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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One of the overriding goals of an athlete is to see how far they can push their body.  Now, I don’t mean going as far as you can then hurting yourself, but rather how toned and trained you can become to be an example of perfection in your sport.

Even though most athletes would depend solely on training and nutrition to get them to their peak ability, there are alternative ways to get there as well.  Some examples would be using HGH supplements, protein shakes, creatine and other sports enhancing substances.  Now, I am not condoning drug use or overuse of these types of supplement, but rather you should look at is as using these types of products to help you achieve more than you can on your own.

Some people are just too scared to try something new and for these people, they will never realize their true potential.  Others will try and convince you that something is bad for you such as telling you that the HGH side effects outweigh the benefits.

I heard all these “horror” stories, but from my experience using HGH over the past year, it turns out that they don’t know what they were talking about.  I have had nothing but positive results from using this supplement, and you could too – just try it out and come to your own conclusions.

Technorati Tags: HGH side effects, hgh supplements

Have you ever had a Diet Cookie?  They’re actually pretty good.  They’re nothing like the tasteless rocks that used to be sold in the super markets.  Matter of fact, I first was introduced to these while on an actual commercial diet.  Now, I see things like “breakfast cookies” in King Sooper’s that are fat and full of fiber and nutrients. 

I bet diets like Diet Miami don’t have these.  I’m always afraid of those diets from Florida or California because my impression is that those have a lot of weird drinks, fruits and salads.  Fine, but I also need breads and carbs, not to mention proteins.  And I’ve been on diets before where the desserts were nothing more than a morsel, which I appreciated because prior to that there were no desserts whatsoever.  But these now that are kinda large and filling plus having fiber, now that’s nice!

I’d rather eat a few cookies a day than just drink liquids two or three times a day.  Some of those diets are like that.  I used to like those shakes, but boy I couldn’t drink more than one a day.  My stomach feels squirrely and unfulfilled.  I’m hoping that this will feel a lot better.

It’s a shameful fact of the elder care industry that sometimes the people who are hired to care for the elderly use their position to commit elder abuse. That’s why it’s so important for anyone working in this field to get elder abuse training so that they can recognize the signs and symptoms of this shameful dereliction of duty to the elderly. Really, it’s crucial that all caregiver training programs include information on the recognition of elder abuse as well as information about how to keep the elderly from being abused.

People who train to be caregivers learn about all kinds of subjects, everything from nutrition to skin care to maintaining wellness, but besides fall prevention in home care, home health care workers can receive no training more important than the prevention of elder abuse. It’s a real crime that people even have to think about this issue. After all, what could be more despicable than abusing a helpless elderly person? So if that’s your opinion, too, and you work with the elderly, you need to be vigilant and you need to know how to recognize the signs of elder abuse either from staff or from your clients’ friends and family members. Elder abuse is not acceptable no matter where or when it occurs.

Technorati Tags: Elder abuse training, fall prevention home care