Healthcare Management Unit 2

planning

the process of deciding in the present what to do to bring about an outcome in the future

True/False: Planning is the process of tentatively deciding what to do because we have no assurance of exactly what the future will bring.

True

Project

a temporary undertaking with:

\-specific objectives/goals

\-definite start and end dates

\-assigned set of resources

\-specific deliverables or work products

\-predefined cost budget

Program

a group of related projects managed in a coordinated way to obtain benefits and control not available from managing them individually

Project Management

The application of the knowledge and skills of employees and using specialized management tools and techniques to achieve the specific business objectives of a team-based endeavor

Project Management Office (PMO)

\-an organizational entity created to assist project managers in achieving project goals

\-define project management procedures and best practices

\-develop standards and methodologies, provide career paths for project managers, and assist project managers with training and certification

Project Management Institute (PMI)

\-leading professional association for project management, and authority for the growing global community of project professionals and individual who use project manegement skills

Project Manager functions

\-setting the project expectations

\-creating the project plan and recruiting the team

\-managing project control

\-recommending plan revisions

\-executing change control

\-preparing, documenting, and communicating project information

Project Management Phases

Initiating, Planning, Executing, Controlling, Closing

What is a Project Charter?

A document that defines the scope and goals of a specific project. It formally recognizes the existence of a project and provides a summary of the project’s objectives and management

What is included in a Project Charter?

\-Proposal

\-Statement of work (SOW)

\-Set expectations for the what, when, and how of the project

Project Scope

\-A way to define and set the boundaries; this then help determine the deliverables that are part of the project

\-The intention of the project

\-The range of a project’s activities or influence.

\-Helps clarify what is out of scope

Project Deliverables

\-The “output” created or generated within the scope of the project as a result of the project.

\-Tangible and intangible

\-Throughout the Project lifecycle

Project Management tools and techniques

\-Task list

\-WBS, Work Breakdown Structure

\-Gantt Chart

\-Status Report

\-Dashboard

Project constraints

Scope, time, cost, quality, risk, resources

Constraints on Scope

\-what work will be done as part of the project

\-what unique product, service, or result does the customer or sponsor expect from the project

Constraints on Time

\-how long should it take to complete the project

\-what is the project’s schedule

Cost Constraints

\-what should it cost to complete the project

\-what is the project’s budget

\-what resources are needed

Constraints on Quality

\-how good does the quality of the products or services need to be

\-what do we need to do to satisfy the customer

Risk Constraints

\-how much uncertainty are we willing to accept on the project

Constraints on Resources

\-what is the availability or lack of and uncertainty

Triple constraint

Meeting scope, time, and cost goals

Initiating processes

\-project formulation, feasibility studies, identify and understand the project stakeholders, strategic design, create the project charter

\-approval and holding a kickoff meeting

Deliverables used in the initiating processes phase

\-project charter

\-project scope statement

Planning processes

*goals and timeline parameters*

\-Establish the project team the project team and collect the project requirements

\-Defining the project goals, project activities, and project timeline

\-Estimate the project costs and develop a project budget

\-Define a quality management plan

\-Develop a communication plan, risk management plan, procurement plan

Deliverables used in the planning processes phase

\-Various Project Plans to address the various needs

Executing processes

*actual implementation steps*

\-Direct and manage the project execution

\-Perform quality assurance

\-Acquire the project team

\-Develop the project team

\-Manage the project team and stakeholders' expectations

\-Conduct Procurement

Deliverables used in the executing processes phase

\-Requested changes

\-Work performance information

\-Project Specific deliverables

Controlling processes

*project management functions; performed throughout the project’s life cycle*

\-Verify and control scope

\-Control the schedule and costs

\-Perform quality control

\-Report performance

\-Monitor and control the risks

Deliverables used in the controlling processes phase

\-Status reports

\-Updated Scope Statement and Project Plan

\-Project Specific deliverables

Closing processes

*implementation of benefits realization studies using the metrics previously defined*

\-Evaluation of the project team members

\-Project close-out meeting

\-Transfer of knowledge

\-Completion and settlement of procurement contracts

Deliverables used in the closing processes phase

\-Lessons learned

\-Project closure report

\-Archive of documents

What does the program manager do?

provides leadership and direction for the project managers heading the projects within the program

The program manager usually is…

someone who is a “seasoned” project manager and has shown success in managing projects

A ___ has a single, well defined goal, while ___ has more general objectives.

project, program

The resources for ____ are usually more variable/multidisciplinary whereas the ____ resources are more dedicated.

project, program

Project sponsor

employee who has the greatest interest in the project’s success

Project Stakeholder

***Anyone*** in the organization who will be affected by the outcome of the project

Project Team

individuals assigned to participate in a specific project

What is the project champion?

the executive in the organization who believes in the benefit of the project and advocates for the project

What is the role of the project champion?

they are responsible for making sure the project objectives align with the organization’s goals

Functional Project Team

Where each employee has a single supervisor and employees are grouped in departments by specialty; each department operates independently of the other departments

Projectized Project Team

Designed around work in projects rather than operations, and the operational department; Multidisciplinary project team led by a Project Manager

Matrix Project Team

When employees report to a functional manager from their original functional area to carry out their operational work and their Project Manager for their project work.

Project Manager Skills

\-leadership but not necessarily a “leader”

^^-***communication****^^

\-negotiation, reaching consensus

\-problem solving (problem definition and decision making)

\-influence but not necessarily “power”

Scope

\-Provides a roadmap

\-Management stakeholder expectation

\-Helps prevent scope creep

Task List

\-Prioritized list of activities that need to be completed on a defined day or by a specific deadline

\-Identification of task responsibility

GANTT Chart

\-Captures each of the work packages identified in the WBS as tasks for the project team

\-Assigns each task to a project team member

\-Identifies the dates when the work begins and when it should be completed

\-Identifies any scheduling dependencies with other tasks

Project Status Report

\-Document that describes the progress of a project within a specific time period and compares it against the project plan.

\-Allow project managers and stakeholders to visualize project data through charts and graphs.

Why do project managers use project status reports?

to keep stakeholders informed of progress, to monitor costs, risks, time and work, to help maintain the project scheduling, and keep everyone on the same page

Dashboard

\-A method that has been developed for presenting a variety of data on a single display in an easy-to-read format

\-Slicing and dicing refers to the process of taking what is known at the highest level of understanding and working downward to identify the underlying causes for the high-level observation.

Deliverables

\-products or services produced or provided as part of a project

examples: Blueprints, training needs survey, training materials, classes, system requirements, performance measurements

Project portfolio management

A business strategy in which organizations group and manage projects and programs as a portfolio of investments that contribute to the entire enterprise’s success.

Task

\-An activity that needs to be accomplished to work towards a goal, in a defined time period, and by a deadline

Report for a project will generally include:

\-The work that’s been completed

\-The plan for what will follow

\-The summary of the project budget and schedule

\-A list of action items

\-Any issues and risks, and what’s being done about them

Project Objectives

\-A high-level description of the changes that will occur as a direct result of the project

\-Describes what will be accomplished as a result of the project

Project Plan includes…

\-the project definition, organization, and schedule

\-scope document

\-change and risk management plans

\-issues managements

\-constraints

\-communication management plan

\-quality assurance plan

\-training plan

Characteristics of planing

\-Most fundamental of management processes

\-Precursor to all other management activities

\-Involves present considerations of future actions

\-“Future” may be years or only moments away

\-Based on the ideal state, which is then refined and modified

\-A cyclic process in which some or many goals are recycled

Participants in Planning

\-Top managers: set the basic tone and give direction

\-Department heads: carry out planning for their jurisdictions, taking into account the unique considerations

\-Rank and file workers: offer feedback about procedural and methods improvements

\-Clients and members: invited to offer feedback about proposed plans

Constraints on planning

\-General setting

\-Legal and accrediting agency mandates

\-Characteristics of the clients

\-Practitioners and employees

Decision making

\-The choice among alternatives to determine the course of action

\-Closely associated with planning

\-The commitment phase

Impact and Effect of Decisions

Not every decision that is or needs to be made is equal

\-High impact, low probability

\-High impact, high probability

\-Short term vs. long term effect

\-Degree and ease of reversibility

How to evaluate a decision’s importance

\-Does it affect the entire organization vs. only one part

\-Irrevocable, creating a new situation

\-Allows for limited flexibility

\-Involves major expense

\-Made under conditions of risk

Tools/techniques that aid in decision making

\-Root and branch (incremental) decisions

\-“Satisficing” and maximizing

\-Paretian optimality

Root Decisions

\-Challenge the basic nature of the organization

\-Far reaching in their effects

\-Usually result in massive innovation

\-Result in changes in space and resource allocation

-BIG

Branch Decisions

\-Are incremental and limited

\-Do not involve reevaluation of mission and goals

\-Objectives and goals are recycled

\-Underlying philosophy remains unchanged

\-Limited innovation

Satisficing

\-involves **minimal criteria**.

\-permits **many possible alternatives**.

\- A “__good enough__” solution is permitted.

Maximizing

\-involves **stringent criteria**.

\-**Very few alternatives** are possible

\-The one __best__ solution is sought

Paretian Optimality

\-Seeks to avoid diminishing or penalizing any one group or department

\-Seeks to meet the needs of all

\-Certain alternatives rejected because they decrease the benefit to one or several groups

\-Involves compromise and consensus

Decision-Making Tools and Techniques

\-Considered opinion and devil’s advocate

\-Factor analysis matrix

\-The decision tree

Considered opinion

\-Use experts who give professional opinions of pros and cons

\-Strict, internal consideration before decision is made

\-Seek to ensure that all aspects are noted

Devil’s Advocate

\-Develop statements of all the negative aspects or weaknesses of each alternative

\-Each alternative is then tested and debated through discussion before the final decision is made

\-Does not make the decision, but helps develop the argument

Factor Analysis Matrix

sets up categories of ESSENTIAL elements vs DESIRED elements and is used to overcome personal preference, foster impartial decision making, and used in connection with budget justification

Steps of a factor analysis matrix

\-The choices available are compared using a table or matrix

\-Factors are assigned relative weights

\-Relative weight set as a point system

The Decision Tree

\-Used to depict possible directions that actions might take

\-Forces the manager to ask: “what then...”

\-Basic decision points are stated

\-Probable events are noted as branches

\-Helps decision maker assess both positive and negative potential outcomes

\-Helps decision maker overcome emotional barriers to objective choice

Tools for assessment of decisions

\-After-Action Review (AAR) with the OODA Loop Analysis

\-Analysis of Unanticipated Consequences

The OODA Loop

Intended as a tool to make rapid decisions in “real time”

Managerial flexibility and a high degree of delegation of authority

The first ‘O’ in OODA Loop stands for

Observe; it is the fact gathering stage

The second ‘O’ in OODA Loop stands for

Orient; it is the assessment of one’s position in relation to the changed situation

The ‘D’ in OODA Loop stands for

Decide; the rapid decision to commit to a new course of action in light of the changed circumstance

The ‘A’ in OODA Loop stands for

Act; the implementation of the new course of action immediately and without delay

After-Action Review (AAR)

\-‘Hotwash’ review is used in emergency response-disaster management situations

\-Intended to be as soon as the crisis has been dealt with but before the response team leaves (What worked? What did not work? What situations need further review?)

\-Follows into a “Lessons Learned” session

Analysis of Unanticipated Consequences

Analysis of when a decision that at one level, leads to successful outcome, but with less that positive overall outcome.

Define the basic management function of organizing

\-A common goal

\-Detailed plans

\-Need for clear authority-responsibility relationships

\-Reconciliation of power and authority elements

\-Need for reduction of inevitable conflict

\-Reconciliation of individual needs with organizational needs

\-Preserving unity of command

\-Necessity of delegating authority

Steps in the organizing process

1\.Goal recognition and statement

2\.Review of organizational environment

3\.Determination of structure needed to reach the goal

4\.Determination of authority relationships and development of organizational chart, job descriptions, and support documents

Organizing

\-grouping the necessary responsibilities and activities into workable units

\-determining the lines of authority and communication

\-developing patterns of coordination

\-Defines and arranges the resources, assigns tasks, groups tasks into teams or departments, delegates authority, and allocates resources across the organization.

Chain of command

\-The line of authority that vertically connects all levels of an organizational hierarchy

\-The path from the top to the bottom that orders and instruction may be expected to flow

\-aka Scalar Principle

splintered authority

The authority of a single manager is not sufficient for unilateral decision making or action

\-May be due to need to coordinate and limits on each manager’s authority

concurring authority

\-When authority is given to a related department to ensure uniformity of practice

\-Must be an agreement

\-There is a system of checks-and-balances

staff

\-Authority that resides in those with certain expertise who counsel or assist those with line authority

\-act as “Support”

\-Dotted Line

In healthcare, the ___ are all of the other non-direct patient care units.

staff

line

\-Provides service and directly advances the objectives of the organization.

\-Formal authority granted by an organization to a supervisor

\-provide “Service”

\-Straight line

In healthcare the ___ are the direct patient care units

line

Describe the dual pyramid organization arrangement found in healthcare authority patterns.

\-Organization of medical staff as one track and administrative units as a second track

\-Each track with its distinctive authority-responsibility designations

Matrix organization

\-Where employees report to a functional manager from their original functional area to carry out their operational work and their Project Manager for their project work.

\-Often used for projects

Temporary departmentation

A division with a predetermined lifetime to meet some temporary need that reflects an organizational pattern that will exist for more than a few months.

The lifespan of the temporary department may be limited by ___

specific funding

Task force

\-A temporary organizational unit created to carry out a specific project or assignment and present its finding to some person or committee.

\-Disbands and ceases functioning when assigned task is completed.

Outsourcing

\-The process of having certain services that could be provided internally performed by agencies or individuals external to the organization

\-Employees are employees of the agency

Independent contractors

\-Practitioner is hired to provide regular, ongoing services for a period of time

\-Importance of clear definition of relationship