Project managers should take heed of Dwight Eisenhower's conclusion that "plans are useless, but planning is indispensable." The project management processes, project charters, project management plans, and project life cycles described in this chapter are nothing more than tools and techniques that can help project teams deliver successful projects— accomplishing the project objectives on time and within budget. The goal of project management is to help deliver successful projects not to demonstrate rigid adherence to a particular process or to produce a particular project management deliverable. Project management should focus first on planning for a successful project and then on adjusting the plans, as necessary, to deal with the project reality. Knowing what processes to follow, which tools to apply, and, most importantly, when to apply the processes and tools is the "art" of project management.
This section includes two examples of CBBS implementations managed by using the concepts in this chapter: rapid deployment of a CBBS for the 2002 Winter Olympic Games and the implementation of RODS as part of an Advanced Practice Center for BioSurveillance in the in Dallas-Fort Worth metroplex. The project examples illustrate how project teams tackled real world problems and applied project management "art" to help deliver successful CBBS projects. Some things to notice in the examples include the following:
• Project teams need to start slowly to progress really quickly. In the face of an extremely short implementation window, the CBBS for the 2002 Winter Olympic Games team did not dispense with the planning phase and rush straight into development. The natural tendency when faced with schedule pressure is to rush to get things started; resisting that tendency is critical. The example shows that time spent up front planning is key to project success, because through the careful planning process the team designed an implementation phase that allowed many activities to run parallel and successfully integrate into a successful product.
• The schedule may determine a "best" CBBS solution approach. Selecting the ASP approach for the CBBS for 2002 Winter Olympic Games was perhaps the most important decision leading to project success. With only seven weeks to deliver a working solution, custom development was essentially impossible and implementing a COTS solution unlikely. Developing a CBBS by using the ASP approach was the approach most likely to succeed.
• Not every project needs to include every life cycle phase. The Advanced Practice Center for BioSurveillance example included all the SDLC phases, as described below. In the CBBS for 2002 Winter Olympic Games example, requirements very closely matched the capabilities of the selected ASP solution, and the design and specification phases were not necessary at all.
• Project phases can overlap if carefully managed. The CBBS for the 2002 Winter Olympic Games project schedule example illustrates how concurrent activities can speed implementation, and the example explains the steps taken to make sure that the activities would integrate into the final solution.
5.1. Rapid Deployment of a CBBS for the 2002 Olympic Winter Games
In preparation for the 2002 Olympic Winter Games in Salt Lake City, the Utah Department's of Health, Environmental Quality, and Food and Agriculture, along with six local health districts and several federal agencies, formed an Environmental and Public Health Alliance to provide enhanced biosurveillance in the region. The events of September 11, 2001, fomented a spirit of collaboration and unity, while the rapidly approaching Winter Olympic Games provided the motivation to further augment this alliance's existing surveillance strategies. In addition, the Games provided an opportunity to demonstrate how a prototypic, real-time CBBS system could be rapidly deployed. Within months of the opening ceremonies, a group comprised of the University of Pittsburgh RODS Laboratory, the Utah Department of Health, and two healthcare systems deployed an automated RODS using chief complaint data from patients registering at emergency departments and urgent cares (an urgent care is a clinic that sees patients without appointments) throughout the region (Gesteland et al., 2002, 2003). The project was completed in seven weeks, and RODS was operational in time for the opening ceremonies of the Games. Although considered at the time a prototype, the system is still in use today.
The project team faced an extremely short implementation window, and this characteristic drove the project management approach. As the example shows, the team focused on project schedule risks in the planning phase. With an understanding of the unique project characteristics, the team designed a project life cycle with phases specific to the selected solution, and aligned with the intense timeline of the project.
Utah had two large health systems, Intermountain Health Care (IHC) and University Health Care. The emergency departments and urgent cares from just these two health systems provided an estimated 70% of acute care in a seven-county region that encompassed all 10 Winter Olympic venues, including the Olympic Village. The project team implemented an existing CBBS and took advantage of the timely data already routinely collected in a standardized electronic format by these two institutions.
The team built the CBBS system by using the University of Pittsburgh RODS system, operating over a redundant network infrastructure comprising the Internet and leased T1 lines donated by Siemens Medical Systems. The team's objective was to deploy a syndromic surveillance system by using chief complaint data for disease outbreak detection.
The participating healthcare organizations had significant concerns that the team had to address in the planning and execution phases of the project. First, both organizations were in the midst of either replacing or upgrading their existing hospital information systems and could commit only limited resources to support this project. Second, the regional healthcare systems were already responding to mandates from the Utah Department of Health to share clinical data via other mechanisms to facilitate health surveillance efforts for the Games. Third, these requests for data sharing came at a time when the healthcare organizations were struggling to prepare for and adapt to new federal regulations promulgated under HIPAA. The team addressed these concerns, in part, by
(1) defining explicit, scope-limited resource requirements,
(2) defining the role the CBBS would play in the surveillance efforts and how it would offset other reporting requirements, and (3) defining the terms of data sharing in compliance with the HIPAA regulations.
The project management plan broke the project into four main task groups: public health, network, data, and application. The project team managed the project by using a Gantt chart (Figure 36.5) to provide an understanding of the task breakdown.
The public health task grouping included two levels. The first was establishing the legal foundation for the data sharing necessary for the project, which included executing the data sharing agreements, establishing the administrative structure to oversee the data, and obtaining institutional review board (IRB) and other necessary approvals. The second was
ROOS in UTW Week Seven
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What you need to know about… Project Management Made Easy! Project management consists of more than just a large building project and can encompass small projects as well. No matter what the size of your project, you need to have some sort of project management. How you manage your project has everything to do with its outcome.