a journey in project management of an enterprise clinical rtls program kimberly brayley director,...
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A Journey in Project Management ofan Enterprise Clinical RTLS Program
Kimberly BrayleyDirector, RTLS Project Management OfficeVeterans Health Administration
Areas of Concentration
– Defining your Project– Schedules and Tasks– Resourcing– Communication &
Education– Tracking Progress– Risks, Issues, and Lessons
Learned– Measuring Success
Hospital System to Health System
VHA currently has 21 VISNs:• 152 Medical Centers• 974 Outpatient Clinics
– 807 Community-Based– 152 Hospital-Based– 9 Mobile
• 6 Independent • 288 Vet Centers• 98 Domiciliary Residential Rehab
Programs • 133 Community Living Centers
In 1996, VA began the creation of Veterans Integrated Service Networks (VISNs) to transform VA Health Care from a “Hospital System” to a “Health System.”
VA RTLS Primary Objectives• Deploy the set of nationally standardized RTLS solutions to:
– VHA Medical Centers, Clinics, non-patient care locations
• That will:– Improve operational efficiency and the quality of Veteran care – Decrease operational costs – Maximize equipment utilization– Increase efficiencies and staff productivity– Reduce delays and improve patient care– Minimize lost and misplaced items– Improve customer and staff satisfaction– Improve the quality and safety of service from patient, physician, and
institution perspectives
VA RTLS Primary Objectives (cont.)• Establish a capability that is compatible and interoperable with
existing information systems internal and external to VA – Ensuring integration, scalability and ease of sustainment across technologies
• Provide medical centers and other VA facilities with the real-time capability to actively track:
– Selected assets, significant medical supplies, staff, patients, and environmental conditions (e.g., temperature and humidity) through a common interface and reporting tool
• Deploy a single instance of a NDR solution for: – Aggregation and in-depth analysis of data from individual “front-end” RTLS
instances: National Data Repository (NDR)
RTLS Program Approach
Assess requirements
Study lessons learned
Document programmatic information
Assess process flows
Identify outcomes and ROI
Determine needs for hardware and software
Determine sequential dependencies between requirements and procurements
Identify and apply critical success factors
Standardize procurement strategies and outcomes
Provide solution on a National Contract
Implement comprehensive, sustainable and repeatable system and user training
Controlled deployment in VA facilities for system and applications / use cases.
Ensure active involvement of leadership and staff for adopting use of technology
Sustain communication and education
Ensure programmatic and business concerns are addressed
Continue to grow uses for technology
Review PriorInvestments
Design Plan Procure and Install
Implement Change
Management
Defining your Complex Project
VISN 7
Facility A
Facility B
Facility C
Facility D
Facility E
Facility F
Facility G
Facility H
VHA RTLS
1 23
4
5
6
7
8
9101
112
15
16
17
18
19
20
21
22
23
Facility E
Asset Tracki
ng
Temp Moni
tor
Sterile
Processing
Cath Lab
Supplies
National PMONational Workgroups
ContractorSubs
LeadershipClinical Departments
Support ServicesPatients & Staff
Defining your Complex Project (cont.)
Project Manager COR
OnBoarding
Deliverable Management
Contractor Point of Contact
Financial Manager
Leader
Educator
Change Manager
Project Planner
Schedules and Tasks• What tasks go into a Project Plan?
– Your Tasks• Workgroups• Committees – not in project• Named resources
– Contractor Tasks• Subcontractors
• Who manages the schedule? How often do you review it?
• What is the real time to complete a task?
• Milestones -Impacts for not meeting dates?
• Other Projects and Issues impacting your schedule– Joint Commission– Construction Schedules– Budget Cycles– Vacations, Holidays, Shift work, Patient Care Areas
Schedules and Tasks: RTLS PMO Integrated Master Schedule (IMS)
• Developed an RTLS IMS, integrating all project schedules into a single high-level source view:
• RTLS Procurements • RTLS Deployments• RTLS Associated Projects• RTLS National Application Workgroups• RTLS PMO
Schedules and Tasks: 30/60-Day Outlook Report
• Developed and provide a monthly 30/60-Day Outlook Report at the beginning of each month of the entire RTLS program
Resources• Roles and Responsibilities• Can you name all the
players on your team?– Who’s on First, What’s on
Second? Exactly…
• Do you have more than 1 SME in an area?
• Don’t task yourself• Is everyone on the right
bus and in the right seat?
Communication and EducationCommunication• Email Groups• SharePoint's• Messaging• Internal PR Plan• Newsletters
Education• Seeing and Understanding• Change management• Frequent• Tiered levels for audience• Lunch and Learns
The task of a leader is to get his people from where they are… to where they have not been - Henry Kissinger
Tracking Progress• Action Item List• Deliverables• Paying Bills Timely• Performance Requirements • Reviews with Contractor• Internal Gate Reviews
Tracking Progress: RTLS Manager DashboardDeveloped a Pilot RTLS Dashboard for VISN Managers:• Serves as an overarching and holistic
tool for each VISN TO, through aggregation of preexisting data sources – Budget (Schedule B, Invoices)
– Schedule (Project Schedule)
– Resources (onboarding, Training)
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*Form included for Checkpoint 3; Plan to review the Deliverable Matrix during the other Checkpoints
Program Initiation
Pre-Procurement Procurement Contract
Initiation Implementation Project Close Sustainment
Gate Review - Decisional
Program Initiation
Base Deployment Project Program Sustainment
Checkpoint - Preparation
Checkpoint 1 informal review of activities with PMO POC
Gate Review 1 formal review of ARP
Gate Review 2 formal review of activities up to TO Award
Checkpoint 2informal review of preparation tasks with PMO POC
Gate Review 3Once the last facility implements an application, initiate theformal review
Checkpoint 4 Informal review of activities to close out the project
Gate Review 4 formal review of activities to maintain RTLS
Checkpoint 3 informalreview(s) of each application being implemented at a facility
Tracking Progress: Gate Reviews for Procurement
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Development Requirements Acquisition Implementation LifeCycle Management
Gate Review - Decisional
Gate Review 1 Gate Review 2 Gate Review 3 Gate Review 4 Gate Review 5
Workgroup Gate Review Lifecycle
Tracking Progress: Gate Reviews for Applications
Workgroup Gate Review Deliverable Approval Matrix
Tracking Progress: Tools and Templates
Tools and Templates• Do you have them?• Can others access?• Does it tell a story?• Is it helpful?• How often do you update it?• Managing your tasks vs the tasks
managing you…
Risks, Issues, and Lessons Learned• Risks:
– Will create a negative effect on your program– Must be mitigated
• Issues:– Problems, situations, findings and decisions that arise during the
program that you may need to take action on or document the outcome.
• Lessons Learned:– Complexity provides for greatest usage – Understanding our mistakes, help us to not repeat them– Can you avoid same mistakes others have already made?
Would you rather Fail Alone.. Or Succeed as a Team?
Measuring Success
The measure of success is not whether you have a tough problem to deal with, but whether it is the same problem you had last year. - John Foster Dulles
Measuring Success (cont.)
• Did you document your expected outcomes?• What story can you tell after you have
completed your project?• Soft vs Hard Benefits…• Pre and Post measurements
Benefits RealizationFunctional Area
Benefit NameAsset
Management SPD Workflow Temp Monitoring
Cath Lab Inventory
Management
Improve Patient Care Improve Managerial Decision Support Reduce Inventory and Equipment Costs
Improve Staff Efficiency
Improve Consistency of Services
Benefit #1: Improve Patient Safety Currently Measured?
Performance Metric Name: Recall Turn-Around Reduction
Metric 1.1: Length of time it takes to respond to a recall after receiving recall order
What type of PM are you?
• Leading or Managing– You manage things and lead people…
• Problem Solving or Creating– Are you carrying around a fire extinguisher?
• Partnering - not just hiring the help– Are we all on the same team?
It's not easy… but it's worth it It's not easy… but it's worth it It's not easy… but it's worth it
IF IT’S NOT WORKING…
“That's just stupid. We need to look at the right way to do things instead of the way we're doing them now.”