Why a Salesforce Project is Like Going to the ER

On the last day of Dreamforce I took a fall while delivering my session. As far as I know, this is the first speaker-related injury in the history of Dreamforce. That effectively ended my week early and I missed a few engagements because of it.

When I was home the pain wasn’t going away and me being the stubborn sort that I am finally succumbed and went to the ER in my hometown. Now I don’t know if the ER’s near you are like the ones near me but hospitals seem to be spending serious shekels to improve their experience. There are billboards in the neighborhood showing average wait times so that you c an select the ER with the lowest wait. As a note – Starbucks if you were to start placing wait times in nearby shops I would consider that a wonderful public service. Just an idea.

Into one of these “modern and efficient” ER’s I go thinking that based on all the advertising my experience would be fast and efficient and my needs, being somewhat basic, would be an easy case and I could go about my day.

Oh. Me. Of. Little. Knowledge.

What transpired was 4-5 hours of the oddest and bizarre process management in my life. And after experiencing it I began to realize that many Salesforce deployments and consulting projects go through a similar process. To be honest it scared me and made me realize that we all could do better if we recognize the phases.

Phase 1 – Recognition

I walked in the door of the ER and the receptionist takes my name and assigned me a medical bracelet with a number. I then fill out a very short form with my name and complaint. After which I am asked to sit down with everyone else in the waiting area where the following is happening: a woman is hacking a lung into a small bowl, a child is wearing a surgical mask due to his disease, a younger couple both looked like they were in a fight and needed patching (I don’t think they fought each other), and a poor elderly lady who was just confused and enjoyed yelling had something wrong with her leg.

All of a sudden I felt small and very much low priority. But I had my laptop, a place to plug into, free wifi, and a coffee machine so I decided to stick around. If it wasn’t for the MRSA probably flying around this wouldn’t be a bad place to work on a regular basis actually.

Let’s correlate this back to Salesforce. This is someone talking during the sales cycle. When someone talks to sales we get your name, address, phone number, and hopefully chief complaint. Was there a deep dive? Did they ask for my insurance cards/some substantial background info? Nope. They just wanted me in the queue.

Phase 2 – Triage

After about 45 minutes I was shown into a small room where an ER nurse performed triage. Was I breathing? Yes. Was I about to succumb to the Black Death? Nope. Great. Back in queue with you! After I left the room, where I did my best to entertain them hoping for fast service, I’m certain they all snickered and wondered how long I was prepared to wait it out since their shifts just started and needed some normal entertainment. Maybe not. It was at that point I figured out where that counter on the billboards stopped. It was right here.

When we are working with sales opportunities we need pull others in with some technical expert to do a clinical triage of your situation and see if we can help you.  Its usually on our clock and schedule unfortunately.   One of my mentors had a saying, “If you’re going to fail, fail fast and move on!” I wish more Salesforce people would do the same. Just say it’s above, or below, your skill set and move forward. Going 14 rounds before determining that you can’t handle this or do not have the manpower to effectively work the project is not helping anyone.

Phase 3 – Cash, Check, First Born, or Kidney?

About an hour passed between triage and the next visit by someone. During that time the poor lady hacking a lung was becoming far worse and I believe the whole room was hoping she was next, the couple in the fight that walked in together we’re being seen at different rates through this process, and the kid with the mask was just looking more pale. Eventually a Physician’s Assistant came out to examine the hacker to say something encouraging but then quickly left the lady in the waiting area.

What came next for me was nothing short of hilarity. A woman came with a push cart with a laptop, external screen, card reader, signature pad, and a huge battery powering it all to where I was working. Her job was to get me into their EMR and setup a method of payment. If you checked into a hotel the process is similar. Or at least that is what I thought.

The number of screens to do what I thought was a simple admit was hilarious. I counted 12. And the number of different user interfaces was at 5. That included the post office Zip + 4 lookup website. And we’re there workarounds? Oh yeah. My insurance was in a different class so it had to be searched with a special option to find it but it took her a few moments to realize that detail and then it just “didn’t work right” so she kept moving forward.

You have to give hospitals credit, at least they ask for a method of payment before providing any substantial services. As consultants we have a signed agreement and then we hope you pay in many cases. There are those cases that choose not to pay for a variety of reasons. If you’re a consultant it’s just the way it is; it may not be your firm’s fault but it happens.  And not being paid is similar to riding a motorcycle. Its not if you will fall off the bike but more WHEN you will fall off the bike. One day – someone is just not going to pay the bill.

You could also tell that someone from the hospital’s IT department was quite proud of their Frankenstein mobile admission cart. They were all over the place as I found out. And I’m certain that the “Franken-ish” of the solution was not entirely the fault of the IT department. Many software packages in the healthcare space are closed off to innovation. Want to make a change in software? Call the vendor, worship their wonderfulness, be happy when they say the change will take 3 months to be put in place, and have a huge minimum fee to cover it. That is if they respond. There are so many hospitals trying to get EMR’s in place and working these days it’s more of a “scorched earth” policy then a helpful one. They are just trying to get these new hospitals standing that many items and requests of current customers are falling to the wayside. And the idea of an open API and Hipaa do not go hand in hand. (End rant)

Back to our friend the payment agent. Here she is trying to use multiple different systems that barely talk with each other to enter my details in the hope they pay.  Her frustration was fairly high but at least she got to walk around while being frustrated. Proponents of the standing desk unite!

Phase 4 – Diagnosis

Now we’re on hour 3 (or 27) of “Dancing with the ER Stars.” Ms. Hack-a-lictious is joyously out of the waiting area much to everyone’s happiness. The poor couple in the fight have split as they lady was seen but the guy was being pushed so far down the queue he just gave up and left. The kid is still there but the PA did come out and it seems that he is just there for an “he’s ok” rather then “he’s falling apart”.

That same PA finally came up to me in the waiting area. She apologized for the wait and decided to do an examination in the waiting area. Say what? Good thing I didn’t show up with a hernia or something….

She decided that an X-ray was needed and in fact activities started speeding up after this. Let’s call this in Salesforce speak an “active project”.

I am finally called up for some diagnosis. That’s more being shown into the X-ray room and get a few pics taken. I am encouraged to gyrate around on a table in different sultry positions that can be found in many a men’s magazine so that everyone can gaze at the awesome that is my knee injury. With photos! It will be on TMZ later tonight!

After which where am I sent? Yup. Back to the waiting room. Why not? I’m getting well acquainted with my new best friends for the past few hours. And the coffee machine makes something approaching the flavor of coffee.

If you’re doing a Salesforce project this is typically the “kick off”. We’re finally getting inside and understanding the extent of the problem that we’ve signed on to help with. And like going for an X-ray, we take some pictures and gather notes but then we have to go away and digest what we learned many times. Trying to come up with solutions and attempt to fix immediately is usually a bad idea. We may ask your company to answer all kinds of questions and talk about what are your pain points and solutions for a while but on the spot solutions are rare and more importantly rarely work.

Phase 5 – Treatment

The PA said before that I will probably not be shown an ER room due to volume and my problem. Fine. Not a problem. Just tell me that I’m not doing irreversible damage and how about a small pain pill please?

Eventually I am actually shown a bed and two nurses start to do some things. First I’m fitted for the worst performing knee brace in history. Stand up – brace doesn’t work. Walking – doesn’t work. This is awesome. Second I’m fitted for crutches but apparently they thought I was Frodo instead of myself so the position they have me in is more “Hunchback” then “Hunky”. I get it. You want me out of here. Guess what I do to! It’s now four and a half hours and I’ve been here since 1:30 on a Monday afternoon. But I did get a script for some pain meds as well and I’m not going to lose my leg tomorrow.

the worst performing knee brace - in the world....
the worst performing knee brace – in the world….

Here’s what concerns me when it comes to Salesforce consulting. My team and I work hard to avoid this but there will always be projects where people just want to move forward and be live. This may seem harsh but try to avoid that idea. We are not looking to enhance our billings. Instead we want to be certain that your go live is smooth. The worst case scenario is a system made to go live without testing and making certain it fits. A bad fitting or poorly designed knee brace is worse than none at all.

Final Thoughts

If you’re a Salesforce consultant many of the above may sound familiar and you may be saying what I was, “there has GOT to be a faster way to do this!” I’m certain there was in this ER and like many businesses any current process is a merging of “that’s the way we always did it” with “here’s a few ideas to make this easier” and “check out this cool widget!”

Are you as a business ready to throw away everything and rethink the process if it will realize you dramatic throughput? How much is that worth to you?

As a consultant how much time are you willing to give before getting paid to be certain that projects go smoothly?

Is it better to try to move a project from start to finish rather than the process of collect and gather, consider, propose, and implement?

Just a few thoughts I was thinking will limping home on my crutches…..

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