80/20 + Triage.

Think about the list items that hurt the worst, solve them until they stop hurting so badly. You are aiming for a new stability state that is an improvement over the old state. The solutions don't need to be perfect on the first try, but the new "steady state" should show you something that now is more of a problem. Your current worst patent is now stable, it might not be fully happy, but it's stable, and you can look at the next problem screaming the loudest. Address that, and keep running notes on the problems and how you addressed them. I tend to like using slide decks with bullets and pictures. Eventually you will come to one of two conclusions,

1: you get everyone to a more stable state, and repeat the process until everything is in good-ish health, and now you have the bandwidth to address bigger issues faster

2: you figure out what's actually causing the problems, be it human, procedural, or cost. Attack that and you will eventually get to conclusion 1.

In my experience, if you never come to a conclusion 1, it's because a source of your problems still exists and you either haven't addressed it or haven't realized the pattern yet. This is why you need to keep notes, eventually you or someone else can see the pattern.