Tag: Other

The Most Important Project of Your Life!

Written by Kenneth Richards on February 14, 2023. Posted in Articles.

Two and a half years ago I started working on probably the most important project of my life, and one that benefits me directly as both the project manager and customer. It would utilize over a million dollars in cost, eight months of focus and attention before moving to operations, and a little over a hundred days of intense focus and coordination. Almost two years ago it moved primarily into monitoring and control phase before moving into a closing phase almost 4 months later. It now sits successfully in operations waiting to see if another project will be needed in the future. If we were indeed successful, then no changes or updates should be needed for this project for a long, long time.

This important project is cancer treatment, and the tenants of project management can be used to help treat patients. In October 2020 I was diagnosed with Acute Myeloid Leukemia (AML) and began the journey through initiation, planning, execution, monitoring and control, and closure. During this time, I was amazed at how similar the process was to managing projects. Thinking of it this way helped me organize my thoughts and make decisions as I stepped through the process. For others that undergo diagnosis and treatment, many of the same requirements and processes I had can be adapted for your treatment. Nursing may even want to formalize some of the steps to accomplish successful outcomes in other types of cancer treatment, but also things like trauma care among others.

Initiating

Initiation was probably the most difficult. This was not a planned project, and in fact one that came completely out of the blue. From the time I found out, a plan did begin to develop, however. While there wasn’t a formal project charter per se, there was an agreement on the goals, the high-level requirements to get there, investigation into assumptions, and determination of funding. Almost all the things that make up a project charter are good to put down on paper as an agreement with the patient. It gives them a plan and direction and helps to organize the high-level requirements of caring for cancer. Many of the high-level items here become more granular in detail as exams are done and more information on a diagnosis is gained. It becomes the foundation for the rest of the project.

Another big part of the Initiating Process Group is identifying stakeholders. Some are obvious, the patient as the customer or project owner. They may even be the project manager depending on how much they want to facilitate or be involved in the project. The project manager may also be another family member such as a spouse or parent, or they may be satisfied in letting the Oncologist as their Primary Care Provider facilitate the care and simply keep them informed as a stakeholder. The decision of role should fall to the patient or guardian as much as possible.

Other stakeholders such as nursing staff, family, and friends, and even nurse navigators and case managers. As groups, stakeholders for me included my employer, Insurance companies, Leukemia & Lymphoma Society (www.lls.org), Be the Match (bethematch.org), and Veteran’s Administration among others. Some needed to be simply updated on status, some provided additional information and research I needed to make decisions, and others had options for funding assistance, materials, and even providing of stem cells for the transplant that was planned.

Planning

As you can imagine, the planning part was the most intensive. Things were new, and just like the Project Management Process Group, it has the largest and most significant number of processes. Every single process in this group played a role in planning for treatment, although in the setting of cancer care, the documentation is a little less formal, and many of the details are rolled into patient care plans and progress notes.

A plan is developed, and scope and time management requirements are determined. There is the initial treatment or consolidation chemotherapy with specific medications and times. The work to be done and schedule was laid out on a calendar to follow so I would know where I was at and what was expected at specific steps along the way. Activities were explained and laid out with a specific sequence and duration.

Cost management was laid out by identifying insurance, coverage and requirements. Much of this was reviewed in the context of this diagnosis since many of the resources would be quite costly. Specialty treatments and medications as well as extended hospitalization could easily grow into the tens of thousands of dollars and it was important to know what cost responsibilities would be to plan for financial assistance, or impact on scope of treatment. Nurse case managers as well as contacts at various non-profits could provide additional information on assistance that could be provided in various scenarios.

Project Quality Management, HR Management, Stakeholder Management, and Procurement Management were important areas as well. Daily tests were performed to identify problems or status in order to plan adjust the plan as required. While a patient does not hire the staff and decide on assignments, it was good to know the responsibilities of those staff as stakeholders so that I could pass my own updates as well as request information from the right people along the way. There were many drugs and treatments, some planned as part of the schedule, and some I could request as things progressed and needs were determined.

One of the most important areas is that of Risk Management. There are many areas of risks that had to be identified up front as part of the treatment. Chemotherapy destroyed cells that help the body fight infection and limiting exposure to risks, identifying problems such as a fever or infection, and treating those problems early helped keep things from progressing to dangerous levels. Risks were identified, plans were made to identify anything that occurred, and steps were planned for what to do if risks turned into issues.

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Executing

Once the plan was put into place, treatment could begin following the steps laid out. Everybody had their roles in managing that work, and everybody had responsibility to double check quality and treatment. I could perform quality assurance checks by verifying information and asking questions about things that seemed different from the expected routine. Nurses double checked meds and transfusions in some cases to be sure that the steps and procedures were being followed. While some of the questions seemed repetitive, they were a key part of performing quality assurance.

Managing Stakeholders and Stakeholder Engagement helped to not only keep everyone on the same plan and aware of any updates, it helped keep family connected to the process and how things were progressing. Using tools such as Social Media made dissemination of information to family and friends much easier.

The several months and rounds of chemotherapy, transfusions and checks culminated in a Stem Cell Transplant in March of 2021 which was the primary goal in the execution phase.

Monitor and Control

Frozen Stem Cells getting ready for transfusion. Held by gloved hands next to the nitrogen container.

As noted in the Execution and Planning groups above, monitor and control was a major part of the process from start to finish. It occurred during each round of chemo, and during the process of the Stem Cell Transplant itself.

After completing the transplant, some quality assurance took place as an inpatient, and then for several months as an outpatient over the next 100 days. Quality checks became less frequent as lab tests stabilized and as treatments based on those checks also became less frequent. A bone marrow biopsy became one of the final quality assurance tests performed at the transplant facility. Once it was determined that the expected results were obtained, cancer was determined to be in remission. I was able to return home back across the country, to settle back into a more normal routine. Stakeholders were updated, and risks continued to decrease over time. Bills were checked and paid.

Closing

My cancer project was placed into what I would consider “operations” in that routine follow-ups decreased from once or twice a month to every two months or more. Ability to return to work became part of normal operations to the point that I’m back at full-time work. Right now with some modifications, life is returning to normal. Quality checks continue as part of the follow-up and as long as they continue to remain normal, no further significant updates or beginning a new project should be required.

If there are abnormal exams or tests from here on out, they will require beginning a new project like this one with possible changes to scope or processes depending on requirements and advances.

Final Thoughts

Cancer is a difficult process for anyone to go through. With all the things involved in my treatment and care from symptoms because of not only the disease, but the treatments involved, I often thought about how much more difficult it is for kids, as well as those without the experience or resources that I had available to me. Having a well laid out and documented plan helped me organize and elicit the information I needed to be informed as a stakeholder and project manager. My medical background helped me understand the hows and whys of the treatment, and my experience in medical billing has helped me navigate the world of health insurance for a diagnosis as challenging as this.

Incorporating some of the processes in project management can help not only staff, but patients better organize their treatment and expectations. Even if not certified in project management, the knowledge gained by medical staff members can only help patients work through the complex healthcare system for things like cancer, trauma care, and chronic illness.

The Courage to Try Something Old – Part 1: Facilitation

Written by Elizabeth Larson on July 13, 2022. Posted in Articles.

We know that it often takes courage to try something new. But what about trying something old? Sometimes it takes courage to do the basics, things that we know work, but for a variety of reasons are deemed to take too long or seem too “old school.” Often the old ways are not welcome. To be sure, the old ways do not always add value. But when they do, it can take courage to convince the organization that it’s worth spending the time. The first one of these oldies but goodies that I will address is about facilitating requirements meetings. Even the concept of a meeting seems a bit old school, and when you add on the discipline needed to successfully facilitate, it can seem insurmountable.

The glorious thing about requirement meetings is that rather than interviewing many stakeholders separately, which is time-consuming, we can get the stakeholders together. It’s a chance to get issues discussed, questions answered, and direction set. But stakeholders may come unprepared or with hidden agendas. There are usually different personalities and communication styles which cause different types of disruption. And it takes courage to take the time to successfully facilitate. It takes courage to keep the meeting focused. Here are three tips that will provide you courage and increase the likelihood of success.

Preparation. No matter how experienced we are, no matter how many meetings we’ve facilitated, no matter how many disruptive stakeholders we’ve encountered, we face new challenges each time we facilitate a requirements session. We can’t eliminate the disruptions, but we can minimize their effect. Thoughtful preparation with the appropriate stakeholders will help us go into each requirements event with confidence. Minimally, we need enough preparation to communicate the following before the meeting:

• Objective. This is an action, stated as a verb. Examples include: to resolve issue(s), develop a process describing a current or future state, review the results of an iteration/phase, or project.
• Desired outcome. This is a thing, stated as a noun. Examples include: decisions, issues, parking lot topics, requirement models and lists, story maps, flows and other diagrams, user stories, action items, follow-up items, and responsibilities, to name a few.
• Attendees, prep work needed of each, and expectations for their contributions during the meeting.
• Topics to be covered, who owns the topic, and approximate time to be spent on each.
• Tools and techniques to be used and how, when, and by whom.

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Meeting agreements (ground rules, protocols). The ability to keep focus during the session requires the use of meeting agreements, or ground rules. Throughout the years we have tried to soften the use of the term “ground rule,” maybe because “rule” seems so inflexible. Regardless, these agreements help keep us grounded. Getting participants to establish and then follow them, though, is tricky but necessary—necessary because disruptive participants can make everyone miserable. If we call out the disruptor, we risk breaking the safe environment and having the other participants shut down. If we do nothing, we will not successfully meet our objectives. There is no one right way to handle disruption. What has worked best for me is to anticipate disruption, include it in the prep work, and hold pre-meetings with those most likely to be disruptive. And the use of a parking lot can be one of the many agreements established.

Quick decision are not decisions. The final thought is that decisions cannot always be made during the meeting. There are a myriad of reasons why trying to curtail discussions and move forward will result in frustration and future changes. We can’t demand that decisions be during the meeting. But we can have a tentative agreement, and then it’s up to us to check in with reluctant participants as needed.
Sound a bit old school? Yes, of course. These are techniques that have been around a very long time. But they work.

We tried getting rid of meetings, and that didn’t work. We tried getting rid of meeting agreements. Chaos. We tried getting quick decisions, only to be blindsided and saddled with rework later. Sometimes the old is not the most popular, but it is the best approach, even if it takes courage to get people on board.

[i] I use the terms requirements meetings, sessions, events, and workshops synonymously.

[ii] I once suggested the use of a parking lot and some of the attendees didn’t know that it was a list of tangential topics that would be handled outside of the meeting or at a future one. They thought that we were actually going to meet in the company’s parking lot!

What Is Expected From Businesses In a Post-Pandemic World?

Written by Ian Chambers on June 22, 2022. Posted in Articles.

By Ian Chambers, CEO – Linea

The onset of the COVID-19 pandemic represented an era-defining paradigm shift for the world of business. Even though the most noticeable impacts of the pandemic have now abated in many parts of the world, the changes it has brought about in the way businesses operate are unlikely to be undone.

The dramatic changes to regular working patterns brought about by pandemic-era lockdowns, combined with a renewed focus on health and wellbeing, have dramatically shifted expectations of what professionals want from their roles. At the same time, customers now also expect a more flexible and conscientious approach to service delivery and are willing to favour companies who are able to provide this.

As such, every organization needs to adjust the way it operates to accommodate these changing realities. By implementing the necessary changes as part of an ongoing process of business improvement, companies can put themselves in a position to capitalize and thrive.

Shifting attitudes and expectations among workers and clients

Many of the changes that the pandemic has brought about can be explained by clear practical requirements – namely, businesses were forced to be a lot more creative and flexible in the way they operated during lockdown, and their employees and customers are now reluctant to give up that flexibility.

For employees, this means that staff have gotten used to being able to work from home and adjust their own working patterns or are keen to retain the additional health and wellbeing benefits they may have received during the pandemic. Expectations among customers and clients, meanwhile, have evolved in complex ways: some have grown accustomed to receiving more flexible terms and conditions, or improved remote access to services, while others may have become frustrated by the lack of face-to-face interaction with customers, and would prefer to return to pre-pandemic ways of working.

There are also an ethical or value-driven dimensions to this evolution, as the pandemic has made many people aware of existing failings and issues of unfairness with the previous status quo. Management can no longer expect to monopolies the highest salaries, while offering only limited flexibility to the workers responsible for generating value, without a risk of undermining their own recruitment capabilities or alienating socially conscious consumers.

As such, the challenge for organizations operating within these rapidly evolving markets is to show they can reflect and operate by the changing values of society. If they fail to do so, they risk being left behind.

How must businesses change to adapt to post-pandemic realities?

With all of this in mind, it is essential for companies to regularly review and implement necessary changes to their operating practices and service models, committing to an ongoing process of business improvement to ensure they are meeting the expectations of modern professionals, consumers and clients.

Here are some of the key areas in which we have seen businesses committing their efforts and resources in the wake of the pandemic:

Developing new core business values and principles that can be closely aligned to post-pandemic norms and expectations, and working to ensure that every member of the organization has bought into these goals and can exemplify them in how they work
Enshrining workforce wellbeing, engagement & stability as a central business value, by embracing of flexible working models, strong staff support, and opportunities for progression, to ensure the organization can attract and retain talent
Mitigating actual & perceived biases that could contribute to systemic unfairness or barriers to success, by viewing decisions from different stakeholder perspectives
Focusing on true customer-centric value and service flexibility, aligning with modern market expectations, to stand out in an increasingly competitive marketplace
Maximizing the use of diverse marketing channels to capitalize on current trends, while acknowledging the need for mindful content and socially conscious messaging
Adopting agile business strategies and approaches, informed by the lessons of the pandemic regarding how quickly circumstances can change
Creating and maintaining financial liquidity to provide future flexibility, giving the organization greater protection against unexpected shifts in the market
Driving value for money & profitability, while sensitively managing concerns around doing so, as businesses can no longer be seen to be cutting corners simply to protect the bottom line
Using societal appetites for progress to help accelerate the adoption of necessary change within the company, and to challenge conversative or risk-averse viewpoints within the organization

Not all of these changes can be implemented with immediate effect – some will involve a long-term process of change management, which will require the business to holistically review its current processes and operations to chart a gradual path of transformation, as measured by definable metrics and achievable milestones.

This can be difficult and time-consuming to achieve, but as the post-pandemic era continues to take shape, it will be an essential step for organizations across multiple sectors. Professional expectations and customer values are evolving quickly – and companies must do the same to remain at the forefront of their respective markets.