This is the fourth in a series of columns that explore what it takes to design, implement and sustain technology projects that produce results as promised for stakeholders. My previous column discussed the idea that there is an IT Hierarchy of Needs. My notion of this hierarchy is shown in Figure 1.

Figure 1: Lee IT Project Hierarchy of Needs

I say that the five levels in my IT Project Hierarchy of Needs are: people, conversation, process, technology and service. The IT Project Hierarchy of Needs functions just as the Maslow Hierarchy of Needs: one level must be mainly fulfilled or completed before moving up to the next level, and each level must be addressed in order, bottom up. You cannot interest a human being in love, belonging, esteem or fine art if she cannot breathe or does not have enough to eat. By the same token, you can have world-class hardware and software (technology) associated with your IT project, but if your people, conversations and processes are incomplete, your project will not deliver on its promise and will not be of service.


People are the foundation of successful IT initiatives: get the right people and everything else follows. If you are skeptical of these kinds of declarations, then you would want evidence from life that you can verify. My short answer would be, Bill Gates, Larry Ellison, Steve Jobs and Kenneth Kizer. You've heard of Gates, Ellison and Jobs - people that shape industries and markets - but you may not have heard of Dr. Ken Kizer.

For decades the United States Veteran's Affairs (VA) hospital system provided substandard care. There were discussions in Congress about closing down the VA hospitals and instituting a voucher system to send veterans to private facilities. It seemed to be a classic case of a government organization that could not compete with private industry in providing customer service and attracting high quality staff.

In 1994 President Clinton appointed Dr. Ken Kizer to the post of Under Secretary for Health. Kizer's qualifications for the post included the fact that he was a Navy veteran, a medical doctor and that he was committed to changing the system. According to the September 4, 2006, Time magazine article "How VA Hospitals Became the Best":

"... Kizer decentralized the VA's cumbersome health bureaucracy and held regional managers more accountable. Patient records were transferred to a system-wide computer network, which has made its way into only 3 percent of private hospitals. When a veteran is treated, the doctor has the vet's complete medical history on a laptop. In the private sector, 20 percent of all lab tests are needlessly repeated because the doctor doesn't have handy the results of the same test performed earlier, according to a 2004 report by the President's information technology advisory committee.

Another innovation at the VA was a bar-code system, as in the supermarket, for prescriptions - a system used in fewer than 5 percent of private hospitals. With a handheld laser reader, a nurse scans the bar code on a patient's wristband, then the one on the bottle of pills. If the pills don't match the prescription the doctor typed into the computer, the laptop alerts the nurse. The Institute of Medicine estimates that 1.5 million patients are harmed each year by medication errors, but computer records and bar-code scanners have virtually eliminated those problems in VA hospitals ..."

Leadership at the Level of Executive Sponsor

Ken Kizer is an example of leadership at the executive sponsor level. When I use the term executive sponsor, I am referring to an individual within an organization who:

  • has formal management responsibility for more than 100 people with at least two levels of managers reporting to him or her,
  • has explicit responsibility for the results of the division of an organization in terms of work product, revenue, expenses, customer satisfaction or some combination of these components,
  • is accountable for staffing at all levels within the organization, including recruiting, hiring, training, retention and termination,
  • has formal budget responsibility,
  • has the authority to approve or disapprove strategic and tactical initiatives at any level within her organization.

Many people at the executive sponsor level have formal authority but rarely demonstrate leadership. I know a leader when I see one because leaders have a proven track record of improving the quality of life for their customers and for the people they work with by providing opportunities for those people that were not going to happen anyway. Leaders consistently exhibit the following characteristics:

  • They hold themselves personally accountable for customer satisfaction.
  • They hold themselves personally accountable for creating career opportunities for the people in their organization.
  • They have a proven track record of sponsoring initiatives that produce measurable results for customers and internal staff.
  • They have a proven track record of managing both formal and informal teams to produce measurable business results.
  • They lead weekly review meetings to design, plan, implement and review key initiatives and these weekly review meetings are focused upon measurable progress towards measurable objectives.
  • They can and will go get the money, the people and the approval for anything that could substantially improve customer and employee satisfaction.
  • They say "I don't know" on a regular basis.
  • They are often angry and vocal about things that don't work for customers and employees and take personal and effective action to fix what is not working.

In my next column I will talk more about leadership at the level of executive sponsor and why this matter to IT initiatives, using Ken Kizer's work at the VA and other examples.

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