Have you every had a director of IT say on the night before the live of a new system, we are also going to bring up this module in its vanilla form to see how it works out. Oh the joys of evil vile scope creep! I’ll share with you a secret, the goal of a scope change process is not to always immediate scream no from the executive ivory towers. A scope change process is to assure that the risk is worth the rewards when it comes to scope change. So let’s talk about how to introduce a scope change process into a chaotic project management culture.

In a chaotic project management culture, the jack of all trades who can do it himself is rewarded, and will look like a cowboy forced to wear a three piece suit when feeling constrained by a scope change management process. Therefore do not introduce a process that constricts and is an obstacle, have it augment efficiency.

There are some common characteristics to a scope change management process.

• The approval of the change is aligned with the organization’s authority to act
• The sponsor approves the changes, before moving to the next level of authority
• The change request form clearly asks for the impacts and the benefits
• Requested Changes have a change number
• The process is agreed to by the sponsor before the project starts

When starting out, with this new process, I’d recommend the pmo clarifies with the IT leadership what is in and not in a scope management standard. We previously shared a scope management standard which can be used as a starting point for the standard. Also the purpose to a scope management process, has to vet at the decision level necessary the requested changes to project scope. After the IT leadership has agreed it makes sense, start organizing a couple of projects with this in the mix. Open discuss using the process with those project sponsors, and executive sponsors if applicable. The goal here is to gain buyin and suggestions as to a process which will work at your organization.

With a scope change management process your outcomes will be clear, the more time planning a commercial off the shelf implementation, the better the execution, and the lesser degree of scope changes. It will also help to engage the project sponsor.

Further Readings on Taming Chaotic Project Management:

• The Top Ten Characteristics of a Chaotic Project Management Environment
• Find out how many active projects are in flight.
• Establish your organization’s current and desired need of Healthcare IT
• Collaborate on Prioritization Decision Criteria
• Have a defined and approved process to accept work.
• How to stop running the daily meeting marathon
• Using the WBS to define deliverables
• How to know when you have a project and when you do not
• 8 Training Tips on how to develop project schedules

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Physician CPOE adoption is being discussed in IT strategy sessions across the US. But before one needs to get it adopted, one has to get it implemented. Truthfully, there are a lot of horror stories out there. One of the main critical success factors for a computerized practitioner order entry (CPOE) implementation is for the order entry team to truly understand the nuances of the electronic ordering process compared with the current paper process.

Here are six steps, you and your project team can take to assure they have got this one in the righteously done category

• Gain an understanding of what went wrong in the horror stories! - Those horror stories have good insights in what not to do, or what to mitigate early. Check out the literature, and if there are similarities, identify a risk
• Have a couple analysts go through the day in the life of the practitioners - Commonly IT departments will hire a nurse or three to help relay this process, however having those individuals accountable for designing and configuring the screen flow. Having them understand how extra clicks actually matter becomes crystal clear in following a nurse or a physician around. There is also no better way to instantly imbed a sense of purpose in IT staff. Using the management chain of command, get the request to the CNO or CMO
• Gain an understanding of what went right! - There are a couple of tales of success stories out there. Check them out and try to see if similar techniques will work for your organization
• Create a strong partnership between the informatics department and IT - Having these two departments become a performing team is the goal of the project manager. Set an environment up for teaming, a common location, team building activities, small wins for the team, and facilitate team development. These two departments are each a leg of the implementation and need to walk in a powerful stride.
• Rather than invent the wheel, use a consultant who has been through it - Having a talented consultant who has traveled this road before is worth their weight in gold. Utilize this skill set in order to help identify understanding gaps.
• Reuse the successful techniques from the documentation coordinators - As AP-DRG’s rolled out, efforts were taken to improve physician documentation so that coders could accurate ascertain SOI and ROM. The techniques to improve the physicians documentation will be similar to their adoption of the CPOE. Additionally this will provide insights into the daily life on the floors
  • Using Rules to support clinical decision support
  • Discovering the organization’s perception of an EHR
  • Getting your physician leadership engaged
  • The 5 levels of healthcare IT Credibility
  • Collaborating with Clinicians

All are open to share their suggestions!

Further Readings:








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