Project Management Made Simple 324kb Ms Word3011

Patient Flow Collaborative II Outpatients
Project management made simple
Project management
made simple
1. Project
Definition
4.Project
Close
3. Project
Execution
Project
Evaluatio
n
2. Project
Planning
Table of contents
Introduction............................................................................................................................................. 4
How to use this Handbook...................................................................................................................... 4
What is a Project?.................................................................................................................................. 5
Characteristics Of A Project............................................................................................................... 7
A Project isnt:.................................................................................................................................... 7
What is Project Management?............................................................................................................... 8
Characteristics of Project Management........................................................................................... 10
Project Management Skills............................................................................................................... 11
Why Do Projects Fail?...................................................................................................................... 12
Research Statistics.......................................................................................................................... 13
Four Phases Project Management.................................................................................................... 14
Phase 1 - Project Definition.................................................................................................................. 18
1.1 Organisational Context............................................................................................................... 19
1.2 Defining The Need For The Project............................................................................................ 19
1.3 Project Aim................................................................................................................................. 20
1.4 Project Objectives...................................................................................................................... 21
1.5 Project Roles.............................................................................................................................. 22
1.6 Project Scope............................................................................................................................. 23
1. 6.1 Project Scope - Template 1.................................................................................................... 23
1.9 Project Constraints..................................................................................................................... 25
1.10 Assumptions............................................................................................................................. 25
1.11 Stakeholders............................................................................................................................ 26
1.11.1 Key questions to ask stakeholders:.......................................................................................26
1.11.2 Assessing Project Stakeholder - Template 2..........................................................................26
1.11.3 Communicating with Stakeholders........................................................................................ 27
1.11.4 Project Stakeholder Contact List - Template 3.......................................................................27
1.12 Deliverables............................................................................................................................. 29
1.12.1 Project Deliverables - Template 4.......................................................................................... 29
1.13 Benefits.................................................................................................................................... 30
1.14 Measures................................................................................................................................. 30
1.15 Project Risks............................................................................................................................ 31
1.15.1 Risk Assessment................................................................................................................... 32
1.15.2 Project Risk Log - Template 5............................................................................................... 33
1.16 Resources Required................................................................................................................ 34
1.16.1 Project Resources - Template 6........................................................................................... 34
Phase 2 - Project Planning................................................................................................................... 37
2.1 Project Team.............................................................................................................................. 38
2.1.1 Selecting Your Project Team................................................................................................... 38
2.1.2 Managing the Project Team..................................................................................................... 39
2.1.3 Types Of Planning................................................................................................................... 40
2.1.4 Definitions............................................................................................................................... 40
2.1.5 Estimating............................................................................................................................... 41
2.1.6 Allocating................................................................................................................................. 41
2.1.7 Critical Path............................................................................................................................. 42
2.1.9 Project Planning -Template 7.................................................................................................. 43
2.1.10 Reviewing The Project Risk Log............................................................................................ 44
2.1.11 Reviewing The Project Budget.............................................................................................. 44
2.1.12 Reviewing The Communication Strategy..............................................................................45
2.1.13 Checklist for Project Planning............................................................................................... 45
3. Project Execution............................................................................................................................. 47
3.1 Key Actions................................................................................................................................ 48
3.1.1 Recruiting the Project Team.................................................................................................... 48
3.1.2 Securing Resources, Facilities and Equipment Required:.......................................................48
Project Management Made Simple
3.1.3 Communication Strategy......................................................................................................... 48

3.1.4 Managing Issues..................................................................................................................... 49
3.1.4.1 Issues Log - Template 9....................................................................................................... 49
3.1.5 Controlling the Project............................................................................................................. 50
3.1.6 Monitoring Progress................................................................................................................ 50
3.1.7 Progress Reporting................................................................................................................. 51
4. Closing the Project........................................................................................................................... 53
4.1 Completion Criteria.................................................................................................................... 54
4.2 Acceptance Process................................................................................................................... 54
4.3 Close-Out Meeting..................................................................................................................... 54
5. Evaluating the Project....................................................................................................................... 55
5.1 Active Evaluation........................................................................................................................ 56
5.2 Post Project Evaluation.............................................................................................................. 56
5.3 Technical Evaluation................................................................................................................... 56
5.4 Post Project Appraisal (Sustainability)......................................................................................56
Glossary of Terms............................................................................................................................ 57
Introduction
We work in an environment of continual change. Changes in the length of stay for
patients undergoing elective surgery, changes in what is scientifically possible,
changes in patient expectations, changes in economic constraints and changes in
demand for health services.
All these changes have one thing in common they have to be effectively managed if
they are to be successful. Change that is uncontrolled is subject to considerable risk
and potentially serious consequences for everyone and the organisation.
The process of managing change is important, from the initial idea or identification of
a problem through to controlling the consequences and reacting to problems as they
occur. The processes, procedures and techniques to manage a project are not
difficult to learn. But success depends on taking a disciplined approach to create new
working habits.
How to use this Handbook

This handbook has been developed for Breakthrough Collaborative team members,
or anyone who wants a simple methodology for project management. The handbook
is written to give practical and well-tested techniques to meet your needs if you have:
Just been given a project to manage

Have managed projects before but seek to improve your skills
Are a Breakthrough Collaborative team member and want to learn project
skills
The handbook will help you to:
Keep your project on track

Ensure that project timetables are set and adhered to
Keep control of costs
Ensure the project team is effective throughout the project
Avoid pitfalls
This handbook is a learning aid for the Breakthrough Collaborative project

management training. The training will step you through the methodology and you will
have an opportunity to try the tools and decide if they would be good for you to use in
your project. After the training you and your Breakthrough Collaborative team can
access support to apply the tools to your own Breakthrough Collaborative project.
What is a Project?
Description
This section will provide an overview of what a project is and how projects are
different from routine work.
Learning Objectives
At the conclusion of this section, participants should be able to
Explain the characteristics of a project
Describe the difference between routine work and projects
Exercise
Think about projects that you have been involved in over the last year. Write down
what is a project, what is everyday routine work and what makes projects different
from everyday routine.
A Project is
Routine work
What are the differences between a project and routine work?
A project is a collection of linked activities, carried out in an organised manner with

a clearly defined
START POINT and END POINT
To achieve some specific results desired to satisfy the strategic need of the
organization at the current time.
Source: How To Be A Better Project Manager. Trevor Young (2001)
Characteristics Of A Project
Having a specified and defined purpose
Unique because it will never be repeated in quite the same way
Being focused on customer/patients needs and expectations
Not being routine but including many routine-type tasks
Having defined constraints of time, cost and people available
Involving people from different departments and even sites
Involving many unknowns and hence many risks
Challenging traditional ways of working to introduce improvements
Providing an opportunity to learn new skills
A Project isnt:
Business as usual, or
Day to day work such as:
Setting up a new starters PC
Amending or modifying data for DHS
Assessing patients clinical need
Admitting patients for elective surgery
What is Project Management?

Description
This section will define project management; outline the four phases of project
management methodology and when to use these phases in relation to the
Breakthrough Collaborative.
Learning Objectives
At the conclusion of this section, participants should be able to:
Explain project management
Describe the four phases of project management methodology
Exercise
In pairs,
Describe the characteristics of Project Management
What are the skills required to manage a project?
List some problems you or others have experienced when managing projects
or participating in projects.
Project Management is the dynamic process that ulitizes the appropriate

resources of the organisation in a controlled and structured manner, to achieve some
clearly defined objectives identified as strategic needs. It is always conducted within
a defined set of constraints.
Characteristics of Project Management

Objective-orientated otherwise why do it?
Change-orientated to create something you need
Multi-disciplined using many skills to achieve success
Opportunistic bypassing the old norms and seeking new ideas
Control-orientated without which you may never finish
Performance-orientated - setting high standards of work and quality
Questioning throwing off old traditions and habits to expose the new
Project Management can also be defined in the following quote:

I keep six honest serving men (they taught me all I know); their names are What and
Why and When and How and Where and Who.
Rudyard Kipling (1865 1936)
10
In the majority of organisations the role of Project Manager is a temporary

management activity associated only with a specific project. The project is an
additional set of activities on top of your normal operational duties that you are
expected to carry out as part of your job.
Project Management Skills
To set targets for people which are aligned to their personal goals
To create a strong sense of responsibility for the project work
To create commitment in the team members, to help team members to prioritise

their workloads and coach them in many aspects of the work
To learn from experts to increase your knowledge
To explain your and management decisions
To encourage people to maintain interest and motivation
To regularly keep everyone informed of progress
To promote an atmosphere supporting free and willing feedback
To manage peer and senior groups to influence their support
To manage third party contractors
To manage conflict in the team
To show your concerns for continuous improvement
To take risks in the interest of the project
To communicate the alignment between the organisations strategic goals and the
project
Source: The Handbook of Project Management, Kogan
11
Why Do Projects Fail?

Many projects encounter problems through the lack of one or more of the following:
Clear aim, objectives, requirements, scope and deliverables at the commencement
of the project, eg
Initial planning takes longer than expected and management is looking for
some progress in the project, so planning is not undertaken.
The project is breaking new ground and is not clear as how to proceed or what
will actually be achieved.
Access to skills, as and when required, eg
People are transferred to other tasks

People are overcommitted with the workload
There is a shortage of the right skill and experience
Sickness and annual leave isnt taken into account
Agreed measurements and control points throughout the project eg

Team members believe that they know what they are doing and therefore
measurements and controls seem superfluous and are considered an insult.
There is a lack of clarity about what results will actually be achieved, and
therefore on how the project can be measured or controlled
Team commitment to the project eg
A team member does not see the point of the project or believes they have
been assigned too much work, responsibility
The team has already been chosen and given assignments, so some
discontent is experienced by team members
Achievable deadlines eg the delivery date is agreed to before the project planning
determines achievable timeframes.
Sponsorship and therefore lack of direction, ownership and issue resolution eg
The is no real project owner or champion for the project
The assigned project owner has no authority to make decisions that direct the
project
12
Scope management eg
The project scope was not clearly defined at the project definition
Scope change management was not effectively applied
Identification and management of risks and issues, eg major obstacles were not preempted, recognised and then tracked to resolutions
Recognitions that new influences alter the projects aims eg
Budget cuts
Changes is service delivery
Phased delivery for long running projects eg
Too much time elapses before the project delivers anything
Requirements keep changing due to length of time
Research Statistics
There is a proven direct correlation between project size and project failure over
90% of projects in the US worth over $6 million have failed.
This equates to the following statistics:
30% of US based projects never reached a fruitful conclusion
US $75billion is wasted annually in projects that fail
51% of projects in the US exceed their budget by 189% and
Most US based projects deliver only 74% of functionality
Source: 1999 Gartner Institute PM Core Capabilities
13
Four Phases Project Management
1. Project
Definition
4.Project
Close
3. Project
Execution
Project
Evaluatio
n
2. Project
Planning
14
Project
Management
Phase
1.Project
Definition
Breakthrough Collaborative Tools

1.Problem identification
Identify problem
Gather baseline data (patient, staff, operational)
2. Stakeholder Analysis
Ranking of importance and impact

Level of involvement
Expectations
3. Scoping Study
2.Project
Planning
Organisational context
Project need
Aim & objectives
Project organisational chart
Parameters, Interfaces, Constraints, Assumptions
Stakeholders
Deliverables, Benefits, Measures
Risks
Resources
Prioritisation Criteria
Checklist
Produce Business Case
Orientation
Session
+
Learning
Session 1
4. What are we trying to accomplish
Project Planning types of planning

Work breakdown Structures
Allocating & Estimating
Critical Path & Gantt Charts
Milestones
Review your Risk Log
Review your Budget
Checklist
5. Forming the project team
Selecting Your Project Team

Skills & Knowledge Required
Selection Criteria
15
3. Project
Execution
6. The current process

7. Redesign
8. Change Strategies
9. Implementation plan
10.Trial & review
4. Project
Close
Recruiting your Project Team

Securing Resources
Controlling
Monitoring
Checklist
Learning
Session
2&3
11. Implementation
Completion criteria
Acceptance Process
Close out Meeting
Active Evaluation
Post Project Evaluation
Technical Evaluation
Post- Project Evaluation (final report)
Learning
Session
3
16
Phase 1 - Project Definition
Phase 1 - Project Definition

Description
This section will consider why it is so important to realistically scope a project
and how organisations prioritise before commencing a project.
Learning Objectives
Describe the organisational and strategic context
Describe the need for the project (quantifiable)
Describe the aim and objectives
Describe the project organizational chart and roles
Describe the parameters, interfaces, constraints and assumptions
Process to identify key stakeholders
Describe the deliverables
Describe benefits of the project
Outline key performance measures
Describe project risks
Identify resources required for the project
Discuss how to select appropriate projects
18
1.1 Organisational Context

Most organisations have limited resources, projects have to be prioritised to ensure
that the greatest benefit is gained from the resources spent. Projects need to be
aligned to the strategic direction of the organization.
Examples:
Improve patient safety
Increase the appropriate use of fresh blood products
Increase elective day surgery procedures
Improve the health of the local population who have multiple chronic conditions
1.2 Defining The Need For The Project

Data should be used to quantify the severity of the problem and impact on the
organisation, patients and staff. This data forms baseline measures and allows the
project team to assess improvements from the progress.
Example:
The DNA rate of 22 percent in outpatients clinic.
Personal:
Reduce the length of time it takes to run around Albert Lake from 65 minutes to 30
minutes so I can be fit enough to run the Marathon in June.
In your Project Definition document, write down your

Organisational context
Project need
19
1.3 Project Aim

In healthcare the project aim should be written from the patient/customer
perspective.
SMART
Specific clearly defined with a target for improvement
Measurable understood metrics are available to identify delivery
Achievable within the current environment, funding, time and skills available
Realistic not trying to get the impossible with many unknowns
Time bound is limited by delivery date based on real need
Examples:
25% decrease in inappropriate patient referrals to clinic x by June 2007
100% improvement in the time to run 5km (Albert Park Lake) by June 2007
20
1.4 Project Objectives

The objectives are the critical elements in the process to achieve the aim.
Examples:
Aim
Identify key outpatient constraints that impact the inward and outward flow of patients
and access to services.
Objective
Increase the number of referrals with the required elements by 30% by June 2007
Aim
100% improvement in the time to run 5km (Albert Lake) by June 2007
Objective
To run three times per week and time each run
To weight train three times per week
To seek coaching on running technique from a professional runner
In your Project Definition document, write down your

Project aim
Project objectives
21
1.5 Project Roles

Exercise
In pairs describe the role of a project facilitator and the role of a clinical lead.
Write down the differences between a clinical leader and project facilitator
Clinical lead
Project facilitator
Differences
22
1.6 Project Scope

The scope of the project defines:
The boundaries eg geographical, type of process or part of the process.
The start and finish points
What the project is going to cover and what the project is not going to cover.
Example
The Patient Flow Collaborative II Outpatients project will involve 29 health services
in Victoria of which 4 will be community health services all other health services in
Australia and will be excluded.
All Saints Hospital will examine the flow of patients in and out of clinic x & y.
1. 6.1 Project Scope - Template 1

Start
Finish
(Boundary)
Date agreed
Inclusion
Exclusion
Additional
Agreed by
23
1. 8 Interfaces
Each project can have inter-relationships with other activities, programs or projects
both inside the organisation and outside the organisation. To avoid re-inventing
wheels and to gain clarity between projects, it is essential to identify any interfaces
that the project may have.
Example
Your Patient Flow Collaborative II Outpatients project may interface with existing
initiatives in your health service such as:
Clinical Risk Management
Service Development
Quality Committee
Exercise
Working in groups, select a project you have been involved in and using the
project definition document identify:
Scope
Interfaces
24
1.9 Project Constraints

All projects have some constraints. Project Constraints usually fall into the following
categories:
Time time to deliver the results.
For example: The project will finish by June 2007
Financial project cost and resource costs to deliver the project.
For example: The budget for the project is $25,000
Quality specifications, regulations or standards that have to be achieved.
For example: All project teams will share progress through simple sampling.
Physical limited space.
For example: The new hospital will be built within the existing grounds of the
Austin Medical Centre.
Resources access to or ability to recruit skilled people.
For example: Recruiting nurses in Victoria
1.10 Assumptions
Assumptions are always made when defining a project. However it is essential to be
explicit about these assumptions and to test them with others.
ASS U ME
Exercise
Working in groups, select a project you have been involved in and using the
project definition document identify:
Constraints
Assumptions
25
1.11 Stakeholders
A project Stakeholder is any person, group of people or organisation who has a
vested interest in the project either now or in the future. Some stakeholders are more
important than others to support the project.
The interest may be:
Positive: supporting a successful outcome or
Negative: striving to hinder or stop the project!
Source: How To Be A Better Project Manager. Trevor Young. 2001
1.11.1 Key questions to ask stakeholders:

Why are they interested?
What are they expecting to gain from the project?
What impact will the project have?
Are they in favour of the project?
What involvement do they have and how can they contribute experience or
knowledge?
1.11.2 Assessing Project Stakeholder - Template 2

Process/
Problem
Stakeholder
Date agreed
Importance
Impact
Expectation
Involvement
Agreed by
26
1.11.3 Communicating with Stakeholders

At the beginning of the project produce a list of the contact details for the
stakeholders in your project.
1.11.4 Project Stakeholder Contact List - Template 3

Name
Title
Location
Address
Telephone/Fax
E-mail
Date updated
Tip: Although you may identify stakeholders at the beginning of your project, many
do not appear until you have started your project. The list of stakeholders will
therefore change and grow with time, so the list will need regular reviewing and
updating.
Communicate, communicate, and communicate

Paul Plsek
The success of any project depends on engaging and communicating with
stakeholders.
27
Exercise
1. Using the template, brainstorm all the stakeholders for the project
2. Rank the importance of the project success to the stakeholder
H - High
M - Medium
L - Low
3. Rank the stakeholders impact on the project
H High
M Medium
L Low
4. Identify their contribution to the project and assess their level of involvement
A - Active involvement in the multi-disciplinary project team
B Consulted/Coopted on initiatives
C Informed on developments
5. Draw the matrix on a flip chart and plot your stakeholders onto the matrix
Example:
Project Aim: 25% decrease in DNA rates in clinic x by June 2007.
Impact
High
Surgical
Registrar
Low
Importance
Low
High
28
1.12 Deliverables
To achieve your aim, you will develop products and/or services, which are known in
project management terms as deliverables
Deliverables are often the result of major activity

There are usually several deliverables in a project
Examples of Deliverables for the Patient Flow Collaborative II Outpatients :

Standardised data collection
Action plans
Interim and final report
1.12.1 Project Deliverables - Template 4

Deliverable
Date agreed
Date
Success Criteria
Sign off
Agreed by
29
1.13 Benefits
Each project will produce benefits. Consider the benefits from different stakeholders
perspectives. Benefits should be quantified.
1.14 Measures
Often the benefits are related to the measures. For example:
Benefit:
Increased patient and GP understanding of the booking procedure resulting in timely
appointment in clinic x.
Performance Measure
The time between referral being made and received has decreased.
Performance can be measured in terms of 4 Ps:
P progress against plan
P people against task
P process improvement against current process
P performance against aim or benefit
30
1.15 Project Risks
A RISK is any event that prevents the project realizing the expectations of your
stakeholders. A risk that happens becomes an issue that must receive prompt
attention to maintain the project is on time.
Three categories of risk
Business risks the viability and context of the project
Project risks associated with the technical aspects of the work to achieve
the aim
Process risks associated with the project process, tools and techniques
employed to control the project
31
1.15.1 Risk Assessment

There is always the possibility that unforeseen risks can lead to unexpected issues
and without prompt action these risks and issues can reduce the likelihood on
delivering the project on schedule, to the quality specified and within budget.
Time
Project
Budget
Quality
When
Assessment
Strategies
Risk management is a continuous process throughout the life

of the project.
Start to define risks in the project definition phase
Complete the project risk log
What exactly is the risk?
What is the probability of it happening based on current data?
What is the likely impact on the project?
What actions will prevent or minimize the risk?
32
Categories of Risk
High
Significant effect on delivering the project on time and in budget.

Serious impact on other related projects. Must by monitored and
reviewed regularly. Review action plans
Medium
Significant impact on the project with possible impact on other projects.

Not expected to affect a project milestone. Review at each project
meeting and assess ranking. Monitor regularly
Low
Not expected to have any serious impact in the project. Review regularly
for ranking and monitor.
Exercise
1. In a group, select one project and brainstorm the risks for the project.
2. Complete the
1.15.2 Project Risk Log - Template 5

Description
Probability
H/M/L
Impact
H/M/L
Date updated
Action
Who By When
Updated by
3. Rank the probability of risk on a scale 1 to 9. 1 is low - most unlikely to happen, 9

is high very high probability it will happen
4. Gain a group consensus if it is a high, medium or low risk to the project.
5. Identify strategies to address the risk
33
1.16 Resources Required

The project team need to estimate the resources required to successfully undertake
the project and document estimations. Key areas for consideration are:
Personnel labour required to complete the project
Facilities office space
Equipment computers, software, furniture, printers, mobile phones
Material and Supplies catering, photocopying, postage, stationary
1.16.1 Project Resources - Template 6

Task
Resource
Date agreed
Cost Supplier
Date
required
Delivered
Agreed by
34
Well done.
Ask the project team including the executive sponsor and clinical lead to
sign off all documents as approved, indicating their acceptance of the
project definition.
Hold a launch meeting
Disseminate all project documentation
35
Phase 2 Project Planning
36
Phase 2 - Project Planning

Description
This section will consider the how to select your project team.
Learning Objectives
Describe the skills they require in their team
Identify potential candidates for their project team
Understand some of the complexities of working in a project team
37
2.1 Project Team

2.1.1 Selecting Your Project Team
Most projects start by being a group of people together from different backgrounds,
with different experiences and skills. The challenge is to:
Identify the skills and knowledge required for the project
Produce criteria to ensure that all the skills and knowledge are in the project team
Bring a group of individuals (stakeholders) into a cohesive project team with a
common aim
Skills & Knowledge Required

(Selection Criteria)
Potential Team Member
38
2.1.2 Managing the Project Team

Managing a project team is often more complex than managing a service or
department in a fixed hierarchy. What are some of the challenges in managing the
project team?
Managing team members who have been drawn from different departments, who
have their own responsibilities outside the project work
The risk of instability in the team due to the changing priorities of the line
managers of your team
Creating an effective team environment with a changing team
Building a team quickly with people who do not know each other
Clarity in roles and responsibilities and inter-relationship between roles and
responsibilities within the project team.
Poor communication and sharing information because the team members do not
know or necessarily trust each other. Encourage effective communication
between team members to increase each others knowledge of the different roles,
responsibilities and inter-relationships
Focusing the team members on performance which may not be consistent with
their personal goals agreed with their line managers
Creating a team identity to encourage the team members to meet regularly and
learn more about each other and promote good working.
39
2.2 Project Planning

Description
This section will consider the how to plan a project.
Learning Objectives
Describe the project planning process
Describe allocating work and estimating timeframes
Explain a work breakdown structure, Gantt Chart and Milestones
2.1.3 Types Of Planning

Macro outline the activities first and then breaking them into tasks
Micro outlining the tasks firsts and grouping them into activities
2.1.4 Definitions
A task a small piece work carried out by one person

An activity a parcel of work comprising of several tasks each of which may be
carried out be different people
Concurrent activities/tasks activities or tasks that are designed to be carried out
at the same time
Series of activities/tasks activities that are designed to be undertaken one after
another, each strictly dependant on each other
40
2.1.5 Estimating
When estimating the time and resources required to complete the task you should:
Schedule full time team members at four productive working days per week, to
allow for holidays, absences, training, unforeseen problems
Include management time where appropriate as an additional 10%
Avoid splitting tasks between individuals
If tasks are spilt, do not reduce time by 50% allow time for communication and coordination
Take individual experience into account
Build in spare time for problem solving, urgent tasks arising, non project related
activities and project meetings
Allow time for cross-functional data transfer and responses
Any estimate is subject to change so keep a record of:
-
the estimates your team decides

any assumptions made during the estimating
where contingencies have been added
how many contingencies have been added and what type
2.1.6 Allocating
Each task requires allocating to a member of the project team and estimating the
time required to complete the task.
When allocating a task you should:
Access the right skills for the work
Provide visible support by the project facilitator
Communicate clearly the performance expected of them
Ensure they have the tools to do the job
Document the responsibilities and communicate this to everyone including their
line managers
41
2.1.7 Critical Path

The critical path is the shortest possible time in which to complete a task, activity and
project. You can reflect on your logical flow to identify your critical path. It is
important to note that if a time changes for task or activity it will also change your
critical path.
2.1.8 Gantt Charts & Milestones

A Gantt Chart graphically reflects the activity, task, duration and calendar dates. The
Gantt Chart highlights the logical flow between activities. The critical path can be
presented on the Gantt Chart.
The Gantt Chart can also include:

Milestones a significant measurable event representing a checkpoint for the
completion of an activity and the delivery of a product or services. All milestones
should apply the SMART test. The milestone is usually indicated by a triangle. A
white triangle represents a scheduled milestone, a black triangle represents a
completed milestone.
Some other common events for milestones are financial audit or quality audit
Project meetings indicated by a filed circle or dot
Project reviews (financial/audit) indicated by a filled square
Computer Project Planning Packages

Microsoft project produces your Gantt Charts and Critical Paths on the computer.
However, if you change one activity or task the package may or may not change all
the other tasks and activities.
42
2.1.9 Project Planning -Template 7

Activity
Task Description
Date agreed
Start
Date
Finish
Date
Allocated
to
Symbol
Agreed by
Congratulations
You have now produced a work breakdown structure (WBS) A work
breakdown structure is a graphical representation of the major activities
and tasks required to complete that activity.
43
2.1.10 Reviewing The Project Risk Log

1. Review any risks that have changed ranking and add any new risks.
2. Produce a short description of the risk
3. Outline when the risk may occur
4. Assess their impact and probability
5. Identify management strategies, actions for any risks that can be prevented
6. Develop contingency plans for avoidance and/or damage limitation
Tip: Never remove a risk from the list because it will act as valuable learning for
future projects
2.1.11 Reviewing The Project Budget
1. Review any costs that have changed either increased or decreased

2. Identify the costs for each activity in the project and produce an operating
budget
3. If there is great variance between the estimated budget and the operating
budget you will have gain approval from the Executive Sponsor again.
4. Start to record costs so that you can monitor variance against your operating
budget.
5. Communicate variances to your project team.
44
2.1.12 Reviewing The Communication Strategy

Communication of progress to the wider stakeholder groups should have been
identified in the project definition. A communication strategy should be developed as
part of the project plan.
Refer to Communication Strategy Template 8
Who
Mode
Frequency (Date)
Who
Project team
Meeting
Weekly
Leader/Facilitator
External
stakeholders
Newsletter
Forum
Monthly
Quarterly
As above
2.1.13 Checklist for Project Planning

Before gaining sign off by the Executive Sponsor for the project plan check the
following:
Is the project definition still valid?
Is the scope still valid?
Has the project team been confirmed in writing?
Are all the stakeholders identified?
Does the team know who manages the stakeholders?
Is the WBS structure developed practical, realistic and achievable?
Is the critical path established and agreed?
Is the project risk log up to date?
Does the Gantt Chart reflect the agreed plan and schedule?
Has the project operating budget been confirmed and agreed?
Does the team have the skills required?
45
Phase 3 - Project Execution
46
3. Project Execution
Description
This section will consider the aspect getting started, controlling and
communicating.
Learning Objectives
Describe the key actions to get started
Explain how to monitor progress against plan
Outline strategies for managing variation from the project plan
Communicate progress
Implement the project
47
3.1 Key Actions

Refer back to the project plan to start the project.
3.1.1 Recruiting the Project Team

At the beginning project, each team member and their line manager should receive
written confirmation of role and responsibilities statement including time commitment,
reimbursement arrangements, location and performance measures.
3.1.2 Securing Resources, Facilities and Equipment Required:

Reflected on the resources, facilities and equipment outlined in the project plan
including:
Computer hardware and software
Office space and furniture
Stationary
Storage
3.1.3 Communication Strategy

Communication of progress to the wider stakeholder groups should have been
identified in a communication strategy as part of the project plan. The
communication strategy should be implemented.
Who
Mode
Frequency(Date)
Who
Project team
Meeting
Weekly
Leader/Facilitator
48
3.1.4 Managing Issues

Major issues should be ranked according to importance an assigned a coloured flag:
Red major issues have serious consequences for the project. Responsibility
Executive Sponsor
Yellow significant impact on the project and/or other projects, if unresolved

could cause delay. Becomes a red flag if delayed for more than three days.
Responsibility Project Leader
Green consequences limited to a confined area of the project and unlikely to

impact on other projects. Becomes a yellow flag if not resolved in time to avoid
project slippage. Responsibility Project Facilitator
3.1.4.1 Issues Log - Template 9

Issue
Description
Severity
R/Y/G
Date updated
Action
Who
When
Updated by
49
3.1.5 Controlling the Project
Controlling a project involves three key elements:

Measuring determining progress against planned for financial, time and quality
Evaluating determining cause of deviations for the plan
Correcting taking action to correct the deviation against plan
All the project documentation requires updating regularly.
3.1.6 Monitoring Progress

Progress against plan should be monitored against measuring, evaluating and
correcting and should be communicated.
Any variance from the plan should be gain approval from the Executive Sponsor and
then be communicated with the stakeholders and project team.
50
3.1.7 Progress Reporting

Progress meetings should be a maximum of one hour. Progress reporting against
the checklist should be by exception.
Milestones due and completed
Milestones due and slippage
Corrective action put in place because of slippage
Milestones due for next period
Issues waiting decisions
New issues escalated
Any risks escalated
Any resource capacity changes forecasted
Any team performance problems and issues
Forecast of project completion
Reasons for any revision of previous forecast
51
Phase 4 - Closing the Project
52
4. Closing the Project

Description
This section will consider the aspects of closing the project.
Learning Objectives
At the conclusion of this section, participants should understand:
Completion criteria
Acceptance process
Closing meeting
53
4.1 Completion Criteria

Defining what completion is and an acceptance process should be included in your
project plan. Completion will be what completion means for your stakeholders and
customers.
Completion criteria could include:
All tasks finished
All activities finished and products or services delivered
Testing the changes
4.2 Acceptance Process

An acceptance process should confirm:
Who is responsible for the each step of the process and the work involved
What post-project support is required and who is responsible
What post-project support must be given and for how long
4.3 Close-Out Meeting

At end of the project have a close out meeting with your Executive Sponsor, Clinical
Leader and any other project team members.
The meeting should:
Review the project achievements and highlight any outstanding work or issues
Agree and confirm responsibilities for any ongoing work or support
Confirm who is responsible for monitoring project benefits
Thank the Executive Sponsor, team and stakeholders
54
5. Evaluating the Project

Description
This section will consider the options for evaluating your project
Learning Objectives
At the conclusion of this section, participants should understand:
Active evaluation
Post project evaluation
Technical evaluation
Post-project appraisal
The evaluation of the project will identify what worked well and what could have been
improved and why.
55
5.1 Active Evaluation

Promoting learning by doing. The project team evaluates the methodology as they
are applying this to the project. The team shares their learning with others to help to
continually improve the methodology of the project and their progress.
The Breakthrough Collaborative is encouraging active evaluation of progress

throughout the project. This will allow project teams to identify any improvements
from their baseline positions and an opportunity to capture the learning.
5.2 Post Project Evaluation

Evaluating at the end of the project. This should be combined with active learning.
The evaluation should develop in-depth questions about every aspect of the project.
5.3 Technical Evaluation

The technical evaluation will demonstrate if the best results were achieved with the
skills, experience and technology available to throughout the project. The technical
evaluation would review if the techniques in the project have resulted in
improvements for patient care and improvements in knowledge and skill of project
teams.
5.4 Post Project Appraisal (Sustainability)

At the project definition phase you outlined the potential benefits in terms of:
Increased efficiency from redesigning processes and procedures
Increased patient/customer satisfaction
Increased staff satisfaction
All of these benefits can be quantified and measured. The organisation and Project
Team would want to compare any cost-benefit analysis carried out at the start of the
project with accumulated benefits. This will require monitoring benefits for a period
after the project to realise the full potential of the projects.
56
Glossary of Terms
Boundaries
The portion of a process from a Supplier to a Customer

that will be the focus of the process improvement.
Process boundaries define what is in and out of scope.
Check Sheet
A data collection form consisting of multiple categories.

Each category has an operational definition and can be
checked off as it occurs. Properly designed, the Check
Sheet helps to summarise the date, which is often
displayed in a Pareto Chart. A Check Sheet is simply a
tool for recording and tallying observations, eg times that
a test report arrived late.
Customer/Client
The receiver of an output of a process, either internal or

external to a hospital or corporate unit. A customer could
be a person, a department, a company, etc. The person
who gets your work.
Data Collection
Gathering facts on how a process works and / or how a

process is working from the customers point of view. All
data collection is driven by knowledge of the process and
guided by statistical principles.
Facilitator
Process guide assigned to a team who educates

members in the CQI processes and helps them select and
use the appropriate tools and other resources.
Ground Rules
Used by teams to set a code of conduct which helps the

group perform more effectively. Five to ten points should
be sufficient, and they should be continuously displayed
for the team to see and refer to.
Action Period
The period of time between Learning Sessions, when teams
work on improvements in their organisations. They are
supported by the Planning Group members and are connected
to other Collaborative Team Members.
Aim
A written, measurable, and time sensitive statement of the
expected results of an improvement process.
Changes Concepts
The list of essential process changes that will help lead to
breakthrough improvement, usually created by the Planning
Group and/or Expert Panel and is based on literature and their
experiences.
57
Collaborative
A time-limited effort (usually 6 to 12 months) of multiple
organisations, that come together with the steering and expert
working groups to learn about and to create improved
processes in a specific topic area. The expectation is that the
teams share expertise and data with each other thus,
Everyone learns, everyone teaches.
Collaborative Team
Involves all participants in the improvement effort.
Cycle or PDSA Cycle
A structured trial of a change process. Drawn from the
Shewhart cycle, this effort includes:
Plan - a specific planning phase;
Do - a time to try the change and observe what happens;
Study - an analysis of the results of the trial; and
Act - devising next steps based on the analysis.
This PDSA cycle will naturally lead to the Plan component of a
subsequent cycle.
Learning Session
A one or two-day meeting during which participating
organisation teams meet with Planning Group members and
collaborate to learn key changes in the topic area, including
how to implement changes, an approach for accelerating
improvement, and a method for overcoming obstacles to
change. Teams leave these meetings with new knowledge,
skills, and materials that prepare them to make immediate
changes.
Measure
An indicator of change. Key measures should be focused,
clarify your teams aim, and be reportable. A measure is used
to track the delivery of proven interventions to patients and to
monitor progress over time.
Model for Improvement
An approach to process improvement, developed by
Associates in Process Improvement, which helps teams
accelerate the adoption of proven and effective changes.
58

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