Every IT team, whether it is an in-house technician or an outside provider, has two kinds of work. One is break-fix: the printer is down, a nurse cannot log in, the Wi-Fi drops in the east wing. The other is project work: upgrading the firewall, rolling out multi-factor authentication, replacing aging computers. Break-fix interrupts. Projects improve. Without a method, break-fix always wins, and the projects that would prevent future break-fix never happen.
A simple scoring approach lets operators and IT decide what goes first, and keeps the conversation fair.
Urgent issues crowd out important ones.
Requests arrive by hallway, email, text and phone, with no single list.
The loudest voice gets the next slot.
Projects lack owners, dates and defined scope.
Nobody sees the cost of delay.
The first step is to put everything in one list. A shared spreadsheet or ticket queue is enough. Capture who asked, what they need, why it matters and who is affected.
Treat break-fix and project work as different lanes with different rules.
Triage by impact and urgency, using simple priority levels:
Critical: resident safety, care delivery or the whole building affected, such as the EHR being unavailable. Respond immediately.
High: a department or many users cannot work, with no workaround.
Medium: one user affected, or a workaround exists.
Low: convenience or cosmetic.
Agree on target response times for each level, and write them down.
Projects need scoring, because they are competing for limited time and money.
Score each project from 1 to 5 on these factors, then combine them.
Risk reduction: does it close a security, compliance or continuity gap?
Resident and care impact: does it help care delivery or safety?
Staff time saved: how many people benefit, and how often?
Cost avoided or saved: does it reduce spend or prevent a larger expense?
Urgency or deadline: is there a contract end, support end date or regulatory driver?
Effort and cost: the opposite scale, where a small, cheap project scores high.
Add up the scores, or weight them. For example, a facility might double the weight for risk reduction and care impact. The exact formula matters less than using it consistently and showing the numbers.
Suppose the list includes replacing six aging workstations, enabling multi-factor authentication for all staff, redesigning the guest Wi-Fi and building a new dashboard. Scoring might show that multi-factor authentication ranks first because it reduces risk across the organization at modest effort, while the dashboard ranks lower until the basics are done. The workstations might rank high if the old machines are slowing medication passes and generating most tickets.
Ticket history tells you which problems repeat. If twenty tickets last quarter involved the same printer model or the same wing's Wi-Fi, a project to fix the cause may save more time than continuing to respond. Review ticket categories monthly and ask: what project would remove this category of tickets?
A common solution is to reserve capacity, for example, one half-day each week or a fixed percentage of the team's time for projects, and defend it. Without protection, break-fix will consume everything. Outside providers can help by assigning project work to engineers who are not also staffing the helpdesk.
Review the ranked list quarterly with the administrator or leadership team.
Show what is in progress, what is next and what is on hold, and why.
Explain trade-offs openly: "If we do this, that moves back."
Revisit scores when circumstances change.
Close the loop, and announce completed projects so staff see the progress.
Scoring so many factors that nobody uses the system.
Letting rank or title override the score without explanation.
Ignoring small quick wins that build goodwill.
Treating every project as urgent.
Leaving projects without owners or target dates.
UnityCare IT works with healthcare and senior-living organizations in Oklahoma, Texas and Arkansas to organize IT requests, protect project time and build a roadmap that leadership can follow. If your backlog feels endless, a short planning session can often bring order to it.
An outsourced IT department with proactive maintenance and one number to call.
Call or text: 405-285-3845
New customers: start@unitycareit.com
Existing customers: support@unitycareit.com
Address: UnityCare Technologies, 2524 N Broadway Ste 554, PMB 947974, Edmond, Oklahoma 73034-4172