Project-management experts know that there’s more to a project than its size. Determining scope may be one of the most critical aspects to manage.

 The nine areas to oversee when managing a project are integration, scope, time, cost, quality, human resources, communications, risk, and procurement, according to the Project Management Institute’s (PMI of Newtown Square, Pa) Project Management Body of Knowledge (PMBOK).1 Each of these factors is important, but one of the most critical is management of scope.

Scope Management
“It’s not just the size of the project but also the actual work involved,” says Herb Sivitz, director of Alaska Clinical Engineering Services (ACES) of Anchorage, Alaska.

Jon Crispin, implementation team leader with Philips Medical Systems, Bothell, Wash, agrees, stating, “Sometimes a smaller project can be harder to manage.”

Determining the overall scope of a project can help you “understand where you fit in the long run,” Sivitz says, offering a new clinic as an example. “We are typically not involved in the construction or the decision-making process behind what inventory will be used in that facility. But we can provide larger insight into those areas.

“Even if we are not responsible for a certain aspect, we can offer information on the installation of equipment, the development of workflow, and compliance with the many regulations,” Sivitz says.

Not defining and understanding the scope of the project can lead to miscommunication, according to Sivitz. “Start with the customer to understand his or her perception and understanding. [When miscommunications arise,] it’s possible thatsome portion of the work has not been defined or has been assumed,” Sivitz says. “You need to match perceptions with the scope.”

Human Resources Management
Everyone also needs to know his or her roles and responsibilities. “It’s critical to make sure you identify all roles and responsibilities for the project,” says Crispin, who handles the installation of Philips’ patient-monitoring systems. “I break down what Philips and the customer are responsible for.” He suggests putting together a detailed list of resource names that includes anyone associated with the project, even if they are not involved past the early stages. This may include the project manager, nurses, information technology (IT) personnel, the team engineer, a clinical educator who will handle training, sales reps, and the hospital project manager, Crispin lists.

“One of the key things is to make sure that everyone knows who the contact people are. Sometimes there are two project managers, so it needs to be clear up front who to go to with questions. People will go to the field engineer because they know him, but it should always come back to the project manager, who needs to know what’s going on on-site and behind the scenes,” Crispin says.

But Crispin likes to keep everyone else informed, too. “I try to cc: everyone on a project, even when it’s a specific question. I want to keep everyone informed and working together,” he says.

Having everyone in the know helps keep the project on track. “If everyone knows what everyone else is doing, it solidifies who’s responsible and inspires them to get it done,” Crispin says. He uses meetings and email to accomplish this. “After completing a walk-through at a customer site, I’ll follow up with an email summarizing what was discussed. In meetings that include all interested parties, assignments made are noted by everyone,” Crispin says.

The peer pressure, however, does not ensure timely completion. “It’s important to make sure that whoever is assigned a task is getting it done on time. There is not a lot of time for delay,” Crispin says, whose projects are typically completed within 8–12 weeks.

Time Management
This 8- to 12-week period begins with the purchase order and ends with the installation. Of this, 6–8 weeks is usually dedicated to entering the order, completing the documentation, scheduling resources, and ordering materials, according to Crispin. “Sometimes, projects need to be completed more quickly, but resources are carefully checked before committing to a shorter time frame,” he says.

Crispin typically handles 50–60 projects at once, and finds that he can reuse material infrequently. “We apply the same philosophy to every project but must typically start from scratch. Every customer’s site is different,” he says, citing complexity, location, and scope as factors.

Elliot B. Sloane, PhD, assistant professor, decision and information technologies, Villanova University, College of Commerce and Finance, Villanova, Pa, suggests that time be managed along with perceptions. “Always provide conservative goals and budgets that you are certain you can deliver. Always set stretch goals that will deliver results well ahead of goals given to your superiors,” Sloane says.

He also advises that project managers “press hard to hit early and mid milestones on or before schedule. Trying to catch up at the end is almost hopeless and usually catastrophically expensive.”1

Sloane also warns that most IT and construction projects are much more complex than initially understood. “The interaction of people, hardware, software, and systems causes many unexpected complications, delays, risks, and costs,” Sloane says. He suggests that the right software tool can be used to help ensure success.

Crispin uses Microsoft Office Outlook for many projects’ calendar needs, but for complex projects, he uses Microsoft Office Project.

ACES also uses Microsoft Office Project, in addition to two other programs, according to Sivitz. “Microsoft Project helps to manage the time and resources for the project. Equipment-list-development software helps to compile equipment data into lists, for instance, by room or customer. A third system—work order management—tracks expenses, such as travel, lodging, per diem, and equipment, which is then used to bill back for all services,” Sivitz says.

Quality/Communications/ Procurement Management
Documentation of expenses is just one of the many items that must be tracked. In addition to this information and the contact list, documentation is also kept to record communication, certifications, equipment, and technical details, such as system drawings. “Our technical documentation includes details on how everything is connected, as well as items such as software revisions and network configuration,” Crispin says. Answers to questions such as, “What is connected to each port?” and, “What frequencies are being used?” should be available in the project materials.

And even though documentation may be accurate and goals may be met, Crispin tries to review every project after its completion to see how the process could have been improved. “We try to complete a ‘lessons learned’ after every project, particularly when we can get feedback both internally and externally. We ask the customer how it could have been done better. The goal is not to diminish the work that was done, but to learn how to improve. We are always trying to fine-tune project management and make it better for everyone,” Crispin says.

Similarly, the ACES team also analyzes problems to determine how things could have been done differently, even going so far as to develop a program to analyze the weather. “We’ve had many problems with scheduling due to unpredictable weather, particularly when working on islands farther away. We are now gathering weather information, such as wind speed and fog conditions, and analyzing the data to use for scheduling purposes,” says Abdul Bukhari, PhD, MC, clinical engineer manager, Field Service Program, ACES.

The ability to handle challenges of this sort is inherent to the job of project manager. “When you are managing 40 or 50 projects, you need to be able to multitask effectively,” says Crispin, who believes that this ability is one that is innate. “Some people can do it, and some can’t. You cannot teach project management. You can hone your skills, but if someone can’t manage time or a project, I don’t know that it can be taught,” Crispin says.

He relies on a combination of skills and techniques taught in school and learned on the job. This is one of the reasons he values the “lessons learned” approach.

Integration Management
Of course, learning takes place throughout a project’s entire life cycle, not just at the end. But according to Sloane, the true end is often elusive. “Yes, there is a beginning and an end, but that end is rarely truly the end. In health care, we live with and by our tools and systems for decades upon decades,” he says.1

Sloane suggests that a project’s life cycle is not always linear but rather is often iterative, cycling through analysis, design/prototype, and review/revise phases until complete. “Projects almost always need test, implementation, and maintenance phases,” says Sloane, who warns that these stages are often overlooked and unbudgeted and therefore are serious risk or failure points.

“An excellent project manager in health care knows that today’s project fits in a much larger matrix of projects that has history—and will create history,” Sloane says. “Many critical interdependencies exist and must be understood and managed for your project to succeed.”1

Renee Diiulio is a contributing writer for 24×7.

1. Sloane EB. Successful project management, with special emphasis on information technology projects. Presented at: Annual Meeting of the Association for the Advancement of Medical Instrumentation; June 8, 2004; Boston.