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Project Management Case 3

Electronic Medical Record System in a Hospital 

Introduction

A large hospital developed an Electronic Medical record System that did not work for its first 6 weeks of operation. Several months later, it was seen as “failing ti what what is was supposed to do”, and as “unreliable”.  This failure led to a major investigation which concluded that basic project management procedures had not been followed and that it would take at least 2 years to put things right.

It was a series of smaller oversight and failures that led to a catastrophic failure of the system as a whole, because of the interdependent nature of the tasks and responsibilities in the project.  Recommendations from the investigation in to the failure invited the hospital administrator to restructure the IT services team, develop and implement an information systems strategy for the hospital, introduce monitoring procedures for IT development projects, instigate formal procedures for employing external consultants and improve communication and built trust between medical practitioners and health communities.

The Failed Project

There was a failure on budgeting for the cost of these particular project deliverables.  An initial costing should been part of the business case made.  By presenting a full business case before the project is started, a commitment to resources is obtained from stakeholders and senior management.  The construction of a business case also ensures that time is allowed to fully assess costs and a benefit of any proposed new system before the project gets underway.

Inadequate attention to tendering and drawing up contracts for consultants seems to have been employed without proper tendering practices followed, and when engaged were not given written briefs.  It appeared that a contract committing the hospital to an expenditure of millions of pesos was signed with the database software suppliers without the hospital having taken legal advice about its contents.

Questions:

Assuming you have read the entire PMBOK, please answer the questions below in no less than 2000 words per question...   new cases will be uploaded ... MERRY CHRISTMAS ..

1. What do you think must be done to prevent failure of the implementation of this system?

2. As a project manager, how would you handle this type of project scenario?

1. What do you think must be done to prevent failure of the implementation of this system?

In my opinion, the best way to prevent this kind of failure is to make sure everything is planned. Check if everything is checked already, it would be best to follow procedures from different methodologies available. In this situation it’s been discussed that they have major failure in terms of budgeting. The implementation process must not be done quickly it needs to follow the planning process where the tasks and schedules are identified. The project should meet the deadline, but we still have to make sure it is completed according to its specifications for it to be able to be used successfully and effectively by the hospital. Here are some of the processes of budgeting which can help this failure project. The system should have undergone beta state and the team should have done a lot of tests to further explore the system for major or minor flaws. Assessments done by system analysts and tester are very significant to make the system better. In order for the system be done correctly and appropriately the team must be well-guided by a good project manager and any selected trusted hospital representative. It was a sequence of failure to notice the small flaws in the system and those small failures that led to the disastrous major failure of the system. It was stated on the case, that suggestions from the investigation in to the failure requested the hospital administrator to restructure the IT services team, develop and implement an information systems strategy for the hospital, introduce monitoring procedures for IT development projects, bring about formal procedures for employing external consultants and improve communication and built trust between medical practitioners and health communities. The system failed because of recklessness and irresponsibility of the assigned team. In this matter the Hospital administrator and the IT service team should also be blamed because they did not reflect about what would be the output of the system and did not consider about the scheduled deadline. Also they did not think ahead of time about the possible risks and issues that may come up along the process of development.

Due to carelessness and the inability to plan well the project failed. The development team for the project should have been meticulous on planning and doing the project so that the system will be useful and helpful to the hospital. The hospital administrator and the IT services team have to think of their reputation while running the project. For two years the team had seemed plentiful, so it seemed okay for them to unhurried discuss the system without being in a rush, whatsoever. They should be devoted to their work. They are responsible on anything about the system and obligated in overall undertakings of the system and liable for any questions and for investigations.

In order to avoid this problem, they must assign a good project manager and a good team leader as well. The previous project manager never did a good job. The project manager failed to plan carefully and he failed to anticipate risks. They also failed to provide proper and effective communication on their team and on the hospital itself as well. Communication is very important as it’s the key element to solving issues quickly and effectively. Transparency between the development team and the hospital was supposed to be stablished strictly. As this will help both teams to assess the project properly if there must be revisions to be met or there are some specifications needed to be added in order for the system to work properly. Failure to come up with a good and effective plan caused them as well to fail to provide a good budget for the cost that they must be spending and also failed to notify the hospital with their legal guidance. A good project manager must do the work with utmost importance and do their jobs legally and with consent with their clients. Never should they branch off to another part of the road and should stick to the main road. This means that he should focus on what’s ahead of the project. There should be certain characteristics to have a good project manager and that he/she must obtain it to have a good progress to a project. Bringing together the team that are qualified for the project is also a necessary step in having a good progress in a project. Picking the right members of the team is a must. For a project to flow smooth it will depend on the people who are working, they must have the connection and the right skills and attitude for the project to complete in a success. These workers must also be taught and be inspired by the project manager themselves. The team must be driven to desire for progress and greatness. These good traits will lead to the success of the project. The numbers of a workforce are needed too for maximum proficiency. Having a lot of workers produces great results but needs great demands for their needs. It also needs a big budget to maintain them. A good balance is needed to maintain the workforce. The project manager should also know the requirements in recruiting a staff since specific jobs must be assigned to specific profession of a staff’s skills the manager should have policies or guidelines in managing staff so that rules will be followed. A project run without frequent budget management and reforecasting will likely be headed for failure. It is because frequent budget checking prevents further monetary issues to go out of hand. A 10 percent budget overrun is far easier to correct than a 50 percent overrun. Your chances of keeping the project on track with frequent review of the budget plan is far greater than if you forecast it once and forget about it. And Just as the budget needs to be constantly revisited to keep it on track; you need to do the same for resource usage, since the people working on a project contribute to its cost. Project managers should review the number of people currently working on a project and the project's future resource needs on a weekly basis. Doing so will ensure that you're fully utilizing the resources you have and that you have the right resources ready for the rest of the project. Regularly revisiting the resource forecast will help keep your project budget on track.

The project manager should always keep the project team informed of the project budget forecast. An informed team is an empowered team that takes ownership of the project. By keeping the team informed of the budget status, they will be more likely to watch their project charges and far less likely to charge extra 'gray area' hours to your project (those are the hours that they know they worked by aren't sure what they were working on.) Also the scope must be tracked well. Scope creep is one of the leading causes of project overruns. As unplanned work finds its way into your project, billable hours mount and the project budget can get out of control. Project managers must carefully manage scope by creating change orders for work that isn't covered by the project's initial requirements. Change orders authorize additional funding for the project to cover the cost of extra work, and thus keep the project to its new budget. The project budget must be a living part of projects—something project managers review with their teams and their stakeholders on a regular basis. Project managers who carefully watch budgets throughout the lives of their projects will keep stakeholders and management happy and thus experience greater project and career success. The information you put into a budget/forecast report like this is great, but it’s not very beneficial if you don’t share it with others. Everyone on your project should see this report regularly. It should be a discussion topic as part of your weekly delivery team meeting if you have one. Make each team member aware of where the budget status is overall as well as where their hours stand against the original forecast for the project. If they are well over their allotment of hours, then it definitely deserves further discussion and analysis.

The more the team learns about the issues, the better prepared they’ll be for the next project. Some matters might occur again, it will be easier for following project team to identify the issues, and resolve them effectively. For instance, it is a manager's duty to manage the task, but it is not his responsibility to pay for someone's mistake. Project management is connected with imparting the duties and responsibilities for a manager. Duties and responsibilities go hand in hand. On the other hand, there is a fine line of difference involving the two. Duty is a task performed by a person out of his profession profile and responsibilities are obligations for which he is liable. All duties may not be responsibilities, but all responsibilities are duties. Project management is a discipline of planning, organizing and managing a specific task and will bring about its completion with excellence and fineness. But in this problem the project manger and the rest of the team members must be look into. However, it's also true that all project failures can be assessed using the same generalities. It helps to understand these because you can then be proactive in avoiding the problems to begin with. There are many opportunities for project problems throughout the lifecycle. Many of these will discharge as the project progresses, leading to major trouble. A failure to clearly and completely define the requirements, resulting in building the wrong features or leaving gaps in the features needed. Other issues might be part of a risk prototype that the team can proactively identify and manage with early risk assessment. Generally, the best system allows the entire project team to view major milestones for the project and their due dates. Given the structure of the milestones, the project manager or members of the team should be able to create to-do lists, assign those tasks to individual members of the staff, and perhaps map those tasks to particular due dates. All of these problems will cause projects to struggle. If problems occur toward the end of the project, you may have no choice but to do whatever is required to push the project to completion. The problems that appear earlier will cause the most trouble over time and are more likely to be the ones that require a full project rescue. While it is important to stay flexible and not get down in overly composite system; the team will need a clear, easy way to track progress and outstanding work. In project making there are many stuffs to think about. Like the unexpected endeavors. The team can encounter changes along the way. They must follow one direction towards one goal –success. Desperately finish the project on time. The significance of developing a proper project should focus on costs and benefits, and understanding how benefits may emerge. The need for both parties to dedicate properly manages the project. The team must regularly validate client’s opinion, for any verification and probable changes for abrupt response to any notifications. Proper coordination and organize progress to the project. This is not list making for the sake of list making. Output must be the same as agreed. The developers should fully understand what to do, so that they will not ruin the project and they will not disappoint the client. Rather, it makes it possible for the team to collaboratively decide on the key steps that are necessary to complete pieces of the work. Things must be clear in the between the developer and the client. All set. Things must run softly and precisely. During the developing stage it should be well-managed and guided by the team. The development must be accurate. Despite the fact that development initiatives have failed at least as often from weak implementation as from deficient objectives, policies or strategies, failed implementation has largely been treated as a minor flaw, a treatable and transitory phenomena. Sometimes it is. But many times implementation failures are in fact the symptom – the practical manifestation – that reveals the very deep underlying problem in the theories of change. This is most clearly evident in ‘fragile’ or high-conflict countries, where persistent crises expose and exacerbate underlying fault-lines in the systems and organizations seeking to provide development assistance. We argue that persistent implementation failure in development, as and when it occurs, is often a product of the deployment of theories of change that inadequately map onto the types of problems they are increasingly being asked to address. These theories reflect and reinforce the ways in which the staff of development agencies perform their tasks, and in which those agencies themselves operate; they also, in turn, reflect and reinforce the structures of the broader systems within which both development staff (agents) and agencies (organizations) are embedded. As such, in order to propose an alternative theory of change, we need to, understand the characteristics of the relationship between agents and organizations, and why, cumulatively, these systems have been (and remain) so attractive in so many different ideological contexts for so long. As development policy increasingly encounters deeply complex issues surrounding the extension of basic public services, land administration, public financial management and legal reform – tasks for which governments everywhere have a clear responsibility, if not mandate – it is unrealistic and inefficient at best, and counterproductive and unethical at worst, to expect that systems which so routinely fail to implement even relatively straightforward objectives will be able to successfully engage deeply complex ones. In short, international development in the twenty-first century needs a new operating system. We endeavor to provide a framework, grounded in case studies and a comparative analysis of contemporary trajectories of administrative capability, to move us in that direction. In conclusion, the implementation process is one of the most critical paths of the project deliverables by which you can advance think of what it may cause to the project. Will it be successful or failure to comply all necessary things. The implementation process will be more seriously tackle and planned by the manager and governed by the team to acquire the result of perfect project and goals achieved. You need to consider it as a major task in order to finish the project and implement it on time and ready to use.

2. As a project manager, how would you handle this type of project scenario?

As a project manager, whether the project is a failure or the project is success, the project manager is the one that is more to be blame because he is more responsible for the success or the failure of the project. The project manager should establish proper and effective communication from his team and his clients. He should always be updated on what’s happening on the project by his team as well as the clients should also be updated as often as possible on what’s the progress of the project. Whether the programmer made a lot of errors whether the system analyst, or whoever it is, it is their responsibility to have good communication with each team member and to analyze everything and share knowledge and ideas to further enhance the chance to make the project succeed. When the project or the whole system fails, as the project manager he should be the one checking the project status timely. That’s why in this case the project failed. It is for the reason that the project manager failed to check on the progress status in timely manner. Any project needs good form of communication and information flow that has to be infused into the team in a systematic and efficient method. If the information is not given to the right person, at the right time and in the right way, the entire project stands at risk. It is important that the project manager and the team should work as a single point of contact for any obligation. As a project manager you have to look far beyond the single project; indeed any individual project can be seen as merely a single step in your team's development. The allocation of tasks should thus be seen as a means of increasing the skills and experience of your team - when the project is done, the team should have gained. Not only in providing information and ideas, but also twill feel ownership in the final plan. As a manager, the manager should have to provide some form of framework both to plan and to communicate what needs doing. There are lots of issues on both sides which the project manager failed to see. As project manager he should be able to see if there are flaws or issues on either side. The project manager should first gather the project team before they start and discuss everything about the project objectives and specifications. Also he should further create more discussion and meetings during the process of project development for him to be able to assess the current projects status. The team should also discuss about the team’s overall performance on doing the project and each team members difficulties and problems making the project. So that the project team can distinguish what were the possible problems on the system. After the problems have been distinguished the project team should help each team member especially the team member(s) who have difficulties doing the project. Of course on fixing the failed project, the project team should exert more effort, thus exerting more time and effort to fix the problem. The project team should always check the programs that were coded before the compilation. After the compilation, the project team should ensure the client that the system will work properly after the redesigning and completion of the system. The Project Manager has the most significant role within the company and the projects itself. As the name suggests, the Project Manager is basically a person who handles, manages and ensures the timely delivery of the project. It is the responsibility of the project manager to ensure that the project/system is managed and executed in the proper manner. In fact, the project manager is a team leader of the team. Managing the team and managing the project has a lot of aspects and responsibilities attached to it. The project manager should ensure that every team member and their abilities are used to the most favorable and more efficient tasks, so that the assignments are completed in a quick and excellent way. As a project manager, the team should be made up of various individuals that are fitted for the project. There are bound to be some differences between the team but as a project manager, it is his responsibility to ensure the smooth interactions between the team members and control the flow of development to achieve the objectives of the project with regards on the quality of the project itself. The project manager should be a good leader and a good example to its members, and create situations where the team staff look up to him as a project manager and try to emulate their positive traits. This will certainly have positive effects on the team as well as the project and its assignments. The primary challenge of Electronic Medical record system is to achieve all of the project/system goals. As a project manager, he should take the first step of the project. Preparing and defining the project scope of work, financial plan, its goals and deliverables, assigning precise responsibilities for the team members. As a Project manager he is necessary in managing all aspects of the project and all characteristics of the team members. Coordinating directly and indirectly with project staff to ensure successful completion of the project – Directing, supervising, supporting and coordinating the project team members/staff. Managing the design of the project documents to monitor project performance and data stored. The project manager’s responsibility is undeniably the most challenging role within the team. To effectively manage the project management process, requires full-time commitment. The most versatile Project Managers are therefore those highly skillful. Though in practice 'time' may be shared with other duties and responsibilities, when it comes to the moment of truth, the project must get the first call when a conflict of importance arises. For each project undertaken the Project Manager should identify, agree and document the responsibilities and the expectations of the project sponsor or the client. Nothing can be controlled which cannot be measured. In a project there are three things which can always be measured - the schedule, the cost, and the users’ (Hospital staffs) satisfaction. I believe that the project manager’s role can be described by the following PM tasks: Employ the best possible team. A project/system will be successfully finished by a great team. As a project manager I should take the first and foremost responsibility. In other words, my role is to find and recruit the best people and be certain of their skills and abilities. Assemble and build a productive team that is able to drive your project to success. I should motivate and lead the team. Next step in building is project management career is to be a truly leader who can explain to everyone what is to be done and by when. If various errands are overdue or require extra push, I will need to identify the delays immediately and then use a corrective action plan to fight the challenge. At the same time, I should be positive and supportive towards the team, so each member of the team will know that I care along the way. I should work harder than they actually do in order to provide good leadership and motivation. Respond to change. As a project manager my responsibility for any change requires to define the project scope in advance, at the planning phase, and then review it regularly to ensure that the team does not perform unauthorized work at any time. And do not be afraid –I and the team should be ready to respond to changes occurred within the project and timely inform the hospital of the changes. As I can communicate the status of the project regularly and develop reports, I can manage with many problems, such as poor performance, lack of workforce, over-estimates, etc. As a project manager I supposed to prepare other assessment team for the project. I should add other member(s) on the team so that they can work it out faster. Consider tasks that need to be done and tailor the team to get the work done. Use designated subgroups as necessary, such as a fact finding subgroup. As a project manager I must be careful that I properly integrate the work of a subgroup into the team's process plan. Make sure that I do not employ subgroups in parallel when their outputs are chronological. Include a member with sufficient skills and knowledge about the client wants and needs. Organize the team by capabilities of the member, assigned members them on their fields. Or as a project manager I should asked the client (Hospital representatives) for an additional time or else asked for schedules which will the client check the improvement of the project. Client should be oriented about the span of the time on how they develop the project. If a date for decision changes, keep both the old date and the new date visible. This helps to spot issues that have been on the log for a long time. Since I’m the Project Manager I’m responsible for accomplishing the project objectives within the limitation of the project. I’m accountable for the outcome (success or failure) of the project. I should be involved with the planning, controlling and monitoring, and also managing and directing the assigned project resources to best meet project objectives, controls and monitors project scope, time, cost and quality—in managing project. I would like to recommend building a new team, with proper communication. Deploy responsible and active members. Arrange the team members appropriately. Meet the deadline. Client must check every little detail of how the work done. Client also must be become conversant with the team. Scheduled date for checking the step-by-step progression of the project. The team must also follow the schedules as it should be. Organize systematic assessment team that is finely tuned to perform accurate and insightful diagnostics, providing the level of detail that the client need to achieve project. As a project manager I have to deliver the performance with better success rates. I am responsible for keeping in touch with the client (Hospital) who has assigned the project to my company and make them aware of the status of the work finished. I should be able to lead my team and bring out the best in them. As a project manager I am also responsible for developing a good dialog and communication with the team member for the success of the project. It is my responsibility to perform efficiently and honestly. By the virtue of being a manager, I need to maintain confidentiality. And I am dependable for establishing easy communication between the employees and the higher authority. In case of emergency, I should be able to solve problems for my team members. I’m also accountable for good team building, which is defined by success. Along with I am in charge for accomplishing project objectives and the result of the project. Effective risk management requires identifying risks, measuring their potential for harm, and creating plans to deal with the threats. Although very few project managers have the skills to defuse all of the time bombs lurking surrounded by their initiatives, efficient project manager assemble resources to help their teams prevail over risk. One of the ways that successful project managers fit into place their teams is a process of identifying risks at the start of a new initiative. For many teams, this consideration occurs at some stage in the identification and preparation phases of the project series. The most important tasks: setting objectives and priorities. Directing the formulation of detailed work programs for staff members within each of the project unit; monitoring and training staff to implement the project; monitoring project performance against objectives; monitoring staff performance against agreed work targets; seeking the opinion of the project's client about the quality of the services provided to them. Basically, the job description of a project manager is to manage the project that he is assigned with. Hence, he becomes accountable for both, starting the project as slated, and finishing it on time. A project manager's role in the growth of a company is a significant one. I, as a Project manager my duties and responsibilities are closely related to each other. As a Project manager it is my duty to supervise and coordinate all the activities. I had to se to see to it, that the task is performed to the fullest of the efficiency. I and the team need to plan out an organizational structure to bring out ease and flow in the task. Suggest new policies and modifications in order to improve the nature of work. Ought to develop good relations with my colleagues and motivate them to do well by appreciating their good performances. My primary duty is to participate in meetings, discussions, and hearings. I am required in keeping and preparing status reports and presenting them to the higher managing authorities in the hospital. Leadership responsibilities of a project manager give the employees a direction, accelerating the pace of work. Sometimes in handling workers, there are barriers that prohibit communication between two persons or groups. When the need to choose on way to report by either by paper or by their mouth in communicating with the others formally and informally. The project manager should have the necessary skills in presenting their report to the workers and clients. Without it, they may not be able to impress them and that would be a bad thing to have. The project manager also needs to handle the workers effectively. If the workers would fight over something then it is the project manager’s job to diffuse the situation fast before it reaches a dangerous effect. The project manager should always be successful in updating their information every time. The information must be transferred from the worker to the manager seamlessly and fast at the same time. There is because the need for information is needed for fast paced work such as the deadline of a project. Since information is needed, a good technology is needed like the internet or hardware that can enable both parties to communication. Communication skills are a good skill for the project manager to exchange information. The information should be clear, precise and complete so that those who receive the information can understand completely what the sender provides. The project manager should handle how the information is given by either going through oral speaking. By transferring information through words of mouth is a good way yet since it is by mouth means that information is given in an informal way. It would be unclear to the receiver especially if there was a language barrier within the two persons. Next one is through writing the information on a piece of paper. With this way, the sender can give their choice of words carefully in a formal way since they have the time to give their information to the receiver. However it becomes obsolete when given a short time to deliver that information because it would be a time consuming process and it would be prepared beforehand. To who the information is spread throughout the organization is the project manager’s job to find out. They can do it themselves if the number of workers are small but if it is huge then they can’t provide the information one by one. They must give it to somebody else as a messenger so that they can’t be troubled with huge problems. After doing all the things needed for the project to go in full work, the project manager should know the limitation of the options the team would have taken. If the project has fewer resources than the project manager expects then they should adapt to the environment and solve the necessary problems that plague the project.