Planning (Quality, Communications, Risk, Etc.), Part 2

Part 2  A responsibility assignment matrix (RAM) is a matrix that maps the work of the project as described in the work breakdown structure (WBS) to the people responsible for performing the work  For smaller projects, it is best to assign WBS activities to individuals; for larger projects, it is more effective to assign the work to organizational units or teams  RACI charts are a type of RAM that show Responsibility (who does the task), Accountability (who signs off on the task or has authority for it), Consultation (who has information necessary to complete the task), and Informed (who needs to be notified of task status/results) roles for project stakeholders 22 Work Package Jeff Pat Bob Mark Clay IHI Bundle Definition A R I I - AHS VAP Bundle Data Sources A R C R - Database A I C R C Daily Script to Update Database A I R C R Reports A C I R R R: Responsible A: Accountable C: Consulted I: Informed 23 Work Package Jeff Pat Bob Mark Clay IHI Bundle Definition A R I I - AHS VAP Bundle Data Sources A R C R - Database A I C R C Daily Script to Update Database A I R C R Reports A C I R R R: Responsible A: Accountable C: Consulted I: Informed 24  A resource histogram is a column chart that shows the number of resources required for or assigned to a project over time  In planning project staffing needs, senior managers often create a resource histogram in which columns represent the number of people needed in each skill category. By stacking the columns, you can see the total number of people needed each month  After resources are assigned to a project, you can view a resource histogram for each person to see how his/her time has been allocated 25 26  A staffing management plan describes when and how people will be added to and removed from a project  It describes the types of people needed to work on the project, the numbers needed for each type of person each month, and how these resources will be acquired, trained, rewarded, and reassigned after the project 27 VAPR Project Staffing Management Plan June 1 Introduction The primary goal of this project is to revise the clinical workflows for ventilated patients within the intensive care units so that they align with the IHI Ventilator Bundle, an evidenced-based set of practices that prevent ventilator associated pneumonia. Staffing Requirements This project will require the following internal staff:  Project manager (PM) for Phase I  Project manager (PM) for Phase II  PMO Support for Phase II (PMO)  SME from clinical analytics  Nursing educator  Physician  IT department staffing (database developer, script developer, interface developer, report developer) Staff Assignments The project manager will work through functional managers to assign individuals to the project. Other than for physicians, all roles will be allocated in .25 FTE increments (staff will all be assigned as .25, .5, .75, or 1 FTE). To minimize communication issues and handoff problems, no roles can be filled by a combination of staff. To ensure consistency, all staff assigned to a role will remain in that role for the life of the project. Training, Rewards, and Reassignment Due to the short timeline and compliance requirements for this project, staff assigned to this project will have appropriate experience. The project manager will do his or her best to provide a challenging and enjoyable work environment. Assignment to the project will not affect an individual’s salary, but the project manager will write a performance evaluation and recommend appropriate rewards. If an individual is not performing as expected, the project manager will work with him or her and the appropriate functional manager to determine whether corrections can be made or if reassignment is necessary. Attachment A: Resource histogram 28  Many experts agree that the greatest threat to the success of any project is a failure to communicate  Many project managers say that 90 percent of their job is communicating, yet many project managers fail to take the time to plan for project communications  Project communications management involves generating, collecting, disseminating, and storing project information  Key outputs include a communications management plan and a project Web site 29 30  Because project communication is so important, every project should include a communications management plan—a document that guides project communications  The plan will vary with the needs of the project, but some type of written plan should always be prepared and address the following items: ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ Stakeholder communications requirements Information to be communicated, including format, content, and level of detail Identification of who will receive the information and who will produce it Suggested methods or guidelines for conveying the information. Description of the frequency of communication Escalation procedures for resolving issues Revision procedures for updating the communications management plan A glossary of common terminology used on the project 31  People who design new healthcare products know how important it is to communicate with both healthcare professionals and consumers when planning new products. For example, Worrell recognized that there was an information imbalance between the patient and the physician relationship. They decided to include thought-leading physicians and patients in their design process to help them develop breakthrough products. They created a short film that describes a novel approach to stakeholder communications.  In “Design we can all live with,” you can hear the perspectives of patients, product developers, and physicians. 32 1. Stakeholder Communications Requirements Because this project involves a variety of clinical disciplines, the project team will use interviews, checklists, and lessons learned from past clinical workflow projects to determine the communications requirements for the project stakeholders. Each of the three clinical disciplines will have specific communications needs, in addition to those of organizational leadership that must be determined, analyzed and fulfilled. 2. Communications Summary The following table summarizes various stakeholders, communications required, the delivery method or format of the communications, who will produce the communications, and when it will be distributed or the frequency of distribution. All communications produced will be archived and available on the project Web site. The project team will use various templates and checklists to enhance communications. The team will also be careful to use the appropriate medium (that is, face-to-face meeting, phone, e-mail, Web site, and so on) and follow corporate guidelines for effective communications. Note the comments/guidelines as well. 33  Project Web sites provide a centralized way of delivering project documents and other communications as well as accessing collaboration tools.  Project teams can develop project Web sites, blogs, or wikis using various tools, or their enterprise project management software might provide all of the communication tools they require.  It is important to select and use tools properly to help meet project communications requirements, and to limit the number of different tools where possible in order to avoid confusion. 34 35  Project stakeholder management planning involves determining strategies to effectively engage stakeholders in project decisions and activities based on their needs, interests, and potential impact.  Outputs of this process are a stakeholder management plan and project documents updates. 36  In addition to information found in the stakeholder register, a stakeholder management plan can include the following:  Current and desired engagement levels  Interrelationships between stakeholders  Communication requirements  Potential management strategies for each stakeholder  Methods for updating the stakeholder management plan 37 Power/ Interest Project Engagement Name Title David Waters, MD High / Medium Supportive Danielle Scheerer, MD, PhD Executive Medical Director Chief Quality Officer High / High Leading Casey Lidwell, MHA Chief Analytics Officer Medium / Low Supportive Potential Management Strategies Dr. Waters is always interested in projects that improve patient care. He is the chief physician and can help us gain their buy-in. Dr. Scheerer is charged with improving patient care, but she rarely serves as project champion. She believes this project will improve patient outcomes and reduce costs to AHS significantly. We need to keep her close to the work and bring her in when we meet clinical resistance. She is a result-oriented person who will make things happen. Casey is supportive, but his commitment is to provide the data required by those on the clinical phase of the project. His interest is to meet their needs, but he has no personal commitment to the project and has several other high priority projects on his plate. He was chosen as the Phase I champion by the sponsor in order to improve his project commitment, but we need to work to keep him engaged. 38  Contingency plans are predefined actions that the project team will take if an identified risk event occurs  Fallback plans are developed for risks that have a high impact on meeting project objectives, and are put into effect if attempts to reduce the risk are not effective; sometimes called contingency plans of last resort  Contingency reserves or contingency allowances are funds held by the project sponsor that can be used to mitigate cost or schedule overruns if known risks occur Management reserves are funds held for unknown risks.  41 1. Methodology The project team will review information related to clinical projects that either changed clinical workflows based off of best practices, or that directly impacted the intensive care units. The team will use a variety of risk identification techniques, including brainstorming, interviews of project and clinical leadership, and risk-related checklists. 2. Roles and Responsibilities Jeff Birdwell, the project manager for Phase I, will be responsible for leading the team and other stakeholders in performing risk-related activities for both phases. As detailed tasks and deliverables are determined, the project manager will delegate those tasks as appropriate. 3. Budget and Schedule As specific risk-related tasks and deliverables are determined, budget and schedule information will be provided. 4. Risk Categories Risks will be categorized based on risk source and risk impact. Risk sources will be technical, clinical, leadership, resources, funding, project management, and environment. Risk impact categories will be scope, budget, quality, and schedule. 5. Risk Probability and Impact Risk probability will use five probability scales: 0-20%, 21-40%, 41-60%, 61-80%, and 81-100%. Each of those probability ranges will be assigned a value of 1, 2, 3, 4, and 5, respectively. The project impact choices are defined as follows, and will also be defined values of 1 through 5. 42  Risk events refer to specific, uncertain events that may occur to the detriment or enhancement of the project ◦ Negative risk events include the performance failure of a product produced as part of a project, delays in completing work as scheduled, increases in estimated costs, supply shortages, litigation against the company, and strikes ◦ Positive risk events include completing work sooner than planned or at an unexpectedly reduced cost, collaborating with suppliers to produce better products, and obtaining good publicity from the project ◦ You can chart the probability and impact of risk events on a matrix 43 44 Negative Risk Responses Positive Risk Responses  Risk avoidance  Risk exploitation  Risk acceptance  Risk sharing  Risk transference  Risk enhancement  Risk mitigation  Risk acceptance