On Time, On Budget

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On Time, On Budget Every TimeIMPROVING THE
RELIABILITYAND COST-EFFECTIVESS OFADVENTIST
HEALTH PROJECTS 6 July 2007 Presentation to
Corporate Presidents Council
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Questions to Ponder
On time, on budgetevery time!

• Are you responsible for project(s) in Adventist
  Health?
• Do you have confidence that your project(s) will
  be completed as scoped out, on time and within
  budget?
• Do you know the actual status of every project?
• Have you had project(s) that were reported on
  schedule and within projected costs right up to
  the point when you found out the real status?
• Have you initiated a project that was never fully
  implemented, or never fully embraced?
• Have you wished for a more predictable perfor-
  mance from your project(s)?

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Purpose of This Presentation
On time, on budgetevery time!

• Share industry data on project effectiveness.
• Ask what this information might mean for
  Adventist Health.
• Recommend some next steps for improving
  performance of projects across Adventist Health,
  starting with the Corporate Office.
• Opportunity for questions.
• Acknowledge Adventist Health accomplishes a lot
  of good in managing projects even so,
  improve-ment of processes always make sense.

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The Project Management Landscape
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• A great many companies dont manage projects as
  efficiently as they tend to manage everything
  else
• They dont adopt PM standards.
• They dont train people professionally.
• They dont know how to hold project teams
  accountable.
• And yet, other companies do all that Reports
  from
• The Standish Group.
• Gartner Group.
• Project Management Institute.

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The PM Landscape 2
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• Data from 2000
• 23 of projects fail (are cancelled, or are
  finished but never used).
• Another 49 are challenged (over budget, over
  schedule, cancelled functions/features).
• Only 28 can be considered successful.
• The costs to industry are great
• 45 cost overruns.
• 63 time overruns.
• 67 of challenged projects drop
  functions/features.

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35
46
Improved, and yet Cost overruns of 47, Time
overruns of 72
Source The Standish Group, 2000 2005-06 CHAOS
Studies.
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The PM Landscape 3
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• Standish Group recipe for success (their Top
  10)
• Executive support (18).
• User involvement (16).
• Experienced Project Manager (14).
• Clear business objectives (12).
• Minimized scope (10).
• Standard software infrastructure (8).
• Firm basic requirements (6).
• Formal methodology (6).
• Reliable estimates (5).
• Other criteria (5).

??

Natural result of an Experienced Project
Manager





Source The Standish Group, 2000 CHAOS Study.
Weight of items influence on project
success.
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From Gartner Group
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• Gartners Critical Program Management approach
• Assertion 66 of large scale projects fail to
  meet stated business objectives, are delivered
  late, or are substantially over budget.
• Assertion Not unheard of for 30-40 of project
  budgets to go into rework.
• Assertion Lacking risk-assessment/mitigation
  mechanisms, at least 10 of 200k projects are
  canceled, as are 20 of all projects.
• Assertion 75 of failed projects gt500k will
  not be tracked through formal project-management
  support 75 of successful projects in that
  category will be.

Source Gartner Group sales piece.
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PM Network Magazine Readers
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PM Network Magazine Readers 2
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PM Network Magazine Readers 3
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VitalSmarts Newsletter Readers
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And Lest We Think .
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• This isnt a problem in health care (according
  to a 2005 HIMSS article) Health care
  respondents
• 50 have 1-4 major IT projects in process.
• 16 have 17 or more major projects in process.
• 60 said 1-10 of their IT projects failed in the
  past year.
• 21 said 10-20 of their projects failed.
• 19 reported a project failure rate of 20.
  Very consistent with 2005-06 CHAOS data.
• Wide perception in health care industry Project
  Manage-ment is just overhead.

Source Healthcare IT News Glen Knight, PMP,
CPHIMS, FHIMSS. Healthcare IT needs project
management. 1 Aug 2005.
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And Lest We Think . 2
On time, on budgetevery time!

• Per Glen Knight (author of the HIMSS article)
• Most health care IT project managers are
  accidental project leaders. LM True across
  health care organizations, not just IT.
• Subject matter experts (excellent technicians and
  analysts) are pressed into PM without any formal
  training.
• Most of these SMEs have other major
  responsibilities.
• Production applications and firefighting will
  always have a priority over even the most
  important projects.
• Its no wonder that many projects are behind
  schedule.
• However, there is a revolution in thinking in
  health care.
• PM needs to become a recognized career path
  within health care.

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Projects and Organizational Structures
 
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• Organizational structures have an
  interaction/impact on project management within
  that organization.

?
Source Project Management Institute.
 
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What Are the Opportunities in AH?
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• To begin with A PM assessment (Roseville).
• How many projects (a defined term).
• Sense of dimension (Large, Medium, Small).
• Honest judgment of relative success (Successful
  Challenged Failed).
• Beyond that, were the original expectations met
  or not (in terms of scope, schedule,
  resources/costs)?
• Without this assessment Have little or no firm
  know-ledge about how expected costs relate to
  actual costs on most Adventist Health projects
  successful, challenged, or failed.

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What Are the Opportunities in AH? 2
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• Re-set organizational views of project
  management
• PM A proven and reliable (that is, repeatable)
  and cost-effective process for planning and
  executing projects.
• Where it makes sense, offload project
  administration from the SMEs, allowing them to
  focus on their technical contributions.
• Set a standard for project leadership in
  Adventist Health.
• The great thing There is a world-wide standard
  for planning and executing projects
• Project Management Institute. 38-year-old
  standards-setting organization, with 232,000
  members in more than 160 countries.
• Certified Project Management Professional.
  There are only three of us PMPs in AH that
  I know of.

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Project-Effectiveness Vision
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Monitor Control
Initiate
Close
The PMI Way Its not rocket science!
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Project-Effectiveness Vision 2
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• What might this look like, organization-wide
  (starting in Roseville)
• Approval Better information for approving
  projects that compete for support and scarce
  resources (strategic fit, resource estimating ,
  return, prioritization).
• Standardization of process and deliverables
  Scope definition Resource estimating
  Scheduling Budget, etc.
• Execution control Scope management Change
  management.
• Status reporting Repeatable, reliable, and
  comparable progress reporting.
• Formal project closure A clear and definite end
  for all projects including canceled ones.

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Sample EVA Status Report
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Re-calc, based on history
Ideal
EVA Earned Value Analysis
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Troubled Projects
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• Starting Place Admitting that a project is in
  trouble.
• PMI has a SIG (special interest group) devoted to
  the area of rescuing troubled projects.
• Effectively/objectively assess project status
  (including early warning signs).
• Understand the troubled project in terms of the
  triple constraints (scope, schedule,
  resources).
• Re-set project stakeholder expectations (as
  needed).
• Develop buy-in during recovery.
• Devise/apply control mechanisms to keep project
  within re-set triple constraints.
• Leverage communication during recovery.

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For Your Consideration
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• What does the ideal PM deployment look like?
  
• A very lean project facilitation function. This
  would help .
• Set standards for PM in Adventist Health
• Increase professionalism among AH project
  leaders.
• Set the expectation that all projects will have
  trained project leaders assigned (PM FTE variable
  by size of project).
• Set the expectation that projects will be
  conducted in a standard manner to increase
  predictability of outcomes.
• Improve standard status reporting to authorizing
  body/ies.
• Capture, preserve and extend learnings from
  project successes and failures.
• Provide project-recovery services.
• Desired outcome Increase confidence in the
  performance of projects in Adventist Health.

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Summary and Conclusion
On time, on budgetevery time!

• A large percentage of projects, by any measure,
  dont fully succeed, or fail entirely.
• Project success is highly correlated with a
  formal, standard approach to project planning and
  execution.
• Adventist Health would benefit from improved
  effectiveness in the performance of internal
  projects.
• There is a small, but growing community of
  project management professionals within Adventist
  Health who are committed to help make this vision
  a reality.
• We need leadership commitment to PM to make this
  vision a reality.

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On Time, On Budget Every TimeIMPROVING THE
RELIABILITYAND COST-EFFECTIVESS OFADVENTIST
HEALTH PROJECTS 6 July 2007 Presentation to
Corporate Presidents Council