MHI 525: Chapter 17

Chapter 17 Notes

Why are leaders at all levels forced to determine the best way to use available resources?

increased demand for effectiveness and efficiency in healthcare delivery

project management

a temporary endeavor undertaken to create a unique product, service, or result/a systematic approach to planning and guiding project processes from start to finish

a proven way to improve outcomes that can directly and positively impact costs through the efficient and effective use of limited resources for HIT

indispensable in health IT, as it is a structured approach to help ensure effective implementations of healthcare initiatives

can improve the quality of health IT project outcomes, provide accountability of expenses, and reduce inefficiencies through structured change control processes

best practices can help create transparency and visibility within the organization and helps eliminate many of these issues

helps ensure delivery of initiatives and projects on time and within budget and provide well-defined value requirements that positively affect the organization’s financial performance, productivity, and delivery of patient services

enhances patient satisfaction either directly or indirectly

fundamental project management practices

allow organizations to reach strategic goals within a planned timeline within cost parameters

What does a strong project management discipline include?

high degrees of communication, organization, interpersonal leadership, cross-functional team coordination and negotiations, problem solving, attentiveness to detail, technical and business domain knowledge, and the ability to methodically guide the project processes through organizational governance parameters

What does a strong project management process include?

initiation or preplanning

formal planning with the creation of a project plan

implementation and execution of that project plan with measurement of progress and performance

project closure through delivery of value through project objectives

What does the temporary nature of projects indicate?

a definite beginning and end

When is the end of a project reached?

when the project’s objectives have been achieved

when the project is terminated because its objectives will not or cannot be met

when the need for the project no longer exists

program management

involves larger implementations, like a large-scale hospital document management application or an organization-wide EHR system

there are multiple, aligned projects affecting many teams or departments that are coordinated and managed in concert

ensures goals, project steps, and resource needs are in sync

portfolio management

even more complex

involves the creation of common programs and projects that are not necessarily related but are important to combine and view as a whole

essential for a healthcare organization to adequately prioritize and approve new project requests and to work strategically on projects throughout the years

provides an essential foundation for decisions and discussions in governance committees as projects are prioritized and funded

centralizes the management of processes, methodologies, and technologies used by PMs, pro- gram managers, and project management offices (PMOs); allows collective management of the entire suite of current and proposed projects

allows for better prioritization and optimization of projects as well as creating the opportunity for efficiencies

Project Management Institute (PMI)

association created to improve organizational success and mature the profession of project management

has conducted a number of studies related to the impact of project management; studies reveal that nearly 80% of all projects fail to meet their objectives if they do not have some type of structured project methodology

What impact does applying appropriate processes, methodologies, and tools within a hospital setting have?

multidimensional benefits by reducing variability across processes, providing standardization across projects, and increasing the overall project success rate

Why do many healthcare projects across departments overlap or even clash?

departments are frequently regarded as separate entities or “silos” where clinical projects and initiatives are often carried out independently at the discretion of a leader and at times without aligning project goals with the larger organizational objectives

standardized and consistent project management

needed throughout the organization at all levels to optimize process and project outcomes across all entities

effective organizations have formal strategic plans showing what they can and will do, so there is a clear understanding of what is expected across organizational departments and levels

List the 3 levels of focus in formal project management

project management

program management

portfolio management

project

refers to an undertaking that is time bound and delivers a particular product or service/a temporary undertaking ending after a set of goals are achieved, involving the application of knowledge, ideas, and skills to execute a plan of action

consists of goals, activities, a timeline, projected risks, and mitigation plans

has an appointed manager who leads the effort

List the project phases

initiation

planning

execution

closure

monitoring & control

formally takes place during the planning and executing phases when most activities are moving at a fast pace

not necessary during initiating and closing because the work has not been defined (initiating) or it is completed (closing)

initiating activities

generally the most important activities and yet often the most rushed or undervalued

requires a PM to gather initial information and resource estimates so that project viability can be assessed

initial project scope and timeline are established so leaders can balance the impact on resources and existing workloads

projects have organization visibility so larger risks and impacts on architecture and existing initiatives can be mitigated across efforts

planning activities

begins once projects are approved, funded, and resourced

lay the foundation for the project life cycle and are used to track future project performance

formally defines projects by project teams and subject matter experts who decompose project deliverables into workable tasks as part of the overall project plan

helps team members achieve defined goals and objectives and serves as a basis for good communication and evaluation for managing project staff and external vendors about timelines and budget

skipping this step or even inadequately completing this step typically hinders progress throughout the life of a project and affects the long-term results stakeholders seek

executing activities

begins once a formal project plan has been completed, resourced, and scheduled

often take the most time and resources to complete

ultimately defines the success of a project; this is where the build of project deliverables and customer testing and approval occurs

use of solid management processes, including effective monitoring and control of all elements of a project—time, cost, quality, change, management of risk, issues, procurement, customer acceptance, and communications—can help ensure success

closing activities

include release management, project delivery, documentation of lessons learned, and formal handoffs to operational and maintenance teams

critical to define and complete in a healthcare setting because some of the same people (resources) who worked on a project are often the ones who maintain that project’s outcomes

project plan

assists project leaders with time management, cost estimation, quality, change, risk, and issues throughout the life of a project

risk management

includes both project threats and opportunities (plausible scenarios that may or may not impact the scope, timeline, or resources of a project, given a set of circumstances)

must be managed to avoid delays or project failure

focus is on planned risk management, identification of risks, performance of qualitative and quantitative risk analysis, and monitoring and control of risk

should include requisite changes to project scope

any issues should be well controlled to keep the project on schedule and avoid project derailment

Why is a clear delineation of the end of every project needed?

helps in understanding when maintenance and operational phases begin

postimplementation review

conducted to gather and share lessons learned and define next steps

typical deliverables in this phase include documentation for support and specific communications to inform stakeholders the project has ended

Why is monitoring project progress and controlling changes to scope critical?

it ensures accurate patient data is captured on the new electronic forms and issues and risks are resolved to keep the project within budget and timeline constraints

List key PMI knowledge components

project integration

scope management

time and cost management

quality management

human resource management

communication management

risk management

procurement management

project integration

includes the development of a project charter

focuses on how project issues will be managed, tracks changes to the original plan, and coordinates replanning, if necessary

project charter/management plan

outlines the direction and management of overall project execution, monitoring and control processes for scope, schedule and resource management, performance of change control procedures, and project closure and release management steps

scope management

focuses on work of the project and clarifies boundaries and areas to include or exclude

involves collecting project requirements (desired functions) and defines the scope in more detail

includes creating a work breakdown structure, scope verification, and validation process with stakeholders and key project sponsors and outlines scope change control

without a well-defined scope document, there is no way to know if a project is in or out of scope at any particular phase

time management

includes estimations of task effort (by complexity), determines the project schedule, and records actual completion dates

includes monitoring and control of schedule and resources, ensuring project teams are empowered to be productive, and reporting accurate time spent on activities (effort) throughout the project

closely aligned with cost management, especially for estimating resources required for tasks and task durations, as these directly align with project costs

cost management

involves the cost of resources such as materials, equipment, facilities, labor, and other related services

determining cost estimates, budget, and financial controls all fall into this category

quality management

includes creating deliverables that meet an acceptable quality level and the quality of the project management process itself, focusing on quality assurance and quality control

quality assurance

consists of auditing and comparing initial quality requirements against quality control measurements

quality control

involves monitoring results of quality activities, which include project deliverables and project management results

human resource management

the management of people and includes aspects like team acquisition, team development, and processes for project resource issue resolution

PMs and RMs closely work together to ensure they are in sync throughout a project

communication management

includes meeting management, risk actions and assessments, project plans, project reviews, stakeholder identification, and project information distribution

stakeholder communication should be frequent and include project status, issues, risks, and successes to adequately manage expectations

risk identification

most effective if done during the planning phase and should include outcomes and possible solutions to threats if the given scenario materializes

procurement management

includes acquiring products or services from outside the project team

includes working with vendors, contractors, and service groups.

List benefits of improved project performance

increased efficiency in service delivery

enhanced customer satisfaction when following formal project management process areas and using key knowledge components

allow organizations to reach strategic goals within a planned timeline within cost parameters

program

refers to a group of related projects managed together

What is the logic behind program management?

it is less complicated, less costly, and more operation- ally efficient to control similar projects together than separately

resource sharing can then occur, as projects might be able to be managed by the same person or with shared resources, leading to significant efficiencies, financial savings, and coordination across projects

What is the purpose of portfolio management?

to determine an optimal resource mix for project implementation and scheduling that is most effective in achieving an organization’s operational and financial goals

portfolio

includes projects that are combined together as a logical group, but are not necessarily linked directly together as in program management

might include aligning projects, programs, and operations with strategic objectives and investing resources in the right work to deliver the expected value

List benefits of portfolio management

helps mitigate individual departments expending monies and labor on single department initiatives

assists in collaborative decision making for organization priorities

removes a portion of organizational politics and deliver clarity across project goals and processes

results in greater organizational stability and realization of projected benefits

Why is initiating a portfolio management process difficult?

portfolio managers must sometimes convince leaders these processes are best for their business

List benefits of portfolio management in healthcare environments

mitigates uncoordinated, decentralized efforts

improve implementation of myriad organizational initiatives

allows for an efficient sharing of resources, where feasible, and a better appraisal of what needs to be accomplished

provides an avenue for measuring ROI at the highest organizational level

portfolio governance committees

determine priorities and funding

also decide if, when, and how any reprioritizations occur within the respective portfolios, based on resource availability

How can organizations accomplish a strong ROI from each project or program?

outcomes must be measurable, weighted, and reviewed by a governance committee

What does integrating cost, schedules, contingencies, and risk response plans in a group with portfolios allow committees to do?

review projects and programs holistically to mitigate issues before projects are funded or implemented; enables organizations to have more visibility and less uncertainty about upcoming efforts

project manager (PM)

responsible for controlling any project changes that occur, ensuring progress is monitored continuously and that performance is measured periodically

activities include a major focus on project planning, budget allocations, and resource allocations

bring structure to a healthcare environment to ensure projects and programs are delivered on time and on budget and within the set scope and requirements

key role is to bring people and processes together to keep a project moving at an optimal pace and to ensure project deliverables are completed accurately and efficiently within the project deadline

have a responsibility to help stakeholders and staff manage the pace of delivery

obliged to control the project scope so it does not diverge from what has been planned

must update the sponsor and other stakeholders and solicit their help when necessary

need to understand the depth of resource requirements throughout a project or program

scope creep

increase of original scope

should be avoided or managed to avoid delays to project schedules

Why do most IT projects and programs tend to grow in scale and complexity as they progress?

as more stakeholders see details of the project they think of additional ideas

What is the most important aspect of scope creep?

the creation of a scope document

What is essential to have so projects can be effectively managed?

a full understanding of what is in and out of scope

project scope document

used to manage a project’s potential scope creep

should include information about project time, cost, and resources

provides an overview of what the project team is expecting to achieve and how the work will be accomplished

can be used to clarify what stakeholders can expect and what the parameters are for any changes that may be requested (scope creep)

List basic questions PMs can ask RMs before activities begin in order to avoid conflicts with resource allocation

who is responsible for allocation of team members’ time for the project or program?

what role will the RM play on the project, if any?

how will the RM and PM coordinate the work? What is the frequency of this coordination?

Why is not recommended that managers serve a dual role of both RM and PM?

the conflicting needs and goals of each role; RMs must ensure their operational area continues to run in parallel with whatever projects or programs are in progress while PMs must fulfill their duties to make certain nothing gets off track

program manager

tasked with similar roles and responsibilities as PMs

guide organization leaders and multiple projects

responsible for planning, executing, and delivering a program or collection of related projects within the defined program scope and schedule

coordinate activities across the group of projects in their program, which adds a level of complexity, monitor progress of individual projects

skills are typically at a higher level of strategic leadership, cross-functional team coordination, organizational resource negotiation, and communication due to the increased complexity of their responsibilities

portfolio manager

responsible for centralized management of portfolio processes, methods, and structures to ensure successful flow of projects within a portfolio

provides information about projects, programs, and resources within a portfolio to governance committees who will evaluate new requests based on strategic alignment

can help committees determine which projects should be given priority in terms of resource allocation, availability, realistic completion timelines, and project overlap because they should be aware of stakeholder demand and have high-level insight to requirements and deadlines of the projects within the portfolio

play a key role in ensuring project and program risks are known to committees and controlled to avoid poor project selection or delays

What is the ultimate success of a portfolio dependent on?

the performance of individual projects

What should portfolio managers do?

perform a value assessment for each completed project to provide information to leadership about long-term value; requires comparing initial definitions of benefits against actual results

List aspects project management tools should track

project scope determination

timelines

budget

resource assignment

project documentation

PERT charts

used to schedule, organize, and coordinate tasks in a project

use the foundation of an “activity list”

provide a graphical view of a project as a network diagram consisting of numbered “nodes”

preferred by some PMS because they clearly show task dependencies

can be more difficult to interpret, particularly in a complex project

Gantt Charts

a graphical view of the duration of tasks and activities shown as a progression in a timeline