Lecture Note
Planning (Integration and Scope)
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University:
California State University, Northridge -
Course:
IS 551 | Managing Projects in Healthcare Informatics Academic year:
2014
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Views:
408
Pages:
40
Author:
Trevor Dunlap
Describe the importance of creating plans to guide project execution, and
list several planning processes and outputs for project integration and
scope management
Discuss the project integration management planning process
Explain the purpose and contents of a team contract and a
project management plan
2
Describe the four project scope management planning processes
Explain the purpose and contents of a scope management plan and
requirements management plan
Discuss different ways to collect project requirements, and prepare
requirements documentation and a requirements traceability matrix
Create a scope statement and project documents updates to define
project scope
Create a work breakdown structure (WBS) and a WBS dictionary to clearly
describe all of the work required for a project
3
Many people have heard the following sayings:
◦ If you fail to plan, you plan to fail.
◦ If you don’t know where you’re going, any road will take you there.
◦ What gets measured gets managed.
Successful project managers know how important it is to develop, refine,
and follow plans to meet project goals
People are more likely to perform well if they know what they are supposed
to do and when
4
Planning is often the most difficult and unappreciated process in
project management
Often, people do not want to take the time to plan well, but theory and
practice show that good planning is crucial to good execution
The main purpose of project planning is to guide project execution,
so project plans must be realistic and useful
5 Knowledge Area
Planning Process
Outputs
Project integration
management
Develop project
management plan
Project management plan
Project scope
management
Plan scope management
Scope management plan
Collect requirements
Requirements management plan
Define scope
Requirements documentation
Requirements traceability matrix
Create WBS
Project scope statement
Project documents updates
Scope baseline
Project documents updates
6
Project integration management involves coordinating all the
project management knowledge areas throughout a project’s life span.
The main planning tasks include:
◦ Creating a team contract (not in the PMBOK® Guide)
◦ Developing the project management plan
7
Team contracts help to promote teamwork, ensure all team members
understand the commitment required of them, and to clarify team
communications
The process normally includes the core project team members reviewing a
template and then working in small groups to prepare inputs for their
team contract
The project manager should act as a coach or facilitator, observing the
different personalities of team members and seeing how well they
work together
Everyone involved in creating the team contract should sign it, and as new
project team members are added, the project manager should review
ground rules with them and have them read and sign the contract as well
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Code of conduct
Participation
Communication
Problem solving
Meeting guidelines
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A project management plan is a document used to coordinate all
project planning documents and to help guide a project’s execution and
control
Plans created in the other knowledge areas are subsidiary parts of the
overall project management plan and provide more detailed information
about that knowledge area
Project management plans facilitate communication among stakeholders
and provide a baseline for progress measurement and project control
◦ A baseline is a starting point, a measurement, or an observation that is
documented so that it can be used for future comparison
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Project management plans should be dynamic, flexible, and receptive to
change when the environment or project changes
Just as projects are unique, so are project plans.
◦ For a small project involving a few people over a couple of months, a project
charter, team contract, scope statement, and Gantt chart might be the only
project planning documents needed; there would not be a need for a separate
project management plan
◦ A large project involving 100 people over three years would benefit from having
a detailed project management plan and separate plans for each knowledge
area
It is important to tailor all planning documentation to fit the needs of
specific projects
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Project Title
Project Purpose
Project Organization
Project Governance
Scope Management
Budget Management
Schedule Management
Approach
References to other project planning documents, as needed
13 PURPOSE
VAP costs AHS over $3.6M per year in costs, and puts our patients at risk for severe and sometimes fatal
consequences. VAP is considered preventable by CMS and has worked with the Institutes for Healthcare
Improvement (IHI) to develop a set of best practices that, if followed, has demonstrated a reduction of
VAP by 50% in other healthcare facilities. AHS will implement a system to collect and report compliance
with the best practices to better manage VAP.
PROJECT ORGANIZATION
The basic organization of the project is provided in Figure 1. The project sponsor, Marilyn Shoemaker, RN,
PhD, will have the final say on major decisions, with consultation from the project steering committee and
project champions, Casey Lidwell and Dr. Danielle Scheerer. The project sponsor should have time to
thoroughly review important project information and provide timely feedback to the project manager.
PROJECT GOVERNANCE
1.
Management Review Process: The project steering committee will meet at least monthly to provide
inputs and review progress on this project.
2.
Progress Measurement Process: The project steering committee will review project progress during
project review meetings, and they can also review information as needed by viewing reports on the
enterprise project management system.
3. Change Approval Process: See Attachment 1 based on AHS standards.
VAPR has been broken down into two phases. The first phase is a proof of concept and the data
collection/reporting system and will be managed by Jeff Birdwell, PMP from the PMO’s office. The second
phase will be managed by Pat Wager, RN from analytics.
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Project scope management involves defining and controlling what work is or
is not included in a project
The main planning tasks include planning scope management, collecting
requirements, defining scope, and creating the WBS
The main documents produced are a scope management plan, a
requirements management plan, requirements documentation, a
requirements traceability matrix, and a scope baseline, which is composed
of an approved scope statement, a WBS, and a WBS dictionary
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The purpose of the process of planning scope management is to
determine how the project scope will be defined, validated, and
controlled.
Project teams usually have several meetings with key stakeholders and
experts to help them develop a scope management plan and
requirements management plan.
16 Requirements Management Plan
Version 1.0 May 29, 20xx
PROJECT TITLE: VENTILATOR ASSOCIATED PNEUMONIA (VAP) REDUCTION – “VAPR”
Planning, tracking, and reporting requirements
Information provided in the business case and project charter will provide valuable information
in determining requirements for this project, as will the IHI Ventilator Bundle itself. All
requirements will be documented within the project management system and will be reviewed
for progress weekly as part of the regular project meetings. Each requirement will be assigned a
customer owner, designated initially as the provider of the requirement, but in some cases as
the staff member who is considered the expert on the requirement itself.
Performing configuration management activities
Requirements can be identified through a variety of methods. Executive clinical leadership will
be interviewed individually, committees such as the Med Exec and Clinical Quality Improvement
Council will be asked for requirements through our sponsor, and our champions will conduct
focus groups with their peers and customers to gather input. Requirements will also be
extracted from the IHI Ventilator Bundle, and both CMS and Joint Commission measures will be
reviewed for additional requirements. Appropriate project stakeholders will analyze, authorize,
track, and report changes to requirements. The project manager must be informed in advance
of potential changes to requirements and be involved in the decision process to approve those
changes. Any change that will impact the project’s cost by more than 2% or extend the schedule
past the identified go live date must be approved by the project steering committee.
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A project’s size, complexity, importance, as well as other factors affect
how much effort is spent on collecting requirements
The PMBOK® Guide, Fifth Edition, defines requirements as “conditions or
capabilities that must be met by the project or present in the product,
service, or result to satisfy an agreement or other formally imposed
specification”
Requirements must be documented in enough detail so that they can be
measured during project execution
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Requirements documents, which can range from a single-page checklist to a
room full of notebooks with text, diagrams, images, etc.
A requirements traceability matrix (RTM), which is a table that lists
requirements, various attributes of each requirement, and the status of the
requirements to ensure that all of them are addressed
19 Req
ID
R26
Name
Identify source
systems that
document
compliance with
the IHI vent
bundle
Category
Technical
Source
Chief Medical
Information
Officer
Status
Complete
Comments
Three sources were
identified:
ClinDoc, Pharmacy
Administration, and
RT Documentation.
R91
Online report to
indicate
compliance, by
patient, with IHI
bundle
Analytics
Chief Quality
Officer
Not started
Data must be no more
than 6 hours old.
R123
Design new
Clinical
ventilator protocol Workflow
for nursing
Chief Nursing
Officer
Not started
Must be reviewed and
approved by the nursing
oversight committee.
20
Good scope definition is crucial to project success because it
◦ Helps improve the accuracy of time, cost, and resource estimates
◦ Defines a baseline for performance measurement and project control
◦ Aids in communicating clear work responsibilities
The project charter, requirements documentation, and organizational process
assets (i.e. policies and procedures related to project management, past project
files, and lessons-learned reports from previous, similar projects) are all inputs
for creating the initial scope statement
Contents of a scope statement vary, but it should include a product scope
description, product user acceptance criteria, and detailed information on all
project deliverables
21 Product Characteristics and Requirements
This project will introduce the IHI Ventilator Bundle (best practices) into our AHS clinical
protocols and workflows. We must identify which, if any, AHS system currently collects data
that would indicate compliance with the five elements in the bundle. If the data is not currently
collected electronically at AHS, a data collection point must be identified. All data must be
integrated into a single online report so that they may correct the patient’s care during the
required time period. To minimize the amount of corrective actions required, the nursing and
respiratory therapy workflows will be modified to include the best practices, and the ventilator
protocols will be modified to automatically include orders for the bundle elements. The
following best practices are included in the IHI Ventilator Bundle:
Patient Head of Bed (HOB) elevation, 30 to 45 degrees
Sedation vacation every 24 hours
Daily oral/mouth care with Chlorhexidine
Venous Thrombosis Embolism (VTE) prophylaxis
Peptic ulcer prophylaxis
Out of Scope
This project will not consider any other patient care, best practices, evidenced based medicine,
or other patient care improvements discovered during the project work. Any additional
potential patient care improvement projects will be submitted to the project request system
and reviewed, approved, and managed separately based on their own merits.
22 Product User Acceptance Criteria
This project will be considered successful if the following measures are met:
Project completed by the end of the next fiscal year (June 30)
Project completed for $980,000 or less
VAP incidence is reduced by 25% within 90 days of go live
VAP incidence rate is reduced by 35% within 180 days of go live
VAP incidence rate is reduced by 50% within 270 days of go live
Product-Oriented Deliverables
1. Data Interfaces from source systems, including registration, bed management, clinical
documentation, and respiratory therapy documentation systems.
2. Database to store IHI bundle data elements collected on AHS patients.
3. Online report to present IHI bundle compliance to caregivers using standard AHS
reporting tools.
4. Convenient and timely report delivery method, including availability on mobile devices.
5. Modified clinical workflows to integrate IHI Ventilator Bundle best practices.
Modified ventilator protocols to integrate IHI Ventilator Bundle best practices.
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The project team should update the project scope statement as new
information becomes available
Name different iterations of the scope statement Version 1.0,
Version 2.0, etc.
A good, up-to-date scope statement helps prevent scope creep, which is
the tendency for project scope to continually increase
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A work breakdown structure (WBS) is a deliverables-oriented
grouping of the work involved in a project that defines
the total scope of the project
The WBS is a document that breaks all the work required for the
project into discrete tasks, and groups those tasks into a
logical hierarchy
Often shown in two different forms:
◦ Graphical or chart form
◦ Tabular or list form
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A work package is at the lowest level of the WBS
It represents the level of work that the project manager monitors and
controls
You can think of work packages in terms of accountability and reporting
◦ If a project has a relatively short time frame and requires weekly
progress reports, a work package might represent work completed in
one week or less
◦ If a project has a very long time frame and requires quarterly progress
reports, a work package might represent work completed in one month
or more
◦ A work package might also be the procurement of a specific product or
products, such as an item purchased from an outside source
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The 2002 Olympic Winter Games and Paralympics took five years to plan
and cost more than $1.9 billion. PMI awarded the Salt Lake Organizing
Committee (SLOC) the Project of the Year award for delivering world-class
games that, according to the International Olympic Committee, “made a
profound impact upon the people of the world.”
Four years before the Games began, the SLOC used a Primavera softwarebased system with a cascading color-coded WBS to integrate planning. A
year before the Games, they added a Venue Integrated Planning Schedule
to help the team integrate resource needs, budgets, and plans. This
software helped the team coordinate different areas involved in controlling
access into and around a venue, such as roads, pedestrian pathways,
seating and safety provisions, and hospitality areas, saving nearly $10
million.*
*Ross Foti, “The Best Winter Olympics, Period,” PM Network (January 2004) p. 23.
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Using guidelines: Some organizations, like the DOD, provide guidelines for
preparing WBSs
The analogy approach: Review WBSs of similar projects and tailor to your
project
The top-down approach: Start with the largest items of the project and
break them down
The bottom-up approach: Start with the specific tasks and roll them up
Mind-mapping approach: Mind mapping is a technique that uses branches
radiating out from a core idea to structure thoughts and ideas
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MindView Business software allows you to create a WBS with a mind map.
You can access a special 60-day trial of their software at
www.matchware.com/intropm.
You can also watch several videos about creating a WBS using a mind map.
For example, the 14-minute “Quickstart” video gives you a great overview of
what you can do with MindView Business software.
There is also a 12-minute “Work Breakdown Structure” video.
See the companion site for this text at www.healthcarepm.com for links to
these and other video highlights.
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It is difficult to create a good WBS
The project manager and the project team must decide as a group how to
organize the work and how many levels to include in the WBS
It is often better to focus on getting the top levels of the WBS done well to
avoid being distracted by too much detail
Many people confuse tasks on a WBS with specifications or think it must
reflect a sequential list of steps
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A WBS dictionary is a document that describes each WBS task in detail
The format can vary based on project needs.
◦ It might be appropriate to have just a short paragraph describing each work
package
◦ For a more complex project, an entire page or more might be needed for the
work-package descriptions
◦ It might require describing the responsible person or organization, resource
requirements, estimated costs, and other information
40 WBS Item Number: 2.3.1
WBS Item Name: Compliance Policy
Requirement Trace: R12 – Enforce VAP Best Practices
Responsible Person: Danielle Scheerer, MD, Chief Quality Officer
Estimated Cost: $0, executive leadership costs not charged to the project
Estimated Duration: 3 months, due to committee schedules and approvals required
Resource Requirements: Executive Quality Oversight Committee (CQO, CNO, CMO, CMIO,
CNIO), Compliance Officer
Description: Caregivers treat patients based on their own experiences,
education, and research. However, there are many best-practices that have
been proven to be superior to those based on individual judgment as they take
into account large numbers of patients studied over extended periods of time.
Although these best practices are proven, the organizations who publish these
practices are not sitting in front of the patient and therefore do not understand
the patient as a whole. A policy must be created that encourages and holds
accountable physicians and nurses for complying with the IHI Ventilator Bundle
that has been designed and proven to reduce the incidence of VAP. The policy
must include the ability to deviate from the best practices if the caregiver
believes it is in the best interest of the patient’s health, but the policy should
also require that the caregiver documents the deviation and reasoning so that
AHS may study the patient outcomes of these patients compared to those who
follow the best practices. The policy must be co-issued by the highest level
clinicians (Chief Medical Officer and Chief Nursing Officer) and communicated,
supported, and enforced by clinical leadership.
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Planning (Integration and Scope)
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