DIY PMO – Assessment and Improvement Efforts for Project Management
By Yuri Campbell, PMP, CHCIO, LSSBB, CISSP
Chief, Medical Information Systems Branch at Army Medicine
In this article, I share an approach I used in supporting a fellow CHIME member and Chief Information Officer (CIO) with a problem he was facing. The task was to assess the project management functions of the new organization he assumed responsibility for. I believe the steps I followed are simple enough to be used by anyone with basic project management skills. This approach is especially useful if you are operating on a restricted budget that is not quite suited for bringing in a high-cost consultant to make everything perfect for you. This is the first of two articles, with this first serving as an introduction followed by a report on the progress the organization achieved after more than a year of implementing and learning from this initial effort.
The newly assigned CIO’s name was Kevin, and Kevin was looking for external help to verify whether or not his staff had the requisite knowledge, skills and resources to operate a world-class project management office (PMO). Kevin has led many projects and initiatives over his extensive military career, but he was not formally trained nor certified as a Project Management Professional. This is where I came into the story to assist. Over the past few years, I was involved with several efforts to establish project management oversight functions at various levels. I charted a PMO for the Information Services Division for my facility, and shortly thereafter also led the efforts to design and implement a supporting PMO at the larger facility level. A year after, I was a part of a team that provided consultation services advising one of the largest military medical treatment facilities on best practices to improve the PMO function the local staff.
The goal Kevin expressed was to create a PMO to help shepherd programs and projects at the greater than 20 medical centers and clinics his staff supported. Recent reorganizations resulted in drastic staff turnovers, and upon assuming his new role, Kevin could not get an immediate answer regarding the exact amount nor status of projects in the organization’s portfolio. This contributed to his uncertainty if his new staff had the tools or resources to execute his intent. One of the first priorities the CIO declared was a renewed focus on establishing the PMO Project Management Office.
The CIO wished to assess the capability of his team as he shaped his vision on developing the PMO under his leadership. If the staff was not prepared to meet his intent, he needed a path to get them to a satisfactory level. The initial steps I took involved clearly identifying the problem from Kevin’s perspective as the customer. Clearly defining the problem was paramount to implementing the right solution.
I used the Donabedian model of structure, process and outcomes, along with Kotter’s 8-Step Change model as guiding principles on this project. The Donabedian model is one frequently used to assess quality in the healthcare arena. It is broad enough however to apply to different situations. The model basically explains that if the proper structures and processes are in place, the desired outcomes should ensue (Donabedian, 2005). Keeping to the brevity required of a short article, suffice it to say that the entire effort was to ensure that Kevin’s teams were using appropriate processes, supported by the right structures, to get the desired outcomes they were seeking.
Using the structure, process, outcomes framework, I built a visual aid that allowed a step-by-step method for conducting the assessment (See Figure 1). This was initially done using a survey style assessment sent to the staff for them to self-report, but was followed up by a face-to-face site visit, where Kevin and I jointly met with the staff, and gained a common level of understanding between all the key stakeholders. While the self-reporting interviews were quite useful and informative, the face-to-face interviews were the most valuable, as they allowed the staff to provide demonstrations of the tools and techniques they did have available to them.
It was important that we did not alienate the staff with any intended changes to policies and procedures of the organization, and so I drew upon the advice of John Kotter’s 8-Step Change model (Kotter, 2014) as we went through this process. While Kotter’s steps (See Figure 2) may not have been applied sequentially because of the operating culture of the organization, it was important to adopt as many of the steps as possible to support realization of the desired end state. We worked to build a guiding coalition with key organizational leaders such as senior project managers, technical experts and respected customer representatives. Kevin’s vision was clear, he wanted his region to lead the enterprise in all metrics. We enlisted a volunteer army of both internal and external supporters, including consultants and other laypersons who saw the vision, were motivated by it, and wanted to be on the team.
Our initial assessment using my flow chart revealed that there were trained and certified Project Management Professionals at the organization, and an internal shared portal capability to support a project management information system. This validated that the structures were in place for a PMO. The processes however, were not so well established, as we discovered through the site visit meetings arranged with the various stakeholders in the organization.
We found that project information resided in silos throughout multiple functional areas, subjecting key stakeholders to unnecessary delay when there was a need for project update briefing. The staff were mostly trained using the Project Management Institutes’ methodologies, a worldwide best practice and the system of choice most often seen in the military health system (MHS); however, I found there was inconsistency with project reporting. For example, work that should be categorized as projects was intermingled with ongoing operational-type tasks on performance monitoring. Implementation variation can lead to inconsistent reporting of project measures. It was not easy to assess the value that a service line contributed to the organization while their efforts were not being consistently measured.
An added benefit from my visit was to help the leadership delineate between projectized work and operational, day-to-day activities. Previously there was a blending of reporting of improving operational work using the Lean methodology of the DMAIC (Define, Measure, Analyze, Improve and Control) and the PMIs method for managing projects, which are not operational, but are time bound for creating a new process, product or service. The CIO gained an appreciation for the complexity of issues his staff had on their plates to accomplish, but also the need to properly organize the onboarding and assignment of work efforts properly binning their reporting practices.
Effective project management is an essential service provided by an Information Services (IS) Division. It is the part of the value chain that delivers solutions to its customers. A well-run project management office delivers on this promise. The CIO must be a leader who provides purpose, direction and motivation to staff members, and ensures maximum alignment towards the organization’s strategic thrusts. Being able to see the direction the organization is moving towards, describing that success to staff members and managing towards those ends is a vital skill necessary for the new CIO leader.
Donabedian, A. (2005). Evaluating the Quality of Medical Care. Milbank Quarterly, 691–729.
Kotter, J. (2014). The 8-Step Process for Leading Change. Retrieved Jan 2017, from Kotter International: https://www.kotterinternational.com/8-steps-process-for-leading-change/
More AEHIA News Volume 2, No. 1:
- Variation in EMR Satisfaction Offers Clues for Ways to Improve – Taylor Davis, KLAS
- AEHIA Board Chair Todd Hatton Talks Goals for 2018 (Audio included) – Zach Donisch, Director of Membership, AEHIA
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