Bayfront Health Systems implemented a Project Management Office (PMO) to manage its portfolio of projects funded by the American Recovery and Reinvestment Act (ARRA). The PMO utilized a workbook to document projects, standardize processes, and ensure compliance. This led to successful outcomes, including on-time and on-budget delivery of ARRA-funded projects. The workbook contained documentation templates, change management processes, risk management procedures, and issue logging to facilitate management of the growing project portfolio. Through use of the PMO workbook and standardized processes, Bayfront was able to efficiently deliver multiple ARRA-focused healthcare IT projects.

1. Managing the Increase in ARRA-Focused
Projects: A Real Success Story with the
Bayfront PMO Workbook
Paul A. Capello, PMP
Project Management Office Manager
Bayfront Health Systems
October 2010

2. Session Objectives
How using a PMO Workbook will make a
difference in the ARRA projects focused future.
Documentation, Documentation, Documentation!
Project Scope.
Project Change.
Project Risk.
Project Issues.
Etc…….
Bayfront Project Portfolio Success Metrics.
“You can’t argue with Success”

3. Bayfront Health Systems founded in 1968, consists
of the facilities listed below:
• Bayfront Medical Center (BMC) St. Petersburg
• Bayfront Medical Plaza St. Petersburg
• Bayfront Convenient Care Clinics –Throughout
Pinellas County(6 Locations)
• Bayfront Family Health Center St. Petersburg
• BayFlite- Largest Helicopter Fleet in the
Southeast US.
• Cerner Client since 2001

4. Cerner Team 2010

5. What is a Project At Bayfront Technology Services?
A Bayfront Project is a “temporary”
endeavor (consisting of greater than 40
work)
hours of work) undertaken to create a
unique product, service or result, i.e., install
new technology, upgrade or change existing
technology.
Projects are quantified by more than 15K in
Capital Costs and need approval from the
Bayfront Technology Steering Committee.

6. BHS Project Process

7. © Data from HIMSS AnalyticsTM Database N = 5166 N = 5235
7

8. American Recovery and Reinvestment Act of 2009
HR 1 -- 111th Congress
$787 Billion
Highly partisan vote
Healthcare gets $147.7 Billion
(HITECH Act)
•$87B for Medicaid
•$25B for support for extending COBRA
•$10B for NIH $19,000 Million
•$19B directly for HIT
8

9. New Project Work Breakdown Structure
PPPD Approval Process
Project Kickoff
Define Software Resources
Define Hardware Requirements
Define Network Configuration(If applicable)
Review Domain Strategy
Update System Documentation
Testing, Testing and More Testing
On Going Training
Production Implementation
CLOSE-DOWN PROCESS BEGINS

11. PMO WORKBOOK HISTORY
In February 2004, Bayfront went Live with Cerner
from 7.8 to 2004.1(Phase 2 – 12 Nets including
ProFit!).
Subsequently, a formal PMO Methodology was
introduced which included the first rendition of the
PMO Workbook.
Cerner subsequent upgrades include:
2005.02.46
2005.02.54
2007.12
2007.19.03

12. ORGANIZATIONAL COMMITTMENT
One of the key foundations of Bayfront’s
Methodology was establishing an
effective Project Structure. Success
requires the Bayfront's Leadership’s
commitment to thorough planning and
regular review and approval of Projects.
An experienced, knowledgeable and
committed Project organization must be
assembled and certain members
designated as leaders.

13. Steering Committee
The purpose of the Steering Committee is the
following:
Provide Executive Direction to the Project Team.
Verify Projects are meeting Bayfront's Strategic
Business objectives.
Resolve Issues that are beyond the authority of the
Project Team.
Additionally, The Steering Committee will verify the
project deliverables meet the business requirements
of Bayfront. These meetings are conducted at key
project milestone dates with the results
communicated to the Project Team.

14. PROJECT ADMINISTRATION
Project monitoring and control procedures document
the process and mechanisms for tracking the
project. Proper monitoring of the project is
dependent upon excellent communication
throughout the project organization. This
communication is the responsibility of the entire
team, but
The Project Manager or Project Lead is the #1 Go To
person on Communication.

15. Project Manager or Lead
Both BMC and Vendor project managers will be responsible for
the following:
Provide full-time project management as detailed in
the contract.
Monitoring project plans and implementation
schedules to ensure upcoming tasks are identified
and communicated to team members.
Making task assignments and ensure task
completion.
Identifying and documenting potential problems or
issues and ensuring these are communicated to the
Project Director and Project Management Team.
Reporting progress to the Project Director and other
Team Leaders in status report meetings.
Maintain the official project documentation.

16. Status Report for Week
Status Report
Customer:
Project: For period: Starting: Ending:
Achievements This Period:
Planned Next Period:
Scope Status:
Budget Status: Original budgeted costs: Expected final costs:
Schedule Status: Planned completion: Expected completion:
Major Issues:

17. PROJECT DELIVERABLES
The key deliverables for the project are as follows:
Visualize the final product
Build a visual of the implemented application by posing the
following questions to the team:
When the system is in place, what will it look like to you?
What does the application have to do to meet your
critical business requirements?
How will information get into the system?
How will that information be updated, used, modified and
distributed?
What technical capabilities are essential for your
environment?
Will the system have to interact and/or integrate with
other systems? If so, how will that occur?
Milestones
*Key deliverables

18. PROJECT WORK PLAN
The project work plan is used to control the
progress of the project on a day-to-day basis.
The project work plan contains the detailed
activities and tasks required to develop the
project deliverables, to monitor progress
compared to plan, and to assign tasks to
project team members. The overall project
work plan is updated weekly based on the
accomplishments communicated at the project
status review meetings, documented in project
status reports, and discussion with project
team members.

19. Meetings
Project status review meetings serve to
convey status, identify issues, and detect
scope changes to the overall project.
Additionally, these meetings serve as a
tool to record and measure team
progress and performance and ensure
project objectives are being met. These
meetings are conducted on a weekly or
bi-weekly basis and typically include the
Project Team.

21. Meetings
The following agenda will be used:
Brief summary of project to date
Review of open issues
Discussion of previous week’s tasks and
accomplishments
Review status and update project work plan
Identify new issues, provide resolutions, or record
on the project issue and project log forms and
assign as appropriate
Assign new tasks and action items for the next
week
The results of the meeting are summarized,
activities recorded and minutes distributed to the
Project Management Team. Team Leaders are
responsible for communicating the results of
these meetings to their sub-teams

22. Bayfront Technology Services
Meeting Minutes Example
MEETING: Bayfront Change Management Meeting
DATE/PLACE/TIME: Monday March 22, 2010 Mangrove Conference room 1:00 pm
ATTENDEES: Paul Capello, Jennifer Greenman, Tony Curtis, Herman Gilyard, Denise Murphy, Mike Musallam, Denise Rafferty, Marge
Slater, Melanie McKee, Heather Morrison, Jason Barth, Helen Bruns, Dave Leclaire
Agenda Item Discussion Action Items Owner Scheduled End
Date
Deactivate "beginning of year" Some temporary code Deactivate "beginning of year" Melanie TBD
hard code in programs: exists in these hard code in programs: McKee
CUG100EX, CUG110EX, programs that need to CUG100EX, CUG110EX,
CUG140EX. be activated for the first CUG140EX.
run of the year, and
then deactivated.
Personnel transaction custom Not a critical item, but Personnel transaction custom Melanie 2/26/2010
programs needed to be one that should be programs needed to be modified to McKee
modified to submit the self- cleaned up... submit the self-service file update
service file update after the HR I have noticed several after the HR file updates so that
file updates so that self-service people in the HR group self-service would pick up the
would pick up the group of self service that are group associated with the new
associated with the new not and never have position. Programs to change are:
position. Programs to change been in HR. CUGTRTR, CUGTRDM,
are: Additionally, that HR CUGTRHI, CUGTRPR,
CUGTRTR, CUGTRDM, group has traditionally CUGTRRH, CUGTRTR
CUGTRHI, CUGTRPR, been limited to a very
CUGTRRH, CUGTRTR small group of people.
Not sure why it has
been expanded to
include people from
Barely Sick etc.

23. Project Documentation
Project Documentation is any material related
to the project that provides an audit of the
project. This includes the formal deliverables
identified in the Project Work Plan, as well as
project status reports, project and steering
committee reports, supporting notes and
memos, key decisions forms, meeting minutes,
and other informal documentation kept by
Project Team members to support their work
and deliverables.

24. Project Documentation
• Project Documentation may be maintained in
electronic form in designated project file
directories, with those project documents
requiring approval printed for distribution and
signature. Project Leads will maintain team
documentation, such as meeting minutes, in
electronic and/or paper form and supply key
deliverables to the Project Director when
completed.

25. RISK MANAGEMENT
Risk Management is the process of identifying areas of
risk that could negatively impact the success of the
project and proactively managing those areas. Risk is
analyzed during the initial stages of the project to lay
the foundation for success and on an ongoing basis
during the project.
Risk assessments are the means used to analyze risk.
They highlight common areas of risk with the intent of
identifying and controlling the risk. After high-risk
areas are identified, risk control processes are selected
and implemented.
The following risk assessment describes potential high-
risk areas of the project and documents the
mechanisms established to control these areas.

26. Risk Target Control Procedures
Business
Vendor involvement not at a level to Vendor involvement at a level to Vendor involvement not at a level to
insure success insure success insure success:
•Implement regular status reporting
•Detailed project management
•Try to expand vendor involvement
•Develop a very detailed project plan
•Include frequent quality reviews
Project Environment
New system hardware required No new system hardware required New system hardware required:
•Gain access to technical specialists
•Integrate delivery and installation
into project schedule
•Purchase proven hardware

27. SECURITY / CONFIDENTIALITY
Data in all its forms (electronic, paper, or other), and throughout its life
cycle (creation, entry, storage, processing and disposal) will be protected
from unauthorized access, modification, destruction and disclosure,
whether accidental or intentional, at Bayfront Health System.
User Access Controls
One of the key ingredients of information protection is user access
controls over who can access the information and how they can
access it. To ensure appropriate levels of access, security
measures will be instituted for this project.
Security will be controlled by menu design as well as security levels
attached to individual items.
A complete analysis of existing application access and security
will be done and adjustments made to ensure all existing users
have access specific to their job requirements.
Password Management
Passwords are not displayed when entered.
Employee Awareness Programs
Monitoring/Reporting

28. Change Management
Change Management is the process of managing changes to
previously agreed-upon areas of the project.
Changes can affect many areas: the project resources,
the project deliverables, the cost and time frame in
which objectives must be achieved and even the
project priority.
Change will be viewed positively as long as its purpose
is to ensure Bayfront's business needs are met.
Change Management documentation preserves the
integrity of the project definition document, provides a
mechanism for handling change requests, and provides
a means for retaining historical change/issue
information to enhance future project management
efforts.

29. Change Management
The following process is followed when a change to the
schedule, budget, or scope of the project is required.
Identify the Change: Determine if the change is within or
outside the scope of the project.
Record the Request: Complete the Change Request Form
and submit to the Project Manager.
Evaluate the Request: The Project Team will review the
proposed change and make a decision to approve,
disapprove, or alter the change request. The Steering
Committee will be contacted if a decision requires approval
at a higher level.
Implement the Change: If it is determined the change
should be incorporated into the project, the Project Work
Plan will be updated to reflect the change in tasks,
resource requirements, deliverables and/or timeframes.

30. Scope Change Request Form
Customer:
Project:
Requested by:
Description of the Change:
Justification for the Change:
Project Impacts (Project Manager Use Only)
Budget and Schedule Impacts:(Project Manager Use Only)
New Project Completion Date: Additional Project Costs:
Date: Resolution Required by:
Signed (Project Manager):
Resolution: (Customer Use Only)
Approved Rejected Date:
Signed:
Name and Title:

32. Issue Management
An Issue is anything that arises which, if left unresolved, could
delay or have an impact on the success of the project.
All Issues are documented on the Project Issue Form. Each
issue is prioritized, assigned an owner, and documented on
the Project Issue Log. Issues the Project Team is unable to
resolve are escalated to the Project Team Management for
resolution or submission to the Steering Committee for
resolution. Outstanding issues are reviewed at the project
status review meeting.
Any Issues that result in an increase in the project budget,
time estimates, or scope must be documented on the Project
Issue Form.

33. Issue Escalation Guidelines:
Level I - Issues are resolved and documented by the Project Team
and/or Work Team. Decision deadline: up to one (1) week.
Level II - Issues which cannot be resolved at the Project Team
Management level are submitted to the Project Director for review
with the Project Team Management. Decision deadline: up to one
(1) week.
Level III - Issues which cannot be resolved at the Project Team
Management level, or which are so sensitive as to require
Executive approval, will be submitted to the Steering Committee,
for resolution. Decision deadline: up to fourteen (14) days.
Level IV - Issues which cannot be resolved at the Steering
Committee level are submitted to the Project Sponsor for review
with senior management. In addition, an issue can be escalated
directly to Level IV based on issue criticality.

34. BAYFRONT MEDICAL CENTER
2007.19.03 TESTING ISSUES
SR# CWX or DATE APP 2007.19.03 TESTING ISSUES- Reported Daily Update
SWX? MOCK HPUX by
CWX UPTIME (package installation) March 22nd to March 26th
STEPS BEFORE GO-LIVE
CWX- Fat clients Update nasp5102 with new code On your NAS share if you have no
Mo, Tony warehouse. Space issues then, rename your
current P5102 to P5102_VMS. Re-sync
the DBMIG (copy from RRD02 to NAS)
once done synching, create a new
copy of DBMIG folder and rename it to
P5102. Use that one for Prod Fat
client setup.
CWX- Mo Fat clients Send new batch file for fat clients 3-24 Mo copied to RRD02 DBMIG
including setup.ini and group files
BMC Fat clients David and Leonard will test upgrading fat
clients before upgrade
Mo and Tony BMCCitrix03- CPDI needs setup?
Desktop PACS Upgrade PACS Viewing Stations for Citrix Almost done
version 11.0

35. PROJECT PROFILE DOCUMENT
I—
PART I—PROFILE IDENTIFICATION AND REGISTRATION
1.Profile/Project
1.Profile/Project Title
2.Profile
2.Profile Control Number
The PMO will register the PPP in the project control system.
1.Profile
1.Profile Preparation Team
Name Specialty Position
1.Profile
1.Profile Completion Date
2.Business/Clinical
2.Business/Clinical Case
•Refer to an early stage SOC
•Strategic Direction or Action Steps
•Budgeted for Capital Year (Yes or No)

36. PART II—PROPOSED PROJECT DESCRIPTION AND
OUTLINE
Project Scope
Project Objectives
Project Background/Linkage
Project Assumptions
Project Classification
Recommended Project Start and
Completion Dates

37. PART III—PROPOSED PROJECT MANAGEMENT PLAN
Project Manager
Project Management Team
Name Specialty Position
1.Project
1.Project Phasing
Project Phase-Workload Estimate Table
Phase-
Work Recommended Recommended Estimated
Phase Package/Activity Schedule Resource Cost

38. PART IV—PROJECT EVALUATION AND VALIDATION
4.1 Project Objectives
4.2 Project Risks
4.3 Project Structure
4.4 Hardware Requirements (If applicable)

39. PROJECT TEAM REVIEW AND APPROVAL FORM
Document/Deliverable: Project Workbook
Date Presented:
Paul Capello, PMO Manager
Date_____________
Jennifer Greenman , Chief Information Officer
Date_____________

40. The Standish Group surveyed 365
respondents covering 8,380 IT applications
Project Success Statistics
across several industries:
• 16.2% of projects completed on-time
and on-budget. .(Bayfront success rate
is 95%)
• 52.7% of projects completed over
budget, over time, and with fewer
features than originally specified.
• 31.1% of projects canceled during the
development cycle.

41. Bayfront Project Portfolio 2009-2010
Project Name
Pharmacy Clinical Intervention Documentation
Email antispyware / Antispam and Trend Antivirus / Antispyware systems
Explorer Menu Clean Up
Philips Xcelera upgrade for Cardiology
QoS/Traffic Shaping on Internet
RAD PACS and Cerner Labs for Heart Center/EP
WISM(Wireless Services Module)
Physician Progress Notes
Life Net Stemi for ED/Cardiac
Clinical Transformation - Post Partum Documentation
Clinical Transformation - Documentation( Phase 1 Form Roll Out and Phase 2 Form Design)
McKesson Accudose
PACS Cube
Point of Care(Arterial Blood Gases)
CLINICAL TRANSFORMATION - Handoffs & PAL & Hardware Assessment
IN BOX
ShoreTel Phone and Voicemail Migration
Cerner Provision Document Imaging(Patient Access Services)
Cerner Provision Document Imaging(Medical Records(HIM)
Cerner Provision Document Imaging(Pharmacy Order Management)
CBORD Upgrade
Optimal Radiology Interface
Sentry Data Systems
All Children's - OB Project - Baby Place
Health Line ECHO ASP for Med Staff Office
Nortel Conversion
Trauma Base
Kronos
Cerner 2007.19

42. PMO Value
According to Forrester Research®,
companies that implemented a successful
PMO achieved an 80% ROI, 20% reduction
in project time.
Companies without a PMO experienced a
74% project failure rate. That is a sobering
statistic.
statistic
Bayfront’s successful PMO is in its 7th year
of existence.

43. Bayfront Active Projects
Project Project Name Status Project Mgr
#
1 Cerner Provision Document Imaging(Lab) Active Shari Goodwin
2 CPOE Active Paul Capello
3 SurgiNet Active John Amodeo
CLINICAL TRANSFORMATION - Rehab Evaluation &
4 Treatment Documentation Active Denise Murphy
5 CLINICAL TRANSFORMATION- Medication Reconciliation Active Lee Ann Sahagun
6 CLINICAL TRANSFORMATION- ED Documentation Active Lee Ann Sahagun
7 CLINICAL TRANSFORMATION - Depart Process Active John Amodeo
8 NextGen Ambulatory EHR Active Heather Morrison
9 Care Focus/ Mercury MD Active Heather Morrison
10 INFOR AP and Material Mgt Active Melanie McKee
11 6 South Conversion Active Dale Graf
12 Philips Xcelera and XPER Upgrade Active Jason Barth
Active 12
Complete 222
Not Active 59
Total 293

44. A Computer in the Patient Room?
“That it will ever come into general use,
notwithstanding its value, is extremely doubtful
because its beneficial application requires much
time and gives a good bit of trouble, both to the
patient and to the practitioner because its hue
and character are foreign and opposed to all our
habits and associations.”
- The London Times, 1834
Commenting on the
44
“stethoscope”

45. Questions and Answers?
Email: Paul.Capello@bayfront.org
Name: Paul Capello
Phone: 727-893-6038
Email: Paul.Capello@bayfront.org
Phone: 727-893-6038