Project Management for Healthcare Project Management for Healthcare Second Edition David Shirley CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2020 by Taylor and Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works International Standard Book Number: 978-0-367-25201-4 (Hardback) Tis book contains information obtained from authentic and highly regarded sources. Reasonable eforts have been made to publish reliable data and information, but the author and publisher cannot assume responsibility for the validity of all materials or the consequences of their use. Te authors and publishers have attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. 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Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com Contents Preface .............................................................................................................xiii Acknowledgments .........................................................................................xxiii About the Author ........................................................................................... xxv SECtion i DEFinition 1 Defning a Project ..................................................................................3 What Is a Project? .......................................................................................3 What Is a Project Life Cycle? ......................................................................4 Te History of Project Management ...........................................................5 Roles and Responsibilities in Project Management .....................................6 Project Management and the Healthcare Environment ..............................6 Establishing Relationships in Healthcare ....................................................8 Diferences in Management ........................................................................9 Strategic Management .............................................................................9 Operations Management .......................................................................11 Crisis Management ...............................................................................11 Project Management .............................................................................12 Summary ..................................................................................................12 Key Review Questions ..............................................................................12 Endnotes ...................................................................................................13 2 Planning for a Project ..........................................................................15 Why Are Projects Chosen? ........................................................................15 Personal .................................................................................................15 Financial ...............................................................................................15 Competitive ..........................................................................................17 Safety ....................................................................................................17 Regulatory .............................................................................................18 Artifcial Intelligence (AI) .....................................................................18 Precision Medicine (PM) .......................................................................19 Summary. ..............................................................................................19 Decision-Making Tools for Choosing a Project .........................................19 v vi ◾ Contents Root Cause Analysis ..............................................................................19 Cost–Beneft Analysis ...........................................................................22 Brainstorming .......................................................................................24 Consensus Building ..............................................................................25 Organizational Structure Infuences on Project Choices .......................25 Functional Organization ..................................................................25 Matrixed Organization .....................................................................26 Project-Focused Organization ...........................................................27 Other Considerations for Project Choice ...............................................29 Regulatory and Industry/Organization Standards ............................30 Key Review Questions ..............................................................................31 Endnote ....................................................................................................31 3 Getting Started ....................................................................................33 Project Sponsor .........................................................................................33 Project Charter ........................................................................................ 34 Goals and Objectives ................................................................................35 Project Players ...........................................................................................37 Project Plan ...............................................................................................39 Te Project Charter ...............................................................................39 Scope Statement ....................................................................................39 Requirements and Expectations ....................................................... 40 Detailed Project Description .............................................................41 Milestones and Deliverables ............................................................. 42 Acceptance/Success Criteria ............................................................. 42 Contractual Specifcations ........................................................................43 Te Work Breakdown Structure ...............................................................43 Dealing with the Creeps ...........................................................................45 Key Review Questions ............................................................................. 46 Endnotes .................................................................................................. 46 SECtion ii tHE DEtAiLS 4 Time ....................................................................................................49 Estimating Time .......................................................................................49 Historical Information ..........................................................................49 Lessons Learned ....................................................................................50 Expert Judgment ...................................................................................50 3- and 6-Point Estimates .......................................................................50 Getting Estimates..................................................................................51 Trusting the Data .............................................................................51 Pushing Back ........................................................................................52 Who Will Do the Tasks? .......................................................................52 Contents ◾ vii Understanding Scheduling Tools ..............................................................53 Network Diagram ................................................................................53 Start–End–Float ...................................................................................54 Gantt Chart .........................................................................................57 Task Relationships ................................................................................57 Other Dependency Considerations ......................................................58 Leads and Lags .....................................................................................59 Calendars and Updating ......................................................................59 Sequencing Tasks .................................................................................60 Schedule Development ..............................................................................60 Schedule Control ......................................................................................60 Crashing ...............................................................................................61 Fast Tracking .......................................................................................61 Key Review Questions ..............................................................................62 5 Costs ....................................................................................................63 Estimating Cost ........................................................................................63 Cost Categories ....................................................................................65 Direct Costs......................................................................................65 Variable Costs ...................................................................................65 Indirect Costs ...................................................................................65 Special Case Costs ........................................................................... 66 Capital Costs ................................................................................... 66 Assessing Costs .........................................................................................67 Types of Estimates ................................................................................67 Order of Magnitude .........................................................................67 Budget Estimate ...............................................................................67 Defnitive Estimate ...........................................................................67 Pro Forma Assessments .....................................................................68 Other Estimating Considerations .....................................................68 Cost Estimating Tools ..............................................................................69 Analogous Estimating ......................................................................69 Parametric Estimating ......................................................................69 Bottom-Up Estimating .....................................................................70 Allocating Budgeted Costs ........................................................................70 Key Review Questions ..............................................................................71 Endnote ....................................................................................................71 6 Quality ................................................................................................73 History of Quality in the United States ....................................................73 Project Quality Management ....................................................................75 Project Planning ...................................................................................75 Quality Management Tools ..................................................................76 Flow Charts ......................................................................................76 viii ◾ Contents Cause-and-Efect Diagrams ..............................................................76 Check Sheets ....................................................................................76 Pareto Charts ................................................................................... 77 Histograms ...................................................................................... 77 Control Charts .................................................................................78 Scatter Plot .......................................................................................79 Project Quality Control ........................................................................79 Project Quality Assurance ....................................................................79 What Is Quality? ..................................................................................80 A Transcendent Approach.................................................................80 Product-Based Approach...................................................................80 User-Based Approach ........................................................................80 Manufacturing-Based Approach .......................................................81 Value-Based Approach ......................................................................81 Quality of Service Approaches ..........................................................81 Basic Statistical Concepts Used in Quality Assessment ........................82 Attributes and Variables ....................................................................82 Mean, Median, Mode .......................................................................82 Range, Variance, Standard Deviation ...............................................82 Te Cost of Quality ..................................................................................83 Summary ................................................................................................. 84 Key Review Questions ............................................................................. 84 Endnotes .................................................................................................. 84 7 Communications .................................................................................85 Te Process of Communicating ................................................................87 Methods of Communicating ................................................................87 Conditions of Communications ...........................................................88 Barriers to Communications .....................................................................88 Improving Your Communications ........................................................... 90 Variables of Communications ...................................................................91 Communications Management Plan .........................................................92 Communications Plan ..........................................................................93 Improving Communications .....................................................................93 Social Media and Healthcare ....................................................................94 Reporting ..................................................................................................97 Key Review Questions ..............................................................................98 Endnotes ...................................................................................................98 8 Change ................................................................................................99 Dealing with Change ................................................................................99 Monitoring and Controlling Changes .....................................................102 Change as a Good Ting ........................................................................106 Support and Authority .......................................................................107 Contents ◾ ix Project Managers as Change Agents ...................................................107 Projects/Change Are One and the Same .............................................108 Summary ................................................................................................108 Key Review Questions ............................................................................108 Endnotes .................................................................................................108 9 Risk ...................................................................................................109 What Is Risk? .........................................................................................109 Risk and Reward .................................................................................... 110 Interviewing ............................................................................................ 111 Risk Matrices .......................................................................................... 111 Risk Identifcation ..................................................................................113 What to Consider ...............................................................................113 Qualitative and Quantitative Risk Analysis ............................................ 114 Lesson Learned ....................................................................................... 115 Responding to Risk ................................................................................ 115 Mitigating Risk .................................................................................. 116 Accepting Risk ................................................................................... 117 Monitoring Risks .................................................................................... 117 Earned Value Manageme nt .................................................................118 Specifc Example of Risk Assessment ... ...............................................120 Clarity and Specifcity of Requirements Risks ................................120 Key Review Questions ............................................................................121 Endnotes .................................................................................................121 10 Contracting and Procurement ...........................................................123 What Is a Contract? ................................................................................123 Contract Types .......................................................................................125 Fixed Price Contracts .........................................................................125 Cost Reimbursable Contracts .............................................................125 Organizing for Contracting ....................................................................126 Centralized Contracting .....................................................................126 Decentralized Contracting .................................................................126 Te Procurement Process ........................................................................127 Pre-Purchase ......................................................................................127 Purchase .............................................................................................128 Post-Purchase .....................................................................................128 Contract Administration and Close-Out ............................................129 Key Review Questions ............................................................................129 Endnotes .................................................................................................129 11 Project Close-Out ..............................................................................131 Internally Facing Reason .........................................................................132 Externally Facing Reason ........................................................................132