Project Management in Health and Community Services

Judith Dwyer, Pauline Stanton, Valerie Thiessen

• Publisher: Routledge
• Year: 2013
• ISBN:
  9781136552366
• Edition: 1
• Topic: Medicine
• Subtopic: Health Care Delivery

In the health and community service industries, projects are increasingly used for the development of new services, and to achieve change in existing services, work practices and delivery models.Until now, project workers in these fields have had to rely on books designed for architects, builders and IT administrators. This is the first textbook to take the principles of project management and place them into a context relevant for people working in health and community services. This book provides a critical guide to both the strategic and operational aspects of using projects and making them work.Covering topics such as the lifecycle of a project, planning, execution and evaluation, risk management, change and effective teams, Project Management for Health and Community Services uses extensive international case studies and examples from the field. Written by authors with years of practical experience, this is a valuable resource for anyone studying or working on health and community services. Project Management for Health and Community Services offers students and professionals practical problem solving strategies and provides a comprehensive guide to managing projects as well as tips on managing a team and the stakeholders.

Part 1

PROJECTS, STRATEGY AND ORGANISATIONS

In Part 1 we define project mangement and explore its development in the challenging, often contested, ever-changing and people-rich environment of the health and community services sector. Part 1 aims to provide an analytical framework which will assist readers to make more effective use of the practical strategies that are presented in Part 2 for planning, designing and managing their projects.

In Chapter 1 we outline a framework for project management success which goes beyond the usual lists of ‘critical success factors’. This framework recognises that characteristics of a project, such as planning and design, adequate resources and the performance of the project team, are influnced by underlying features in the health and community services sector and in each organisation.

In Chapter 2 we focus on these two underlying determinants of process success or failure: the sector and the organisation. The nature of the sector raises a number of challenges, including the seductions of project funding, the impact of idealism and managing the key stakeholders. Key features of the organisation include clear strategic directions, strong leadership and capable structures. We also explore building a project management culture and the people side of project management. Chapter 2 includes a brief discussion of managing projects in government departments.

Finally, we outline how this analysis might be used in practice, and we end the section with a discussion and a checklist featuring key questions intended to help practitioners choose good projects.

1

WHY PROJECT MANAGEMENT?

‘Project management is turning a good idea into a successful outcome. You could have a great idea but if you don’t have the skills to bring it to life in the real world it is only ever a good idea.’ (Experienced clinician manager)

This chapter explains what projects are and what project management can deliver. It covers the origins and development of project management as a method, and the reasons for its increasing popularity. We briefly discuss what we have learnt about the way projects are used in health and community services, and introduce a framework for success in project management.

WHAT IS A PROJECT?

A project is an organised, time-limited, one-off effort towards a defined goal, which requires resources, and is traditionally described as having a ‘3D’ objective (e.g. Rosenau 1998): to meet specifications, to finish on time and to do it within budget. In industries like building and construction, almost all production is structured into projects. Building a bridge is the archetypal example—you only build it once; you must complete the steps in the correct order, and bring the various materials, skills and resources together at the right times; there is a clear outcome; and there is always a deadline and a budget. To use an example closer to home, pharmaceutical companies typically use project management methods in the process of researching and developing new drugs, and in many ways the R&D divisions of pharmaceutical companies can be seen as simply a collection of projects.

Projects can vary in scope from something as simple as implementing the use of a new type of catheter to a complex undertaking like introducing a new model of care. Projects may be visible to the whole organisation and wider community, glamorous and exciting, or they may be hidden away in a small team or department—committed people doing good work.

Projects, programs and experts

In the health and community sectors there is a need to distinguish projects from programs. For a community health service, for example, developing and testing a Tai Chi program to enable older people to enhance their strength and balance is a project. Once the concept has been proven, the methods developed and the decision made to incorporate this approach, the regular offering of a 10-week Tai Chi program is not a project, but rather requires program management techniques to ensure that it remains effective and is delivered efficiently. While there is some overlap between program planning and design methods, and project management, there are some differences in that projects have a definite beginning and end whereas programs continue perhaps for many years and often evolve and develop. The term ‘program management’ is also used in the project management literature to mean ‘a group of projects managed in a coordinated way’ to obtain benefits not available from managing them individually (PMI 2000).

We also found that some people equate projects with the use of management consultants. Consultants are often used for projects, and the skills of managing consultants are an important aspect of project management capability in many organisations, but projects can be completed using entirely in-house staff and resources. The larger organisations we surveyed typically have some form of in-house project capability, people who play a role as project managers for the organisation and as internal consultants to support emerging project managers.

What is project management?

Project management is a set of methods and tools designed to enable organisations to plan, manage and achieve once-off tasks or goals. It sets out to solve the problems of defining what is needed, planning how to deliver it, managing the required resources in a timely and efficient manner, ensuring successful delivery and bedding down the outcomes.

Project management is increasingly used in all sorts of industries and organisations for several reasons, most of them to do with the pace and scope of change. In a world where new products and services are constantly replacing old standards, project management offers a method for driving the development process and whatever changes are needed for implementation. At the same time, products and services are becoming more complex. Many things that used to be able to be done by one person, or within one functional team, now require a broad range of knowledge and skill, as well as the resources of several parts of the organisation. The most typical example of this is the increasing need for any operational change in hospitals to involve not only the clinical or support unit which initiates the change, but also the information systems department.

Project management offers a different way of working together within an organisation, across departmental boundaries, to bring the necessary knowledge and resources to bear on a complex problem. This is particularly relevant to human services where changing the way people work together is often an explicit project goal.

In industry generally, relationships between organisations are also becoming more complex. For example, suppliers and contractors are increasingly working in alliances and partnerships with product makers and service providers. One of the main methods they use is conducting joint projects to develop and implement new ways of coordinating each party’s contribution to ‘the value chain’. Again, parallel developments can be seen in human services, in areas like child protection, mental health, emergency retrieval services and primary health care (Walker 2001). Multi-disciplinary teams are becoming more common in the sector, and the experience of working in an interdisciplinary way is valuable preparation for project work.

As a result of all these trends, project management skills are needed by virtually all managers, as well as those who specialise in project management. Out of 236 respondents to a survey published in 2002 (White and Fortune), 63 per cent described themselves as managing the project, but not as project managers—they were managers, team leaders, senior managers, consultants and directors. This demonstrates the point that ‘managers need to practise the skills of both general and project management, and the separation of the two areas of management is no longer necessary or desirable’ (Healy 1997:2).

New problems, new solutions: the origins of modern project management

The capacity for innovation is a human characteristic, and major projects to achieve innovation have been completed throughout human history. Building the Great Wall, for example, or developing cities would have required some form of coordinated work towards a goal. But modern project management methods arose in the twentieth century.

There are two essential elements of modern project management. The first is a large set of tools and techniques for planning and coordinating the multiple inputs required for major projects. Henry Gantt, a pioneer in the field of scientific management, developed his famous chart (see Chapter 5) in the early twentieth century in a military context (Meredith and Mantel 2000) and perhaps he should be given the credit for the first project management tool. The 1950s saw the development of more advanced tools, including the Critical Path Method (developed by Du Pont to manage the shutdown of complex plants safely and efficiently) and the Program Evaluation and Review Technique (PERT), which was developed by the US military (Perce 1998).

The second key element is the role of the project manager and the project team. The defining characteristic of the project-manager role is that it has authority over the whole project, regardless of how many line management departments are involved. The first modern use of the project manager role occurred in the early 1950s, when Bechtel was appointed as the project manager for the Transmountain Oil Pipeline in Canada, and assigned one person to take overall responsibility for integrating the entire huge undertaking. At the same time, the US Air Force was beginning to use ‘joint project offices’ to integrate aircraft production projects (Stretton 1997). The need to find the right project manager and the right project team, people who understand and embrace this role and have the necessary skills to carry it out, has become a major factor in the development of the project management profession.

The emerging professional discipline of project management was subsequently developed, in the typical style of new professions, through the establishment of associations and other peak bodies (the ‘clubs and societies’ phase). The International Project Management Association (www.ipma.ch) was established in 1965 in Europe, the Project Management Institute (www.pmi.org) in the USA in 1969, and the Australian Institute of Project Management (www.aipm.com.au) in 1976 (Stretton 1997).

Project management, and the role of the project manager, spread rapidly throughout industry. The National Aeronautical and Space Agency became a major developer and user of project techniques from the 1960s, and improved on the ‘3D objective’ statement with the slogan ‘better, faster, cheaper’ in the 1980s to describe their response to the need to work with tighter budgets. The information technology industry also adopted the practice of project management (for new product and service development) and provided the technology required for a proliferation of project management software, such as the popular Microsoft Project.

PROJECT MANAGEMENT APPROACHES

A survey of the methods actually used in project management in a range of public and private sector industries, conducted in the UK (White and Fortune 2002), found that in-house methods, developed and mandated by the respondents’ organisations, were most popular, followed by basic tools such as Gantt charts and cost–benefit analysis.

The most popular criteria used by respondents for judging success were the standard 3D objectives (that is, being on time, on budget and meeting specifications). Other criteria included the fit between the project and the organisation and the results of the project for the organisation’s performance—in terms of both business yield and minimising disruption caused by the project.

There is a wealth of literature which presents different approaches to project management. Perhaps the single most influential source is the Project Management Body of Knowledge (inevitably known as ‘PMBOK’), published by the Project Management Institute (Project Management Institute 2000). The PMBOK describes five key processes—initiating, planning, executing, controlling and closing—and nine key elements (‘knowledge areas’) in project management—scope management, time management, cost management, quality management, human resources management, communication, risk management, procurement (including contract) management and managing integration. We draw heavily on the PMBOK framework in this book and we have found that most project management approaches have significant commonalities with it. For example, Rosenau (1998) describes five key activities project definition, planning, leading, monitoring and completing.

Projects in health and community services

The use of project management methods is well established in the health and community services industries. Community services staff in local government, and in community health centres, began defining much of their community development and health promotion work as projects in the 1970s and 1980s, and developed in-house templates and protocols to plan and manage their work. These methods have proven effective, and are now standard practice in the community health and service areas.

Hospitals have been using project management methods for capital and IT projects for many years, but widespread application of these methods to their core business only began in the 1990s, learnt largely from management consultants and staff with community health backgrounds. The introduction of continuous quality improvement methods, and process re-engineering, were also important sources of project thinking and project skill development.

Australian health authorities, on the other hand, have tended to focus on the development of in-house approval processes and work flow management methods and, until recently, have been less systematic in adopting the key features of project management, other than in the capital and IT areas. Many central health authorities are skilled users of contracted projects, and it seems that there has often been a transfer of project skills from the consultants to departmental staff.

In human service organisations, project management methods are used for four basic purposes:

1. The development of new services, programs or technologies;

2. To improve existing services, care processes, work practices or service delivery models;

3. The implementation of new organisational structures or systems; and

4. The construction, installation and/or commissioning of new equipment and facilities.

Mainstream project management methods, with their origins in engineering, are best suited to the latter. Choosing, installing and commissioning a new MRI suite in a diagnostic centre, or building a new child care centre, for example, are tasks for which project management methods are ideal: they lend clarity, discipline and predicta...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Contents
• List of figures, tables and cases
• Abbreviations
• About the authors
• Acknowledgments
• Introduction
• PART 1: PROJECTS, STRATEGY AND ORGANISATIONS
• PART 2: MANAGING PROJECTS SUCCESSFULLY
• References
• Index