This document discusses setting up Project Management Offices (PMOs) for large project initiatives. It outlines the typical challenges of managing large, complex projects including size, cost, scope, collaboration needs, and increased uncertainty. It proposes that PMOs can help address these challenges by providing operational support, oversight of tactical and strategic activities, and improved performance visibility and reporting. The document then provides a 4-step approach to setting up a PMO for a large project: 1) Evaluate the project's needs, 2) Define the PMO charter, 3) Set up the PMO by staffing roles and implementing processes, and 4) Operate and improve the PMO over the project lifecycle by staying aligned with needs.