joined. The deadline wasn’t moving, and neither was the lack of visibility into what was actually broken.

No issue tracker existed

Problems were being reported and fixed ad hoc, with no shared visibility into what was open or how urgent it actually was.

Limited resources to work every issue alone

A flat list of separate tickets would have buried the few root causes actually driving most of the complaints.
02

What I built and decided

Three decisions, in the order they had to happen.
Decision 01 · Visibility

Build a shared issue tracker from scratch

Alternative considered

Push through without a formal tracker

Why this one
No way to see what was actually blocking go-live versus just noise; visibility had to come before triage. The tracker went on to become the standard tracking approach for the project system-wide.
Decision 02 · Root causes

Group related issues into parent/sub relationships

Alternative considered

Log every issue flat and separate

Why this one
Limited resources meant related issues had to be worked together. A handful of grouped root causes ended up clearing a much larger number of surface complaints.
Decision 03 · Escalation

Match escalation urgency to channel, not one fixed path

Alternative considered

Pick a single escalation channel and force everything through it

Why this one
A typo didn’t need the same escalation as a blocking issue. Keeping multiple channels open let urgent things move fast without burying smaller fixes.
03

The scope decision

With 20 days on the clock, the real choice was what to launch to. The timeline for the held-back rollout isn’t fixed yet.
Now · live

2 job categories, 60+ cost centers

Live on the original 20-day schedule, at a scope the team could actually stand behind.

Later · held back

Support staff, other clinical staff

Held back deliberately, so the launch didn’t turn into a rushed full rollout on the same deadline.

04

How this connects to outcomes

Still running; these are the numbers as of now.
Built the visibility system first, then scoped the launch deliberately, and it’s already the project’s standard.
From noise to root causes
Why tickets outnumber issues
  1. Step 1
    115+
    ServiceNow tickets
    Raw, as submitted
  2. Step 2
    60+
    Root issues
    Grouped into parent/sub issues
Many tickets bundle 2+ issues each; the tracker groups them back down to the root causes actually being fixed.
60+
Issues logged and personally resolved
Before and after go-live
115+
ServiceNow tickets behind those issues
Many bundle 2+ issues each
60+
Cost centers live today
2 job categories, on the original date

STAR Employee Recognition Award

The tracker became the standard tracking approach for the project system-wide, and I was recognized with the health system’s STAR Employee Recognition Award for this work.
“This STAR is for Manish who has been a major help on a few projects, especially TimeKeep Self Scheduling. Thank you for all you do!”
KS
Kaleena Soorma, RN
Director of Patient Care Services, Emergency Department
Mount Sinai West
Get in touch

Let’s talk about what you’re building.

Leading a high-stakes rollout or a clinical operations change? I’d like to hear what you’re working on.

Book a 15-min chat Connect on LinkedIn