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Eating an Elephant One Bite at a Time: Lessons in Leading Big Projects from Initiation to Completion Eric Schoomaker, MD PhD LTG (Ret) USA Scholar-in-Residence.

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Presentation on theme: "Eating an Elephant One Bite at a Time: Lessons in Leading Big Projects from Initiation to Completion Eric Schoomaker, MD PhD LTG (Ret) USA Scholar-in-Residence."— Presentation transcript:

1 Eating an Elephant One Bite at a Time: Lessons in Leading Big Projects from Initiation to Completion Eric Schoomaker, MD PhD LTG (Ret) USA Scholar-in-Residence 14 MAR 2013

2 Teaching Objectives My objectives would be for: 1. Attendees/learners should have a framework for approaching the leadership and management of complex, multi-step, cross-organizational projects to achieve mutually beneficial strategic goals. 2. Attendees/learners should know examples of key lessons learned by the presenter from personal experiences with such projects. 3. Attendees/learners should have a pretty good recipe for "elephant stew"!

3 Framework for Tackling Complex Projects Clearly define the problem you are solving or the mission you desire to accomplish. Adopt an aspirational mindset; many reasons why you can’t succeed—seek those reasons and methods why you can! Know where influence without authority must apply—the limits of your authority. Imagine achieving the summit of your ascent and reconstruct the route by which you arrived at the top.

4 Framework for Tackling Complex Projects (cont’d) Divide the overall task into major lines of effort using a comprehensive analysis of elements, such as DOTMLPF. If working with or leading a team, select teammates on the basis of diversity of thinking and skillsets. Work on parallel LOEs; tackle rate-limiting steps with focus and vigor. Communicate, communicate, communicate…

5 DOTMLPF Doctrine—the way we achieve the mission Organization—how we are organized to do so Training—how we prepare to work Materiel—all the “stuff” required to work Leader Development & Education—how we prepare our leaders from the tactical to the strategic Personnel—availability of qualified people Facilities—real property required

6 Landstuhl Army Regional Medical Center (2 nd General Hospital) in Summer, 1990

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8 LARMC DESERT STORM Mission To expand to 850 operating beds upon direction of 7 th MEDCOM CDR. Increase intensive care beds to a total of 90, including 34 burn beds, and operate a total of 8 operating rooms. Return to peacetime configuration on demand.

9 How Do We Approach This Elephant Stew?

10 Mission Analysis/Problems 850 Beds/90 ICU/ incl 34 Burn Beds/8 ORs: Structurally configured & staffed for 300 beds—although designed for 1000 Conventional care must continue until ordered to expand; must return as promptly when war ends Continue community care until expansion: LARMC space balance was outpatient clinics with equipment—must be replicated to continue care Infrastructure (power, gas, suction) inadequate for expansion: Upgrade or work around Must deploy some of key staff and prepare area units for deployment: Replace key personnel Very limited conversion and restoration time (7 days): Front- load much of the work and expedite transition

11 Problems: DOTMLPF Gap Analysis Structurally configured & staffed for 300 beds—although designed for 1000: T,M,L,P Conventional care must continue until ordered to expand; must return as promptly when war ends: T,L,P LARMC space balance was outpatient clinics with equipment: M,F Infrastructure (power, gas, suction) inadequate for expansion: M Replace key deploying personnel: T,L,P Front-load much of the conversion & restoration work and expedite transition: T, L

12 Atop the summit… …and the route that got you there!

13 LARMC ODS/DS Lines Of Effort and Phases LOELOE Pt Care Deploy/ Redeploy Readiness DS Rec/Rep Evacuation POM Units Dep/Redep LARMC Staff Planning Reservist Rec/Train Expansion Conv/Restore ALERT EXPAND RESTORE DEPLOY CONVERT

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15 Arrival and in-processing of Reservists in LARMC gym

16 Each ward or clinic assigned a van parked between buildings under control of wardmaster

17 Electrical upgrades for ICU areas and patient rooms

18 Bundeswehr Reservists unpacking & assembling beds in LARMC warehouse…an allied effort.

19 Completed ICU bed in outpatient exam room

20 LARMC ODS/DS Takeaway Lessons Even seemingly impossible missions are achievable with the right combination of problem analysis, dedicated people and imagination. “No plan survives contact with the enemy.” “Plans are nothing, planning is everything” (or, it’s not the plan, it’s the planning.) Don’t allow the tactical to distract from the strategic. Everyone has something to contribute to a complex mission. When all is in turmoil, exploit the chaos and make all of the changes you desire.

21 “Forty Days of Winter: Walter Reed, the Wounded and the Washington Post” February - March 2007 February 15 - Thursday Dana Priest and Anne Hull Meet MG Weightman and Staff

22 February 18 - Sunday First Washington Post Article

23 Conditions in Bldg 18 February 18 - Sunday First Washington Post Article

24 Media Storm

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27 March 5 - Monday House Committee on Oversight and Government Reform Hearings at Walter Reed

28 Changes in leadership…

29 Initial Hearings DoD Independent Review Group Testimony House, Senate Appropriations Committee

30 Combined effects of: Unprecedented Battlefield Survival Unprecedented Battlefield Survival Medical Regulating Challenges Medical Regulating Challenges Limited Primary Care Capacity Limited Primary Care Capacity BRAC BRAC A-76 Workforce Privatization A-76 Workforce Privatization Long-standing PDES concerns Long-standing PDES concerns Fragmented wounded warrior C2 Fragmented wounded warrior C2 Others… Others… Combined effects of: Unprecedented Battlefield Survival Unprecedented Battlefield Survival Medical Regulating Challenges Medical Regulating Challenges Limited Primary Care Capacity Limited Primary Care Capacity BRAC BRAC A-76 Workforce Privatization A-76 Workforce Privatization Long-standing PDES concerns Long-standing PDES concerns Fragmented wounded warrior C2 Fragmented wounded warrior C2 Others… Others… At Walter Reed: A Perfect Storm…


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