Project Management Skills for Healthcare

Methods and Techniques for Diverse Skillsets

Lisa Bove, Susan M. Houston

• Publisher: Productivity Press
• Year: 2020
• ISBN:
  9781000080773
• Edition: 1
• Topic: Medicine
• Subtopic: Public Health, Administration & Care

Project management skills are valuable for any healthcare project, not just technology projects. Non-technology activities that would benefit from project management skills include implementing a new policy housewide, updating training for use of the electronic health record (EHR), creating a new orientation program, quality assurance activities, submitting an article or presentation, writing a research proposal, or opening a new patient care unit. In addition, project management skills are not just for project managers, but they can be used by anyone leading these types of activities, such as managers, staff, educators, and researchers.

Many books on healthcare project management have been focused on technology projects while non-technology projects flounder without the required knowledge or skills of the person leading the project. The purpose of this book is to discuss these skills based on the Project Management Institute (PMI) standards in a way that non-project managers would be able to understand and apply. Concepts from project initiation through project closure will be presented twice, first for novices and then for project leaders with more advanced skills.

Practical, accessible, and containing numerous examples for each phase of the PMI Framework, this book will be a valuable resource for all healthcare professionals and both novice and experienced project managers.

Chapter 1

Introduction

Healthcare organizations are always working to be more efficient while providing the best care possible. More evidence-based practice is being defined through the use of big data, analytics, and outcome measurements. Software and hardware are constantly being implemented and optimized to improve processes, documentation, and the bottom line. This focus on efficiency and outcomes leads many organizations to add multiple projects to their day-to-day management of patients. Because of this, many people who are assigned to the project have little experience with project management skills or the project management process, which can lead to project failure.

Project Definition

A project differs from day-to-day management of the organization. A project is defined as a “temporary endeavor undertaken to create a unique product, service, or result,” and has a defined beginning and end (PMI, 2017, 4). While projects themselves are temporary, their results or deliverables exist beyond the end of the project. Projects drive change in organizations and can add to business value through increased market share, better outcomes, and/or better efficiency. Projects come in all sizes. They can be as big and complicated as building a new hospital or implementing a new electronic medical record across multiple facilities. They can also be smaller, but no less important or complicated, such as implementing a new evidenced based practice or teaching program.

Project Failure Rates

Whether big or small, however, many projects fail. And projects fail at an amazing rate. The Standish Group published their ground-breaking Chaos report on project statistics in 1994. In their initial study of 365 companies' information technology (IT) projects, they found 31.1% of projects would be cancelled before they got completed, 52.7% of projects would cost 189% of their original estimates, and only 16.2% would be completed on-time and on budget (Standish, 1994). Of the projects completed, only 42% of the originally proposed features and functions would be available. In addition, they found that larger companies had a lower success rate with projects – that is projects completed on time, on budget and on target – than small- or medium-size companies. In their 2015 report, they revised the definition of success to include six individual attributes of success, adding meeting goals, finding value, and satisfaction to the original attributes (Standish, 2015). Using the original attributes, 36% of projects were successful, while only 29% were considered successful with the revised attributes (Standish, 2015). One of the biggest changes in their 2015 study showed that smaller projects failed more than larger projects, 61% and 11% respectively.

While The Standish Group initially looked at IT projects, the success or failure of other projects is similar. Starting with their 2015 report, The Standish Group studied many types of projects, including projects in the banking, retail, government, and healthcare industries. They found that healthcare projects were only successful 29% of the time. In addition, they only looked at projects that were defined as projects by the facility studied. Many healthcare projects are not managed like projects but instead are something that a leader attempts to achieve and are probably not included in these statistics, which means failure rates in healthcare are probably much higher.

The Standish Group is not the only organization assessing project failure and the impact of these failures. A Harvard Business Review reported that over half of projects fail (HBR, 2012). In addition to lack of project management, they suggest project failure is due to the fact that people do not speak up about issues with the project. Many leaders assume they know how to implement a project and what the potential risks are, but often staff and even patients have valid concerns that need to be addressed. Both HBR and The Standish Group, as well as many other experts, have shown that project management can increase the probability of successfully completing a project on time, on budget, and with the expected scope and quality. In the 1994 Chaos report, the three major reasons for project success, in addition to project management, included user involvement, executive management support, and a clear statement of requirements (Standish, 1994). As projects and project management have evolved, successful projects should now also invest in smart, trained people, executive sponsorship, organizational emotional maturity, user involvement, and optimization in order to increase the likelihood of success (Standish, 2015). While many healthcare leaders are ‘smart, trained people’, project management skills are not usually part of their knowledge base.

Using the Project Management Process to Improve Success

In order to increase the likelihood of project success, each project should follow a standard project management process. Project management is defined as “the application of knowledge, skills, tools, and techniques to project activities to meet the project requirements and to obtain benefits and control not available by managing program components individually” (PMI, 2017, 10). Project management can help organizations to implement projects effectively and efficiently. In addition, project managers (PMs) can help increase the chance of project success by using standard tools and balancing the influence of constraints on the overall project.

Project management processes fit in the project lifespan and are discussed in five groups: Initiation, Planning, Execution, Monitoring and Control, and Closing process groups (PMI, 2017). Successful projects use tools within each of these project groups. For example, a business case defines why a project needs to be done. A project charter describes what needs to be done as well as what is required to complete the project, and a Work Breakdown Structure (WBS) or workplan describes when project tasks will be done. A communication plan describes how information during the project will be shared and a risk management plan helps to plan for potential issues during the project. Project managers (PMs) use these tools throughout the project to manage tasks, scope, and resolve issues.

Purpose and Chapter Overviews

The purpose of this book is to introduce the project management processes to novice project managers and discuss project management tools used at any level of experience. This book is intended to be used by IT and non-IT project managers. Chapter 2 (Project Management Processes) describe the overall standards and knowledge domains of project management. This will set the stage for the rest of the chapters. In addition, best practices in each of the process groups will be discussed. Chapter 3 (Novice to Expert) will address Dreyfus' learning continuum from novice to expert. In this chapter, we will discuss how this model describes how knowledge acquisition occurs and provides a method to assess and support the development of skills and competencies. PMs can move through the five stages – novice, advanced beginner, competent, proficient, and expert – as they develop project management skills. Expert PMs do not stop learning; rather, they continue to evaluate their practice and learn new skills to keep up-to-date. Throughout this book, we will use the term experienced, rather than expert to support this tenant. Each of the following chapters will focus on the project management process groups. Each process group will be discussed first at a novice level and then at a more experienced PM level. Tools that can be used at each level will be addressed as well.

Chapter 4 (Initiation – Novice) will discuss the initiation process group. Initiation begins with the request for a new project and ends when a decision is made related to the authorization of the project. Tools discussed in this chapter include the request for the project and a project charter or business case. The terms stakeholders and sponsor(s) will also be described. Chapter 5 (Planning – Novice) begins as the project authorized and resources are available, after the initiation phase is completed. The planning process group includes the processes and tools that are needed to successful determine how a project will be managed. In this chapter, we will discuss how the PM will focus on creating the project management plan that includes the workplan with assumptions and constraints and finalize scope and communication plan. As discussed in the chapter, without proper planning, the project is less likely to be successful.

Once planning is complete, the PM will begin to focus on the actual work of the project. Chapter 6 (Execution, Monitoring and Control – Novice) will address how a novice PM will carry out the project management plan and performing the scheduled activities. Along with the execution process group, this chapter will discuss the simultaneous monitor and control process group. These process groups are carried out together until the project reaches the closure phase. The execution phase is where the work of the project gets done. It includes ‘build’, test, training, and go-live activities. The monitor and control phase is simultaneous with the execution phase and includes the main work of the PM during these phases. Tools discussed in this chapter include managing scope and requirements, status reporting and communication, and issues and risks management. Chapter 7 (Closing – Novice) will discuss how the project is finalized. The closing process group begins when the project is live, but doesn't end until the project deliverables are accepted by the sponsor(s), documentation is completed and archived, and resources are released. In addition, the PM will complete a completion document which will describe the project metrics and outcomes.

Chapter 8 (Initiation – Expert) will begin the second half of the book. In this, and the following chapters, the project management process groups will be discussed at a more complex level. Up to this point in the book, basic tools that the PM would use in each phase of the project were discussed. In the expert chapters, additional tools will be discussed that will help a PM manage larger, more complex projects. Chapter 8 (Initiation – Expert) will discuss creating a more detailed project charter, as well as the process to submit a project request. Chapter 9 (Planning – Expert) expands on the previous planning chapter to add more tools the PM can use during the planning phase. More details about how to create the workplan and detailed change request, issues, risks and quality management plans will also be included. In addition, organization success factors will be addressed. Chapter 10 (Execution, Monitoring and Control – Expert) will describe tools that will help the PM to execute larger, more complex projects. In this chapter, we will also discuss additional constraints that the PM needs to manage in order to move the project successfully to the closing phase. The last chapter, Chapter 11 (Closing – Expert) will discuss completing the project and closing out the metrics and other project deliverables. In addition, in this chapter, we will discuss transitioning the project to support.

Case Study

The case study described below includes projects that could be assigned to a novice or more experienced PM. Throughout this book this case study will be used to describe example tools PMs use to successfully implement projects. Different tools will use different projects within the case study to illuminate the way a project manager uses them throughout the project. We are using the project examples, not to create full project management plans, but rather using the various projects listed to give as many examples as we can.

According to Health Facilities Management's 2017 Hospital Construction Survey, conducted in cooperation with the American Society for Healthcare Engineering (ASHE), 14% of hospitals surveyed have an acute care build project underway. Seven percent have a specially unit or building underway, and 6% are building a critical access facility. Ninety-five percent of respondents said they involve clinical and nonclinical staff in the design process of a new facility. They estimate it takes 7–8 years to design and build a major hospital, and during that time, clinical practice can change, so teams need to be responsive to change.

Your organization is building a new building and re-organizing patient care units. The Tower, as it is commonly called, will require new staff, new computers and communication devices, and patient equipment. In addition, policies, procedures, and electronic medical record documentation will be reviewed and potentially revised. While there is a construction team who is responsible for the actual building and supplies, your team needs to help develop and implement the plans to:

• Create and deliver an orientation plan (training materials) for the new units
• Locate hardware
• Review policies and procedures around the admission, discharge, and transfer processes
• Revise the electronic medical record to include the new units, locations, and service lines, as well as any required new documentation
• Order, configure, test, and install the new computer (handhelds and carts) equipment Tower before patients are moved, and
• Facilitate the patient move (go-live plan)

You will be working within the larger Tower project but will only be responsible for a specific project as listed above. You will be working with the IT, Education, Quality, and Facilities departments, as well as the construction team during the transition.

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Contents
• List of Figures and Tables
• Acknowledgments
• About the Authors
• 1 Introduction
• 2 Project Management Process
• 3 Novice to Expert
• 4 Initiation – Novice
• 5 Planning – Novice
• 6 Execution, Monitoring and Control – Novice
• 7 Closing – Novice
• 8 Initiation – Expert
• 9 Planning – Expert
• 10 Execution, Monitoring and Control – Expert
• 11 Closing – Expert
• References and Additional Reading
• Index