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Patient Flow Collaborative II Outpatients

Project management made simple

Project management made simple

4.Projec t Close Project Evaluatio n

1. Project Definitio n

3. Project Executi on

2. Project Planning

Patient Flow Collaborative II Outpatients

Project management made simple

Table of contents ..............................................................................................................................................................3 Introduction.............................................................................................................................................4 How to use this Handbook......................................................................................................................4 What is a Project?..................................................................................................................................5

Characteristics Of A Project ..................................................................................................7 A Project isnt:........................................................................................................................7


What is Project Management?...............................................................................................................8

Characteristics of Project Management................................................................................10 Project Management Skills...................................................................................................11 Why Do Projects Fail?..........................................................................................................12 Research Statistics.................................................................................................................13
Four Phases Project Management....................................................................................................14 Phase 1 - Project Definition..................................................................................................................18

1.1 Organisational Context...................................................................................................19 1.2 Defining The Need For The Project ...............................................................................19 1.3 Project Aim ....................................................................................................................20 1.4 Project Objectives...........................................................................................................21 1.5 Project Roles...................................................................................................................22 1.6 Project Scope...................................................................................................................23 1. 6.1 Project Scope - Template 1.........................................................................................23 1.9 Project Constraints..........................................................................................................25 1.10 Assumptions..................................................................................................................25 1.11 Stakeholders .................................................................................................................27 1.11.1 Key questions to ask stakeholders: ...........................................................................27 1.11.2 Assessing Project Stakeholder - Template 2..............................................................27 1.11.3 Communicating with Stakeholders............................................................................28 1.11.4 Project Stakeholder Contact List - Template 3..........................................................28 1.12 Deliverables..................................................................................................................30 1.12.1 Project Deliverables - Template 4..............................................................................30 1.13 Benefits ........................................................................................................................31 1.14 Measures.......................................................................................................................31 1.15 Project Risks.................................................................................................................32 1.15.1 Risk Assessment........................................................................................................33 1.15.2 Project Risk Log - Template 5...................................................................................34 1.16 Resources Required.......................................................................................................35 1.16.1 Project Resources - Template 6................................................................................35
Phase 2 - Project Planning...................................................................................................................38

2.1 Project Team ..................................................................................................................39 2.1.1 Selecting Your Project Team.......................................................................................39 2.1.2 Managing the Project Team.........................................................................................40 2.1.3 Types Of Planning.......................................................................................................41 2.1.4 Definitions....................................................................................................................41 2.1.5 Estimating....................................................................................................................42 2.1.6 Allocating ....................................................................................................................42 2.1.7 Critical Path..................................................................................................................43 2.1.9 Project Planning -Template 7.......................................................................................44
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2.1.10 Reviewing The Project Risk Log...............................................................................45 2.1.11 Reviewing The Project Budget..................................................................................45 2.1.12 Reviewing The Communication Strategy..................................................................46 2.1.13 Checklist for Project Planning...................................................................................46
3. Project Execution.............................................................................................................................48

3.1 Key Actions.....................................................................................................................49 3.1.1 Recruiting the Project Team........................................................................................49 3.1.2 Securing Resources, Facilities and Equipment Required:...........................................49 3.1.3 Communication Strategy..............................................................................................49 3.1.4 Managing Issues ..........................................................................................................50 3.1.4.1 Issues Log - Template 9............................................................................................50 3.1.5 Controlling the Project.................................................................................................51 3.1.6 Monitoring Progress.....................................................................................................51 3.1.7 Progress Reporting.......................................................................................................52
4. Closing the Project...........................................................................................................................54

...............................................................................................................................................54 4.1 Completion Criteria.........................................................................................................55 4.2 Acceptance Process.........................................................................................................55 4.3 Close-Out Meeting..........................................................................................................55
5. Evaluating the Project.......................................................................................................................56

5.1 Active Evaluation............................................................................................................57 5.2 Post Project Evaluation...................................................................................................57 5.3 Technical Evaluation.......................................................................................................57 5.4 Post Project Appraisal (Sustainability).........................................................................57 Glossary of Terms.................................................................................................................58

Project Management Made Simple

Patient Flow Collaborative II Outpatients

Project management made simple

Introduction
We work in an environment of continual change. Changes in the length of stay for patients undergoing elective surgery, changes in what is scientifically possible, changes in patient expectations, changes in economic constraints and changes in demand for health services. All these changes have one thing in common they have to be effectively managed if they are to be successful. Change that is uncontrolled is subject to considerable risk and potentially serious consequences for everyone and the organisation. The process of managing change is important, from the initial idea or identification of a problem through to controlling the consequences and reacting to problems as they occur. The processes, procedures and techniques to manage a project are not difficult to learn. But success depends on taking a disciplined approach to create new working habits.

How to use this Handbook


This handbook has been developed for Breakthrough Collaborative team members, or anyone who wants a simple methodology for project management. The handbook is written to give practical and well-tested techniques to meet your needs if you have: Just been given a project to manage Have managed projects before but seek to improve your skills Are a Breakthrough Collaborative team member and want to learn project skills

The handbook will help you to: Keep your project on track Ensure that project timetables are set and adhered to Keep control of costs Ensure the project team is effective throughout the project Avoid pitfalls

This handbook is a learning aid for the Breakthrough Collaborative project management training. The training will step you through the methodology and you will have an opportunity to try the tools and decide if they would be good for you to use in your project. After the training you and your Breakthrough Collaborative team can access support to apply the tools to your own Breakthrough Collaborative project.

Project Management Made Simple

Patient Flow Collaborative II Outpatients

Project management made simple

What is a Project?
Description
This section will provide an overview of what a project is and how projects are different from routine work.

Learning Objectives
At the conclusion of this section, participants should be able to Explain the characteristics of a project Describe the difference between routine work and projects

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Exercise
Think about projects that you have been involved in over the last year. Write down what is a project, what is everyday routine work and what makes projects different from everyday routine. A Project is Routine work

What are the differences between a project and routine work?

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A project is a collection of linked activities, carried out in an organised manner


with a clearly defined START POINT and END POINT To achieve some specific results desired to satisfy the strategic need of the organization at the current time.
Source: How To Be A Better Project Manager. Trevor Young (2001)

Characteristics Of A Project
Having a specified and defined purpose Unique because it will never be repeated in quite the same way Being focused on customer/patients needs and expectations Not being routine but including many routine-type tasks Having defined constraints of time, cost and people available Involving people from different departments and even sites Involving many unknowns and hence many risks Challenging traditional ways of working to introduce improvements Providing an opportunity to learn new skills

A Project isnt:
Business as usual, or Day to day work such as: Setting up a new starters PC Amending or modifying data for DHS Assessing patients clinical need Admitting patients for elective surgery

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What is Project Management?


Description
This section will define project management; outline the four phases of project management methodology and when to use these phases in relation to the Breakthrough Collaborative.

Learning Objectives
At the conclusion of this section, participants should be able to: Explain project management Describe the four phases of project management methodology

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Exercise
In pairs, Describe the characteristics of Project Management

What are the skills required to manage a project?

List some problems you or others have experienced when managing projects or participating in projects.

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Project Management is the dynamic process that ulitizes the appropriate


resources of the organisation in a controlled and structured manner, to achieve some clearly defined objectives identified as strategic needs. It is always conducted within a defined set of constraints.
Source: How To Be A Better Project Manager. Trevor Young (2001)

Characteristics of Project Management


Objective-orientated otherwise why do it? Change-orientated to create something you need Multi-disciplined using many skills to achieve success Opportunistic bypassing the old norms and seeking new ideas Control-orientated without which you may never finish Performance-orientated - setting high standards of work and quality Questioning throwing off old traditions and habits to expose the new

Project Management can also be defined in the following quote:


I keep six honest serving men (they taught me all I know); their names are What and Why and When and How and Where and Who. Rudyard Kipling (1865 1936)

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In the majority of organisations the role of Project Manager is a temporary management activity associated only with a specific project. The project is an additional set of activities on top of your normal operational duties that you are expected to carry out as part of your job.

Project Management Skills


To set targets for people which are aligned to their personal goals To create a strong sense of responsibility for the project work To create commitment in the team members, to help team members to prioritise their workloads and coach them in many aspects of the work To learn from experts to increase your knowledge To explain your and management decisions To encourage people to maintain interest and motivation To regularly keep everyone informed of progress To promote an atmosphere supporting free and willing feedback To manage peer and senior groups to influence their support To manage third party contractors To manage conflict in the team To show your concerns for continuous improvement To take risks in the interest of the project To communicate the alignment between the organisations strategic goals and the project
Source: The Handbook of Project Management, Kogan

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Why Do Projects Fail?


Many projects encounter problems through the lack of one or more of the following: Clear aim, objectives, requirements, scope and deliverables at the commencement of the project, eg Initial planning takes longer than expected and management is looking for some progress in the project, so planning is not undertaken. The project is breaking new ground and is not clear as how to proceed or what will actually be achieved. Access to skills, as and when required, eg People are transferred to other tasks People are overcommitted with the workload There is a shortage of the right skill and experience Sickness and annual leave isnt taken into account

Agreed measurements and control points throughout the project eg Team members believe that they know what they are doing and therefore measurements and controls seem superfluous and are considered an insult. There is a lack of clarity about what results will actually be achieved, and therefore on how the project can be measured or controlled Team commitment to the project eg A team member does not see the point of the project or believes they have been assigned too much work, responsibility The team has already been chosen and given assignments, so some discontent is experienced by team members Achievable deadlines eg the delivery date is agreed to before the project planning determines achievable timeframes. Sponsorship and therefore lack of direction, ownership and issue resolution eg The is no real project owner or champion for the project The assigned project owner has no authority to make decisions that direct the project

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Scope management eg The project scope was not clearly defined at the project definition Scope change management was not effectively applied Identification and management of risks and issues, eg major obstacles were not preempted, recognised and then tracked to resolutions Recognitions that new influences alter the projects aims eg Budget cuts Changes is service delivery Phased delivery for long running projects eg Too much time elapses before the project delivers anything Requirements keep changing due to length of time

Research Statistics
There is a proven direct correlation between project size and project failure over 90% of projects in the US worth over $6 million have failed. This equates to the following statistics: 30% of US based projects never reached a fruitful conclusion US $75billion is wasted annually in projects that fail 51% of projects in the US exceed their budget by 189% and Most US based projects deliver only 74% of functionality

Source: 1999 Gartner Institute PM Core Capabilities

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Four Phases Project Management

4.Projec t Close Project Evaluatio n

1. Project Definitio n

3. Project Executi on

2. Project Planning

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Project Management Phase 1.Project Definition

Breakthrough Collaborative Tools 1.Problem identification


Identify problem Gather baseline data (patient, staff, operational)

2. Stakeholder Analysis
Ranking of importance and impact Level of involvement Expectations

3. Scoping Study
Organisational context Project need Aim & objectives Project organisational chart Parameters, Interfaces, Constraints, Assumptions Stakeholders Deliverables, Benefits, Measures Risks Resources Prioritisation Criteria Checklist Produce Business Case

Orientation Session + Learning Session 1

2.Project Planning

4. What are we trying to accomplish


Project Planning types of planning Work breakdown Structures Allocating & Estimating Critical Path & Gantt Charts Milestones Review your Risk Log Review your Budget Checklist

5. Forming the project team


Selecting Your Project Team Skills & Knowledge Required Selection Criteria

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3. Project Execution

6. The current process 7. Redesign 8. Change Strategies 9. Implementation plan 10.Trial & review
Recruiting your Project Team Securing Resources Controlling Monitoring Checklist

Learning Session 2&3

4. Project Close

11. Implementation
Completion criteria Acceptance Process Close out Meeting Active Evaluation Post Project Evaluation Technical Evaluation Post- Project Evaluation (final report)

Learning Session 3

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Phase 1 - Project Definition

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Phase 1 - Project Definition


Description
This section will consider why it is so important to realistically scope a project and how organisations prioritise before commencing a project.

Learning Objectives
At the conclusion of this section, participants should be able to: Describe the organisational and strategic context Describe the need for the project (quantifiable) Describe the aim and objectives Describe the project organizational chart and roles Describe the parameters, interfaces, constraints and assumptions Process to identify key stakeholders Describe the deliverables Describe benefits of the project Outline key performance measures Describe project risks Identify resources required for the project Discuss how to select appropriate projects

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1.1 Organisational Context


Most organisations have limited resources, projects have to be prioritised to ensure that the greatest benefit is gained from the resources spent. Projects need to be aligned to the strategic direction of the organization. Examples: Improve patient safety Increase the appropriate use of fresh blood products Increase elective day surgery procedures Improve the health of the local population who have multiple chronic conditions

1.2 Defining The Need For The Project


Data should be used to quantify the severity of the problem and impact on the organisation, patients and staff. This data forms baseline measures and allows the project team to assess improvements from the progress. Example: The DNA rate of 22 percent in outpatients clinic. Personal: Reduce the length of time it takes to run around Albert Lake from 65 minutes to 30 minutes so I can be fit enough to run the Marathon in June.

In your Project Definition document, write down your Organisational context Project need

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1.3 Project Aim


In healthcare the project aim should be written from the patient/customer perspective.

SMART Specific clearly defined with a target for improvement Measurable understood metrics are available to identify delivery Achievable within the current environment, funding, time and skills available Realistic not trying to get the impossible with many unknowns Time bound is limited by delivery date based on real need

Examples: 25% decrease in inappropriate patient referrals to clinic x by June 2007

100% improvement in the time to run 5km (Albert Park Lake) by June 2007

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1.4 Project Objectives


The objectives are the critical elements in the process to achieve the aim. Examples: Aim Identify key outpatient constraints that impact the inward and outward flow of patients and access to services. Objective Increase the number of referrals with the required elements by 30% by June 2007 Aim 100% improvement in the time to run 5km (Albert Lake) by June 2007 Objective To run three times per week and time each run To weight train three times per week To seek coaching on running technique from a professional runner

In your Project Definition document, write down your Project aim Project objectives

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1.5 Project Roles


Exercise In pairs describe the role of a project facilitator and the role of a clinical lead. Write down the differences between a clinical leader and project facilitator Clinical lead Project facilitator

Differences

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1.6 Project Scope


The scope of the project defines:

The boundaries eg geographical, type of process or part of the process. The start and finish points What the project is going to cover and what the project is not going to cover.

Example The Patient Flow Collaborative II Outpatients project will involve 29 health services in Victoria of which 4 will be community health services all other health services in Australia and will be excluded. All Saints Hospital will examine the flow of patients in and out of clinic x & y.

1. 6.1 Project Scope - Template 1


Start Finish (Boundary) Inclusion Exclusion Additional

Date agreed

Agreed by

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1. 8 Interfaces
Each project can have inter-relationships with other activities, programs or projects both inside the organisation and outside the organisation. To avoid re-inventing wheels and to gain clarity between projects, it is essential to identify any interfaces that the project may have.

Example Your Patient Flow Collaborative II Outpatients project may interface with existing initiatives in your health service such as: Clinical Risk Management Service Development Quality Committee Exercise Working in groups, select a project you have been involved in and using the project definition document identify: Scope Interfaces

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1.9 Project Constraints


All projects have some constraints. Project Constraints usually fall into the following categories:

Time time to deliver the results. For example: The project will finish by June 2007 Financial project cost and resource costs to deliver the project. For example: The budget for the project is $25,000 Quality specifications, regulations or standards that have to be achieved. For example: All project teams will share progress through simple sampling. Physical limited space. For example: The new hospital will be built within the existing grounds of the Austin Medical Centre. Resources access to or ability to recruit skilled people. For example: Recruiting nurses in Victoria

1.10 Assumptions
Assumptions are always made when defining a project. However it is essential to be explicit about these assumptions and to test them with others.

ASS U ME

Exercise Working in groups, select a project you have been involved in and using the project definition document identify: Constraints Assumptions
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1.11 Stakeholders
A project Stakeholder is any person, group of people or organisation who has a vested interest in the project either now or in the future. Some stakeholders are more important than others to support the project. The interest may be: Positive: supporting a successful outcome or Negative: striving to hinder or stop the project!
Source: How To Be A Better Project Manager. Trevor Young. 2001

1.11.1 Key questions to ask stakeholders:


Why are they interested? What are they expecting to gain from the project? What impact will the project have? Are they in favour of the project? What involvement do they have and how can they contribute experience or knowledge?

1.11.2 Assessing Project Stakeholder - Template 2


Process/ Problem Stakeholder Importance Impact Expectation Involvement

Date agreed

Agreed by

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1.11.3 Communicating with Stakeholders


At the beginning of the project produce a list of the contact details for the stakeholders in your project.

1.11.4 Project Stakeholder Contact List - Template 3


Name Title Location Address Telephone/Fax E-mail

Date updated Tip: Although you may identify stakeholders at the beginning of your project, many do not appear until you have started your project. The list of stakeholders will therefore change and grow with time, so the list will need regular reviewing and updating.

Communicate, communicate, and communicate Paul Plsek The success of any project depends on engaging and communicating with stakeholders.

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Exercise
1. Using the template, brainstorm all the stakeholders for the project 2. Rank the importance of the project success to the stakeholder H - High M - Medium L - Low 3. Rank the stakeholders impact on the project H High M Medium L Low 4. Identify their contribution to the project and assess their level of involvement A - Active involvement in the multi-disciplinary project team B Consulted/Coopted on initiatives C Informed on developments 5. Draw the matrix on a flip chart and plot your stakeholders onto the matrix Example: Project Aim: 25% decrease in DNA rates in clinic x by June 2007. Impact High Surgical Registrar

Low Importance Low High

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1.12 Deliverables To achieve your aim, you will develop products and/or services, which are known in project management terms as deliverables Deliverables are often the result of major activity There are usually several deliverables in a project

Examples of Deliverables for the Patient Flow Collaborative II Outpatients : Standardised data collection Action plans Interim and final report

1.12.1 Project Deliverables - Template 4


Deliverable Date Success Criteria Sign off

Date agreed

Agreed by

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1.13 Benefits
Each project will produce benefits. Consider the benefits from different stakeholders perspectives. Benefits should be quantified.

1.14 Measures
Often the benefits are related to the measures. For example: Benefit: Increased patient and GP understanding of the booking procedure resulting in timely appointment in clinic x. Performance Measure The time between referral being made and received has decreased. Performance can be measured in terms of 4 Ps: P progress against plan P people against task P process improvement against current process P performance against aim or benefit

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1.15 Project Risks

A RISK is any event that prevents the project realizing the expectations of your stakeholders. A risk that happens becomes an issue that must receive prompt attention to maintain the project is on time.
Source: How To Be A Better Project Manager. Trevor Young (2001)

Three categories of risk

Business risks the viability and context of the project

Project risks associated with the technical aspects of the work to achieve the aim

Process risks associated with the project process, tools and techniques employed to control the project

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1.15.1 Risk Assessment


There is always the possibility that unforeseen risks can lead to unexpected issues and without prompt action these risks and issues can reduce the likelihood on delivering the project on schedule, to the quality specified and within budget. Time

Project Quality Budget

When

Risk management is a continuous process throughout the life of the project. Start to define risks in the project definition phase Complete the project risk log What exactly is the risk? What is the probability of it happening based on current data? What is the likely impact on the project? What actions will prevent or minimize the risk?

Assessment Strategies

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Categories of Risk High Significant effect on delivering the project on time and in budget. Serious impact on other related projects. Must by monitored and reviewed regularly. Review action plans Significant impact on the project with possible impact on other projects. Not expected to affect a project milestone. Review at each project meeting and assess ranking. Monitor regularly Not expected to have any serious impact in the project. Review regularly for ranking and monitor.

Medium

Low

Exercise 1. In a group, select one project and brainstorm the risks for the project. 2. Complete the

1.15.2 Project Risk Log - Template 5


Description Probability H/M/L Impact H/M/L Action Who By When

Date updated

Updated by

3. Rank the probability of risk on a scale 1 to 9. 1 is low - most unlikely to happen, 9 is high very high probability it will happen 4. Gain a group consensus if it is a high, medium or low risk to the project. 5. Identify strategies to address the risk

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1.16 Resources Required The project team need to estimate the resources required to successfully undertake the project and document estimations. Key areas for consideration are:

Personnel labour required to complete the project Facilities office space Equipment computers, software, furniture, printers, mobile phones Material and Supplies catering, photocopying, postage, stationary

1.16.1 Project Resources - Template 6


Task Resource Cost Supplier Date required Delivered

Date agreed

Agreed by

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Well done.
Ask the project team including the executive sponsor and clinical lead to sign off all documents as approved, indicating their acceptance of the project definition. Hold a launch meeting Disseminate all project documentation

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Phase 2 Project Planning

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Phase 2 - Project Planning


Description
This section will consider the how to select your project team.

Learning Objectives
At the conclusion of this section, participants should be able to: Describe the skills they require in their team Identify potential candidates for their project team Understand some of the complexities of working in a project team

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2.1 Project Team 2.1.1 Selecting Your Project Team


Most projects start by being a group of people together from different backgrounds, with different experiences and skills. The challenge is to: Identify the skills and knowledge required for the project Produce criteria to ensure that all the skills and knowledge are in the project team Bring a group of individuals (stakeholders) into a cohesive project team with a common aim

Skills & Knowledge Required (Selection Criteria)

Potential Team Member

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2.1.2 Managing the Project Team


Managing a project team is often more complex than managing a service or department in a fixed hierarchy. What are some of the challenges in managing the project team?

Managing team members who have been drawn from different departments, who have their own responsibilities outside the project work The risk of instability in the team due to the changing priorities of the line managers of your team Creating an effective team environment with a changing team Building a team quickly with people who do not know each other Clarity in roles and responsibilities and inter-relationship between roles and responsibilities within the project team. Poor communication and sharing information because the team members do not know or necessarily trust each other. Encourage effective communication between team members to increase each others knowledge of the different roles, responsibilities and inter-relationships Focusing the team members on performance which may not be consistent with their personal goals agreed with their line managers Creating a team identity to encourage the team members to meet regularly and learn more about each other and promote good working.

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2.2 Project Planning


Description
This section will consider the how to plan a project.

Learning Objectives
At the conclusion of this section, participants should be able to: Describe the project planning process Describe allocating work and estimating timeframes Explain a work breakdown structure, Gantt Chart and Milestones

2.1.3 Types Of Planning


Macro outline the activities first and then breaking them into tasks

Micro outlining the tasks firsts and grouping them into activities

2.1.4 Definitions

A task a small piece work carried out by one person An activity a parcel of work comprising of several tasks each of which may be carried out be different people Concurrent activities/tasks activities or tasks that are designed to be carried out at the same time Series of activities/tasks activities that are designed to be undertaken one after another, each strictly dependant on each other

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2.1.5 Estimating
When estimating the time and resources required to complete the task you should: Schedule full time team members at four productive working days per week, to allow for holidays, absences, training, unforeseen problems Include management time where appropriate as an additional 10% Avoid splitting tasks between individuals If tasks are spilt, do not reduce time by 50% allow time for communication and coordination Take individual experience into account Build in spare time for problem solving, urgent tasks arising, non project related activities and project meetings Allow time for cross-functional data transfer and responses Any estimate is subject to change so keep a record of: the estimates your team decides any assumptions made during the estimating where contingencies have been added how many contingencies have been added and what type

2.1.6 Allocating
Each task requires allocating to a member of the project team and estimating the time required to complete the task. When allocating a task you should: Access the right skills for the work Provide visible support by the project facilitator Communicate clearly the performance expected of them Ensure they have the tools to do the job Document the responsibilities and communicate this to everyone including their line managers
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2.1.7 Critical Path


The critical path is the shortest possible time in which to complete a task, activity and project. You can reflect on your logical flow to identify your critical path. It is important to note that if a time changes for task or activity it will also change your critical path.

2.1.8 Gantt Charts & Milestones


A Gantt Chart graphically reflects the activity, task, duration and calendar dates. The Gantt Chart highlights the logical flow between activities. The critical path can be presented on the Gantt Chart.

The Gantt Chart can also include: Milestones a significant measurable event representing a checkpoint for the completion of an activity and the delivery of a product or services. All milestones should apply the SMART test. The milestone is usually indicated by a triangle. A white triangle represents a scheduled milestone, a black triangle represents a completed milestone. Some other common events for milestones are financial audit or quality audit Project meetings indicated by a filed circle or dot Project reviews (financial/audit) indicated by a filled square

Computer Project Planning Packages Microsoft project produces your Gantt Charts and Critical Paths on the computer. However, if you change one activity or task the package may or may not change all the other tasks and activities.

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2.1.9 Project Planning -Template 7


Activity
Task Description Start Date Finish Date Allocated to Symbol

Date agreed

Agreed by

Congratulations
You have now produced a work breakdown structure (WBS) A work breakdown structure is a graphical representation of the major activities and tasks required to complete that activity.

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2.1.10 Reviewing The Project Risk Log


1. Review any risks that have changed ranking and add any new risks. 2. Produce a short description of the risk 3. Outline when the risk may occur 4. Assess their impact and probability 5. Identify management strategies, actions for any risks that can be prevented 6. Develop contingency plans for avoidance and/or damage limitation

Tip: Never remove a risk from the list because it will act as valuable learning for future projects

2.1.11 Reviewing The Project Budget

1. Review any costs that have changed either increased or decreased 2. Identify the costs for each activity in the project and produce an operating budget 3. If there is great variance between the estimated budget and the operating budget you will have gain approval from the Executive Sponsor again. 4. Start to record costs so that you can monitor variance against your operating budget. 5. Communicate variances to your project team.

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2.1.12 Reviewing The Communication Strategy


Communication of progress to the wider stakeholder groups should have been identified in the project definition. A communication strategy should be developed as part of the project plan. Refer to Communication Strategy Template 8 Who Project team External stakeholders Mode Meeting Newsletter Forum Frequency (Date) Weekly Monthly Quarterly Who Leader/Facilitator As above

2.1.13 Checklist for Project Planning


Before gaining sign off by the Executive Sponsor for the project plan check the following: Is the project definition still valid? Is the scope still valid? Has the project team been confirmed in writing? Are all the stakeholders identified? Does the team know who manages the stakeholders? Is the WBS structure developed practical, realistic and achievable? Is the critical path established and agreed? Is the project risk log up to date? Does the Gantt Chart reflect the agreed plan and schedule? Has the project operating budget been confirmed and agreed? Does the team have the skills required?

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Phase 3 - Project Execution

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Patient Flow Collaborative II Outpatients

Project management made simple

3. Project Execution
Description
This section will consider the aspect getting started, controlling and communicating.

Learning Objectives
At the conclusion of this section, participants should be able to: Describe the key actions to get started Explain how to monitor progress against plan Outline strategies for managing variation from the project plan Communicate progress Implement the project

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Project management made simple

3.1 Key Actions


Refer back to the project plan to start the project.

3.1.1 Recruiting the Project Team


At the beginning project, each team member and their line manager should receive written confirmation of role and responsibilities statement including time commitment, reimbursement arrangements, location and performance measures.

3.1.2 Securing Resources, Facilities and Equipment Required:


Reflected on the resources, facilities and equipment outlined in the project plan including: Computer hardware and software Office space and furniture Stationary Storage

3.1.3 Communication Strategy


Communication of progress to the wider stakeholder groups should have been identified in a communication strategy as part of the project plan. The communication strategy should be implemented. Who Project team Mode Meeting Frequency(Date) Weekly Who Leader/Facilitator

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Patient Flow Collaborative II Outpatients

Project management made simple

3.1.4 Managing Issues


Major issues should be ranked according to importance an assigned a coloured flag:

Red major issues have serious consequences for the project. Responsibility Executive Sponsor

Yellow significant impact on the project and/or other projects, if unresolved could cause delay. Becomes a red flag if delayed for more than three days. Responsibility Project Leader

Green consequences limited to a confined area of the project and unlikely to impact on other projects. Becomes a yellow flag if not resolved in time to avoid project slippage. Responsibility Project Facilitator

3.1.4.1 Issues Log - Template 9


Issue Description Severity R/Y/G Action Who When

Date updated

Updated by

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Patient Flow Collaborative II Outpatients

Project management made simple

3.1.5 Controlling the Project

Controlling a project involves three key elements: Measuring determining progress against planned for financial, time and quality Evaluating determining cause of deviations for the plan Correcting taking action to correct the deviation against plan

All the project documentation requires updating regularly.

3.1.6 Monitoring Progress


Progress against plan should be monitored against measuring, evaluating and correcting and should be communicated. Any variance from the plan should be gain approval from the Executive Sponsor and then be communicated with the stakeholders and project team.

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Patient Flow Collaborative II Outpatients

Project management made simple

3.1.7 Progress Reporting


Progress meetings should be a maximum of one hour. Progress reporting against the checklist should be by exception.

Milestones due and completed Milestones due and slippage Corrective action put in place because of slippage Milestones due for next period Issues waiting decisions New issues escalated Any risks escalated Any resource capacity changes forecasted Any team performance problems and issues Forecast of project completion Reasons for any revision of previous forecast

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Patient Flow Collaborative II Outpatients

Project management made simple

Phase 4 - Closing the Project

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Patient Flow Collaborative II Outpatients

Project management made simple

4. Closing the Project


Description
This section will consider the aspects of closing the project.

Learning Objectives
At the conclusion of this section, participants should understand: Completion criteria Acceptance process Closing meeting

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Patient Flow Collaborative II Outpatients

Project management made simple

4.1 Completion Criteria


Defining what completion is and an acceptance process should be included in your project plan. Completion will be what completion means for your stakeholders and customers. Completion criteria could include: All tasks finished All activities finished and products or services delivered Testing the changes

4.2 Acceptance Process


An acceptance process should confirm: Who is responsible for the each step of the process and the work involved What post-project support is required and who is responsible What post-project support must be given and for how long

4.3 Close-Out Meeting


At end of the project have a close out meeting with your Executive Sponsor, Clinical Leader and any other project team members. The meeting should: Review the project achievements and highlight any outstanding work or issues Agree and confirm responsibilities for any ongoing work or support Confirm who is responsible for monitoring project benefits Thank the Executive Sponsor, team and stakeholders

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Patient Flow Collaborative II Outpatients

Project management made simple

5. Evaluating the Project


Description
This section will consider the options for evaluating your project

Learning Objectives
At the conclusion of this section, participants should understand: Active evaluation Post project evaluation Technical evaluation Post-project appraisal The evaluation of the project will identify what worked well and what could have been improved and why.

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Patient Flow Collaborative II Outpatients

Project management made simple

5.1 Active Evaluation


Promoting learning by doing. The project team evaluates the methodology as they are applying this to the project. The team shares their learning with others to help to continually improve the methodology of the project and their progress.

The Breakthrough Collaborative is encouraging active evaluation of progress throughout the project. This will allow project teams to identify any improvements from their baseline positions and an opportunity to capture the learning.

5.2 Post Project Evaluation


Evaluating at the end of the project. This should be combined with active learning. The evaluation should develop in-depth questions about every aspect of the project.

5.3 Technical Evaluation


The technical evaluation will demonstrate if the best results were achieved with the skills, experience and technology available to throughout the project. The technical evaluation would review if the techniques in the project have resulted in improvements for patient care and improvements in knowledge and skill of project teams.

5.4 Post Project Appraisal (Sustainability)


At the project definition phase you outlined the potential benefits in terms of: Increased efficiency from redesigning processes and procedures Increased patient/customer satisfaction Increased staff satisfaction All of these benefits can be quantified and measured. The organisation and Project Team would want to compare any cost-benefit analysis carried out at the start of the project with accumulated benefits. This will require monitoring benefits for a period after the project to realise the full potential of the projects.

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Glossary of Terms Boundaries The portion of a process from a Supplier to a Customer that will be the focus of the process improvement. Process boundaries define what is in and out of scope. A data collection form consisting of multiple categories. Each category has an operational definition and can be checked off as it occurs. Properly designed, the Check Sheet helps to summarise the date, which is often displayed in a Pareto Chart. A Check Sheet is simply a tool for recording and tallying observations, eg times that a test report arrived late. The receiver of an output of a process, either internal or external to a hospital or corporate unit. A customer could be a person, a department, a company, etc. The person who gets your work. Gathering facts on how a process works and / or how a process is working from the customers point of view. All data collection is driven by knowledge of the process and guided by statistical principles. Process guide assigned to a team who educates members in the CQI processes and helps them select and use the appropriate tools and other resources. Used by teams to set a code of conduct which helps the group perform more effectively. Five to ten points should be sufficient, and they should be continuously displayed for the team to see and refer to.
The period of time between Learning Sessions, when teams work on improvements in their organisations. They are supported by the Planning Group members and are connected to other Collaborative Team Members. Aim A written, measurable, and time sensitive statement of the expected results of an improvement process. Changes Concepts The list of essential process changes that will help lead to breakthrough improvement, usually created by the Planning Group and/or Expert Panel and is based on literature and their experiences.
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Check Sheet

Customer/Client

Data Collection

Facilitator

Ground Rules

Action Period

Patient Flow Collaborative II Outpatients

Project management made simple

Collaborative A time-limited effort (usually 6 to 12 months) of multiple organisations, that come together with the steering and expert working groups to learn about and to create improved processes in a specific topic area. The expectation is that the teams share expertise and data with each other thus, Everyone learns, everyone teaches. Collaborative Team Involves all participants in the improvement effort. Cycle or PDSA Cycle A structured trial of a change process. Drawn from the Shewhart cycle, this effort includes: Plan - a specific planning phase; Do - a time to try the change and observe what happens; Study - an analysis of the results of the trial; and Act - devising next steps based on the analysis. This PDSA cycle will naturally lead to the Plan component of a subsequent cycle. Learning Session A one or two-day meeting during which participating organisation teams meet with Planning Group members and collaborate to learn key changes in the topic area, including how to implement changes, an approach for accelerating improvement, and a method for overcoming obstacles to change. Teams leave these meetings with new knowledge, skills, and materials that prepare them to make immediate changes. Measure An indicator of change. Key measures should be focused, clarify your teams aim, and be reportable. A measure is used to track the delivery of proven interventions to patients and to monitor progress over time. Model for Improvement An approach to process improvement, developed by Associates in Process Improvement, which helps teams accelerate the adoption of proven and effective changes.

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