A Primer on Project Management for Health Care

Effective project management requires that the people involved in a project contribute through distinct roles, each with their own set of responsibilities.

Project management has emerged as one of the most prominent business skills of our time because its use can help control costs, reduce risk, and improve outcomes. Used across disciplines, project management is the process of systematically planning, organizing, and then executing a pre-determined set of steps in order to maximize resource use and achieve specific objectives. According to a U.S. News and World report, project management is one of the top skill sets sought by employers.

Why? The Project Management Institute (PMI), an organization created in 1969 to promote the discipline of project management, credits the process with helping businesses save time and money, improve ROI, and reduce risk. It also cites many benefits to staff members including improved collaboration and decreased stress.

Project management has emerged as one of the most prominent business skills of our time

As healthcare in the United States continues to evolve under mounting cost and quality pressures, the need for project management becomes ever more apparent. Understanding and applying the foundations of project management can significantly improve outcomes across health care delivery settings.

This article will give an overview of project management, provide some practical tips on how to incorporate its principles into your work, and explore why a more formal approach to project management is needed in health care.

How Does Project Management Work?

Effective project management requires that the people involved in a project contribute through distinct roles, each with their own set of responsibilities:

  • The project manager is responsible for planning, managing, and executing the project by engaging team members.
  • The project sponsor is a senior leader who provides guidance and makes key decisions.
  • The project team consists of anyone who contributes to the execution of the project.
  • A project stakeholder is anyone who is impacted by the project’s outcome or provides resources.

According to many project management guidelines, projects consist of four phases. In each phase, key activities must be accomplished and key deliverables must be produced. Below is a description of each phase along with practical tips you can use to implement project management in your own work.

Phase 1: Initiate the Project

At their onset, projects must be defined and approved. During this phase, background information, market research, and other pertinent data should be reviewed. The project manager should be selected. Project goals should be determined and aligned with those of the organization. If goals do not align, the project will likely not be approved.

Key activity: Do your homework. Talk to colleagues who have undertaken similar efforts and conduct background research. Learn about the cost (in terms of financial and human resources) and amount of time the effort would require.

Key considerations: Think critically about the need driving this project. How will a successful outcome improve your work, organization, and field? Is that outcome worth the effort and cost? Think realistically about the resources the project requires and whether they justify the end result. Consider who would carry out the work at each stage.

Key deliverable: Create a concise but powerful overview of the project’s expected outcomes, costs, and benefits. This should include both a description of and a justification for the project. Present your overview to an organizational leader who has the authority to approve the project.

Phase 2: Plan the Project

Once the project has been approved, the next step is creating a step-by-step plan of how it will be executed. The project plan should contain a schedule detailing all project-related activities, a budget, a list of everyone who will contribute and what they will do, and a description of how progress and results will be measured.

Key activity: Develop the project plan as stated above, including a budget, schedule, list of team members, and progress indicators.

Key considerations: Think carefully about everyone involved in the project, including the project team, any stakeholders, or any other colleagues or leaders who may want to have a say – or provide valuable advice – about the project plan. It’s easy to make changes while in the planning stages but very difficult to make any changes after execution is under way.

Key deliverable: The key deliverable is the project plan. Once it is finalized, it should be presented for approval. Once it’s approved, a kickoff meeting with the project team should be held to review all components.

Phase 3: Execute the Project

The third phase is carrying out the project plan. Measuring progress and monitoring any changes from the plan are important steps in this phase. Peter Drucker, a notable Austrian management expert, famously said, “If you cannot measure it, you cannot manage it.” This statement underscores the importance of measuring one’s progress against pre-determined criteria for success.

Key activities: As you begin to execute the project, be sure to communicate key deadlines and activities with the project team. Keep a close eye on your schedule and budget. Track and communicate your progress and results with the project team and the project sponsor.

Key considerations: When executing your project, one or many tasks or results will inevitably diverge from the project plan. This is normal. The important thing is to adjust future steps to minimize any negative effects. Your project sponsor can provide guidance around how to reallocate resources in order to get your project back on track.

Key deliverables: Keep a detailed list of any delays, failed steps, additional costs, or other unforeseen changes. Make any necessary adjustments to future project steps to ensure that your project stays on time and on budget – and communicate all changes with your team. Continually update the schedule and budget as steps are completed.

Phase 4: Close the Project

At the very end of the project management process, there are several key deliverables: documentation from each step, any products or deliverables the project yielded, reviews for each team member, and lessons learned. An updated budget and an updated timeline should reflect the total cost and number of hours spent as compared to the budgeted amount.

Why We Need Project Management in Healthcare

Healthcare delivery is one of the world’s largest industries, and it is growing and changing rapidly. The Henry J. Kaiser Family Foundation reports (1, 2) that there are nearly 5 million practicing physicians and nurses in the nation – and these figures do not include the many other types of healthcare professionals. A report on the future of healthcare co-written by Georgetown University’s Health Policy Institute and the National Institutes of Health predicts that 5.6 million new healthcare jobs will be created by 2020.

Much of this growth is driven by the rising number of Americans who have health insurance, or “covered lives.” Since the passing of the Affordable Care Act, the U.S. government reports that the uninsured rate fell to a record-breaking 9.2 percent and experts predict that an additional 34 million Americans will enroll for coverage over the next 10 years. While this shift is generally viewed as favorable, it has drawn more attention to the need for efficiency and effectiveness in how healthcare services are delivered.

Another major issue is cost. Americans spent $3.0 trillion on healthcare in 2014 and spending is expected to grow, according to projections published in the journal Health Affairs. In a 2009 Institute for Healthcare Improvement white paper, Martin et al. stated, “Until recently, the rationale for health care providers to undertake quality improvement initiatives rested largely on ‘doing the right thing.’ Any financial benefit…was an attractive side effect.” Today, this statement couldn’t be farther from the truth as decreasing reimbursements have forced healthcare organizations to explore ways to lower costs.

These issues, coupled with new electronic health records systems, regulations, and technologies have drastically enhanced the need for project management in healthcare. Organizations are taking on projects to incorporate new elements into their workflows, improve processes at every stage of the continuum of care, and enhance their facilities while improving outcomes and decreasing costs. According to the Massachusetts Hospital Association, the benefit of using project management in healthcare is “to be one step ahead of any potential risk” as they complete this vast array of projects.

Additional complexities, such as regulatory limitations and varied stakeholders, increase the need for project management in healthcare. Project managers must be mindful of countless processes and regulations around patient safety, quality, and privacy. All industries have their own rules, but healthcare is notably complex, with the government and private agencies, such as the Joint Commission, watching closely. These increased restrictions place all the more importance on project planning and execution.

The need for project management in health care is becoming ever more apparent

Further, healthcare lacks a simple “buyer” and “seller” relationship. Rather, there are many parties involved. If the product is care, patients are the recipients and doctors and nurses are the providers, however health insurance payers and the government are the buyers. The number of stakeholders increases complexity. Similarly, healthcare project teams may be larger and more diverse due to the inherently cross-functional nature of patient care, requiring a project manager who is flexible and willing to take all views into consideration. Projects in health care may require more approvers or more buy-in; it’s important that all parties be identified in the planning stage to avoid delays in the execution stage.

All in all, more project managers, and project management, are needed in healthcare. In an industry that is changing and growing at an astounding pace, project management can offer structure and discipline. Using this proven methodology will help the field accomplish more in less time, save resources, and foster collaboration.

Harvard T.H. Chan School of Public Health offers Health Care Project Management: The Intersection of Strategy, People, and Process, a four day continuing education program on project management skills for health care settings. To learn more about this opportunity, click here.