The Role of Project Management in the Acute Care Continuum


In theory, it was a fantastic idea. Ingenious Med, a hospital charge capture solution, would allow hospitalist physicians to enter billing information directly into the system via their mobile devices or web browser, eliminating a previously manual and paper-based system.

The product promised to unify coding, communication, revenue and business intelligence in a single platform. Its potential seemed limitless.

But for Vituity, getting Ingenious Med off the ground presented a new challenge. Implementation required close coordination with the IT departments at multiple Vituity hospitalist sites — plus managing relations with an outside vendor.

And the stakes were high. Rigorous testing would be required to ensure the platform's functionality and security. The system would also need to integrate seamlessly with existing systems, including each client hospital's unique EMR and ADT.

These challenges were layered over the usual budget and time constraints — not to mention the difficulty of gaining buy-in from 13 different provider teams accustomed to keeping paper charge notes.

In the past, Vituity projects had been overseen by functional area managers; but it was clear that to make Ingenious Med fly, we'd need a more disciplined approach.

So at the company's request, I left my role as an internal consultant and became a project management office of one.

Challenging Times

Complex problems have become par for the course in the healthcare industry. Regulatory compliance, quality improvement, mergers and technology and clinical integration require innovative solutions that span departmental and organizational boundaries.

Often, projects addressing these challenges are "owned" by department managers who do their best but may lack:

  • An enterprise perspective
  • Project management discipline and training
  • Sufficient work time
  • Authority over project team members outside their area

Too often, the results are missed delivery dates, cost overruns, incomplete deliveries and dissatisfied customers.

The federal government's ongoing struggles with underscore the importance of rigorous project management.

A Centralized Approach

In the case of Ingenious Med, our investment in project management paid off. Using sound PM principles, I was able to manage Ingenious Med to a successful implementation on time and within budget. This helped make the case for establishing a centralized Project Management Office (PMO) within our organization last year.

Today, anyone in our enterprise can initiate a project by gaining executive sponsorship. Potential projects are reviewed, authorized and prioritized by an Executive Sponsor Team. This group also oversees the project portfolio to monitor the health of all projects and make sure the PMO's work is aligned with enterprise business strategy.

The PMO guides approved projects through the initiation, planning and execution phases. Throughout we observe and measure the process to detect potential problems. Finally, we tie up loose ends and bring each project to a formal close.

Advantages of Professional Project Management

The PMO measures its success by the success of our customers — the departments, leaders and teams we serve. Here are just a few of the ways we work to add value to their projects:

Provide a comprehensive business case. Complex, cross-departmental projects require significant investments of time, money, resources and manpower. We work with sponsors to justify the project by documenting expected benefits and risks and examining available options.

Honor constraints. We help teams achieve the best possible results while adhering to budget, time and scope requirements.

Engage stakeholders. At the initiation stage, we work with project sponsors to identify end users, support personnel and others with a stake in the project's outcome. We then work stakeholders throughout the project to promote open communication, manage expectations and involve them as appropriate.

Eliminate thrash. A disciplined project management approach helps limit losses due to false starts, needless conflict and indecision. Increased efficiency from the outset helps reduce cycle time and delivery costs.

Set clear goals and milestones. Teams are most motivated when they understand what they should be doing, when they should be doing it and the criteria for success. Project management provides a clear roadmap of the steps that will be followed to reach the team's goal.

Manage risk. Project managers are trained to identify what could go wrong in the early stages of the project. This creates opportunities for proactive risk control and mitigation.

Create transparency and trust. Project management keeps leadership, sponsors and stakeholders informed about the progress and health of their projects.

Educate and empower. The PMO advances project management professionalism across the enterprise by providing teams with the training, guidance and tools they need for success.

What Clients Are Saying

In many ways, implementing Ingenious Med was a tipping point for our organization. We had a long list of cross-departmental projects that had been on the books for years and were either creeping along or getting no traction.

In the past year, the PMO has changed all that. By using a consistent, disciplined approach, we resurrected many stalled projects, saw them to completion and moved them out of the portfolio.

Internal PMO clients have been enthusiastic in their praise. They report that the process helps them gain a clearer picture of project scope, budget, and timeline in advance. They like the added layers of organization and decision-making support that our project managers provide. Communication between departments and outside vendors has eased significantly. And many clients say that working with the PMO helped them become more knowledgeable about process improvement overall.

But the most exciting feedback we've received: clients feel that PM enhances our organizational culture and collaborative spirit. By co-designing projects, participants learn about their teammates' roles and how their actions impact others across the enterprise. With support and facilitation, they increase their ability to adapt and "roll with the punches." We've heard rewarding reports of team members rallying together during times of stress. It's exciting to see how each new project builds understanding across the enterprise and enhances our focus on common goals.