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Building a healthier MIT: From strategy to implementation Administrative and Fiscal Officers Meeting Spring 2019

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Page 1: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Building a healthier MIT:From strategy to implementation

Administrative and Fiscal Officers Meeting

Spring 2019

Page 2: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Building a healthier MIT, so MIT can build a better world.

Mission Statement

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 31

Page 3: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Through collaboration, innovation, education, and excellence in service, MIT Medical redefines campus health. Our community depends on our expertise, and other universities and healthcare organizations look to our example. Every patient who comes through our doors knows they will receive excellent care.

Vision Statement

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 32

Page 4: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Vision Statement in Practice

• Growing, not shrinking

– Not just a student health center — an MIT health center

• Treating patients, supporting populations

– Care for patients outside of visits and beyond our walls

• An integral part of MIT and its mission

– We care for those who innovate, and we innovate too

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 33

Page 5: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 34

MIT Medical Strategic PlanDeliver

an excellent MIT Medical experience

Cultivate a healthier

MIT

Developa vibrant

laboratory of innovation

Promoteand supporta culture of

sustainability and

stewardship

PositionMIT Medical

to engage in the next

generation of healthcare

Page 6: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Organizational “Deferred Maintenance”

• We defined a bold strategic vision that is

tempered by our recognition of required

organizational “deferred maintenance”

• Significant work to strengthen, and build,

supporting capabilities

• Shore up gaps in policies, standard

procedure, physical infrastructure, and

the capabilities of our team

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 35

Page 7: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Electronic medical record

• State-of-the-art when launched in the late 1990's, limited upgrades since

Care delivery model

• Individual provider-centric approach supplanted by teams and "Patient-Centered Medical Homes"

Flat organizational structure

• Senior leadership-biased, with limited mid-level managers

Too little information

• Robust data collection, but limited tools to convert into actionable information for front-line clinicians

Compliance gaps

• Policies and procedures lagged behind best practice models in the ever-changing healthcare ecosystem

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 36

Organizational “Deferred Maintenance”

Page 8: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Foundation Year+

Our Approach…

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 37

Deliver an excellent MIT Medical experience

Cultivate a healthier

MIT

Developa vibrant

laboratory of innovation

Promoteand supporta culture of

sustainability and

stewardship

PositionMIT Medical

to engage in the next

generation of healthcare

Page 9: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Foundation Year Components

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 38

• Population Health

• Project Management Office

Capabilities

• Organizational Structure Redesign

• Investing in our Team

• Zero-based Budgeting

• Zero-based Staffing

Approaches People

Page 10: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Population Health Universe

Population Health

Care “Beyond the Walls”

• Helps to convert data into

actionable information

– Patient registries

– Risk scoring

• Supports care improvements

and value-driven approaches

• Creates visibility of care outside

of MIT Medical

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 39

Capabilities

Hospital

Home

Pharmacy

Lab HealthPlan

RegistrarHR

Clinic

Page 11: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Tools and Approaches

• Clarity of project ownership and

executive sponsorship

• Industry-standard project

documentation, including project

charters, plans, and risk registers

• Online team collaboration and

Organization-wide dashboards with

“Smartsheets”

Project Management Office (PMO)

Role of the PMO

Ensure that projects align with MIT Medical’s strategic vision

Monitor progress and provide reporting to stakeholders and executive sponsors

Identify risks and proactively develop mitigation and contingency plans

Creating a culture of production, on-time delivery of project milestones

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 40

Capabilities

Page 12: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Zero-based Budgeting

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 41

Building from the Ground Up

Look ahead to estimate efficiency-related changes

Look for savings wherever possible

Compare to prior year’s actual results, not budget

Review budgets at the G/L level

Every dollar, every year, must be justified for every cost center

Approaches

Page 13: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Outcomes

• Attrition creates opportunities to

evaluate each role, function

• Process is consistent and transparent

– No surprises when roles are not backfilled

– Creates culture of demonstrating need

– Emphasizes organizational priorities

• Limits annual headcount requests

Zero-based Staffing

Staffing Without Assumptions

Existing position opens

Requirement to justify replacement

Weighed against all

open requests

Allocate headcount to highest need

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 42

3

4 1

2

Approaches

Page 14: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Reorganization Approach

• Align administrative functions with

clinical teams, creating partnerships

• Create new functional managers and

front-line team leads across the

organization

• Add more differentiated and

achievable steps for professional

advancement

Organizational Structure Redesign

Challenges of a Flat Organization

Too few middle managers providing “on-the-ground” leadership

Limited pathways for employee development

Managers with excessively large spans of control

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 43

People

Page 15: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

“Leadership Everywhere”

Executiveleadership

“Drivers of change”

Managers & supervisors“Coaches and champions”

Functional leads“On-the-ground experts”

Individual contributors“Leaders-in-training”

Investing in Our Team

Engaging and Developing

• Conduct annual healthcare-specific

employee engagement survey

– Set a baseline for interventions and

measure progress

• Executive coaching for key leaders

• Comprehensive management

training program – creating MIT

Medical leaders at all levels

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 44

People

Page 16: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Foundation Year Components

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 45

• Population Health

• Project Management Office

Capabilities

• Organizational Structure Redesign

• Investing in our Team

• Zero-based Budgeting

• Zero-based Staffing

Approaches People

Page 17: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Building a healthier MIT:From strategy to implementation

Administrative and Fiscal Officers Meeting

Spring 2019

Page 18: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Building a healthier MIT, so MIT can build a better world.

Mission Statement

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 31

Page 19: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Through collaboration, innovation, education, and excellence in service, MIT Medical redefines campus health. Our community depends on our expertise, and other universities and healthcare organizations look to our example. Every patient who comes through our doors knows they will receive excellent care.

Vision Statement

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 32

Page 20: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Vision Statement in Practice

• Growing, not shrinking

– Not just a student health center — an MIT health center

• Treating patients, supporting populations

– Care for patients outside of visits and beyond our walls

• An integral part of MIT and its mission

– We care for those who innovate, and we innovate too

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 33

Page 21: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 34

MIT Medical Strategic PlanDeliver

an excellent MIT Medical experience

Cultivate a healthier

MIT

Developa vibrant

laboratory of innovation

Promoteand supporta culture of

sustainability and

stewardship

PositionMIT Medical

to engage in the next

generation of healthcare

Page 22: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Organizational “Deferred Maintenance”

• We defined a bold strategic vision that is

tempered by our recognition of required

organizational “deferred maintenance”

• Significant work to strengthen, and build,

supporting capabilities

• Shore up gaps in policies, standard

procedure, physical infrastructure, and

the capabilities of our team

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 35

Page 23: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Electronic medical record

• State-of-the-art when launched in the late 1990's, limited upgrades since

Care delivery model

• Individual provider-centric approach supplanted by teams and "Patient-Centered Medical Homes"

Flat organizational structure

• Senior leadership-biased, with limited mid-level managers

Too little information

• Robust data collection, but limited tools to convert into actionable information for front-line clinicians

Compliance gaps

• Policies and procedures lagged behind best practice models in the ever-changing healthcare ecosystem

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 36

Organizational “Deferred Maintenance”

Page 24: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Foundation Year+

Our Approach…

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 37

Deliver an excellent MIT Medical experience

Cultivate a healthier

MIT

Developa vibrant

laboratory of innovation

Promoteand supporta culture of

sustainability and

stewardship

PositionMIT Medical

to engage in the next

generation of healthcare

Page 25: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Foundation Year Components

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 38

• Population Health

• Project Management Office

Capabilities

• Organizational Structure Redesign

• Investing in our Team

• Zero-based Budgeting

• Zero-based Staffing

Approaches People

Page 26: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Population Health Universe

Population Health

Care “Beyond the Walls”

• Helps to convert data into

actionable information

– Patient registries

– Risk scoring

• Supports care improvements

and value-driven approaches

• Creates visibility of care outside

of MIT Medical

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 39

Capabilities

Hospital

Home

Pharmacy

Lab HealthPlan

RegistrarHR

Clinic

Page 27: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Tools and Approaches

• Clarity of project ownership and

executive sponsorship

• Industry-standard project

documentation, including project

charters, plans, and risk registers

• Online team collaboration and

Organization-wide dashboards with

“Smartsheets”

Project Management Office (PMO)

Role of the PMO

Ensure that projects align with MIT Medical’s strategic vision

Monitor progress and provide reporting to stakeholders and executive sponsors

Identify risks and proactively develop mitigation and contingency plans

Creating a culture of production, on-time delivery of project milestones

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 40

Capabilities

Page 28: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Zero-based Budgeting

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 41

Building from the Ground Up

Look ahead to estimate efficiency-related changes

Look for savings wherever possible

Compare to prior year’s actual results, not budget

Review budgets at the G/L level

Every dollar, every year, must be justified for every cost center

Approaches

Page 29: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Outcomes

• Attrition creates opportunities to

evaluate each role, function

• Process is consistent and transparent

– No surprises when roles are not backfilled

– Creates culture of demonstrating need

– Emphasizes organizational priorities

• Limits annual headcount requests

Zero-based Staffing

Staffing Without Assumptions

Existing position opens

Requirement to justify replacement

Weighed against all

open requests

Allocate headcount to highest need

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 42

3

4 1

2

Approaches

Page 30: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Reorganization Approach

• Align administrative functions with

clinical teams, creating partnerships

• Create new functional managers and

front-line team leads across the

organization

• Add more differentiated and

achievable steps for professional

advancement

Organizational Structure Redesign

Challenges of a Flat Organization

Too few middle managers providing “on-the-ground” leadership

Limited pathways for employee development

Managers with excessively large spans of control

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 43

People

Page 31: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

“Leadership Everywhere”

Executiveleadership

“Drivers of change”

Managers & supervisors“Coaches and champions”

Functional leads“On-the-ground experts”

Individual contributors“Leaders-in-training”

Investing in Our Team

Engaging and Developing

• Conduct annual healthcare-specific

employee engagement survey

– Set a baseline for interventions and

measure progress

• Executive coaching for key leaders

• Comprehensive management

training program – creating MIT

Medical leaders at all levels

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 44

People

Page 32: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Foundation Year Components

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 45

• Population Health

• Project Management Office

Capabilities

• Organizational Structure Redesign

• Investing in our Team

• Zero-based Budgeting

• Zero-based Staffing

Approaches People

Page 33: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 46

Foundation Year+

Page 34: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

The “Why” of a Foundation Year

Creating a foundation isn’t easy,

fast or glamorous… but if you want

to dream big, it is a requirement.

And we are dreaming big.

March 6, 2019

MIT Medical | AOFO Meeting

PAGE 47

Page 35: Building a healthier MIT: From strategy to implementation · Role of the PMO Ensure that projects align with ... Too few middle managers providing “on-the-ground” leadership Limited

Building a healthier MIT, so MIT can build a better world.