S05/S43: HIT System Lifecycle
Content
HIT System Lifecycle: Proven Project Management Methods W k h M th d Workshop
Judy Murphy, RN, FACMI, FHIMSS J d M h
Vice President, Information Services, Aurora Health Care, Milwaukee, WI [email protected] judy murphy@aurora org
Cindy Gadd, PhD, MBA, MS
Associate Professor & Director of Educational Programs, Dept of Biomedical Informatics, Vanderbilt University [email protected]
Agenda
• Tuesday, May 25, 2010
10:00-10:10am 10:10–10:50am 10:50-11:00am 11:00–11:30am 11:30-11:40am 11:40-12:15pm 1:30-1:40pm 1:40–2:20pm 2:20-2:30pm 2 20 2 30 2:30–3:00pm Introductions & Review Agenda g PART 1: Systems Lifecycle Exercise Set-Up p Complete Exercise & Take Break Exercise Report-Out PART 2: Project Management Introductions & Review Agenda PART 1: Systems Lifecycle Exercise S t U E i Set-Up Complete Exercise & Take Break
• Wednesday May 26, 2010 Wednesday, 26
3:00-3:10am 3:10-3:45pm 3 10 3 45
Exercise Report-Out PART 2 P j t M 2: Project Management t
2
PART 1: System Life Cycle
• We will cover … What is the Systems Life Cycle What is a Project What is Project Management 10 Reasons Projects Fail
3
As people learn from past mistakes in completing IT projects, a model has been developed and refined over the years to try and maximize the chances of a successful project. This method / model is called the SYSTEMS LIFE CYCLE, and outlines the steps in an IT project. It consists of a series of stages that take a project from its i t f i f t th t t k j tf it very first stages to the final outcome of a fully working, fully integrated system. The t Th term 'lif cycle' is used because the process never 'life l 'i db th really ends. Systems are created, they become mature, they grow old and are replaced by new ones. It is a cycle.
4
5
Why is Systems Lifecycle needed?
IT change is particularly risky! Consider the sobering results obtained from a survey of over 14,000 organizations (OASIG study(1)):
80-90% of systems fail to meet performance goals 80% of systems are late and over budget y g 40% of systems fail or are abandoned Less than 40% of implementations fully address training and skills requirements Less than 25% properly integrate business and technology objectives Just 10-20% of businesses meet all their success criteria. 31.1% of projects are canceled before they get completed 52.7% of projects cost over 189% of their original estimates Only 16.2% of projects are completed on time & on budget
(2) http://www.projectsmart.co.uk/docs/chaos-report.pdf 6
The Standish Group research(2) shows:
(1) http://www.it-cortex.com/Stat_Failure_Rate.htm
There are many things that can and do go wrong when an organization is planning to develop/install a new HIT system. H t Here i a humorous look at a few: is h l k t f
http://www.geekzone.co.nz/juha/1637
What could be done better? What could reduce the chances of failure?
Pay attention to the Systems Lifecycle Use good Project Management oject a age e t
8
Systems Lifecycle
Parallels with the Problem-Solving Process
Organization Analysis & Design Development (Build) Testing Training
Implement Post Conversion Support
Assess Diagnosis
Plan
Intervene
Evaluate
9
Systems Lifecycle
Organization
•Project Charter •Scope •Organization Chart •Project Team Project •Budget •Identify Improvement Opportunities •Benefit Realization Benefit •Baseline Measures
10
Systems Lifecycle
Organization Analysis & Design •Process Fl P Flow A l i & Redesign Analysis R d i •Hardware •Detailed System design: •Applications •Features/functions F t /f ti •Database/Vocabularies •Security •Reports •Interfaces I t f
11
Analysis and Design
Documentation of Current State
Meet ith t k h ld M t with stakeholders Who will be effected Gather what you are doing today y g y Current workflow process Current examples, tools, printouts Current problems/challenges Identify data you want coded for automation Determine if changes will be made Determine a process for “change” D t i f “ h ” Determine a process of “signing off” change
12
Analysis and Design
Future State Design
Workflow Re-Engineering/Process Re-Design Identify Process Tasks Streamlined by automation Enhanced by operational change Eliminated Learn the functionality of your new system to L th f ti lit f t t design and make decisions Gap Analysis Current to Future “Reality” vs. “Blue Sky”; 1 or 2 step process
13
AMCMC FUTURE STATE INPATIENT RECORD PROCESSING
Sample Visio Workflow Diagram
Existing chart
STAR AFTER T PATIEN IS T DISCHARGED
OBTAIN DISCHARGE REPORT FROM INCOMPLETE AREA
DISCHARGE REPORT
OBTAIN INPATIENT RECORDS FROM CLINICAL AREAS THE MORNING AFTER DISCHARGE
VERIFY ALL CHARTS HAVE BEEN RETREIVED
Volumes will normally be created when patient is admitted
himCreateVolume.exe CREATE VOLUME Existing chart ? no-new Profile Print bar code
New chart
yes himCreateVolume.exe UPDATE THE CHART LOCATION UP DATE CHART LOCATION himUpdateChartLocation.exe
Visit records
Profile
ASSEMBLE THE CHART ADD VISIT RECORDS TO THE CHART himCreateVolume.exe himCreateVolume exe CREATE VOLUME Print bar code
Patient chart
IS THE FOLDER FULL? NO
YES
Profile
New chart
PLACE CHART ON PRONGS
PAGE 2
PATIENT IDENTIFIER DATA FLOW
Updates Only
SUNQUEST
PATIENT ID's ---------------------"HM" 11111111 (ROBERT SMITH) "HM" 260011111111 (JANET JONES) ORD ID's _________
Open Engine will prefix the patient ID with the client code (2600) to k i h h li d keep HPC patient unique on SunQuest. Likewise, on outbound transactions, Open Engine will strip off the client code prefix. Outstanding decision: Should we prefix with the entire client code or just use the org code (i.e., 26)?
SMS REGISTRATION
NOTE: The manual chatr# is not always known at the time of registration. Also, the clinic location is not identified at the time of registration.
000011111111 NAME: JANET JONES CHART # = 00185731 CASE # = 00666666
PAT ID + HIS ORD NUM + SUNQ ORD CODE
Updates Only
CHARTSCRIPT
PATIENT ID's --------------------"HMH" 11111111 12345678 (ROBERT SMITH) "HPC" 11111111 115808 (JANET JONES) [Clinic locn => Locn code] Store CHART# in UDF?
PT KEY=PAT SYS ID (MANUAL CHART# - Data Field) FIN KEY=CASE#
NOTE: The encoutner# is generated at the time of the scheduled appointment. The clinic location is identified at this time too. A "Reg" transaction is genterated for all feeds, then a schedule transaction to HNA. Also, the manual chart# is not always known at the time of the scheduled appointment.
SMS SCHEDULING
000011111111 NAME: JANET JONES CHART # = 00185731 ENCOUNTER# = 115808
DOC ID's __________
Order Status Orders
PAT ID + DOC (Need Order # for Radiology)
Results
Sample Data Flow Diagram
SunQuest Lab Charges L SMS BILLING PROCESS IDENTIFIERS NEEDED: 1) MRU# or PAT SYS ID... 2) CASE# or ENCOUNTER #... 3) ORDER #, If applicable...
Updates Only
HNA
Orders
FIN KEY=ENCOUTNER#
ADZ
"31" 11111111 NAME: ROBERT SMITH CASE# = 12345678
PATIENT ID's --------------------(3100) 11111111 12345678 (ROBERT SMITH) (2600) 11111111 115808 (JANET JONES) [Clinic locn => f ilit code] [Cli i l > facility d ]
Order Status
A N H rs de rd O
ORD ID's ID s ----------------
d an
PAT ID + HNA ORD NUM
Results
es rg ha C
OCF
PT KEY=HOSP ORG+MRU# FIN KEY=CASE#
"HMH" 11111111 HMH (ROBERT SMITH) "HPC" 11111111 (JANET JONES)
ChartScript Dictating Radiologist
Systems Lifecycle
Organization
Analysis & Design
Development (Build) •Construct Databases C t tD t b & Data Dictionaries •Configure Applications •Build Security •Write Reports W it R t •Infrastructure •Desktop/Mobile devices •Printers •Network N t k •Redundancy/Disaster recovery •Interfaces •Write Policy/Procedures
16
Systems Lifecycle
Organization
Analysis & Design
Development (Build)
Testing
•Conduct Testing - Unit - System - Integration - Stress - Volume
17
Systems Lifecycle
Organization
Analysis & Design
Development (Build)
Testing
Training
•Complete Training Materials •Conduct Train the Trainers •Conduct End User Training
18
Systems Lifecycle
Organization
Analysis Development & Design (Build)
Testing
Training
Implement
• Operational i l Readiness • Go/No-Go Decision i i • Go-Live
19
Systems Lifecycle
Organization
Analysis & Design
Development (Build)
Testing
Training Implement Post
Conversion Support
20
What is a Project?
A project is a multi-task, one-time job that has definite t ti d fi it starting and d ending points, a welldefined scope of work to be done, a budget, and a temporary team. p y
http://en.wikipedia.org/wiki/Project_management http://en wikipedia org/wiki/Project management 21
What is a Project?
The Project Management Institute (PMI) defines a project as f ll d fi j t follows: A project is a temporary endeavor undertaken to create a unique product or service. Temporary means that every project has a definite beginning d definite d d fi i b i i and a d fi i end. Unique means that the product or service is different in some distinguishing way from all other products or services.
http://www.pmi.org/Pages/default.aspx 22
What is a Project?
A project is a p problem scheduled for solution. solution
— Dr. J. M. Juran
http://www.juran.com/HomeLeftNav/juran_mgt_system.aspx 23
Project Management Defined
Project management is facilitation of the planning, scheduling, and controlling of all work that must be done to meet project objectives.
24
What Is Project Management?
Project management is the application of knowledge, skills, tools and techniques to p j q project activities to meet project requirements.
Project management … a systematic process for implementing systems on time, within budget, and in line with customer g , expectations of quality.
d 2004. A guide to Project Management Body of Knowledge (PMBOK), 3rd Ed.
25
Project Management across the Systems Lifecycle
Organization Analysis & Design Development (Build) Testing Training
Implement Post Conversion Support
Start Plan
……...Project Management……….
(Project Organization & Work Planning)
26
OTHER RESOURCES: Top 10 Project Management Challenges by P.W. Ford
http://projectmanagementcourse.com/project-challenges.html htt // j t t / j t h ll ht l
Project Mangement Imperatives: Ten Keys to Success by Jerry Manas
http://www.pmthink.com/2007/01/project-management-imperatives-ten.htm
27
Exercise Set-Up
Strategic Analysis g y
SWOT Analysis Stakeholder Analysis y
28
Initiating: SWOT Analysis
( (Strengths–Weaknesses-Opportunities-Threats) g pp )
SWOT Analysis: Strategic planning is an
important component of project initiation and planning.
Focuses team members on project requirements and facilitates identification of factors that may impact achievement of project deliverables. Assists with identifying potential Strengths and Weaknesses of your team relative to a project and the potential Opportunities and Threats inherent in p pp the project.
*Template available in workshop handouts
29
Initiating: SWOT Analysis
( (Strengths–Weaknesses-Opportunities-Threats) g pp )
30
Initiating: Stakeholder Analysis
Documents important (often sensitive) information about each stakeholder:
Stakeholders’ names Their roles on the project Unique facts about each stakeholder Their level of influence on and interest in the project Suggestions for managing relationships with each stakeholder – what do you need form them and what do they need from you y y Identify potential sources and causes of resistance and strategies for overcoming
31
Initiating: Stakeholder Analysis
32
Plan to influence Stakeholders
33
Agenda
• Tuesday, May 25, 2010
10:00-10:10am 10:10–10:50am 10:50-11:00am 11:00–11:30am 11:30-11:40am 11:40-12:15pm 1:30-1:40pm 1:40–2:20pm 2:20-2:30pm 2 20 2 30 2:30–3:00pm Introductions & Review Agenda g PART 1: Systems Lifecycle Exercise Set-Up p Complete Exercise & Take Break Exercise Report-Out PART 2: Project Management Introductions & Review Agenda PART 1: Systems Lifecycle Exercise S t U E i Set-Up Complete Exercise & Take Break
• Wednesday May 26, 2010 Wednesday, 26
3:00-3:10am 3:10-3:45pm 3 10 3 45
Exercise Report-Out PART 2 P j t M 2: Project Management t
34
PART 2: Project Management
• We will cover … Five Process Groups and the IPECC Flow
1. 2. 2 3. 4. Initiating Planning Executing Monitoring & Controlling
5. Closing
Knowledge Areas in each Process Group The “Triple Constraint” Triple Constraint
35
Project Management Methodology
Provides a systematic means to gain control over cost, quality, risk, scope, & time (e.g. variables that determine project success)
TIME
QUALITY
PROJECT MANAGEMENT
COST
SCOPE
RISK
36
Project Management: 5 Process Groups
1. 2. 3. 3 4. 5. 5 Initiating g Planning Executing Monitoring and Controlling Closing Cl i
37
The IPECC Flow
Initiating
Planning
Executing
Monitoring & Controlling Closure
Source: Partners HealthCare PMO
38
Level of Activity and Overlap of Process Groups Over Time
Source: Schwalbe, K. (2006). Information Technology Project Management, Fourth Edition, pg. 73.
39
40
Relationship of Process Groups
Process groups can be mapped to the PlanDo-Check-Act Cycle Cycle. Each process group marked by:
Inputs, tools and techniques, outputs (deliverables). Individual process groups linked by inputs/outputs. Outputs from each process group become inputs to next process group.
Project Management Process Groups Mapped to the Plan-Do-CheckAct Cycle (PMBOK, 2004; p. 40)
Often iterated prior to project completion completion.
41
Process Group Triangle
When large/complex l / l projects are separated into phases, phases the process groups will be repeated for each phase
Project Management Process Group Triangle (PMBOK, 2004; p. 69) 42
Knowledge Areas for each Process Group
Knowledge Area Project Management Process Groups
Initiating Project Integration Management Project Scope Management Project Time Management Project Cost Management Project Q j Quality Management y g Project Human Resource Management Project Communications Management Project Risk Management Project Procurement Management Planning Executing Monitoring & Controlling Closing
X
X X X X X X X X X
X
X X X X
X
X X X
X X X X
X
X
X
43
Adapted from: Schwalbe, K. (2006). Information Technology Project Management, 4th Edition, pps. 76-77
The IPECC Flow
Initiating
Planning
Executing
Monitoring & Controlling Closure
Source: Partners HealthCare PMO 44
Initiating Purpose
The purpose of the project initiation process is to identify the project need, stakeholders, identif p oject need stakeholde s and main goals of the project.
Identify the problem this project solves Understand the business case & ROI Identify the project players Create a shared vision for the project deliverables Craft C ft a project mission th t i congruent with j t i i that is t ith the vision of the organization
45
Initiating Tools & Techniques
Business Case SWOT Analysis
(Strengths–Weaknesses-Opportunities-Threats)
Stakeholder Analysis Skill I Inventory t Project Charter Roles & Responsibilities Matrix / RACI Chart
(Responsible-Accountable-Consulted-Informed)
Value Risk Assessment Weighted D i i W i ht d Decision Matrix M t i Project Portal Project Initiation Checklist
46
Initiating: Project Charter
A project charter is a document that p j formally recognizes the existence of a project and provides direction on the project s project’s objectives and management. management Key project stakeholders should sign a project charter to acknowledge agreement on the goals & intent of the project. Defines the overall approach to the project project, the deliverables and project success
47
the Project Charter …
Facilitates communication among stakeholders Defines approved purpose, scope, objectives, cost and purpose scope objectives schedule baselines Documents agreement between groups/stakeholders Documents assumptions Provides baseline for scope and expectation management Shows how project will be organized Lists team members Defines roles/responsibilities Describes purpose & mission D ib i i Identifies project goals ( g phase outputs) p ) Describes deliverables (tangible p
48
Project Charter example
49
Initiating: RACI Chart
50
Initiating: Value Risk Assessment
51
Initiating: Weighted Decision Matrix
52
The IPECC Flow
Initiation
Planning
Executing
Monitoring & Controlling Closure
Source: Partners HealthCare PMO 53
A common argument for not planning is, “We don’t have time to plan.”
The more critical the deadline, , the more necessary the plan. plan
54
Planning Purpose, Tools & Techniques
The purpose of the project planning process is to guide execution of the project. Tools & Techniques
Scope Statement – including what s in and what’s what’s out of scope WBS: Work Breakdown Structure Gantt Chart
55
Simply put, the PLANNING phase defines …
56
Planning: Scope Statement
Developed from:
Voice of the customer Project charter Stakeholder analysis SWOT a a y O analysis (strengths, weaknesses, opportunities, threats)
57
Planning: Work Breakdown Structure
(Network Diagram format) WBS: A deliverable-oriented grouping of project elements and tasks that organizes and defines the total scope of the project.
(Milosevic, 2003)
58
Planning: Work Breakdown Structure
(Gantt Chart format)
59
60
61
62
63
The IPECC Flow
Initiation
Planning
Executing
Monitoring & Controlling Closure
Source: Partners HealthCare PMO 64
65
Executing Purpose
the work in the project plan, meet project h k h l requirements on time, within budget and in a way that is satisfying to the customer
Commonly involves:
Developing specifications Conducting programming Conducting testing Introducing new hardware/software/procedures Int od ing ne ha d a e/soft a e/p o ed es
The purpose of the executing process is to complete
66
Executing Tools & Techniques
Project Meeting – agendas and minutes Request for Proposal Template Updated Gantt chart – Planned vs. Actual Time Reporting t l Ti R ti tool Risk identification and mitigation plan Issue log Progress/Status reports
67
Executing: Time Reporting Tools
68
Executing: Issue Log
69
The IPECC Flow
Initiation
Planning
Executing
Monitoring & Controlling Closure
Source: Partners HealthCare PMO 70
Monitoring & Controlling Purpose
The purpose of the monitoring & controlling p ocesses cont olling processes is to observe p oject obse e project execution so the potential problems can be identified in a timely manner and de ed ey a e a d corrective action can be taken when necessary to control execution of the project (PMI, 2004). j t
Performed throughout life of project (within p process g group and across p j p project) ) Provides feedback between project phases
71
Monitoring & Controlling Definitions
Monitoring: keep track of project processes associated with initiating, planning, executing and initiating planning closing a project.
Project performance (actual) vs. project plan (projected) Risks identified, tracked, response plan in place Status reporting, progress measurement and reporting
Controlling: Corrective or preventive actions taken to direct project performance.
Determining when change has occurred Managing and approving change. May necessitate revisiting the project plan and making updates.
72
In words, “Cost is a function of Cost Performance, Time, and Scope.”
73
Project Management: The Triple Constraint
Framework for evaluating l ti the project impact when changes occur in time cost time, or scope. Quality is at center. center Changes in one point will affect at least one other point and is likely to affect quality.
74
Monitoring & Controlling Tools
Project management methodology h d l Project management system Time reporting tool Progress reports Expert judgment
75
Monitoring & Controlling: Progress Reports
How is my project doing overall? Are my project on schedule? Are my time y estimates accurate? Are my resources properly utilized? Are my cost estimates accurate?
76
Monitoring & Controlling:
ID 1 6 10 14 18 22 27 30 70 110 150 156 196 197 200 212 235 254 294 295 345 356 387 392 397 402 407 Task Admin Training Support WAMH Benefits Measurement Planning Steps Current State Complete Interviews Perform Process Observat Complete Visio's Future State Visio WorkFlow Design App Build Design Radnet Superuser Training Firstnet Carenet/Orders Obtain Visio Signoffs Cert Build WAMH and SSMC Radnet Firstnet Carenet/Orders Testing Functional Integration Problem Resolution Prod Build WAMH and SSMC Baseline 3,042 hr 1,119 hr Actuals 772 hrs 2001 E-A-C Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 3,086 hr 755 hrs 17.97 hr 22 hrs 290.5 hr 65 hrs 59 hrs 142.5 hr 761.6 hr 70.5 hr 558.73 hr 194.1 hr 54 hrs 84.9 hr 279.73 hr 28.5 hr 314 hrs 126.5 hr 31.5 hr 156 hrs 496.03 hr 191.33 hr 160 hrs 41.2 hr 547.5 hr 245 hrs 1,114.5 hr
780 hrs 139.5 hr 24 hrs 22 hrs 63 hrs 59 hrs 803.5 hr 54 hrs 143 hrs 73 hrs 79 hrs 410 hrs 40.5 hr 103 hrs 28 hrs 110 hrs 462.42 hr 175.42 hr 160 hrs 32 hrs 532.5 hr 2 hrs 22 hrs 65 hrs 59 hrs 468 hrs 70.5 hr 139 hrs 36.5 hr 30.5 hr 181 hrs 23.5 hr 108 hrs 9.5 hrs 33 hrs 79.5 hr 51.5 hr 0 hrs 3 hrs 5 hrs
3,689.5 hr 1,316 hr 4,152.42 h
281 hrs 290.5 hr
Red Original B li R d = O i i l Baseline Black = Current Schedule
135 hrs 142.5 hr
657 hrs 350.5 hr
241 hrs 150.5 hr
77
The IPECC Flow
Initiation
Planning
Executing
Monitoring & Controlling Closure
Source: Partners HealthCare PMO 78
Closing Purpose
Finalize all project activities to formally close th project f ll l the j t
Finalize all activities and transfer the remaining work to the appropriate people Main outputs include:
Administrative closure procedures d st at e c osu e p ocedu es Contract closure procedures Final products, services, or results Measurements for benefit realization and return on investment
Celebration!
79
Closing Tools & Techniques
Project Closure Meeting Post Implementation Survey p y
Product Effectiveness Management of the Triple Constraints (Scope, Budget, Schedule) Risk Management Communications M C i ti Management t Acceptance Management Organizational Change Management g Issue Management Performance of the Project Team
“Lessons Learned” Meeting
What was done well? What was done poorly? Where improvement is needed in future projects?
Project Closeout Checklist j
80
PMI (Project Management Institute)
81
PMP
(Project Management Professional Certification)
82
Thanks! From Judy & Cindy
Judy Murphy, RN, FACMI, FHIMSS J d M h
Vice President, Information Services, Aurora Health Care, Milwaukee, WI [email protected] judy murphy@aurora org
Cindy Gadd, PhD, MBA, MS
Associate Professor & Director of Educational Programs, Dept of Biomedical Informatics, Vanderbilt University [email protected]
Agenda
• Tuesday, May 25, 2010
10:00-10:10am 10:10–10:50am 10:50-11:00am 11:00–11:30am 11:30-11:40am 11:40-12:15pm 1:30-1:40pm 1:40–2:20pm 2:20-2:30pm 2 20 2 30 2:30–3:00pm Introductions & Review Agenda g PART 1: Systems Lifecycle Exercise Set-Up p Complete Exercise & Take Break Exercise Report-Out PART 2: Project Management Introductions & Review Agenda PART 1: Systems Lifecycle Exercise S t U E i Set-Up Complete Exercise & Take Break
• Wednesday May 26, 2010 Wednesday, 26
3:00-3:10am 3:10-3:45pm 3 10 3 45
Exercise Report-Out PART 2 P j t M 2: Project Management t
2
PART 1: System Life Cycle
• We will cover … What is the Systems Life Cycle What is a Project What is Project Management 10 Reasons Projects Fail
3
As people learn from past mistakes in completing IT projects, a model has been developed and refined over the years to try and maximize the chances of a successful project. This method / model is called the SYSTEMS LIFE CYCLE, and outlines the steps in an IT project. It consists of a series of stages that take a project from its i t f i f t th t t k j tf it very first stages to the final outcome of a fully working, fully integrated system. The t Th term 'lif cycle' is used because the process never 'life l 'i db th really ends. Systems are created, they become mature, they grow old and are replaced by new ones. It is a cycle.
4
5
Why is Systems Lifecycle needed?
IT change is particularly risky! Consider the sobering results obtained from a survey of over 14,000 organizations (OASIG study(1)):
80-90% of systems fail to meet performance goals 80% of systems are late and over budget y g 40% of systems fail or are abandoned Less than 40% of implementations fully address training and skills requirements Less than 25% properly integrate business and technology objectives Just 10-20% of businesses meet all their success criteria. 31.1% of projects are canceled before they get completed 52.7% of projects cost over 189% of their original estimates Only 16.2% of projects are completed on time & on budget
(2) http://www.projectsmart.co.uk/docs/chaos-report.pdf 6
The Standish Group research(2) shows:
(1) http://www.it-cortex.com/Stat_Failure_Rate.htm
There are many things that can and do go wrong when an organization is planning to develop/install a new HIT system. H t Here i a humorous look at a few: is h l k t f
http://www.geekzone.co.nz/juha/1637
What could be done better? What could reduce the chances of failure?
Pay attention to the Systems Lifecycle Use good Project Management oject a age e t
8
Systems Lifecycle
Parallels with the Problem-Solving Process
Organization Analysis & Design Development (Build) Testing Training
Implement Post Conversion Support
Assess Diagnosis
Plan
Intervene
Evaluate
9
Systems Lifecycle
Organization
•Project Charter •Scope •Organization Chart •Project Team Project •Budget •Identify Improvement Opportunities •Benefit Realization Benefit •Baseline Measures
10
Systems Lifecycle
Organization Analysis & Design •Process Fl P Flow A l i & Redesign Analysis R d i •Hardware •Detailed System design: •Applications •Features/functions F t /f ti •Database/Vocabularies •Security •Reports •Interfaces I t f
11
Analysis and Design
Documentation of Current State
Meet ith t k h ld M t with stakeholders Who will be effected Gather what you are doing today y g y Current workflow process Current examples, tools, printouts Current problems/challenges Identify data you want coded for automation Determine if changes will be made Determine a process for “change” D t i f “ h ” Determine a process of “signing off” change
12
Analysis and Design
Future State Design
Workflow Re-Engineering/Process Re-Design Identify Process Tasks Streamlined by automation Enhanced by operational change Eliminated Learn the functionality of your new system to L th f ti lit f t t design and make decisions Gap Analysis Current to Future “Reality” vs. “Blue Sky”; 1 or 2 step process
13
AMCMC FUTURE STATE INPATIENT RECORD PROCESSING
Sample Visio Workflow Diagram
Existing chart
STAR AFTER T PATIEN IS T DISCHARGED
OBTAIN DISCHARGE REPORT FROM INCOMPLETE AREA
DISCHARGE REPORT
OBTAIN INPATIENT RECORDS FROM CLINICAL AREAS THE MORNING AFTER DISCHARGE
VERIFY ALL CHARTS HAVE BEEN RETREIVED
Volumes will normally be created when patient is admitted
himCreateVolume.exe CREATE VOLUME Existing chart ? no-new Profile Print bar code
New chart
yes himCreateVolume.exe UPDATE THE CHART LOCATION UP DATE CHART LOCATION himUpdateChartLocation.exe
Visit records
Profile
ASSEMBLE THE CHART ADD VISIT RECORDS TO THE CHART himCreateVolume.exe himCreateVolume exe CREATE VOLUME Print bar code
Patient chart
IS THE FOLDER FULL? NO
YES
Profile
New chart
PLACE CHART ON PRONGS
PAGE 2
PATIENT IDENTIFIER DATA FLOW
Updates Only
SUNQUEST
PATIENT ID's ---------------------"HM" 11111111 (ROBERT SMITH) "HM" 260011111111 (JANET JONES) ORD ID's _________
Open Engine will prefix the patient ID with the client code (2600) to k i h h li d keep HPC patient unique on SunQuest. Likewise, on outbound transactions, Open Engine will strip off the client code prefix. Outstanding decision: Should we prefix with the entire client code or just use the org code (i.e., 26)?
SMS REGISTRATION
NOTE: The manual chatr# is not always known at the time of registration. Also, the clinic location is not identified at the time of registration.
000011111111 NAME: JANET JONES CHART # = 00185731 CASE # = 00666666
PAT ID + HIS ORD NUM + SUNQ ORD CODE
Updates Only
CHARTSCRIPT
PATIENT ID's --------------------"HMH" 11111111 12345678 (ROBERT SMITH) "HPC" 11111111 115808 (JANET JONES) [Clinic locn => Locn code] Store CHART# in UDF?
PT KEY=PAT SYS ID (MANUAL CHART# - Data Field) FIN KEY=CASE#
NOTE: The encoutner# is generated at the time of the scheduled appointment. The clinic location is identified at this time too. A "Reg" transaction is genterated for all feeds, then a schedule transaction to HNA. Also, the manual chart# is not always known at the time of the scheduled appointment.
SMS SCHEDULING
000011111111 NAME: JANET JONES CHART # = 00185731 ENCOUNTER# = 115808
DOC ID's __________
Order Status Orders
PAT ID + DOC (Need Order # for Radiology)
Results
Sample Data Flow Diagram
SunQuest Lab Charges L SMS BILLING PROCESS IDENTIFIERS NEEDED: 1) MRU# or PAT SYS ID... 2) CASE# or ENCOUNTER #... 3) ORDER #, If applicable...
Updates Only
HNA
Orders
FIN KEY=ENCOUTNER#
ADZ
"31" 11111111 NAME: ROBERT SMITH CASE# = 12345678
PATIENT ID's --------------------(3100) 11111111 12345678 (ROBERT SMITH) (2600) 11111111 115808 (JANET JONES) [Clinic locn => f ilit code] [Cli i l > facility d ]
Order Status
A N H rs de rd O
ORD ID's ID s ----------------
d an
PAT ID + HNA ORD NUM
Results
es rg ha C
OCF
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"HMH" 11111111 HMH (ROBERT SMITH) "HPC" 11111111 (JANET JONES)
ChartScript Dictating Radiologist
Systems Lifecycle
Organization
Analysis & Design
Development (Build) •Construct Databases C t tD t b & Data Dictionaries •Configure Applications •Build Security •Write Reports W it R t •Infrastructure •Desktop/Mobile devices •Printers •Network N t k •Redundancy/Disaster recovery •Interfaces •Write Policy/Procedures
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Systems Lifecycle
Organization
Analysis & Design
Development (Build)
Testing
•Conduct Testing - Unit - System - Integration - Stress - Volume
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Systems Lifecycle
Organization
Analysis & Design
Development (Build)
Testing
Training
•Complete Training Materials •Conduct Train the Trainers •Conduct End User Training
18
Systems Lifecycle
Organization
Analysis Development & Design (Build)
Testing
Training
Implement
• Operational i l Readiness • Go/No-Go Decision i i • Go-Live
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Systems Lifecycle
Organization
Analysis & Design
Development (Build)
Testing
Training Implement Post
Conversion Support
20
What is a Project?
A project is a multi-task, one-time job that has definite t ti d fi it starting and d ending points, a welldefined scope of work to be done, a budget, and a temporary team. p y
http://en.wikipedia.org/wiki/Project_management http://en wikipedia org/wiki/Project management 21
What is a Project?
The Project Management Institute (PMI) defines a project as f ll d fi j t follows: A project is a temporary endeavor undertaken to create a unique product or service. Temporary means that every project has a definite beginning d definite d d fi i b i i and a d fi i end. Unique means that the product or service is different in some distinguishing way from all other products or services.
http://www.pmi.org/Pages/default.aspx 22
What is a Project?
A project is a p problem scheduled for solution. solution
— Dr. J. M. Juran
http://www.juran.com/HomeLeftNav/juran_mgt_system.aspx 23
Project Management Defined
Project management is facilitation of the planning, scheduling, and controlling of all work that must be done to meet project objectives.
24
What Is Project Management?
Project management is the application of knowledge, skills, tools and techniques to p j q project activities to meet project requirements.
Project management … a systematic process for implementing systems on time, within budget, and in line with customer g , expectations of quality.
d 2004. A guide to Project Management Body of Knowledge (PMBOK), 3rd Ed.
25
Project Management across the Systems Lifecycle
Organization Analysis & Design Development (Build) Testing Training
Implement Post Conversion Support
Start Plan
……...Project Management……….
(Project Organization & Work Planning)
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OTHER RESOURCES: Top 10 Project Management Challenges by P.W. Ford
http://projectmanagementcourse.com/project-challenges.html htt // j t t / j t h ll ht l
Project Mangement Imperatives: Ten Keys to Success by Jerry Manas
http://www.pmthink.com/2007/01/project-management-imperatives-ten.htm
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Exercise Set-Up
Strategic Analysis g y
SWOT Analysis Stakeholder Analysis y
28
Initiating: SWOT Analysis
( (Strengths–Weaknesses-Opportunities-Threats) g pp )
SWOT Analysis: Strategic planning is an
important component of project initiation and planning.
Focuses team members on project requirements and facilitates identification of factors that may impact achievement of project deliverables. Assists with identifying potential Strengths and Weaknesses of your team relative to a project and the potential Opportunities and Threats inherent in p pp the project.
*Template available in workshop handouts
29
Initiating: SWOT Analysis
( (Strengths–Weaknesses-Opportunities-Threats) g pp )
30
Initiating: Stakeholder Analysis
Documents important (often sensitive) information about each stakeholder:
Stakeholders’ names Their roles on the project Unique facts about each stakeholder Their level of influence on and interest in the project Suggestions for managing relationships with each stakeholder – what do you need form them and what do they need from you y y Identify potential sources and causes of resistance and strategies for overcoming
31
Initiating: Stakeholder Analysis
32
Plan to influence Stakeholders
33
Agenda
• Tuesday, May 25, 2010
10:00-10:10am 10:10–10:50am 10:50-11:00am 11:00–11:30am 11:30-11:40am 11:40-12:15pm 1:30-1:40pm 1:40–2:20pm 2:20-2:30pm 2 20 2 30 2:30–3:00pm Introductions & Review Agenda g PART 1: Systems Lifecycle Exercise Set-Up p Complete Exercise & Take Break Exercise Report-Out PART 2: Project Management Introductions & Review Agenda PART 1: Systems Lifecycle Exercise S t U E i Set-Up Complete Exercise & Take Break
• Wednesday May 26, 2010 Wednesday, 26
3:00-3:10am 3:10-3:45pm 3 10 3 45
Exercise Report-Out PART 2 P j t M 2: Project Management t
34
PART 2: Project Management
• We will cover … Five Process Groups and the IPECC Flow
1. 2. 2 3. 4. Initiating Planning Executing Monitoring & Controlling
5. Closing
Knowledge Areas in each Process Group The “Triple Constraint” Triple Constraint
35
Project Management Methodology
Provides a systematic means to gain control over cost, quality, risk, scope, & time (e.g. variables that determine project success)
TIME
QUALITY
PROJECT MANAGEMENT
COST
SCOPE
RISK
36
Project Management: 5 Process Groups
1. 2. 3. 3 4. 5. 5 Initiating g Planning Executing Monitoring and Controlling Closing Cl i
37
The IPECC Flow
Initiating
Planning
Executing
Monitoring & Controlling Closure
Source: Partners HealthCare PMO
38
Level of Activity and Overlap of Process Groups Over Time
Source: Schwalbe, K. (2006). Information Technology Project Management, Fourth Edition, pg. 73.
39
40
Relationship of Process Groups
Process groups can be mapped to the PlanDo-Check-Act Cycle Cycle. Each process group marked by:
Inputs, tools and techniques, outputs (deliverables). Individual process groups linked by inputs/outputs. Outputs from each process group become inputs to next process group.
Project Management Process Groups Mapped to the Plan-Do-CheckAct Cycle (PMBOK, 2004; p. 40)
Often iterated prior to project completion completion.
41
Process Group Triangle
When large/complex l / l projects are separated into phases, phases the process groups will be repeated for each phase
Project Management Process Group Triangle (PMBOK, 2004; p. 69) 42
Knowledge Areas for each Process Group
Knowledge Area Project Management Process Groups
Initiating Project Integration Management Project Scope Management Project Time Management Project Cost Management Project Q j Quality Management y g Project Human Resource Management Project Communications Management Project Risk Management Project Procurement Management Planning Executing Monitoring & Controlling Closing
X
X X X X X X X X X
X
X X X X
X
X X X
X X X X
X
X
X
43
Adapted from: Schwalbe, K. (2006). Information Technology Project Management, 4th Edition, pps. 76-77
The IPECC Flow
Initiating
Planning
Executing
Monitoring & Controlling Closure
Source: Partners HealthCare PMO 44
Initiating Purpose
The purpose of the project initiation process is to identify the project need, stakeholders, identif p oject need stakeholde s and main goals of the project.
Identify the problem this project solves Understand the business case & ROI Identify the project players Create a shared vision for the project deliverables Craft C ft a project mission th t i congruent with j t i i that is t ith the vision of the organization
45
Initiating Tools & Techniques
Business Case SWOT Analysis
(Strengths–Weaknesses-Opportunities-Threats)
Stakeholder Analysis Skill I Inventory t Project Charter Roles & Responsibilities Matrix / RACI Chart
(Responsible-Accountable-Consulted-Informed)
Value Risk Assessment Weighted D i i W i ht d Decision Matrix M t i Project Portal Project Initiation Checklist
46
Initiating: Project Charter
A project charter is a document that p j formally recognizes the existence of a project and provides direction on the project s project’s objectives and management. management Key project stakeholders should sign a project charter to acknowledge agreement on the goals & intent of the project. Defines the overall approach to the project project, the deliverables and project success
47
the Project Charter …
Facilitates communication among stakeholders Defines approved purpose, scope, objectives, cost and purpose scope objectives schedule baselines Documents agreement between groups/stakeholders Documents assumptions Provides baseline for scope and expectation management Shows how project will be organized Lists team members Defines roles/responsibilities Describes purpose & mission D ib i i Identifies project goals ( g phase outputs) p ) Describes deliverables (tangible p
48
Project Charter example
49
Initiating: RACI Chart
50
Initiating: Value Risk Assessment
51
Initiating: Weighted Decision Matrix
52
The IPECC Flow
Initiation
Planning
Executing
Monitoring & Controlling Closure
Source: Partners HealthCare PMO 53
A common argument for not planning is, “We don’t have time to plan.”
The more critical the deadline, , the more necessary the plan. plan
54
Planning Purpose, Tools & Techniques
The purpose of the project planning process is to guide execution of the project. Tools & Techniques
Scope Statement – including what s in and what’s what’s out of scope WBS: Work Breakdown Structure Gantt Chart
55
Simply put, the PLANNING phase defines …
56
Planning: Scope Statement
Developed from:
Voice of the customer Project charter Stakeholder analysis SWOT a a y O analysis (strengths, weaknesses, opportunities, threats)
57
Planning: Work Breakdown Structure
(Network Diagram format) WBS: A deliverable-oriented grouping of project elements and tasks that organizes and defines the total scope of the project.
(Milosevic, 2003)
58
Planning: Work Breakdown Structure
(Gantt Chart format)
59
60
61
62
63
The IPECC Flow
Initiation
Planning
Executing
Monitoring & Controlling Closure
Source: Partners HealthCare PMO 64
65
Executing Purpose
the work in the project plan, meet project h k h l requirements on time, within budget and in a way that is satisfying to the customer
Commonly involves:
Developing specifications Conducting programming Conducting testing Introducing new hardware/software/procedures Int od ing ne ha d a e/soft a e/p o ed es
The purpose of the executing process is to complete
66
Executing Tools & Techniques
Project Meeting – agendas and minutes Request for Proposal Template Updated Gantt chart – Planned vs. Actual Time Reporting t l Ti R ti tool Risk identification and mitigation plan Issue log Progress/Status reports
67
Executing: Time Reporting Tools
68
Executing: Issue Log
69
The IPECC Flow
Initiation
Planning
Executing
Monitoring & Controlling Closure
Source: Partners HealthCare PMO 70
Monitoring & Controlling Purpose
The purpose of the monitoring & controlling p ocesses cont olling processes is to observe p oject obse e project execution so the potential problems can be identified in a timely manner and de ed ey a e a d corrective action can be taken when necessary to control execution of the project (PMI, 2004). j t
Performed throughout life of project (within p process g group and across p j p project) ) Provides feedback between project phases
71
Monitoring & Controlling Definitions
Monitoring: keep track of project processes associated with initiating, planning, executing and initiating planning closing a project.
Project performance (actual) vs. project plan (projected) Risks identified, tracked, response plan in place Status reporting, progress measurement and reporting
Controlling: Corrective or preventive actions taken to direct project performance.
Determining when change has occurred Managing and approving change. May necessitate revisiting the project plan and making updates.
72
In words, “Cost is a function of Cost Performance, Time, and Scope.”
73
Project Management: The Triple Constraint
Framework for evaluating l ti the project impact when changes occur in time cost time, or scope. Quality is at center. center Changes in one point will affect at least one other point and is likely to affect quality.
74
Monitoring & Controlling Tools
Project management methodology h d l Project management system Time reporting tool Progress reports Expert judgment
75
Monitoring & Controlling: Progress Reports
How is my project doing overall? Are my project on schedule? Are my time y estimates accurate? Are my resources properly utilized? Are my cost estimates accurate?
76
Monitoring & Controlling:
ID 1 6 10 14 18 22 27 30 70 110 150 156 196 197 200 212 235 254 294 295 345 356 387 392 397 402 407 Task Admin Training Support WAMH Benefits Measurement Planning Steps Current State Complete Interviews Perform Process Observat Complete Visio's Future State Visio WorkFlow Design App Build Design Radnet Superuser Training Firstnet Carenet/Orders Obtain Visio Signoffs Cert Build WAMH and SSMC Radnet Firstnet Carenet/Orders Testing Functional Integration Problem Resolution Prod Build WAMH and SSMC Baseline 3,042 hr 1,119 hr Actuals 772 hrs 2001 E-A-C Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 3,086 hr 755 hrs 17.97 hr 22 hrs 290.5 hr 65 hrs 59 hrs 142.5 hr 761.6 hr 70.5 hr 558.73 hr 194.1 hr 54 hrs 84.9 hr 279.73 hr 28.5 hr 314 hrs 126.5 hr 31.5 hr 156 hrs 496.03 hr 191.33 hr 160 hrs 41.2 hr 547.5 hr 245 hrs 1,114.5 hr
780 hrs 139.5 hr 24 hrs 22 hrs 63 hrs 59 hrs 803.5 hr 54 hrs 143 hrs 73 hrs 79 hrs 410 hrs 40.5 hr 103 hrs 28 hrs 110 hrs 462.42 hr 175.42 hr 160 hrs 32 hrs 532.5 hr 2 hrs 22 hrs 65 hrs 59 hrs 468 hrs 70.5 hr 139 hrs 36.5 hr 30.5 hr 181 hrs 23.5 hr 108 hrs 9.5 hrs 33 hrs 79.5 hr 51.5 hr 0 hrs 3 hrs 5 hrs
3,689.5 hr 1,316 hr 4,152.42 h
281 hrs 290.5 hr
Red Original B li R d = O i i l Baseline Black = Current Schedule
135 hrs 142.5 hr
657 hrs 350.5 hr
241 hrs 150.5 hr
77
The IPECC Flow
Initiation
Planning
Executing
Monitoring & Controlling Closure
Source: Partners HealthCare PMO 78
Closing Purpose
Finalize all project activities to formally close th project f ll l the j t
Finalize all activities and transfer the remaining work to the appropriate people Main outputs include:
Administrative closure procedures d st at e c osu e p ocedu es Contract closure procedures Final products, services, or results Measurements for benefit realization and return on investment
Celebration!
79
Closing Tools & Techniques
Project Closure Meeting Post Implementation Survey p y
Product Effectiveness Management of the Triple Constraints (Scope, Budget, Schedule) Risk Management Communications M C i ti Management t Acceptance Management Organizational Change Management g Issue Management Performance of the Project Team
“Lessons Learned” Meeting
What was done well? What was done poorly? Where improvement is needed in future projects?
Project Closeout Checklist j
80
PMI (Project Management Institute)
81
PMP
(Project Management Professional Certification)
82
Thanks! From Judy & Cindy
