PM Introduction to Healthcare

It's been a while since posting for the last time, a LONG while actually.And as they say, blogs are like sharks, you should get them moving all the time.
Several weeks ago we had a project management (PM) workshop in the healthcare organization I work in. This was intended as an orientation introduce PM concepts and benefits to all staff working or managing projects, which they might be doing without knowing it.
The trainer was my PMP trainer,Eng. Nael Mattar,who was one of the PMBOK guide last edition reviewers, and we had the chance to go back in time and remember those moments we had in our first training session together. The trainees were impressed with the concepts and methodology of PM,its importance, and how beneficial it could be in their daily work. Some department heads has asked me to assist them in their upcoming projects instantly after finishing the 3 days workshop. Hopefully this will to apply PM would not wean over time.
Some of the hot topics that attracted attention were:
Organizational culture: A big discussion and debate took place around this principle. Some of the attendess were very keen to understand their current workplace culture,and what could be changed to adopt a more PM friendly environment.
Planning: I guess some attendees were shocked to see how crucial it's to plan well, and why there is so much emphasis on it.This could be due to the bad habits and the lack of awareness we have in this part of the world.
Communication management: Always a nice subject to talk about. Putting it in a formalized and structured framework was kind of new to many.

All in all, it was a great start, and everyone has enjoyed this new way of thinking and doing things, and the simple and friendly approach the trainer has.Time will tell if this was just a bubble, or a successful embrace of PM standards in the organization.

Pecha Kucha

Today, I conducted the first Pecha Kucha day in Saudi Arabia, and it was a great success with so much positive feedback.. In this event and others that I have been involved in, I found that event management as a project is no different than any other project in terms of stakeholder management, even though you are managing it by yourself but have so many others participating in the event itself.
Patience, persistence, good communications, and clear schedule and deadlines puts all the participants at ease, and encourage them to continue their preparations for the big day. In the last couple of weeks, for one reason or another, some of the participants were about to drop out from the event, which could lead to a disaster in such first of its kind endeavors. Pushing and encouraging them, assuring them that they will get all the help they need, reminding them of the main goals behind the event and how much their participation is important and useful were the most important techniques I used to keep everyone on the bus and lead a successful event.
Few months ago, this was just an idea, and seeing it come true with such favorable outcome is a very euphoriating sensations..More later

Waste of time...!

During a recent project between two healthcare organizations,actually two of the biggest and most prestigious ones in Riyadh, we tried to utilize some tools and techniques of PM to raise the possibility of a successful outcome. A charter and a WBS was put, although not a complete or comprehensive ones, but a good start for a project team of which most of the members never used or even heard of PM standards. An activity list was also encouraged, and the team members struggled at beginning to break down the main work packages into activities with timelines and assigned responsibilities to make it easier for tracking and monitoring. One of the suggestions between me and another project savvy was to use Gantt charting to help visualize the progress and schedule the project activities, which was one of the concerns of the steering committee (to kick off the joint operations before dead summer months).When we tried using MS Project, and actually showed everyone how to fill it in simple steps, one of the committee leaders called me and said: "we though PM is supposed to help the project, not waste our time", of course he was talking about the planning phase. There are two folds for his impression, which I totally understand (although disagree with), the first one is that the use of new technology or applications is usually resisted by those who never used it before, or those who are more comfortable with less technology in their work. The second aspect of it is that many people unfortunately think that the time you spend in detailed meticulous planning is actually a waste, and the only time they see you are actually doing something is when you start executing and everybody gets busy performing. Planning is one of the most important stages of any work or project, if not the most important, and in my opinion, the time we take in planning is time well spent as long as it's good and structured planning (people mistake a couple of meeting and emails as good planning).Planning is acually doing something, people may not see a product or a code generated,but this planning is what makes creating that product or developing that code much easier, and faster.In the PM Network published by PMI in March, I read about the story of a marvelous railway project in India, where they had to restructure part of the railway system in only 48 hours, as it was the only time to stop the busy railway traffic in Mumbai without disrupting the city life and business, but they spent one year in planning this event, yes one full year to execute only scheduled 48 hours of hard continuous work, and guess what, it was finished ahead of schedule and the railway returned to function the third day. This much planning was spent in such a short term project, so you would expect months and months of "good" systematic planning to be spent on long term strategic endeavors.

Business Center Reform

I should have posted this two months ago, when we finished the business center (BC)reform plan in Sultan Humanitarian City, which spanned period of the last 3 months in 2009. The project was a success because it went on schedule and with the intended main goals,and with some expectations being exceeded.
The Plan was about restructuring the previously chaotic state of the BC, with redistribution of roles and responsibilities, and developing clear procedures and work flow cycles.
Some of the major results are clarity in daily operations, increased productivity, improved interdepartmental relationships, and the most important of all, staff satisfaction and enhanced morals.
During the initial assessment before implementing the plan, several projects and initiatives were defined, and plans were laid accordingly, and a road map for the near future started to see light.
The feedback from the staff themselves, management, other departments, and even the patients as our main clients was mostly on the positive side, some were totally astonished.
Staff performance, attendance, promptness, cooperation, and sense of responsibility were all affected and they realized the difference between working in a structured and more professional workplace and one without rules, planning or clear responsibilities.
What went right?! more later...

The idea book !

It didn't take long to finish reading two of my long-awaited books on two of my favourite subjects, presentations & design (see previous post) and creativity, I've waited for months to get em, and it took me 10 days to eat them.
The idea book, by Fredrik Haren ( you can see his picture in the first post downwards, with hair!), is an interesting as well as irritating book about creativity and innovative thinking, it challenges our ways of looking at life and how we think about doing things, whether in business, or on personal level. The book is written and presented in a unique way rapped in an elegant black hard cover. Of course, there are few things which I didn't like , or perhaps, couldn't fully grasp, but in general the book is a must-read for those who like to think differently, not just for the sake of being different, but because they think that thinking similar to others is mostly, wrong! Speaking of “rebels".

Presentation Zen

Presentations are an important and integral tool in today's business, almost all kinds of professions.However, power point presentations have become so dull and boring for many of us, partly because of the misuse of the application ( even by microsoft CEO), and partly because of the unprepared and careless presenters. Just finished reading the book " Presentation Zen" by Garr Reynolds, which lastly reached my bookcase after long time of looking for it. It shows how you can transform your power point presentations (your whole presentation attitude adn perspective as a whole) to a more intersting, outstanding experience, depending on the clean and simple design methods that are similar to Zen design philosophy.I sent my recent two presentations to the editor and he was kind enough to comment and commend them.The website and blog of the same title is so generous of ideas and advice on making better presentations.Looking forward for more zen desing in upcoming presentations!

CPHIMS !

It's been a long time since my last post.I was waiting for this moment when I get the result of my CPHIMS certification. I'm now a certified professional in healthcare information and management systems , by HIMSS-USA.
It's the same feeling when I got the PMP,holding a credential in something I liked and been doing for a while without professional recognition.

Hope to post more about it later.Congratulations to me !

Tough Clients !

It's resonating almost in all healthcare related projects, especially those that involve a good deal of new processes or technology, that physicians are the hardest to get their buy-in and cooperation. Well, that claims is true, but not totally because of the doctors. When it comes to technology, doctors are some of the very technical enthusiast people, sounds surprising?. In a quick glance, you can see how much high-tech gadgets and machinery they are
using in their daily practice, ranging from simple diagnostic devices, to very complicated surgical tools used in operating theaters,and those things are getting more and more advanced. So, the reason is not being an old-fashion doctor, or tech-phobic, at least not in all cases. So, what could be the reason? Physicians ego, very true in many instances, but that's not a the root cause, it's how you approach that barrier.
In many projects, customer requirements and stakeholders management are a crucial part of project success, or failure, in that matter, and the same thing applies to dealing and involving those hard headed people called doctors(I'm a doctor, so I'm not discriminating or anything, but it's good to acknowledge the truth).Obviously, getting the buy-in of doctors when implementing a new project would be a harder job, let say, than nurses or technicians..etc, which needs a lot of thought, time, and effort to gain, and that is usually underestimated. Yes,underestimation of involving the doctors and getting their ownership is often overlooked, or underestimated, and that's one of the main reasons of healthcare projects' failures. And here were sound project management methods comes into the equation. Clinicians should be involved from the start of the project,perhaps in project selection sessions, rather than being imposed by the hospital's management; they should be involved in the planning of the project, in documenting the criteria of success, in well planned and generous training for new procedures or products, and so on. By doing that, we will not only get their blessings and support, but they will lead the change and feel that the project success is also their personal success. It needs a little more attention than we usually give, and to try hard enough to get them on board.

PMI in Amsterdam

It has been a week since I came back from the beautiful city of Amsterdam, after attending the PMI Global congress EMEA 2009.As usual, it was a great opportunity to network with project managers from 49 countries , coming from different backgrounds and industries, to share their views of this interesting profession and personal experiences. It was also a good educational experience, where well known professionals presented their knowledge and experience in different aspects of project management, ranging from sustainability( the keynote speech), Agile methodology which also had a lot of attention in this event, to interactive workshops about team building and stakeholders management. Some of the concepts presented were fairly new, or shall I say unusual, like Pecha Kucha (which I'm still wondering what could be the correct pronunciation, in Japanese of course); the lazy project manager, axiology and thought processes, which made me see things from a slightly different perspective; which is a sign of a successful educational event, for me at least. Some of the main points that I took back from the presentations I attended are:

Great project managers: The PM success definition has expanded, project complexity increased, and dependence on sponsors became more. Studies showed that planning, effective communication, user involvement, and soft skills are critical components that made successful project managers stand out among other PMs in the surveyed projects.

Portfolio Management: is not a rocket science, but needs more disciplined and structured approach, involving all key stakeholders and decision makers. The top-down dissemination of the strategic goals is crucial to all organizational divisions.

Agile project management: Trust in your project team members, strong customer focus, iterative and test-driven development, prioritization of the product backlog are the main elements of successful agile planning.

Lazy, but productive! : In complex and demanding projects, the PM should find easier ways to manage the team and the project rather than becoming stressed and overwhelmed by tasks and problems. A lazy but productive PM should relax, breath normally, plan ahead for any possible crisis, filter the issues reaching him/her, delegate as much as possible, then prioritize whatever issues remaining to deal with.

Axiology: Our thought processes are complex and involves different types of stimuli, internal and external, and a successful manager should realize those stimuli, AKA advisors, and keep them in balance as much as possible, and shift the thought to more useful thinking, rather than rationalizing and re-enforcing bad habits. Success is always a conscious thought.

At the closing session, PMI announced that the next PMI Global Congress for EMEA will be in.....Milan !

http://congresses.pmi.org/EMEA2009/images/EMEA2009Gallery/index.htm

Six Sigma & Healthcare

I was surprised to know that the famous industrial quality methodology , six sigma, is applicable in healthcare. I attended my first six sigma course, got my yellow belt,and working on continuing up to the blackbelt.The tools used in six sigma can be applied easily on healthcare services and process to reduce error and variations.For sometime, after becoming interetsed in PM, I was looking for a risk analysis tool in healthcare, and there was FMEA (Failure Mode & Effect Analysis), once an industrial risk management tool, is now applied to healthcare.Surprisingly enough, risk assessment tool like FMEA, is one of the JCI requirements for healthcare service accreditation.
I think six sigma is a powerful tool in any QI department within healthcare organizations, as it could help improve care delivery, manage risks, and reduce medical errors.

Bedside Buy-in !

It's needless to say, that in healthcare field, the most important stakeholder is our customer, the patient.Other customer scan be the end-users of a health information system, or the pharmacist using a new drug..etc , but for doctors and other care-givers, it's always about the patient (or should be always).In project management, the buy-in of the stakeholders is an essential requirement for the success of the project.In the clinical context, where the patient is the center of attention and care, this buy-in translates into what we call " autonomy" of the patient, in which we involve the patient in the the decision making process about his/her condition and treatment options.This is believed to enhance the compliance with the treatment plan,especially in chronic long lasting conditions, or recovery from an acute illness.Counselling the patient about his/her social life style is another way of obtaining a better buy-in from our dearest customer.

Master and Teacher

I had the pleasure to join the workshop for project management in healthcare IT, which was held as an adjacent activity to the e-HIM symposium I attended last week.The workshop was much like an introductory course in project management for IT professionals who don't know about PM, and for me, was a kind of a refesher course with emphasis on healthcare IT projects, which we become involved in every now and then.I must admit that the most useful thing in this course is being instructed (unknowingly) by the teacher of my teacher who gave me the PMP course before. I've noticed some similarity in the teaching style and flow, and confirmed that when I spoke to the instructor (Eng.Momen) in one of the breaks,and it turned out that my former PM instructor (Eng.Nael) was one of his students, and that they worked together in one of the major e-government projects in the country.I don't know why, but it felt good to be trained by the master and the teacher, both of great knowledge and personality.
The emphasis on the importance and the usual failure in risk management in IT projects was very clear, as well as the focus on meeting the end-user requirements and satisfaction for a successful outcome.

technology is easy !

Last week, we had a two days symposium about electronic health information management(e-HIM), which was organized by SAHI and KFMC.The event was a nice opportunity to share experiences and get to know what other countries are doing in this field, and the recent achievements in this technology. I was glad to present the experience of our hospital with regards to ICD10-AM, the Australian coding system for diagnoses, which is an essential part of any health information system.And I finished my speech with these words of wisdom that I quoted from my brother graduation project long time ago: technology is easy, but people are hard.
HIS or HIM ?
In the symposium, emphasis was put on the importance of health information management as a holistic approach, rather than just health informatics which many people are fascinated about. The way we manage our health information processes, from medical records, to coding, to integration of data, to the use of software applications and ending by PHR, all are important to be managed and taken care of to ensure successful, errorless, confidential and reliable health information, and must be done by trained and experienced personnel. This point was mentioned also in the presentation of one keynote speaker, Dr.Mervat AbdulHak, the former president of AHIMA-United States, who also mentioned an interesting point that the head of the office of the national coordinator (ONC)of health technology in US, which is more like a national governing body for health technology, is a physician appointed by the former presidency.

Clinical Project Management..The Full Story

Project management in healthcare revolves mainly around IT projects and information systems, biotechnology,and clinical trials of pharmaceutical agents. The latter is usually referred to clinical project management, with roles like clinical research manager in a clinical research organization (CRO) .
However, this kind of clinical project management doesn't really concern the way doctors and nurses totally manage their cases from A-Z . What if project management methodologies were incorporated on the management of patients, regardless of the kind of disease or mode of treatment? And what if these processes were a routine part of daily work of doctors or nurses, who already follow some of these tools without being called project management, if we considered the medical case of each patient as a unique temporary project. Doctors , with the help and support of nurses, do go into all phases of a project, that is initiation by accepting patients and admitting them under their care; planning of their management based on the history, signs and symptoms, available test results, initial assessment, and discussion of treatment options to promote patient's autonomy and compliance; executing of the desired management plan by doing the required investigations, procedures, and giving the needed treatment; monitoring and controlling by daily rounds and examinations of the patient's clinical status, follow-up testing; and closing by discharging the patient or releasing him/her from the hospital when the outcome is successful and the problem is resolved. All these phases with other details in between involve a great amount of progress reporting and documentation in all sorts of charts and forms, consents and approvals,all recorded in the patient's chart,also involves justifications based on medical necessity, modifications of the management plan, communication with different stakeholders starting from the patient, his/her family, caregivers , medical staff and other internal and external parties, cost estimation and budgeting, especially in the private sector, quality monitoring of the treatment outcome and normalization of results, scheduling of the tests or treatment especially in lengthy cases, involvement of certain resources and manpower from different specialties and care delivery teams, and assessment of related risks with appropriate medical intervention if occurred, and lessons learned that can be utilized in future similar cases or medical research. Such process are in the heart of daily medical practice, becoming well organized and developed, and go hand in hand with evidence-based medicine and clinical practice guidelines. Looking at this from a project management point of view, one can integrate all in a unified and standard framework, and try to apply it to daily clinical management of patients, and see if this could let to improved outcomes, better client satisfaction, more efficient and waste-free work cycles, and perhaps to lower costs of medical treatment, especially in the current global situation, where reducing the cost of healthcare is facing higher demands, and has become one of the priorities for every political agenda.

A small ( i ) Center

Being a member of PMI, a standard delivering and improving organization, who doesn't spare any effort or resource to support it's members, provide networking and educational oppurtunities,keeps them informed with it's rich of knowledgebase and publications, allows them to be heard and share their ideas, and supports them with different ways aimed at advancing their careers, such organization, deserves with no doubt the volunteering and advocay of it's members to the cause of spreading and advancing the profession globally.
In my case, aside from membership and volunteering , I've decided to spread the word about PMI's vision , especially in our region of the world,by simply displaying the PMP credential in my office, and making PM network issues available at hand for work colleagues and visitors to browse and benefit from.
In fact,because of that,I've been asked in many instances about the PMP credential, how to earn it, how to get involved, and the role of project management in our work, which added another aspect to my little office, to become an information center that helps in raising the awareness about this profession, of which I'm glad and will continue to do.

PMI Asia-Pacific Congress, Kuala Lumpur

My first post would be about my first PMI global congress that I attended eariler this month in Kuala lumpur, Malaysia. As a novice and enthusiast in the project management field, everything looked bright and shiny to me ( despite the costs! ).However, I attended many international medical conferences and symposia, and I can tell how well organized and well managed this event was.

I had the chance to see the growing KL city, meet it's nice people,get wet under the tropical rain! and also develop my professional career by attending the congress, and network with all PM professionals at all levels and from different backgrounds.Also,I had the chance to speak to the CEO , Mr.Balestrero, and knew that I was the first doctor (physician) he ever heard of becoming a PMP and be interested in this field ( please save the applause).

What I didn't expect was the realtively small number of attendees, especially from this region of the world where industrial nations with heavy populations are making projects left and right, at least from China !.Anyway,it could be better to mingle with a smaller group in order to know and be known, who knows !.Overall, it was a great congress, with good presentations, an exceptional keynote speaker, and an outstanding organizing committee , which gave me a powerful motive to attend another congress soon this year.Thank you PMI, teri mekasi KL.