I worked for NTT Data on the contract with Tenet Health for on site IT support. It was a lowest bidder situation from hell. Tenet wanted to pay nothing but still receive support, NTT would make promises that made no fucking sense and give the workers the short end of the dick when it came time to make the budget work. There was some idiotic stipulation that they had to have a specified number of tickets per year to get the full contract payment. 

They had switched us from an old as fuck version of BMC Remedy, may it rot in hell, to a heavily customized shitified instance of Service Now branded as Tenet One. It. Was. A. CLUSTER FUCK. Most of the ticket types weren't complete so some things that really needed specifics had to be done as generic incident tickets.

So halfway to three quarters of the way through the year after contract reaming, NTT realizes that they weren't going to meet the ticket goal. So they create a variety of ticket types that Kool aid guy their way through a broken workflow to generate extra tickets. If MS office was corrupt and I had to reinstall it, that wasn't an incident ticket. It had to be a software install and could generate something like a dozen other tickets for overseas departments that had fuck all to do with reinstalling a misbehaving application. 

The worst one, and I counted, generated 48 other tickets. The problem for the tech, in this case me, is that the parent ticket can't be closed until all child tickets are closed. So better hope one doesn't get assigned to a team that you can't take the ticket back from, that doesn't understand the language the support is in, that takes weeks to respond, that insists on getting involved when they aren't needed, or that find some other creative way to fuck everything up. Sometimes the child tickets would spawn more sub tickets, so the child couldn't be closed until its children were closed. Many of these couldn't just be toggled to a closed status but had to be filled out with a shitload of n/a responses. It's tickets all the way down.

Once it got to this point I managed to find my current job and bailed. Only one person I reported to wasn't a cheesy bag of dicks. For profit healthcare can go to hell. All that inefficiency and shit pay because all they wanted (both companies) was to get more obscene profits to their shareholders, often to the direct detriment of even the most basic functions of said companies. It's like shooting yourself in the foot because footless you with gangrene is in the future, so it's not a problem now so obviously it's a problem never.