As we drive towards "Zero Defects" in all aspects of the delivery of care, a computer breaking can be a serious problem. Users expect a high-level of prevention strategies to keep any equipment from breaking at all. Technological limitations and economic pressures (not to mention "Murphy's Law") tend to preclude us from building systems all the way to the desktop, laptop, handheld, or other end-user device that could never go down. If systems do break, they are expected to be fixed quickly and fixed the first time. This is a very reasonable expectation, and it is a very good expectation to have. If users do not have this type of high expectation for system uptime, and the commensurate ties to high productivity, then you have found yourself a good opportunity to provide leadership outside of IT.

Expectations should be high. It is well established downtime in the server room or on the network is a big "no-no." As we push forward with clinical technologies the amount of problems caused by downtime is no longer simply directly associated with amount of users affected. Big problems are often caused by a series of small things going wrong. One small problem could lead to one big error. It is important to focus on preventing problems, keeping working spares, proactive monitoring, and back-up workflow processes as integral parts of IT involvement in supporting users. IT should have the courage to strive for "zero defects" and push the rest of the hospital in that regard, but if needed, the IT Team should be "Johnny/Jane-on-the-Spot" with a high-quality, "fix-it-right-the-first-time" encounter. A "fix-it-right and fix-it-once" approach even when the seemingly smallest thing breaks is a "zero defects" attitude in-and-of-itself that Deming, Crosby, or any of the pioneers of the quality movement would be happy to see.

It is easy to say superior customer service in the area of break/fix in an important strategy. Actually providing that superior break/fix to your users is a different story. It is a serious operational challenge that can be hard to deliver.
There is a lot to learn in meeting this challenge. IT Departments tend to have some of the best process analysts on the campus. With these skills and abilities, the operational challenge should be able to be met. Walking the walk with your internal processes is the best way to gain creditability with other Departments, so IT can be more effective in helping them find solutions to transform the business. Whether the help desk consists of a phone bank of fifty analysts or a single computer technician, good break/fix processes from the server-room to the desktop are a good way to exemplify solid execution of a complicated process, and is an important part of being highly effective with IT in the organization.