PROVIDENCE, R.I.—Working through internal challenges was a difficult feat for Care New England Health System, a 643-bed, 6,878-employee system spanning the state of Rhode Island. However, creating a project management office and implementing staff training led to overall cost savings, employees from the health system said during a May 7 presentation at the HIMSS New England (NEHIMSS) chapter conference.
"In 2001, the facility hired an external consultant to help decide and determine what our strategic goals and mission would be for the new century,” said Wendy McCarron, director of Care New England’s PMO.
During the consultation, the initial idea to implement a PMO was proposed, along with 50 or so initiatives that the facility could work on to make productivity at Care New England more efficient.
In 2007, the facility merged the PMO and its IT department, where Care New England’s entire project portfolio is now managed.
Prior to 2007, “the area of evaluating a project was a big grey area,” said Brandt Swanson, a project manager at the facility. He added that previous projects weren’t reported properly to top management, which led to discrepancies.
In addition, McCarron said that managing an entire project portfolio is very difficult at a system with multiple facilities. “Not all of them have the same priority for the projects, not all of them have the same amount of funding each year, so the PMO's job is to act as the liaison to close that gap and help set the overall direction for CNE for both the clinical and financial areas," Swanson said.
Prior to the positive changes in workflow, “whoever hollered the loudest was the one who got their initiatives worked on,” explained McCarron. At that time, CNE faced internal challenges such as inaccurate budgets, no prioritization process and inadequate staff training.
Outside forces also weighed in heavily on the facility, including decreases in reimbursements, uncompensated care due to low state unemployment rates and higher mandates.
To alleviate this, McCarron said, “Our executives told us we have to tighten our belt and control expenses. We had to do more with less money. I hate that statement, but basically that is where we were at."
To do so, CNE increased guidelines, delivered a project portfolio system, increased document structure and implemented a training toolkit to make employees more efficient.
“Probably our biggest accomplishment was that we developed an internal education system including a project management guidebook and training,” said McCarron. Swanson said reforming CNE’s governing structure by implementing steering committees was also beneficial.
Currently, the committees work as a gateway by meeting once a week to review project requests. The committee doesn’t approve the projects but instead offers insight and can endorse or oppose projects.
“This works because now every project, no matter how big or small, is evaluated the same way,” said Swanson. Because there is now a standard process across the health system, CNE has a more accurate budget and a more balanced portfolio.
The facility spent three to four months developing a home-grown, web-based project portfolio management system (PPM) to gain better compliance while still saving costs. “The bottom line is that we developed this system for $15,000,” said Swanson, compared to the $150,000 the facility would have paid to purchase a PPM through a vendor.
The PPM system has resulted in time savings, has improved communication and standardization, and has streamlined project practices, allowing project information to be brought up within minutes rather than hours, he said.
Because the facility had such a large volume of projects and staff training lagged, staff often missed deadlines, said Karen Carlson, senior project manager. "Training was a huge issue. We really wanted to make sure that our staff was going to have the understanding to be able to look forward to responsibilities that were coming their way," Carlson said.
The facility implemented a team-based approach that relied on internal resources and brought together staff from various departments: “Job description number nine—all other duties assigned—is rampant in our hospital,” she said.
CNE created a management guidebook and training curriculum to create guidance and increase transparency into the PMO. “We didn’t have a great way to bring in fancy project manager training, we didn’t have money to hire additional project