Sample Chapter

1. @2016 Job Launch Accelerator
Managing Projects for
Competitive Advantage

2. Chapters
1. Projects and Deliverables
2. Overview of the Project Management Life-Cycle
3. Project Initiation
4. Project Plan
5. Work Breakdown Structure
6. Scheduling
7. Monitoring Project Progress
8. Controlling Project Progress
9. Project Governance: Structure and Support
10. Project Approaches: Traditional and Agile

3. Overview and Project
Initiation
Part II

4. Overview of the Project
Management Life-Cycle
Chapter 2

5. Learning Objectives
The learning objective of this chapter is to introduce the project management process
by following a simple project from beginning to end. While it is just an overview, it will
provide a framework for understanding the details that will be developed in
subsequent chapters.
In this chapter you will learn how writing the problem statement, writing an initiation
statement, creating a project charter, executing the project, monitoring progress, and
controlling the outcomes establishes a logical and systematic way to think about the
project management process.

6. Outline
 Introduction
 Learning Objectives
 Orlando Center for Ambulatory Medicine
 Problem Statement
 Project Initiation
 Project Plan
 Schedules
 Project Execution
 Monitoring and Controlling
 Closing
 Summary
 Questions

7. Introduction
As you learned in the last chapter, the basics of the project management process
share similarities with the process of scheduling one’s daily activities. Yet, as you are
aware, organizational projects can be considerably more complex. So in this chapter
you will have the opportunity to see how a systematic and orderly approach to these
projects can help deliver successful outcomes.

8. Putting the Principles to Work
The project management process involves several steps, PMBOK calls then process
groups. These groups include initiating, planning, executing, monitoring and
controlling, and closing. Shortly you will learn more about them. But learning about
them is not enough. Indeed frameworks, concepts, methodologies and skills by
themselves, are never enough. We all know, for example, that it is one thing to watch
an instructional video on golf but quite another to put those principles to work on the
golf course.

9. Cases Provide a Context
What we do need in addition to these frameworks is an understanding of how they
can be applied to the real-world.
Accordingly, an overview of the project management life cycle is presented in this
chapter as a case study for two reasons. First, it introduces the basic framework of
project management, but second it provides a realistic context illustrating how this
framework can actually be applied.

10. Orlando Center for Ambulatory Medicine
The Orlando Center for Ambulatory Medicine, OCAM,
located in Orlando, Florida, is committed to providing
quality outpatient care to its patients at an affordable
cost. Its services include ophthalmology, cosmetic
surgery, general surgery, reconstructive surgery,
orthopedics, podiatry, gynecology, urology,
otolaryngology/ENT, and pain management.
Three months ago the president of the center, Doctor
Jason Stopman, called Lisa Gonzalez, OCAM project
manager, into his office.

11. “Lisa, I just finished reading an article on
the Internet. We could be in for a tough
time.”
Stopman was referring to an Associated
Press article reporting a federal study of
infections and infection control
procedures at same-day surgery centers
like OCAM.
He removed a copy of the article from
his briefcase. “Lisa, take a minute and
read this.”
Associated Press Article
Initiating

12. Associated Press Article
By CARLA K. JOHNSON
CHICAGO — A new federal study finds many same-day surgery centers — where patients get
such things as foot operations and pain injections — have serious problems with infection
control.
Failure to wash hands, wear gloves and clean blood glucose meters were among the reported
breaches. Clinics reused devices meant for one person or dipped into single-dose medicine vials
for multiple patients.
The findings, appearing in Wednesday's Journal of the American Medical Association, suggest
lax infection practices may pervade the nation's more than 5,000 outpatient centers, experts said.
"These are basic fundamentals of infection control, things like cleaning your hands, cleaning
surfaces in patient care areas," said lead author Dr. Melissa Schaefer of the Centers for Disease
Control and Prevention. "It's all surprising and somewhat disappointing."
Centers for Disease Control and Prevention

13. Federal Study
The study reported in the article was conducted at 68 centers in three states:
Maryland, North Carolina and Oklahoma. Sixty-seven percent of these centers had a
least one lapse in infection control. In total, fifty-seven percent of those centers
were cited for deficiencies.
The lapses were widespread. Staff often failed to wash their hands, wear gloves and
clean lab equipment such as blood glucose meters and cardiac monitors. Some
clinics were even found to reuse devices meant for single-use. At others, staff used
single-dose medicine vials for more than one patient.

14. Background Data
The study was authorized in response to a
major hepatitis C outbreak in Las Vegas, an
outbreak that was believed to have been
“caused by unsafe injection practices at two
now-closed clinics.”
When Lisa finished reading, Stopman continued the conversation. “ Lisa, what
concerns me most is that the U.S. Health and Human Services Secretary has
announced plans to expand control over ambulatory surgical centers.

15. OCAM Infection Record Too High
Lisa asked, “Haven’t we had this under control? I think we are doing as well as any
other clinic in the Orlando area. Why should we be concerned?”
“We should,” Stopman interrupted. “ I just checked our records and for a long time
our average has stabilized at about 20 infections per month and as this article
suggests we have probably just accepted this as part of our surgical risk. What is
worse is that we know about the infections that have been reported to us but don’t
know about others that have gone unreported. I am concerned that there may be
deficiencies in our procedures and that we haven’t done enough to provide the best
care for our patients.”
After a pause, he continued, “With federal and state authorities placing greater
emphasis on infection rates, we need to do something and do it quickly.”
“How can I help?” replied Lisa.

16. Project Goal
“I need you to come up with a new infection control plan for the clinic. Considering
the results of this federal study I suspect that our next audit will be tough, and I don’t
want to take any chances. The last thing we need is for the Feds or State to close us
down.”
“What’s our goal?” asked Lisa.
“As usual I always like to set a target for our projects, replied Stopman. “In this case it
is simple. We need to reach a zero infection rate two months after your new plan is
implemented.”
“That sounds way too ambitious? How can any clinic reach that goal,” Lisa
responded.
Stopman, referring back to the article, read a quote from Dr. David Shapiro. “Any
incident is one too many.” Then Stopman added, “We have to do whatever it takes.
The consequences of non-compliance are much too high”

17. Project Scope
Lisa thought for a moment. “Doctor Stopman, I can understand your concern, but
your target will be tough to reach.”
“I won’t compromise the goal, so lets not talk about that any more.
Lisa thought for a moment and then focusing on the scope of the project proceeded
to see if she could get some concessions from Stopman. “I think you’re expecting the
staff to do too much in too short a time. Infection control involves nurses,
equipment, physicians, nurses aids and even administrative staff. How can we
possibly solve a problem this large and get rates to Zero.”

18. Project Scope
“What’s the alternative, interjected Stopman.”
Lisa replied, “Why don’t we narrow the scope and first identify only one area like
orthopedics? We could study the procedures they follow, determine if they just need
closer compliance or if they need major revisions. If there are problems we could
develop new ones. Then, once we succeed in making improvements in orthopedics
we can apply the approach we used to other departments, one department at a time.
If we do it that way we have a multi-phase study that will be easier to manage than a
single-phase one where we do it all at once. But even more importantly we will be
learning as we move from one department to the next.”

19. Project Scope
At this point Stopman became impatient. “Lisa, my major concern is that we will not
pass our next inspection which could happen today or tomorrow. We need to make
these changes and make them fast. Focusing on just the orthopedic department is
not acceptable and will just waste valuable time.”
Stopman got down to business and asked Lisa to develop a formal Project Plan,
sometimes called a project charter. This document would include the following:
• Business Case
• Problem Statement
• Scope Statement
• Tasks
• Schedule
• Resource Requirements

20. Problem Statement
Lisa returned to her desk and wrote a business
case, sometimes called a problem statement,
which she then emailed to Stopman.
Given the increased concern over infection rates
nationally, the likelihood that federal and state
audits will increase, and the need to improve the
quality of patient care, OCAM will engage in a
study to review existing infection control
processes and then determine appropriate
standards and quality control procedures to
improve performance. The goal is to reduce
infections to zero percent within two months of
implementing the new system.
Project Plan
Business Case

21. Scope Statement
The next step would be to write a scope statement. This is a
formal statement establishing what is to be considered
within the bounds of the project.
Lisa had two requirements that she felt should be included in
the project’s scope. The first would be the purchase of new
clinical equipment that would be much easier to clean. The
second was the addition of a new staff member to enforce
compliance of new methods and procedures.
The request for a new position was inspired by an article she
had recently read in an on-line nursing publication. In it she
learned that many hospitals were now hiring an infection
preventionist, a staff position created to cut infection rates.
Project Plan
Problem
Statement
Scope

22. Scope Management
While the article that Lisa had read did not focus on
ambulatory centers like OCAM, it did conclude that
hospitals suffer 1.7 million healthcare-acquired
infections a year, adding $20 billion to health care costs.
Infection preventionists, the article concluded were
proving to be instrumental in slashing these infection
rates and saving money.
Lisa thought that hiring such an individual would be
essential in enforcing new procedures and in reaching
her ambitious project goal of zero percent in two
months.
Project Plan
Problem
Statement
Scope

23. Tasks
The development of a reliable schedule would be an
important step in creating the project charter. But in
preparation for creating this schedule it would be
necessary to decompose the project into smaller
tasks or deliverables.
Conferring with staff, Lisa was able to put together a
list of tasks necessary to complete the project.
Project Plan
Problem
Statement
Scope
Tasks

24. Tasks
With the tasks identified, Lisa then grouped them
into intermediate deliverables. The final deliverable
would depend, of course on the successful
completion of these intermediate deliverables.
Lisa defined seven intermediate deliverables. They
included interview data obtained from the nursing
staff; Interview data from the medical staff; best
practices from leading clinics across the country; data
summary report, group meeting reports; draft of new
procedures; and a formal training plan.
Intermediate Deliverables
Interview data - Nurses
Interview data - Physicians
Industry best practices
Data Interpretation
Group meeting reports
Draft of new procedures
Training plan

25. Schedule
Lisa then created a schedule around those tasks. Some
would have to be completed before others could be
started, and others, like data collection, could be
undertaken simultaneously with other tasks.
She then concluded that the earliest the project could be
completed would be nine weeks from the date it was
started. Further, she identified several tasks, such as
interviews with physicians and nurses, which if delayed
could delay the completion of the entire project. Those
activities comprised the Critical Path of the OCAM
project.
Problem
Statement
Scope
Tasks
Schedule
Project Plan

26. Project Plan
In three days the project charter was on Stopman’s desk.
Stopman immediately called Lisa. “You’re asking for too
much. I can’t approve it. We need to talk!

27. Scope Creep
When they met two hours later Stopman insisted that Lisa had
succumbed to scope creep. “I know that replacing some of
the older equipment and hiring an infection-preventionist is
tempting, but you are adding to the complexity of this project,
adding to the time it will take us to get it done, and adding to
its cost. Let’s resist the temptation to increase the project
scope and fall victim to scope creep. How about just getting it
done with the resources we have?”

28. Schedule Contested
Stopman then turned his attention to the schedule.
“You schedule calls for completion in nine weeks. What would it take to shorten it to
eight weeks? I am sure you can eliminate some delays.”
Lisa replied. “I suppose we could work some overtime. The big problem will be to get
the staff and physicians to understand the importance of this project and to give it a
high enough priority so that they will be available to help us put it together. I worry
that they will push it aside given their clinical responsibilities”

29. Top Management Support
“The stakes are too high, we have to do it” replied Stopman.
Lisa added, “It might help if you make it absolutely clear that this project is top
priority and has your full support. Will you speak to them?”
“Absolutely, consider it done. But if I do this, can you promise me that you will have it
done in 8 weeks? ” Stopman asked.”
“You have a deal,” answered Lisa.

30. Top Management Support
Two days later, Stopman called a staff meeting for key
stakeholders. He started by reading excerpts from the
Internet article that initially raised his concern. Then he
opened the meeting to discussion.
There were several in the group that were reluctant to
initiate what appeared to be a major change in how they
performed their work, but about half of the staff
expressed support for the project.
When the meeting came to a close, Stopman asked
everyone to give Lisa their full cooperation.

31. Project Execution
Project execution started immediately. Several meetings
were scheduled. The first included physicians. The second
included registered nurses, licensed practical nurses and
nurses aids. The third included housekeeping and
maintenance workers. No one was left out.
There was still some resistance expressed by a few nurses
and physicians but Lisa responded by reading from the
Associated Press article and then summarizing the
infection problems that had occurred at OCAM in the
past. Eventually, as in the meeting with key stakeholders,
staff began to realize that their standard operating
procedures needed to change.
Project Plan
Project Initiation
Project Execution

32. Project Execution
Lisa then initiated a review of the procedures followed by
other clinics across the country as well as a review of
state and federal guidelines.
As part of her review she placed several calls to leading
hospitals in the United States and learned how they dealt
with this problem. A few had all but completely
eliminated infections and had been cited in the press for
their near-perfect record. She learned a lot from these
conversations and came away with a better
understanding of the problems, roadblocks and solutions
related to to the successful design and implementation of
new procedures.
Project Plan
Project Initiation
Project Execution

33. Project Execution
Once data collection was complete, Lisa called another
meeting with each of the three groups where she
summarized what she had learned. She then asked for
reactions and suggestions.
After an hour of discussion it became clear that almost
everyone was receptive to the external data she had
collected and its implications. One person said that if
others could do it so could they.
Project Plan
Project Initiation
Project Execution

34. Project Execution
Once these meetings were complete and the staff had a
chance to participate in discussions, Lisa began to
formalize the new infection control program including the
new procedures that would be put into place once the
plan was approved by Stopman.
Project Plan
Project Initiation
Project Execution

35. Project Execution
Evidence clearly suggests that hands are the most
common vehicle for transmission of infections and “hand
hygiene” is the single most effective means of preventing
transmission. While the infection processes that were
identified by Lisa were complex, the following
summarizes the hand washing procedures that would be
followed.
Project Plan
Project Initiation
Project Execution
• Before touching a patient – to protect the patient from harmful germs carried
on the care giver’s hands
• Before aseptic procedures – to protect the patient against harmful germs,
including the patient's own germs
• After body fluid exposure – to protect staff and the health care environment
from the harmful patient's germs
• After touching the patient – to protect staff and the health care environment
from the harmful patient's germs
• After touching the patient's surrounding – to protect staff and the health care
environment from the patient's germs.

36. Project Execution
A final meeting was held with the staff at which time the
plan was unveiled. There were questions and concerns
but most were resolved before the meeting was
adjourned.
Still, a few individuals, from the nursing and medical side,
found the plan and its procedures an “overkill.” But in
Lisa’s words, there were always a few who would find it
hard to “go along.”
Project Plan
Project Initiation
Project Execution

37. Monitoring and Controlling
Projects never unfold as predicted or expected. And the
OCAM project was no exception. In its third week the
second meeting with physicians was postponed twice
because several key stakeholders were busy. Then in the
fourth week attendance at a nursing staff meeting
dropped to about half of what it was the week before.
As Lisa continued to monitor progress she became
increasing concerned that interest and commitment to the
project was flagging. Unless she actively controlled the
project, on-time completion could be jeopardized.
Monitoring &
Controlling
Project Plan
Project Initiation
Project Execution

38. Monitoring and Controlling
What was particularly troubling to Lisa was that these
meetings were on the project’s critical path and delays
already threated to put the project one week behind
schedule. But worse, unless she took control the delays
could increase in the remaining weeks and project
completion could be further delayed.
Monitoring &
Controlling
Project Plan
Project Initiation
Project Execution

39. Monitoring and Controlling
Lisa called an urgent meeting with the physicians and later
with the nursing staff where she raised this issue.
They all complained that the project was interfering with
their clinical responsibilities and that the time available to
work on the project was limited. After considerable
discussion, they reluctantly agreed to make up for lost
time. Future meetings would be scheduled after normal
work hours. The meeting adjourned and the project was,
hopefully, back on track.
Monitoring &
Controlling
Project Plan
Project Initiation
Project Execution

40. Monitoring and Controlling
Her constant monitoring of the project’s progress as well
as her efforts to impose controls whenever the project
went off-course, proved successful.
Monitoring &
Controlling
Project Plan
Project Initiation
Project Execution

41. Closing
It was week seven, the project was back on schedule and only
one task remained; developing a training program for the
nurses, physicians, housekeeping and maintenance staff.
Several key stakeholders from all sides attended three
meetings. Several suggestions were made.
Lisa and two nurses then took the responsibility for preparing
training materials that included a classroom segment, an on-
line segment and a series of posters that would be placed
throughout the facility at strategic and vulnerable locations.
Training was scheduled for the end of week eight.
Closing
Monitoring &
Controlling
Project Plan
Project Initiation
Project Execution

42. Closing
The project closed with the training sessions, then at the end
of these sessions the team met to review the approach they
had taken and to determine what had gone right and what
had gone wrong. Lisa often held these Post-Implementation
Audit sessions after the completion of a project to ensure
that future projects would benefit from lessons learned.
Closing
Monitoring &
Controlling
Project Plan
Project Initiation
Project Execution

43. Summary
The OCAM case study introduced the sequence of
steps normally associated with a project. While it
was a relatively simple case it is still, nonetheless,
representative of the steps followed in a wide
variety of projects.
Here you were also exposed to the importance of
understanding the context within which a case
occurs. Indeed, some of the challenges in a health
case like OCAM can be quite different from those in
the development of an off-shore call center for a
consumer product. But the project management
concepts and general methodology followed for
both are very similar.

44. Summary
Finally, you learned the role of the business case,
project plan, schedules, project execution,
monitoring and controlling and closing.
In the following chapters the issues raised in the
OCAM case will be explored in much greater detail.

45. Review Questions
1. A schedule, lie the one mentioned in the OCAM case, must be included as part of
the business plan. T or F
2. For carefully planned projects, like the OSAM project, it is not necessary to
monitor and control progress. T or F
3. The critical path includes those activities which if delayed would delay the entire
project. T or F
4. Scope management primarily focuses on the schedule. T or F
5. A business plan is written before the project plan. T or F

46. Review Answers
1. A schedule be included as part of the business plan. F
2. For carefully planned projects like the OSAM project, it is not necessary to monitor
and control progress. F
3. The critical path includes those activities which if delayed would delay the entire
project. T
4. Scope management primarily focuses on the schedule. F
5. A problem statement is written before the project plan. T

47. Vocabulary
Business Case
Competitive Position
Competitive Advantage
Critical Path
Lessons Learned
Methodology
Multi-Phase Study
Problem Statement
Project Manger
Scope
Scope Creep
Single-Phase Study
Stakeholder
Top-Management Support