Project Management Chapter 5 Discussion Questions

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Project Management Chapter 5 Discussion Questions

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Chapter 5: Project Management 129 Conclusion > and the project interrupting This chapter provides a basic introduction to the science and discipline of and has a history in construction projects. Successful healthcare organizations project management. The field is finding a home in healthcare IT departments of the future will use this rigorous methodology to make significant changes ccess of the team. on commitments and improvements throughout their operations. being receptive to ce the “air time ing her point; it Discussion Questions ate the meeting reviewing ques. 1. Who should be included as members of the project team, key office? In a hospital? Support your choices. stakeholders, and project sponsors for a clinical project in a physician’s 2. Identify five common risks in healthcare clinical projects, and develop contingency responses for each. r Exercises clearly the tive project 1. Download the project charter and project schedule from the companion website, and On the web at perform the following activities: ache.org/books/OpsManagement3 a. Complete the missing portions of the charter. b. Develop a risk assessment and mitigation plan. c. Add tasks to the schedule for those areas that require more specificity. d. Apply resources to each task, determine the critical path, and devise a method to crash the project to reduce its total duration by 20 ization cation and ons, percent. 2. Review the Institute for Healthcare Improvement website (see especially www.ihi.org/knowledge/Pages/ImprovementStories/default.aspx), ming and select one of the quality improvement projects described. Although you will not know all the details of the organization that executed this project , create a charter document for your chosen project. istration 3. For the project identified in exercise 2, create a feasible WBS and project schedule. Enter the schedule into Microsoft Project. d summarizing her point; it interrupting- Ject air time” departments projects. Successful healthcare organizations olicit input. project and has a history in co is to evaluate the meeting w minutes reviewing ques- and improvements throughout their operations. of the future will use this rigorous methodology to make significant changes Discussion Questions 1. Who should be included as members of the project team, key stakeholders, and project sponsors for a clinical project in a physician’s office? In a hospital Support your choices. 2. Identify five common risks in healthcare clinical projects, and develop . contingency responses elebrate our Exercises leadership, clearly the vard. Effective project nation f the organization the organization and 1. Download the project charter and project schedule from the companion website, and On the web at perform the following activities: ache.org/books/Ops Managementz sex a. Complete the missing portions of the charter. b. Develop a risk assessment and mitigation plan. c. Add tasks to the schedule for those areas that require more specificity. d. Apply resources to each task, determine the critical path, and devise a method to crash the project to reduce its total duration by 20 percent. 2. Review the Institute for Healthcare Improvement website (see especially www.ihi.org/knowledge/Pages/ImprovementStories/default.aspx), and select one of the quality improvement projects described. Although you will not know all the details of the organization that executed this project, create a charter document for your chosen project. 3. For the project identified in exercise 2, create a feasible WBS and project schedule. Enter the schedule into Microsoft Project. ve interactions, Ligh-performing alth Administration Chapter 5: Project Management 127 Healthcare Operations Manag 126 Disruptive Innovation Small Project Medium Project Large Project 400-2,400 hours UW-N 910 Variable 2,400+ hours 40-400 hours 1 week-3 months 3-6 months 6 months-2 years EXHIBIT 5.18 Project Manager’s Role Based on Effort and Duration of a Project Effort range Duration Manage and “do some” b910 Manage “Doer” with some help Project leader role Source: Slack (2005). Used with permission. McLaughlin and Militello (2015) conducted a review of disruptive innovation literature and noted the following: cept of creative disruption to the healthcare industry. His basic theory of disruption new companies or totally independent business units that create new, value-added into simple, affordable ones. Disruptive solutions emerge almost always through is a process by which complicated, expensive products and services are transformed processes. However, significant disruption has arrived in the healthcare sector in a way not imagined by Christensen. It came from the Affordable Care Act (ACA)…. Under Christensen’s idea of disruptive solutions, it seems that managers should be at the forefront of knitting together new concepts of cost containment, quality and exceptional service to transform their organization into providers of simple and affordable solutions within the context of ACA principles. The review identified three key steps for creating effective disruptive innovations in healthcare (McLaughlin and Militello 2015): 1. Test the business model against the needs of the customer. 3. Look across disciplines and organizational boundaries for ideas and 2. Pilot test one or two ideas to create or counter disruption. Team Structure and Authority Team members may be selected and the project structure determined by the project manager, but in many cases they are outlined by the project sponsor and other members of senior management. Formally documenting the team makeup and how team members are assigned in the project charter and scope is impor- tant in clarifying team roles for both team members and project stakeholders. A number of key issues must be addressed as the project team is formed. The most important is the project manager’s level of authority to make deci- sions. Can the project manager commit resources, or must he ask senior man- agers or department heads each time a new resource is needed? Is the budget controlled by the project manager, or does a central financial authority control it? Is administrative support available to the team, or do the project team members need to perform these tasks themselves? encouragement. Finally, care should be taken to avoid overscheduling team members. All members must have the availability to work on the project as expected. All of the project management tools and approaches contained in this chan ter are being used by organizations to undergird the work of innovation centers, Team Meetings The Project Manager and Project Team The project manager’s role is pivotal to the success of any project, as he must select, develop, and nurture high-functioning team members, among other critical activities. The project manager’s skills also include running effective meetings and facilitating optimal dialogue during these meetings. A weekly or biweekly project team meeting is highly recommended to keep a project on schedule. At this meeting, the project’s progress can be monitored and discussed and actions initiated to resolve deviations and problems. All good team meetings include a comprehensive agenda and a complete set of minutes. Minutes should be action oriented (e.g., “The schedule slippage for task 17 will be resolved by assigning additional resources from the temporary pool”). In addition, the individual accountable for following through on the issue should be identified. If the meeting’s deliberations and actions are confidential, everyone on the team should be aware of the policy and adhere to it uniformly. The decision-making process should be clear and understood by all team members. In some situations, all major decisions are made by the project manager. In others, team members may have veto power if they represent a major department that is expected to commit resources. Some major decisions may require review and approval by individuals external to the project team. The use of data and analytical techniques is strongly encouraged as part of the Team Skills A project manager can take on multiple roles in a project. In many smaller healthcare projects , the project manager is the person who actually accomplishes several of the project tasks. In larger or more complex projects, the projet manager’s job is solely to lead and manage the individuals performing the tasks. Slack (2005) provides a useful matrix to determine what role a project manager should assume in projects of varying sizes (exhibit 5,18). decision-making process. Chapter 5: Project Management Healthcare Operations Management 125 124 Agile Project Management UW-MI 9102 clinic). building a new b9102 . services or new processes. rather than monthly). means measures of progress. • The project team and customer are colocated. available as the project is chartered and scheduled. In these cases, agilep In some situations, knowledge of the tasks necessary for project successistan as opposed to “puzzles,” to which the solution is known but complex (e.g., Characteristics of agile project management include the following. Innovation Centers Customer satisfaction is achieved by rapid, continuous delivery of Mergers and consolidations of providers and health plans have increased since the enactment of the Affordable Care Act in 2010. A key strategic objective Newly prototyped services or processes are delivered frequently well of the law was to encourage the development of systems of care, as they have demonstrated superior cost-effectiveness and quality. However, as these systems have proliferated, their leaders have realized that growth in size also frequently • The effectiveness and ease of use of these prototypes are the price growth in bureaucracy and the consequent loss of rapid innovation. To remedy this dilemma, many systems have created innovation centers. The Commonwealth Fund conducted a survey in 2014-2015 of innovation • The project team can easily incorporate late changes. The project team and customer interact informally and frequently. centers in 31 healthcare systems. The authors of this study reviewed charac- teristics of these centers and determined that, in general, the innovation cen- ters were “places that are working to discover, develop, test, and/or spread • Continuous attention is given to technical excellence and good desig The project team is cross-functional across the organization, new models of care delivery’-in hospitals, clinics, and patients’ homes. The innovations they test may be internally developed or adopted from elsewhere” in the new services or processes. (Commonwealth Fund 2015). These centers focused on a variety of topics, as • The project team regularly adapts to changing circumstances. Exhibit 5.16 illustrates agile project management. Agile project management is best used for “mysteries,” to which there Care coordination are no known answers (e.g., finding the best treatment for an emerging discus Disease-specific outcomes 87% Access 87% Patient engagement 84% Workflow efficiencies 77% Population health Clinical decision support Collaborate with customers Intraprofessional communication 71% to define and refine Utilization 68% Home-based care requirements. 65% Wellness 65% Patient safety 61% Devices 61% Charter project. Community-based services Determine expected time Build prototype service Price transparency frame, cost, and performance. or process. Other responses 100% Percentage of Innovation Center Survey Respondents displayed in exhibit 5.17. 90% EXHIBIT 5.17 Focus of Innovation Centers 77% 74% EXHIBIT 5.16 Agile Project Management 55% 35% 30% No 0% 50% Does it meet expected performance? Implement-90 to scale Source: Commonwealth Fund (2015). Used with permission. Note : Percentages based on 31 innovation center respondents. “Other responses” include spending reductions, the uninsured, helping seniors age in place, teaching/education, data mining, and data Yes analysis. Chapter 5: Project Management Healthcare Operations Manager 123 122 details performance data, task durations, work locations, and other monitor the work of the contractor. UW-MI 9102 Selecting a Vendor b9102 . projects encounter problems. They also serve as a resource for the training and development of project managers. PMOs support the project manager in many ways, including but not limited to the following (PMI 2013): Managing shared resources across all projects administered by the PMO Identifying and developing project management methodology, best practices, and standards Coaching, mentoring, training, and oversight Developing and managing project policies, procedures, templates, and other shared documentation Monitoring compliance with project management standards, policies, procedures, and templates via project audits • Coordinating communications across all projects . Once a preliminary SOW has been developed, the organization solicits p als and selects a vendor. A useful first step is to issue a request for informe generate responses from vendors about their products and experience w (RFI) to as many possible vendors as the project team can identify. The te similar organizations. On the basis of these responses, the number of feel vendors can be reduced to a manageable set for consideration, remaining vendors under consideration for the task. The RFP asks for a detail A more formal request for proposal (RFP) can then be issued to proposal, or bid. The following criteria should be applied in the reviewing RFPs and awarding the contract: • What is the vendor’s total cost estimate for completing the task • Does the vendor clearly understand the organization’s requirements: • Does the vendor have the capability and correct technical approach to • Does the vendor have a management approach to monitor successful • Can the vendor provide maintenance or meet future requirements and • Does the vendor provide references from clients that are similar to the processo Another useful function of a PMO is that it maintains an information system that can provide reports to project stakeholders and senior management. The contents of this information system may include the following: deliver the requested service? execution of the SOW? . Progress reports on individual projects (schedule , cost, performance) . Risk management (tasks with high risks and their current status) • Performance failures and remediation steps • A log of lessons learned changes? Project Closure contracting organization? • Does the vendor assert intellectual or proprietary property rights in the products it supplies Project Management Office Many types of organizations outside the healthcare industry (e.g., architecture consulting) are primarily project oriented. Such organizations often havez centralized project management office (PMO) to oversee the work of thet staff. Because healthcare delivery organizations are primarily operational, the majority do not use this structure. However, departments in large hospitals and clinics, such as IT and quality, have begun to use a centralized project office approach. In addition some organizations have designated and trained project leaders in Six Sigui or Lean techniques. These project leaders are assigned from a central PMO PMOs provide a single structure through which to monitor progros on all projects in an organization and reallocate resources as needed when A successful project should have an organized closure process, which includes a formal stakeholder presentation and approval process. In addition, the proj- ect sponsor should sign off at project completion to signify that performance levels have been achieved and all deliverables have been received. During the closeout process, special attention should be paid to project staff, who will be interested in knowing their next assignment. A disciplined handoff of staff from one project to the next allows successful completion of the closure process. All documents related to the project should be indexed and stored. This process can be helpful if outside vendors have participated in the project and a contract dispute arises in the future. Historical documents can also provide a good starting point for the next version of a project. The project team should conduct a final session to identify lessons learned-good and bad in the execution of the project. These lessons should be included in the project documentation and shared with other project man- agers in the organization.