A Journey in Project Management ofan Enterprise Clinical RTLS Program

Kimberly BrayleyDirector, RTLS Project Management OfficeVeterans Health Administration

Areas of Concentration

– Defining your Project– Schedules and Tasks– Resourcing– Communication &

Education– Tracking Progress– Risks, Issues, and Lessons

Learned– Measuring Success

Hospital System to Health System

VHA currently has 21 VISNs:• 152 Medical Centers• 974 Outpatient Clinics

– 807 Community-Based– 152 Hospital-Based– 9 Mobile

• 6 Independent • 288 Vet Centers• 98 Domiciliary Residential Rehab

Programs • 133 Community Living Centers

In 1996, VA began the creation of Veterans Integrated Service Networks (VISNs) to transform VA Health Care from a “Hospital System” to a “Health System.”

VA RTLS Primary Objectives• Deploy the set of nationally standardized RTLS solutions to:

– VHA Medical Centers, Clinics, non-patient care locations

• That will:– Improve operational efficiency and the quality of Veteran care – Decrease operational costs – Maximize equipment utilization– Increase efficiencies and staff productivity– Reduce delays and improve patient care– Minimize lost and misplaced items– Improve customer and staff satisfaction– Improve the quality and safety of service from patient, physician, and

institution perspectives

VA RTLS Primary Objectives (cont.)• Establish a capability that is compatible and interoperable with

existing information systems internal and external to VA – Ensuring integration, scalability and ease of sustainment across technologies

• Provide medical centers and other VA facilities with the real-time capability to actively track:

– Selected assets, significant medical supplies, staff, patients, and environmental conditions (e.g., temperature and humidity) through a common interface and reporting tool

• Deploy a single instance of a NDR solution for: – Aggregation and in-depth analysis of data from individual “front-end” RTLS

instances: National Data Repository (NDR)

RTLS Program Approach

Assess requirements

Study lessons learned

Document programmatic information

Assess process flows

Identify outcomes and ROI

Determine needs for hardware and software

Determine sequential dependencies between requirements and procurements

Identify and apply critical success factors

Standardize procurement strategies and outcomes

Provide solution on a National Contract

Implement comprehensive, sustainable and repeatable system and user training

Controlled deployment in VA facilities for system and applications / use cases.

Ensure active involvement of leadership and staff for adopting use of technology

Sustain communication and education

Ensure programmatic and business concerns are addressed

Continue to grow uses for technology

Review PriorInvestments

Design Plan Procure and Install

Implement Change

Management

Defining your Complex Project

VISN 7

Facility A

Facility B

Facility C

Facility D

Facility E

Facility F

Facility G

Facility H

VHA RTLS

1 23

4

5

6

7

8

9101

112

15

16

17

18

19

20

21

22

23

Facility E

Asset Tracki

ng

Temp Moni

tor

Sterile

Processing

Cath Lab

Supplies

National PMONational Workgroups

ContractorSubs

LeadershipClinical Departments

Support ServicesPatients & Staff

Defining your Complex Project (cont.)

Project Manager COR

OnBoarding

Deliverable Management

Contractor Point of Contact

Financial Manager

Leader

Educator

Change Manager

Project Planner

Schedules and Tasks• What tasks go into a Project Plan?

– Your Tasks• Workgroups• Committees – not in project• Named resources

– Contractor Tasks• Subcontractors

• Who manages the schedule? How often do you review it?

• What is the real time to complete a task?

• Milestones -Impacts for not meeting dates?

• Other Projects and Issues impacting your schedule– Joint Commission– Construction Schedules– Budget Cycles– Vacations, Holidays, Shift work, Patient Care Areas

Schedules and Tasks: RTLS PMO Integrated Master Schedule (IMS)

• Developed an RTLS IMS, integrating all project schedules into a single high-level source view:

• RTLS Procurements • RTLS Deployments• RTLS Associated Projects• RTLS National Application Workgroups• RTLS PMO

Schedules and Tasks: 30/60-Day Outlook Report

• Developed and provide a monthly 30/60-Day Outlook Report at the beginning of each month of the entire RTLS program

Resources• Roles and Responsibilities• Can you name all the

players on your team?– Who’s on First, What’s on

Second? Exactly…

• Do you have more than 1 SME in an area?

• Don’t task yourself• Is everyone on the right

bus and in the right seat?

Communication and EducationCommunication• Email Groups• SharePoint's• Messaging• Internal PR Plan• Newsletters

Education• Seeing and Understanding• Change management• Frequent• Tiered levels for audience• Lunch and Learns

The task of a leader is to get his people from where they are… to where they have not been - Henry Kissinger

Tracking Progress• Action Item List• Deliverables• Paying Bills Timely• Performance Requirements • Reviews with Contractor• Internal Gate Reviews

Tracking Progress: RTLS Manager DashboardDeveloped a Pilot RTLS Dashboard for VISN Managers:• Serves as an overarching and holistic

tool for each VISN TO, through aggregation of preexisting data sources – Budget (Schedule B, Invoices)

– Schedule (Project Schedule)

– Resources (onboarding, Training)

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*Form included for Checkpoint 3; Plan to review the Deliverable Matrix during the other Checkpoints

Program Initiation

Pre-Procurement Procurement Contract

Initiation Implementation Project Close Sustainment

Gate Review - Decisional

Program Initiation

Base Deployment Project Program Sustainment

Checkpoint - Preparation

Checkpoint 1 informal review of activities with PMO POC

Gate Review 1 formal review of ARP

Gate Review 2 formal review of activities up to TO Award

Checkpoint 2informal review of preparation tasks with PMO POC

Gate Review 3Once the last facility implements an application, initiate theformal review

Checkpoint 4 Informal review of activities to close out the project

Gate Review 4 formal review of activities to maintain RTLS

Checkpoint 3 informalreview(s) of each application being implemented at a facility

Tracking Progress: Gate Reviews for Procurement

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Development Requirements Acquisition Implementation LifeCycle Management

Gate Review - Decisional

Gate Review 1 Gate Review 2 Gate Review 3 Gate Review 4 Gate Review 5

Workgroup Gate Review Lifecycle

Tracking Progress: Gate Reviews for Applications

Workgroup Gate Review Deliverable Approval Matrix

Tracking Progress: Tools and Templates

Tools and Templates• Do you have them?• Can others access?• Does it tell a story?• Is it helpful?• How often do you update it?• Managing your tasks vs the tasks

managing you…

Risks, Issues, and Lessons Learned• Risks:

– Will create a negative effect on your program– Must be mitigated

• Issues:– Problems, situations, findings and decisions that arise during the

program that you may need to take action on or document the outcome.

• Lessons Learned:– Complexity provides for greatest usage – Understanding our mistakes, help us to not repeat them– Can you avoid same mistakes others have already made?

Would you rather Fail Alone.. Or Succeed as a Team?

Measuring Success

The measure of success is not whether you have a tough problem to deal with, but whether it is the same problem you had last year. - John Foster Dulles

Measuring Success (cont.)

• Did you document your expected outcomes?• What story can you tell after you have

completed your project?• Soft vs Hard Benefits…• Pre and Post measurements

Benefits RealizationFunctional Area

Benefit NameAsset

Management SPD Workflow Temp Monitoring

Cath Lab Inventory

Management

Improve Patient Care Improve Managerial Decision Support Reduce Inventory and Equipment Costs

Improve Staff Efficiency

Improve Consistency of Services

Benefit #1: Improve Patient Safety Currently Measured?

Performance Metric Name: Recall Turn-Around Reduction

Metric 1.1: Length of time it takes to respond to a recall after receiving recall order

What type of PM are you?

• Leading or Managing– You manage things and lead people…

• Problem Solving or Creating– Are you carrying around a fire extinguisher?

• Partnering - not just hiring the help– Are we all on the same team?

It's not easy… but it's worth it It's not easy… but it's worth it It's not easy… but it's worth it

IF IT’S NOT WORKING…

“That's just stupid. We need to look at the right way to do things instead of the way we're doing them now.”