How do healthcare organizations improve project management in a time of limited financial resources?
This was a hot topic last week at the World Health Care Leadership Summit on Project and Portfolio Management for Healthcare Executives in Boston.
"How do we close the completion gap in healthcare projects?" asked David Shore, co-director of the certificate program in project management in healthcare at the Harvard University School of Public Health. Shore moderated a panel at the conference that brought executives at three health systems together to discuss cost containment in healthcare projects.
Shore opened the discussion by asking the three executives about the greatest challenges in project management at large health systems.
Kim Savolainen, senior project manager at the Mayo Clinic Center for Innovation in Rochester, Minn., said simply defining and delimiting projects is a dominant task, while Paul Capello, project office manager at Bayfront Health System in St. Petersburg, Fla., listed keeping stakeholders satisfied as a dominant concern.
"Stakeholders do not always have to understand the details of project management, but they need to be able to see the benefits," Capello said.
Buddy Gillespie, chief technology officer and CIO-emeritus at Wellspan Health in York, Pa., said the growing importance of technology makes project management particularly challenging.
"IT projects are not siloed projects, but are organizational projects," he said.
Shore asked the panelists to explain how they organized the competing concerns of resource management, project scope and timetables in "selling" their projects to hospital executives and other stakeholders.
"We have a small project management team and can focus on only a few things in a small time frame," Savolainen said. "We always try to put very clear deliverables in place, but when we talk about implementing change organizationally, it's like trying to steer the Titanic."
Capello said a critical part of his job is setting and managing expectations.
"We have to clearly define what a project will bring to the organization," he said. "You can set all the right expectations, but changes do happen, so you have to put in processes to address and manage change."
Capello said he created a clinician steering committee at Bayfront that prioritizes risk and resources on projects. He said engaged clinicians help project managers get "buy-in" from health system executives.
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Bayfront has a portfolio of 288 projects, although the project management team strictly defines what constitutes an "active project." The health system only maintains 10-15 active projects, which allows for better management.
Savolainen said defining "high-priority projects" allows for greater management focus and offers a higher probability of success. Still, the danger always exists that smaller projects will be neglected.
"I know that we excel at the priority projects, but what happens to the other projects that don't meet that standard?" she asked.
According to Shore, most project management offices in U.S. healthcare systems – when they exist – tend to reside in IT departments. But this may not be the best location.
"Why should project management reside in IT?" Shore asked. "How do we rebalance the portfolio?"
When healthcare organizations decide to create a project management office, they need to determine whether they want a "light" or a "heavy" PMO. But the data on which is better remains inconclusive, Shore said.
"Most PMOs have been around a short time, and they often have very short lives," he noted. "The success of a PMO depends on the culture of the organization."
Capello said Bayfront has five project managers, and all reside in the IT department, while Savolainen said Mayo Clinic has an "enterprise-wide" portfolio management office.
No matter where a health system's PMO resides, transparency is critical to success, Gillespie said.
"We make an effort to be very transparent," he said. "We meet with senior VPs monthly to update them on projects. You need to be transparent in order to encourage participation from other parts of the organization."
Savolainen said that Mayo's project management office is very transparent in its activities in order to "sell the vision" of what a PMO does.
"It's the exception where we're not sharing information," she said. "You need to bring people onboard."