Patient Flow Collaborative II – Outpatients
                           Project management made simple




Project manageme...
Patient Flow Collaborative II – Outpatients
                                                                              ...
Patient Flow Collaborative II – Outpatients
                                                                              ...
Patient Flow Collaborative II – Outpatients
                                                    Project management made si...
Patient Flow Collaborative II – Outpatients
                                                     Project management made s...
Patient Flow Collaborative II – Outpatients
                                                  Project management made simp...
Patient Flow Collaborative II – Outpatients
                                                        Project management mad...
Patient Flow Collaborative II – Outpatients
                                                     Project management made s...
Patient Flow Collaborative II – Outpatients
                                               Project management made simple
...
Patient Flow Collaborative II – Outpatients
                                                        Project management mad...
Patient Flow Collaborative II – Outpatients
                                                     Project management made s...
Patient Flow Collaborative II – Outpatients
                                                    Project management made si...
Patient Flow Collaborative II – Outpatients
                                                         Project management ma...
Patient Flow Collaborative II – Outpatients
                                            Project management made simple



...
Patient Flow Collaborative II – Outpatients
                                                       Project management made...
Patient Flow Collaborative II – Outpatients
                                                        Project management mad...
Patient Flow Collaborative II – Outpatients
                      Project management made simple




Phase 1 - Project Def...
Patient Flow Collaborative II – Outpatients
                                                      Project management made ...
Patient Flow Collaborative II – Outpatients
                                                    Project management made si...
Patient Flow Collaborative II – Outpatients
                                                   Project management made sim...
Patient Flow Collaborative II – Outpatients
                                                    Project management made si...
Patient Flow Collaborative II – Outpatients
                                                    Project management made si...
Patient Flow Collaborative II – Outpatients
                                                      Project management made ...
Patient Flow Collaborative II – Outpatients
                                                    Project management made si...
Patient Flow Collaborative II – Outpatients
                                                     Project management made s...
Patient Flow Collaborative II – Outpatients
                                                       Project management made...
Patient Flow Collaborative II – Outpatients
                                                       Project management made...
Patient Flow Collaborative II – Outpatients
                                                      Project management made ...
Patient Flow Collaborative II – Outpatients
                                                    Project management made si...
Patient Flow Collaborative II – Outpatients
                                                   Project management made sim...
Patient Flow Collaborative II – Outpatients
                                                         Project management ma...
Patient Flow Collaborative II – Outpatients
                                                      Project management made ...
Patient Flow Collaborative II – Outpatients
                                                       Project management made...
Patient Flow Collaborative II – Outpatients
                                                  Project management made simp...
Patient Flow Collaborative II – Outpatients
                                           Project management made simple




...
Patient Flow Collaborative II – Outpatients
                                 Project management made simple




Phase 2 – ...
Patient Flow Collaborative II – Outpatients
                                                     Project management made s...
Patient Flow Collaborative II – Outpatients
                                                   Project management made sim...
Patient Flow Collaborative II – Outpatients
                                                     Project management made s...
Patient Flow Collaborative II – Outpatients
                                                     Project management made s...
Patient Flow Collaborative II – Outpatients
                                                       Project management made...
Patient Flow Collaborative II – Outpatients
                                                      Project management made ...
Patient Flow Collaborative II – Outpatients
                                                  Project management made simp...
Patient Flow Collaborative II – Outpatients
                                                     Project management made s...
Patient Flow Collaborative II – Outpatients
                                                      Project management made ...
Patient Flow Collaborative II – Outpatients
                                 Project management made simple




Phase 3 - ...
Patient Flow Collaborative II – Outpatients
                                                     Project management made s...
Patient Flow Collaborative II – Outpatients
                                                       Project management made...
Patient Flow Collaborative II – Outpatients
                                                 Project management made simpl...
Patient Flow Collaborative II – Outpatients
                                                     Project management made s...
Patient Flow Collaborative II – Outpatients
                                                    Project management made si...
Patient Flow Collaborative II – Outpatients
                                 Project management made simple




Phase 4 - ...
Patient Flow Collaborative II – Outpatients
                                                     Project management made s...
Patient Flow Collaborative II – Outpatients
                                                   Project management made sim...
Patient Flow Collaborative II – Outpatients
                                                     Project management made s...
Patient Flow Collaborative II – Outpatients
                                                     Project management made s...
Patient Flow Collaborative II – Outpatients
                                                      Project management made ...
Patient Flow Collaborative II – Outpatients
                                                       Project management made...
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Project management made simple (324kb, MS Word)

  1. 1. Patient Flow Collaborative II – Outpatients Project management made simple Project management made simple 1. Project 4.Project Definition Close Project Evaluation 3. Project 2. Project Execution Planning
  2. 2. Patient Flow Collaborative II – Outpatients Project management made simple Table of contents ..............................................................................................................................................................3 Introduction.............................................................................................................................................4 How to use this Handbook......................................................................................................................4 What is a Project?..................................................................................................................................5 Characteristics Of A Project ..................................................................................................7 A Project isn’t:........................................................................................................................7 What is Project Management?...............................................................................................................8 Characteristics of Project Management................................................................................10 Project Management Skills...................................................................................................11 Why Do Projects Fail?..........................................................................................................12 Research Statistics.................................................................................................................13 Four Phases – Project Management....................................................................................................14 Phase 1 - Project Definition..................................................................................................................18 1.1 Organisational Context...................................................................................................19 1.2 Defining The Need For The Project ...............................................................................19 1.3 Project Aim ....................................................................................................................20 1.4 Project Objectives...........................................................................................................21 1.5 Project Roles...................................................................................................................22 1.6 Project Scope...................................................................................................................23 1. 6.1 Project Scope - Template 1.........................................................................................23 1.9 Project Constraints..........................................................................................................25 1.10 Assumptions..................................................................................................................25 1.11 Stakeholders .................................................................................................................26 1.11.1 Key questions to ask stakeholders: ...........................................................................26 1.11.2 Assessing Project Stakeholder - Template 2..............................................................26 1.11.3 Communicating with Stakeholders............................................................................27 1.11.4 Project Stakeholder Contact List - Template 3..........................................................27 1.12 Deliverables..................................................................................................................29 1.12.1 Project Deliverables - Template 4..............................................................................29 1.13 Benefits ........................................................................................................................30 1.14 Measures.......................................................................................................................30 1.15 Project Risks.................................................................................................................31 1.15.1 Risk Assessment........................................................................................................32 1.15.2 Project Risk Log - Template 5...................................................................................33 1.16 Resources Required.......................................................................................................34 1.16.1 Project Resources - Template 6................................................................................34 Phase 2 - Project Planning...................................................................................................................37 2.1 Project Team ..................................................................................................................38 2.1.1 Selecting Your Project Team.......................................................................................38 2.1.2 Managing the Project Team.........................................................................................39 2.1.3 Types Of Planning.......................................................................................................40 2.1.4 Definitions....................................................................................................................40 2.1.5 Estimating....................................................................................................................41 2.1.6 Allocating ....................................................................................................................41 2.1.7 Critical Path..................................................................................................................42 2.1.9 Project Planning -Template 7.......................................................................................43 Project Management Made Simple 2
  3. 3. Patient Flow Collaborative II – Outpatients Project management made simple 2.1.10 Reviewing The Project Risk Log...............................................................................44 2.1.11 Reviewing The Project Budget..................................................................................44 2.1.12 Reviewing The Communication Strategy..................................................................45 2.1.13 Checklist for Project Planning...................................................................................45 3. Project Execution.............................................................................................................................47 3.1 Key Actions.....................................................................................................................48 3.1.1 Recruiting the Project Team........................................................................................48 3.1.2 Securing Resources, Facilities and Equipment Required:...........................................48 3.1.3 Communication Strategy..............................................................................................48 3.1.4 Managing Issues ..........................................................................................................49 3.1.4.1 Issues Log - Template 9............................................................................................49 3.1.5 Controlling the Project.................................................................................................50 3.1.6 Monitoring Progress.....................................................................................................50 3.1.7 Progress Reporting.......................................................................................................51 4. Closing the Project...........................................................................................................................53 ...............................................................................................................................................53 4.1 Completion Criteria.........................................................................................................54 4.2 Acceptance Process.........................................................................................................54 4.3 Close-Out Meeting..........................................................................................................54 5. Evaluating the Project.......................................................................................................................55 5.1 Active Evaluation............................................................................................................56 5.2 Post Project Evaluation...................................................................................................56 5.3 Technical Evaluation.......................................................................................................56 5.4 Post –Project Appraisal (Sustainability).........................................................................56 Glossary of Terms.................................................................................................................57 Project Management Made Simple 3
  4. 4. Patient Flow Collaborative II – Outpatients Project management made simple Introduction We work in an environment of continual change. Changes in the length of stay for patients undergoing elective surgery, changes in what is scientifically possible, changes in patient expectations, changes in economic constraints and changes in demand for health services. All these changes have one thing in common – they have to be effectively managed if they are to be successful. Change that is uncontrolled is subject to considerable risk and potentially serious consequences for everyone and the organisation. The process of managing change is important, from the initial idea or identification of a problem through to controlling the consequences and reacting to problems as they occur. The processes, procedures and techniques to manage a project are not difficult to learn. But success depends on taking a disciplined approach to create new working habits. How to use this Handbook This handbook has been developed for Breakthrough Collaborative team members, or anyone who wants a simple methodology for project management. The handbook is written to give practical and well-tested techniques to meet your needs if you have: • Just been given a project to manage • Have managed projects before but seek to improve your skills • Are a Breakthrough Collaborative team member and want to learn project skills The handbook will help you to: • Keep your project on track • Ensure that project timetables are set and adhered to • Keep control of costs • Ensure the project team is effective throughout the project • Avoid pitfalls This handbook is a learning aid for the Breakthrough Collaborative project management training. The training will step you through the methodology and you will have an opportunity to try the tools and decide if they would be good for you to use in your project. After the training you and your Breakthrough Collaborative team can access support to apply the tools to your own Breakthrough Collaborative project. Project Management Made Simple 4
  5. 5. Patient Flow Collaborative II – Outpatients Project management made simple What is a Project? Description This section will provide an overview of what a project is and how projects are different from routine work. Learning Objectives At the conclusion of this section, participants should be able to • Explain the characteristics of a project • Describe the difference between routine work and projects Project Management Made Simple 5
  6. 6. Patient Flow Collaborative II – Outpatients Project management made simple Exercise Think about projects that you have been involved in over the last year. Write down what is a project, what is everyday routine work and what makes projects different from everyday routine. A Project is Routine work What are the differences between a project and routine work? Project Management Made Simple 6
  7. 7. Patient Flow Collaborative II – Outpatients Project management made simple A project is a collection of linked activities, carried out in an organised manner with a clearly defined START POINT and END POINT To achieve some specific results desired to satisfy the strategic need of the organization at the current time. Source: How To Be A Better Project Manager. Trevor Young (2001) Characteristics Of A Project  Having a specified and defined purpose  Unique because it will never be repeated in quite the same way  Being focused on customer/patients needs and expectations  Not being routine but including many routine-type tasks  Having defined constraints of time, cost and people available  Involving people from different departments and even sites  Involving many unknowns and hence many risks  Challenging traditional ways of working to introduce improvements  Providing an opportunity to learn new skills A Project isn’t:  Business as usual, or  Day to day work such as:  Setting up a new starter’s PC  Amending or modifying data for DHS  Assessing patients clinical need  Admitting patients for elective surgery Project Management Made Simple 7
  8. 8. Patient Flow Collaborative II – Outpatients Project management made simple What is Project Management? Description This section will define project management; outline the four phases of project management methodology and when to use these phases in relation to the Breakthrough Collaborative. Learning Objectives At the conclusion of this section, participants should be able to:  Explain project management  Describe the four phases of project management methodology Project Management Made Simple 8
  9. 9. Patient Flow Collaborative II – Outpatients Project management made simple Exercise In pairs, Describe the characteristics of Project Management What are the skills required to manage a project? List some problems you or others have experienced when managing projects or participating in projects. Project Management Made Simple 9
  10. 10. Patient Flow Collaborative II – Outpatients Project management made simple Project Management is the dynamic process that ulitizes the appropriate resources of the organisation in a controlled and structured manner, to achieve some clearly defined objectives identified as strategic needs. It is always conducted within a defined set of constraints. Source: How To Be A Better Project Manager. Trevor Young (2001) Characteristics of Project Management Objective-orientated – otherwise why do it? Change-orientated – to create something you need Multi-disciplined – using many skills to achieve success Opportunistic – bypassing the old norms and seeking new ideas Control-orientated – without which you may never finish Performance-orientated - setting high standards of work and quality Questioning – throwing off old traditions and habits to expose the new Project Management can also be defined in the following quote: “I keep six honest serving men (they taught me all I know); their names are What and Why and When and How and Where and Who.” Rudyard Kipling (1865 – 1936) Project Management Made Simple 10
  11. 11. Patient Flow Collaborative II – Outpatients Project management made simple In the majority of organisations the role of Project Manager is a temporary management activity associated only with a specific project. The project is an additional set of activities on top of your normal operational duties that you are expected to carry out as part of your job. Project Management Skills • To set targets for people which are aligned to their personal goals • To create a strong sense of responsibility for the project work • To create commitment in the team members, to help team members to prioritise their workloads and coach them in many aspects of the work • To learn from experts to increase your knowledge • To explain your and management decisions • To encourage people to maintain interest and motivation • To regularly keep everyone informed of progress • To promote an atmosphere supporting free and willing feedback • To manage peer and senior groups to influence their support • To manage third party contractors • To manage conflict in the team • To show your concerns for continuous improvement • To take risks in the interest of the project • To communicate the alignment between the organisations strategic goals and the project Source: The Handbook of Project Management, Kogan Project Management Made Simple 11
  12. 12. Patient Flow Collaborative II – Outpatients Project management made simple Why Do Projects Fail? Many projects encounter problems through the lack of one or more of the following: Clear aim, objectives, requirements, scope and deliverables at the commencement of the project, eg  Initial planning takes longer than expected and management is looking for some progress in the project, so planning is not undertaken.  The project is breaking new ground and is not clear as how to proceed or what will actually be achieved. Access to skills, as and when required, eg  People are transferred to other tasks  People are overcommitted with the workload  There is a shortage of the right skill and experience  Sickness and annual leave isn’t taken into account Agreed measurements and control points throughout the project eg  Team members believe that they know what they are doing and therefore measurements and controls seem superfluous and are considered an insult.  There is a lack of clarity about what results will actually be achieved, and therefore on how the project can be measured or controlled Team commitment to the project eg  A team member does not see the point of the project or believes they have been assigned too much work, responsibility  The team has already been chosen and given assignments, so some discontent is experienced by team members Achievable deadlines – eg the delivery date is agreed to before the project planning determines achievable timeframes. Sponsorship and therefore lack of direction, ownership and issue resolution eg  The is no real project owner or champion for the project  The assigned project owner has no authority to make decisions that direct the project Project Management Made Simple 12
  13. 13. Patient Flow Collaborative II – Outpatients Project management made simple Scope management eg  The project scope was not clearly defined at the project definition  Scope change management was not effectively applied Identification and management of risks and issues, eg major obstacles were not pre- empted, recognised and then tracked to resolutions Recognitions that new influences alter the projects aims eg  Budget cuts  Changes is service delivery Phased delivery for long running projects eg  Too much time elapses before the project delivers anything  Requirements keep changing due to length of time Research Statistics There is a proven direct correlation between project size and project failure – over 90% of projects in the US worth over $6 million have failed. This equates to the following statistics:  30% of US based projects never reached a fruitful conclusion  US $75billion is wasted annually in projects that fail  51% of projects in the US exceed their budget by 189% and  Most US based projects deliver only 74% of functionality Source: 1999 Gartner Institute PM Core Capabilities Project Management Made Simple 13
  14. 14. Patient Flow Collaborative II – Outpatients Project management made simple Four Phases – Project Management 1. Project 4.Project Definition Close Project Evaluation 3. Project 2. Project Execution Planning Project Management Made Simple 14
  15. 15. Patient Flow Collaborative II – Outpatients Project management made simple Project Management Breakthrough Collaborative Tools Phase 1.Project 1.Problem identification Definition • Identify problem • Gather baseline data (patient, staff, operational) 2. Stakeholder Analysis • Ranking of importance and impact • Level of involvement • Expectations 3. Scoping Study • Organisational context • Project need • Aim & objectives • Project organisational chart • Parameters, Interfaces, Constraints, Assumptions • Stakeholders Orientation • Deliverables, Benefits, Measures Session • Risks + Learning • Resources Session 1 • Prioritisation Criteria • Checklist • Produce Business Case 2.Project 4. What are we trying to accomplish Planning • Project Planning – types of planning • Work breakdown Structures • Allocating & Estimating • Critical Path & Gantt Charts • Milestones • Review your Risk Log • Review your Budget • Checklist 5. Forming the project team • Selecting Your Project Team • Skills & Knowledge Required • Selection Criteria Project Management Made Simple 15
  16. 16. Patient Flow Collaborative II – Outpatients Project management made simple 3. Project 6. The current process Execution 7. Redesign 8. Change Strategies 9. Implementation plan Learning 10.Trial & review Session • Recruiting your Project Team 2&3 • Securing Resources • Controlling • Monitoring • Checklist 4. Project 11. Implementation Close • Completion criteria • Acceptance Process • Close out Meeting Learning • Active Evaluation Session 3 • Post Project Evaluation • Technical Evaluation • Post- Project Evaluation (final report) Project Management Made Simple 16
  17. 17. Patient Flow Collaborative II – Outpatients Project management made simple Phase 1 - Project Definition
  18. 18. Patient Flow Collaborative II – Outpatients Project management made simple Phase 1 - Project Definition Description This section will consider why it is so important to realistically scope a project and how organisations prioritise before commencing a project. Learning Objectives At the conclusion of this section, participants should be able to:  Describe the organisational and strategic context  Describe the need for the project (quantifiable)  Describe the aim and objectives  Describe the project organizational chart and roles  Describe the parameters, interfaces, constraints and assumptions  Process to identify key stakeholders  Describe the deliverables  Describe benefits of the project  Outline key performance measures  Describe project risks  Identify resources required for the project  Discuss how to select appropriate projects Project Management Made Simple 18
  19. 19. Patient Flow Collaborative II – Outpatients Project management made simple 1.1 Organisational Context Most organisations have limited resources, projects have to be prioritised to ensure that the greatest benefit is gained from the resources spent. Projects need to be aligned to the strategic direction of the organization. Examples: Improve patient safety Increase the appropriate use of fresh blood products Increase elective day surgery procedures Improve the health of the local population who have multiple chronic conditions 1.2 Defining The Need For The Project Data should be used to quantify the severity of the problem and impact on the organisation, patients and staff. This data forms baseline measures and allows the project team to assess improvements from the progress. Example: The DNA rate of 22 percent in outpatients clinic. Personal: Reduce the length of time it takes to run around Albert Lake from 65 minutes to 30 minutes so I can be fit enough to run the ½ Marathon in June. In your Project Definition document, write down your  Organisational context  Project need Project Management Made Simple 19
  20. 20. Patient Flow Collaborative II – Outpatients Project management made simple 1.3 Project Aim In healthcare the project aim should be written from the patient/customer perspective. SMART Specific – clearly defined with a target for improvement Measurable – understood metrics are available to identify delivery Achievable – within the current environment, funding, time and skills available Realistic – not trying to get the impossible with many unknowns Time bound – is limited by delivery date based on real need Examples:  25% decrease in inappropriate patient referrals to clinic x by June 2007  100% improvement in the time to run 5km (Albert Park Lake) by June 2007 Project Management Made Simple 20
  21. 21. Patient Flow Collaborative II – Outpatients Project management made simple 1.4 Project Objectives The objectives are the critical elements in the process to achieve the aim. Examples: Aim Identify key outpatient constraints that impact the inward and outward flow of patients and access to services. Objective Increase the number of referrals with the required elements by 30% by June 2007 Aim 100% improvement in the time to run 5km (Albert Lake) by June 2007 Objective To run three times per week and time each run To weight train three times per week To seek coaching on running technique from a professional runner In your Project Definition document, write down your  Project aim  Project objectives Project Management Made Simple 21
  22. 22. Patient Flow Collaborative II – Outpatients Project management made simple 1.5 Project Roles Exercise In pairs describe the role of a project facilitator and the role of a clinical lead. Write down the differences between a clinical leader and project facilitator Clinical lead Project facilitator Differences Project Management Made Simple 22
  23. 23. Patient Flow Collaborative II – Outpatients Project management made simple 1.6 Project Scope The scope of the project defines:  The boundaries eg geographical, type of process or part of the process.  The start and finish points  What the project is going to cover and what the project is not going to cover. Example The Patient Flow Collaborative II – Outpatients project will involve 29 health services in Victoria of which 4 will be community health services all other health services in Australia and will be excluded. All Saints Hospital will examine the flow of patients in and out of clinic x & y. 1. 6.1 Project Scope - Template 1 Start Finish Inclusion Exclusion Additional (Boundary) Date agreed Agreed by Project Management Made Simple 23
  24. 24. Patient Flow Collaborative II – Outpatients Project management made simple 1. 8 Interfaces Each project can have inter-relationships with other activities, programs or projects both inside the organisation and outside the organisation. To avoid re-inventing wheels and to gain clarity between projects, it is essential to identify any interfaces that the project may have. Example Your Patient Flow Collaborative II – Outpatients project may interface with existing initiatives in your health service such as:  Clinical Risk Management  Service Development  Quality Committee Exercise Working in groups, select a project you have been involved in and using the project definition document identify:  Scope  Interfaces Project Management Made Simple 24
  25. 25. Patient Flow Collaborative II – Outpatients Project management made simple 1.9 Project Constraints All projects have some constraints. Project Constraints usually fall into the following categories:  Time – time to deliver the results. For example: The project will finish by June 2007  Financial – project cost and resource costs to deliver the project. For example: The budget for the project is $25,000  Quality – specifications, regulations or standards that have to be achieved. For example: All project teams will share progress through simple sampling.  Physical – limited space. For example: The new hospital will be built within the existing grounds of the Austin Medical Centre.  Resources – access to or ability to recruit skilled people. For example: Recruiting nurses in Victoria 1.10 Assumptions Assumptions are always made when defining a project. However it is essential to be explicit about these assumptions and to test them with others. ASS – U –ME Exercise Working in groups, select a project you have been involved in and using the project definition document identify:  Constraints  Assumptions Project Management Made Simple 25
  26. 26. Patient Flow Collaborative II – Outpatients Project management made simple 1.11 Stakeholders A project Stakeholder is any person, group of people or organisation who has a vested interest in the project either now or in the future. Some stakeholders are more important than others to support the project. The interest may be: Positive: supporting a successful outcome or Negative: striving to hinder or stop the project! Source: How To Be A Better Project Manager. Trevor Young. 2001 1.11.1 Key questions to ask stakeholders:  Why are they interested?  What are they expecting to gain from the project?  What impact will the project have?  Are they in favour of the project?  What involvement do they have and how can they contribute experience or knowledge? 1.11.2 Assessing Project Stakeholder - Template 2 Process/ Stakeholder Importance Impact Expectation Involvement Problem Date agreed Agreed by Project Management Made Simple 26
  27. 27. Patient Flow Collaborative II – Outpatients Project management made simple 1.11.3 Communicating with Stakeholders At the beginning of the project produce a list of the contact details for the stakeholders in your project. 1.11.4 Project Stakeholder Contact List - Template 3 Name Title Location Address Telephone/Fax E-mail Date updated Tip: Although you may identify stakeholders at the beginning of your project, many do not appear until you have started your project. The list of stakeholders will therefore change and grow with time, so the list will need regular reviewing and updating. “Communicate, communicate, and communicate” Paul Plsek The success of any project depends on engaging and communicating with stakeholders. Project Management Made Simple 27
  28. 28. Patient Flow Collaborative II – Outpatients Project management made simple Exercise 1. Using the template, brainstorm all the stakeholders for the project 2. Rank the importance of the project success to the stakeholder H - High M - Medium L - Low 3. Rank the stakeholders impact on the project H – High M – Medium L – Low 4. Identify their contribution to the project and assess their level of involvement A - Active involvement in the multi-disciplinary project team B – Consulted/Coopted on initiatives C – Informed on developments 5. Draw the matrix on a flip chart and plot your stakeholders onto the matrix Example: Project Aim: 25% decrease in DNA rates in clinic x by June 2007. Impact High • Surgical Registrar Low Importance Low High Project Management Made Simple 28
  29. 29. Patient Flow Collaborative II – Outpatients Project management made simple 1.12 Deliverables To achieve your aim, you will develop products and/or services, which are known in project management terms as “deliverables” • Deliverables are often the result of major activity • There are usually several deliverables in a project Examples of Deliverables for the Patient Flow Collaborative II – Outpatients :  Standardised data collection  Action plans  Interim and final report 1.12.1 Project Deliverables - Template 4 Deliverable Date Success Criteria Sign off Date agreed Agreed by Project Management Made Simple 29
  30. 30. Patient Flow Collaborative II – Outpatients Project management made simple 1.13 Benefits Each project will produce benefits. Consider the benefits from different stakeholders perspectives. Benefits should be quantified. 1.14 Measures Often the benefits are related to the measures. For example: Benefit: Increased patient and GP understanding of the booking procedure resulting in timely appointment in clinic x. Performance Measure The time between referral being made and received has decreased. Performance can be measured in terms of 4 P’s: P – progress against plan P – people against task P – process improvement against current process P – performance against aim or benefit Project Management Made Simple 30
  31. 31. Patient Flow Collaborative II – Outpatients Project management made simple 1.15 Project Risks A RISK is any event that prevents the project realizing the expectations of your stakeholders. A risk that happens becomes an issue that must receive prompt attention to maintain the project is on time. Source: How To Be A Better Project Manager. Trevor Young (2001) Three categories of risk  Business risks – the viability and context of the project  Project risks – associated with the technical aspects of the work to achieve the aim  Process risks – associated with the project process, tools and techniques employed to control the project Project Management Made Simple 31
  32. 32. Patient Flow Collaborative II – Outpatients Project management made simple 1.15.1 Risk Assessment There is always the possibility that unforeseen risks can lead to unexpected issues and without prompt action these risks and issues can reduce the likelihood on delivering the project on schedule, to the quality specified and within budget. Time Project Budget Quality When • Risk management is a continuous process throughout the life of the project. • Start to define risks in the project definition phase • Complete the “project risk log” Assessment • What exactly is the risk? • What is the probability of it happening based on current data? • What is the likely impact on the project? Strategies • What actions will prevent or minimize the risk? Project Management Made Simple 32
  33. 33. Patient Flow Collaborative II – Outpatients Project management made simple Categories of Risk High Significant effect on delivering the project on time and in budget. Serious impact on other related projects. Must by monitored and reviewed regularly. Review action plans Medium Significant impact on the project with possible impact on other projects. Not expected to affect a project milestone. Review at each project meeting and assess ranking. Monitor regularly Low Not expected to have any serious impact in the project. Review regularly for ranking and monitor. Exercise 1. In a group, select one project and brainstorm the risks for the project. 2. Complete the 1.15.2 Project Risk Log - Template 5 Description Probability Impact Action Who By When H/M/L H/M/L Date updated Updated by 3. Rank the probability of risk on a scale 1 to 9. 1 is low - most unlikely to happen, 9 is high – very high probability it will happen 4. Gain a group consensus if it is a high, medium or low risk to the project. 5. Identify strategies to address the risk Project Management Made Simple 33
  34. 34. Patient Flow Collaborative II – Outpatients Project management made simple 1.16 Resources Required The project team need to estimate the resources required to successfully undertake the project and document estimations. Key areas for consideration are:  Personnel – labour required to complete the project  Facilities – office space  Equipment – computers, software, furniture, printers, mobile phones  Material and Supplies – catering, photocopying, postage, stationary 1.16.1 Project Resources - Template 6 Date Task Resource Cost Supplier required Delivered Date agreed Agreed by Project Management Made Simple 34
  35. 35. Patient Flow Collaborative II – Outpatients Project management made simple Well done. Ask the project team including the executive sponsor and clinical lead to sign off all documents as approved, indicating their acceptance of the project definition. • Hold a launch meeting • Disseminate all project documentation Project Management Made Simple 35
  36. 36. Patient Flow Collaborative II – Outpatients Project management made simple Phase 2 – Project Planning Project Management Made Simple 36
  37. 37. Patient Flow Collaborative II – Outpatients Project management made simple Phase 2 - Project Planning Description This section will consider the how to select your project team. Learning Objectives At the conclusion of this section, participants should be able to:  Describe the skills they require in their team  Identify potential candidates for their project team  Understand some of the complexities of working in a project team Project Management Made Simple 37
  38. 38. Patient Flow Collaborative II – Outpatients Project management made simple 2.1 Project Team 2.1.1 Selecting Your Project Team Most projects start by being a group of people together from different backgrounds, with different experiences and skills. The challenge is to:  Identify the skills and knowledge required for the project  Produce criteria to ensure that all the skills and knowledge are in the project team  Bring a group of individuals (stakeholders) into a cohesive project team with a common aim Skills & Knowledge Required Potential Team Member (Selection Criteria) Project Management Made Simple 38
  39. 39. Patient Flow Collaborative II – Outpatients Project management made simple 2.1.2 Managing the Project Team Managing a project team is often more complex than managing a service or department in a fixed hierarchy. What are some of the challenges in managing the project team?  Managing team members who have been drawn from different departments, who have their own responsibilities outside the project work  The risk of instability in the team due to the changing priorities of the line managers of your team  Creating an effective team environment with a changing team  Building a team quickly with people who do not know each other  Clarity in roles and responsibilities and inter-relationship between roles and responsibilities within the project team.  Poor communication and sharing information because the team members do not know or necessarily trust each other. Encourage effective communication between team members to increase each others knowledge of the different roles, responsibilities and inter-relationships  Focusing the team members on performance which may not be consistent with their personal goals agreed with their line managers  Creating a team “identity” to encourage the team members to meet regularly and learn more about each other and promote good working. Project Management Made Simple 39
  40. 40. Patient Flow Collaborative II – Outpatients Project management made simple 2.2 Project Planning Description This section will consider the how to plan a project. Learning Objectives At the conclusion of this section, participants should be able to:  Describe the project planning process  Describe allocating work and estimating timeframes  Explain a work breakdown structure, Gantt Chart and Milestones 2.1.3 Types Of Planning Macro – outline the activities first and then breaking them into tasks Micro – outlining the tasks firsts and grouping them into activities 2.1.4 Definitions A task – a small piece work carried out by one person An activity – a parcel of work comprising of several tasks each of which may be carried out be different people Concurrent activities/tasks – activities or tasks that are designed to be carried out at the same time Series of activities/tasks – activities that are designed to be undertaken one after another, each strictly dependant on each other Project Management Made Simple 40
  41. 41. Patient Flow Collaborative II – Outpatients Project management made simple 2.1.5 Estimating When estimating the time and resources required to complete the task you should:  Schedule full time team members at four productive working days per week, to allow for holidays, absences, training, unforeseen problems  Include management time where appropriate as an additional 10%  Avoid splitting tasks between individuals  If tasks are spilt, do not reduce time by 50% allow time for communication and co- ordination  Take individual experience into account  Build in spare time for problem solving, urgent tasks arising, non project related activities and project meetings  Allow time for cross-functional data transfer and responses Any estimate is subject to change so keep a record of: - the estimates your team decides - any assumptions made during the estimating - where contingencies have been added - how many contingencies have been added and what type 2.1.6 Allocating Each task requires allocating to a member of the project team and estimating the time required to complete the task. When allocating a task you should:  Access the right skills for the work  Provide visible support by the project facilitator  Communicate clearly the performance expected of them  Ensure they have the tools to do the job  Document the responsibilities and communicate this to everyone including their line managers Project Management Made Simple 41
  42. 42. Patient Flow Collaborative II – Outpatients Project management made simple 2.1.7 Critical Path The critical path is the shortest possible time in which to complete a task, activity and project. You can reflect on your logical flow to identify your critical path. It is important to note that if a time changes for task or activity it will also change your critical path. 2.1.8 Gantt Charts & Milestones A Gantt Chart graphically reflects the activity, task, duration and calendar dates. The Gantt Chart highlights the logical flow between activities. The critical path can be presented on the Gantt Chart. The Gantt Chart can also include:  Milestones ▲– a significant measurable event representing a checkpoint for the completion of an activity and the delivery of a product or services. All milestones should apply the SMART test. The milestone is usually indicated by a triangle. A white triangle represents a scheduled milestone, a black triangle represents a completed milestone. Some other common events for milestones are financial audit or quality audit  Project meetings – indicated by a filed circle or dot  Project reviews (financial/audit) u – indicated by a filled square Computer Project Planning Packages Microsoft project produces your Gantt Charts and Critical Paths on the computer. However, if you change one activity or task the package may or may not change all the other tasks and activities. Project Management Made Simple 42
  43. 43. Patient Flow Collaborative II – Outpatients Project management made simple 2.1.9 Project Planning -Template 7 Activity Task Description Start Finish Allocated Symbol Date Date to Date agreed Agreed by Congratulations You have now produced a work breakdown structure (WBS) A work breakdown structure is a graphical representation of the major activities and tasks required to complete that activity. Project Management Made Simple 43
  44. 44. Patient Flow Collaborative II – Outpatients Project management made simple 2.1.10 Reviewing The Project Risk Log 1. Review any risks that have changed ranking and add any new risks. 2. Produce a short description of the risk 3. Outline when the risk may occur 4. Assess their impact and probability 5. Identify management strategies, actions for any risks that can be prevented 6. Develop contingency plans for avoidance and/or damage limitation Tip: Never remove a risk from the list because it will act as valuable learning for future projects 2.1.11 Reviewing The Project Budget 1. Review any costs that have changed – either increased or decreased 2. Identify the costs for each activity in the project and produce an operating budget 3. If there is great variance between the estimated budget and the operating budget you will have gain approval from the Executive Sponsor again. 4. Start to record costs so that you can monitor variance against your operating budget. 5. Communicate variances to your project team. Project Management Made Simple 44
  45. 45. Patient Flow Collaborative II – Outpatients Project management made simple 2.1.12 Reviewing The Communication Strategy Communication of progress to the wider stakeholder groups should have been identified in the project definition. A communication strategy should be developed as part of the project plan. Refer to Communication Strategy Template 8 Who Mode Frequency (Date) Who Project team Meeting Weekly Leader/Facilitator External Newsletter Monthly As above stakeholders Forum Quarterly 2.1.13 Checklist for Project Planning Before gaining sign off by the Executive Sponsor for the project plan check the following:  Is the project definition still valid?  Is the scope still valid?  Has the project team been confirmed in writing?  Are all the stakeholders identified?  Does the team know who manages the stakeholders?  Is the WBS structure developed practical, realistic and achievable?  Is the critical path established and agreed?  Is the project risk log up to date?  Does the Gantt Chart reflect the agreed plan and schedule?  Has the project operating budget been confirmed and agreed?  Does the team have the skills required? Project Management Made Simple 45
  46. 46. Patient Flow Collaborative II – Outpatients Project management made simple Phase 3 - Project Execution Project Management Made Simple 46
  47. 47. Patient Flow Collaborative II – Outpatients Project management made simple 3. Project Execution Description This section will consider the aspect getting started, controlling and communicating. Learning Objectives At the conclusion of this section, participants should be able to:  Describe the key actions to get started  Explain how to monitor progress against plan  Outline strategies for managing variation from the project plan  Communicate progress  Implement the project Project Management Made Simple 47
  48. 48. Patient Flow Collaborative II – Outpatients Project management made simple 3.1 Key Actions Refer back to the project plan to start the project. 3.1.1 Recruiting the Project Team At the beginning project, each team member and their line manager should receive written confirmation of role and responsibilities statement including time commitment, reimbursement arrangements, location and performance measures. 3.1.2 Securing Resources, Facilities and Equipment Required: Reflected on the resources, facilities and equipment outlined in the project plan including:  Computer hardware and software  Office space and furniture  Stationary  Storage 3.1.3 Communication Strategy Communication of progress to the wider stakeholder groups should have been identified in a communication strategy as part of the project plan. The communication strategy should be implemented. Who Mode Frequency(Date) Who Project team Meeting Weekly Leader/Facilitator Project Management Made Simple 48
  49. 49. Patient Flow Collaborative II – Outpatients Project management made simple 3.1.4 Managing Issues Major issues should be ranked according to importance an assigned a coloured flag:  Red – major issues have serious consequences for the project. Responsibility Executive Sponsor  Yellow – significant impact on the project and/or other projects, if unresolved could cause delay. Becomes a red flag if delayed for more than three days. Responsibility Project Leader  Green – consequences limited to a confined area of the project and unlikely to impact on other projects. Becomes a yellow flag if not resolved in time to avoid project slippage. Responsibility Project Facilitator 3.1.4.1 Issues Log - Template 9 Issue Severity Action Who When Description R/Y/G Date updated Updated by Project Management Made Simple 49
  50. 50. Patient Flow Collaborative II – Outpatients Project management made simple 3.1.5 Controlling the Project Controlling a project involves three key elements: Measuring – determining progress against planned for financial, time and quality Evaluating – determining cause of deviations for the plan Correcting – taking action to correct the deviation against plan All the project documentation requires updating regularly. 3.1.6 Monitoring Progress Progress against plan should be monitored against measuring, evaluating and correcting and should be communicated. Any variance from the plan should be gain approval from the Executive Sponsor and then be communicated with the stakeholders and project team. Project Management Made Simple 50
  51. 51. Patient Flow Collaborative II – Outpatients Project management made simple 3.1.7 Progress Reporting Progress meetings should be a maximum of one hour. Progress reporting against the checklist should be by exception.  Milestones due and completed  Milestones due and slippage  Corrective action put in place because of slippage  Milestones due for next period  Issues waiting decisions  New issues escalated  Any risks escalated  Any resource capacity changes forecasted  Any team performance problems and issues  Forecast of project completion  Reasons for any revision of previous forecast Project Management Made Simple 51
  52. 52. Patient Flow Collaborative II – Outpatients Project management made simple Phase 4 - Closing the Project Project Management Made Simple 52
  53. 53. Patient Flow Collaborative II – Outpatients Project management made simple 4. Closing the Project Description This section will consider the aspects of closing the project. Learning Objectives At the conclusion of this section, participants should understand:  Completion criteria  Acceptance process  Closing meeting Project Management Made Simple 53
  54. 54. Patient Flow Collaborative II – Outpatients Project management made simple 4.1 Completion Criteria Defining what completion is and an acceptance process should be included in your project plan. Completion will be what completion means for your stakeholders and customers. Completion criteria could include:  All tasks finished  All activities finished and products or services delivered  Testing the changes 4.2 Acceptance Process An acceptance process should confirm:  Who is responsible for the each step of the process and the work involved  What post-project support is required and who is responsible  What post-project support must be given and for how long 4.3 Close-Out Meeting At end of the project have a close out meeting with your Executive Sponsor, Clinical Leader and any other project team members. The meeting should:  Review the project achievements and highlight any outstanding work or issues  Agree and confirm responsibilities for any ongoing work or support  Confirm who is responsible for monitoring project benefits  Thank the Executive Sponsor, team and stakeholders Project Management Made Simple 54
  55. 55. Patient Flow Collaborative II – Outpatients Project management made simple 5. Evaluating the Project Description This section will consider the options for evaluating your project Learning Objectives At the conclusion of this section, participants should understand:  Active evaluation  Post project evaluation  Technical evaluation  Post-project appraisal The evaluation of the project will identify what worked well and what could have been improved and why. Project Management Made Simple 55
  56. 56. Patient Flow Collaborative II – Outpatients Project management made simple 5.1 Active Evaluation Promoting learning by doing. The project team evaluates the methodology as they are applying this to the project. The team shares their learning with others to help to continually improve the methodology of the project and their progress. The Breakthrough Collaborative is encouraging active evaluation of progress throughout the project. This will allow project teams to identify any improvements from their baseline positions and an opportunity to capture the learning. 5.2 Post Project Evaluation Evaluating at the end of the project. This should be combined with active learning. The evaluation should develop in-depth questions about every aspect of the project. 5.3 Technical Evaluation The technical evaluation will demonstrate if the best results were achieved with the skills, experience and technology available to throughout the project. The technical evaluation would review if the techniques in the project have resulted in improvements for patient care and improvements in knowledge and skill of project teams. 5.4 Post –Project Appraisal (Sustainability) At the project definition phase you outlined the potential benefits in terms of:  Increased efficiency from redesigning processes and procedures  Increased patient/customer satisfaction  Increased staff satisfaction All of these benefits can be quantified and measured. The organisation and Project Team would want to compare any cost-benefit analysis carried out at the start of the project with accumulated benefits. This will require monitoring benefits for a period after the project to realise the full potential of the projects. Project Management Made Simple 56
  57. 57. Patient Flow Collaborative II – Outpatients Project management made simple Glossary of Terms Boundaries The portion of a process from a Supplier to a Customer that will be the focus of the process improvement. Process boundaries define what is in and out of scope. Check Sheet A data collection form consisting of multiple categories. Each category has an operational definition and can be checked off as it occurs. Properly designed, the Check Sheet helps to summarise the date, which is often displayed in a Pareto Chart. A Check Sheet is simply a tool for recording and tallying observations, eg times that a test report arrived late. Customer/Client The receiver of an output of a process, either internal or external to a hospital or corporate unit. A customer could be a person, a department, a company, etc. The person who gets your work. Data Collection Gathering facts on how a process works and / or how a process is working from the customer’s point of view. All data collection is driven by knowledge of the process and guided by statistical principles. Facilitator Process guide assigned to a team who educates members in the CQI processes and helps them select and use the appropriate tools and other resources. Ground Rules Used by teams to set a code of conduct which helps the group perform more effectively. Five to ten points should be sufficient, and they should be continuously displayed for the team to see and refer to. Action Period The period of time between Learning Sessions, when teams work on improvements in their organisations. They are supported by the Planning Group members and are connected to other Collaborative Team Members. Aim A written, measurable, and time sensitive statement of the expected results of an improvement process. Changes Concepts The list of essential process changes that will help lead to breakthrough improvement, usually created by the Planning Group and/or Expert Panel and is based on literature and their experiences. Project Management Made Simple 57
  58. 58. Patient Flow Collaborative II – Outpatients Project management made simple Collaborative A time-limited effort (usually 6 to 12 months) of multiple organisations, that come together with the steering and expert working groups to learn about and to create improved processes in a specific topic area. The expectation is that the teams share expertise and data with each other thus, “Everyone learns, everyone teaches.” Collaborative Team Involves all participants in the improvement effort. Cycle or PDSA Cycle A structured trial of a change process. Drawn from the Shewhart cycle, this effort includes: Plan - a specific planning phase; Do - a time to try the change and observe what happens; Study - an analysis of the results of the trial; and Act - devising next steps based on the analysis. This PDSA cycle will naturally lead to the Plan component of a subsequent cycle. Learning Session A one or two-day meeting during which participating organisation teams meet with Planning Group members and collaborate to learn key changes in the topic area, including how to implement changes, an approach for accelerating improvement, and a method for overcoming obstacles to change. Teams leave these meetings with new knowledge, skills, and materials that prepare them to make immediate changes. Measure An indicator of change. Key measures should be focused, clarify your team’s aim, and be reportable. A measure is used to track the delivery of proven interventions to patients and to monitor progress over time. Model for Improvement An approach to process improvement, developed by Associates in Process Improvement, which helps teams accelerate the adoption of proven and effective changes. Project Management Made Simple 58

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