The Healthcare Technology Management (HTM) professional can have a multitude of tasks to accomplish in their daily work routine. Many of these tasks involve medical equipment projects that need to be planned, budgeted, deployed, installed or removed. There are many efficiencies that can be had by having an effective project management program and understanding the Project Management Institute’s (PMI) 47 processes of inputs, tool, techniques, outputs and formulas can greatly assist the HTM professional in organizing and implementing a successful project plan. The biggest impact to a PMI program is understanding the process and realizing the influences that can affect success.
The first step is knowing what is a Project? The Project Management Institute states “a project as a temporary endeavor started to create a unique product, service, or result.” A project is an effort with limited time, limited budget, resource availability and limited performance specifications to meet the needs of the project’s customer. PMI has listed the five characteristics that consider what a work effort must have to define it as a project.
1. The project must have established objectives that are results-oriented. These objectives are called deliverables that must be produced or specific services that are provided.
2. The work required in a project should be performed within a specific time-period.
3. A project typically involves some element that has not been performed or is unique.
4. A project must meet specific time, cost and performance requirements. The constraints of time, cost and performance are called the triple constraints and are the work options and actions of a project that establish the completion schedule (time), budget (cost) and scope (performance).
5. One of the most important elements of a project is accountability. A project must have assigned resources for the assigned budget and assigned individuals to accomplish the project.
Because projects have a beginning and an end, the complete time duration represents a project life cycle. The project management process reveals that projects are generally accomplished in five distinct phases. The initiation phase is where the project charter is written to confirm the existence of the project and seek funding to complete the project. The planning phase is where the development of a project scope statement, work breakdown schedule (WBS), risk management plan, project schedule, communication plan, resources plan and quality plan take place. These plans will guide all the support for the rest of the project. The execution phase is where the work of the project is done and where the development of the deliverables and accomplish the product of the project. The monitoring and control phase manages the project and is designed to bring the project in on time and on budget or make the corrections needed for this result. The close out phase is where the project’s records are updated and where the project’s lessons that are learned are recorded. Once documentation is complete, the final payments can be made, and the project team can be released for other projects. The Project Charter is the most important document to create for a project. This will list the ideas of the project into a process that can be vetted and approved by those in the position. This charter should contain the project title that will be used to identify the project. A project description of why the project is being created with a mission or purpose of the requirements that are being achieved. This should also contain a description of the end-product and what that looks like.
From the business side, a business case will be required and this should state why the project is being created. What are the competitive advantages to the project, are there cost savings or money making opportunities? Will additional patient care services be required and will the patients or the business benefit from the project? One of the most recent project requirements has been new regulation and that has been driving new projects. The budget should also be addressed and an initial high-level budget can be included.
The project charter should also have the authority level of the project manager to spend the budgetary resources or modify project schedules. There should be some failsafes that ensure that your clinical engineering project, as the subject matter expert, is driven by the project manager but guided by your knowledge of the project. The key stakeholders should be listed so that you and the project manager know who is working with them to complete this project. There should be clear objectives with measurable results of the services performed that must be obtained. The significant points or events in the project must be listed in the milestones. These comments must state when the stakeholders expect to reach these points? When should phase one testing be complete or when should the new CT be ready in the hospital?
The project charter is designed to answer typical questions that anyone would ask before approving a large purchase, or a large project. This is where the who, what, when, and why must be answered in the project charter. Who will be doing the work? What will be done? When will it start and when will the project end? Why are we doing this project work? Companies ask these same questions every day before starting a project to ensure that only the right projects are moved forward.
There are five typical project organizations that most companies use in their processes to manage projects. There will be only a brief discussion of the types of project organization to stay on subject on integrating project management in clinical engineering. The project management industry groups the matrix organization into three separate categories.
The functional organizations are similar to your typical biomed shop where the technicians report to a supervisor, and the supervisor reports to a manager that reports to a senior management person. This structure is well designed for typical day operations and not for complex projects. There are projects that are possible, but are typically done by one functional area. Replacing old equipment would be an example of a project that would not need much support from other departments. Project managers do not exist in this organization, but technicians may have a temporary title of project manager. A better description may be project coordinators to accomplish similar projects and would report to the manager. This lack of autonomy that a project manager requires when managing projects makes it very difficult to manage them in functional organization.
The matrix organizations were developed to support functional organizations to operate with cross-functional teams from other functional areas such as IT, facilities and construction. The weak matrix, the functional manager retains project control and utilizes project coordinators on the project. The advantage of the weak matrix is that a cross-functional team assists in making the project much easier to accomplish. In a balanced matrix, project managers are aligned with functional mangers and are useful when the project is equally significant as daily biomed work. In the strong matrix, the project manager controls all resources for projects with a dedicated cross-functional team. This organizational type is used on projects that are of high value to a company.
In a project-focused organization, the project teams are dedicated and separate from functional areas. These teams could be contractors and are used by large corporations for R&D projects, complex construction projects, and by the aerospace and automobile industry.
In today’s project management, there are traditional and agile project management methods. The types discussed are traditional project management forms that are used for typical design and repetitive projects. Agile project management is used on hard to define projects that require innovation, where the function is known and are collaborative with many functional teams. Traditional and agile project management function very similarly. They both require a charter to get the project started and both require authorization to begin the project.
The traditional project management system will be focused on the project scope that lists all the project requirements. This is also where the work breakdown schedule (WBS) will be developed that will outline all the work activities required to complete the project scope. The WBS has project elements for the cost estimation and development of a project budget, project schedule creation, risk management, and all the other components of the project plan.
In an agile project management system, the project typically starts from the customers’ requirements for functionality and performance because the specifics for the project cannot be defined at the time the scope is written. The difference is that the scope is developed as the project progresses and deliverables are created.
Projects require the project manager to understand where to begin the work. This occurs in agile as well as traditional project management where both begin by gathering the requirements from the key stakeholders. In traditional project management, the requirements are interpreted into a comprehensive scope. While in agile project management, the requirements are combined into a scope with very little detail.
Another variable of how projects are managed is the culture of an organization. The consequence of the organizational culture on the project management process can affect projects in different ways. There is an affect on how departments are anticipated to cooperate and support each other in the quest for project success. The culture influences the commitment level an employee has with the project and other competing projects and goals. Organizational culture also influences the way projects are planned, how work estimates are done, and the assignment of resources. Lastly, the culture similarly affects the way managers evaluate the project team’s performance and outcomes.
In conclusion, projects are the “stepping stone” of a health care system’s strategy. The organization, method, and culture determine the driving force for a hospital’s total strategic vision. The building blocks of a company’s strategy are the successful projects they complete and by having an effective project management program with an action-oriented plan is the strategic strength of a health care organization. The health care projects such as new medical equipment replacement, an ICU expansion or the implementation of new MRI technology of a hospital organization is critical to its mission and strategic goals. Furthermore, the mission, objectives, strategies, goals and plans of a health care organization must all be incorporated in an effective project management program.
Eddie Acosta, MBA, CBET(e), CLRT, is a member of the TechNation Editorial Board and Business Development Manager with Colin Construction Company.
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