HM 15: HOSPITAL PLANNING & PROJECTS

HM 15: HOSPITAL PLANNING & PROJECTS
Dr Kithsiri Edirisinghe MBBS, MSc, MD ( Medical Administration)

Modular Objectives Objective: The course gives a comprehensive idea of hospital projects from conception to its commissioning. Mode of Learning: Lectures & discussion

15.01 Introduction to Hospital Projects and its Components
Learning outcomes: Basic knowledge on organizing hospital projects Discussion topic: Introduction to project management, fundamental principles, scope, components and measurements Methodology: Lecture discussion

15.02 Introduction to Hospital Project Feasibility
Learning outcomes: Competence in feasibility study of hospital projects Discussion topic: Feasibility study: Introduction to demographic, epidemiological, health sector, financial feasibility; Selecting geographical areas and business opportunities for patient groups and sizes and types of hospital facilities. Methodology: Lecture discussion

15.3 Introduction to Conceptualization of Hospital Projects and Proposals
Learning outcomes: Competence in conceptualization and organizing investment proposals Discussion topic: Conceptualization and the planning of medical services, organization of the project and investment proposals Methodology: Lecture discussion

15.04 Introduction to Organizing and Managing Hospital Planning and Projects
Learning outcomes: Basic knowledge on hospital project planning and construction management Discussion topic: Hospital planning : Designing the civil, M & E, equipment, different hospital designs; consideration of energy; physical movements; preparing architect’s brief equipment planning and budgeting; Activity plan and the controls of construction, equipment establishments and standards. Methodology: Lecture discussion

15.05 Strategic Business Planning
Learning outcomes: Competence in formulating a strategic business plan on hospital construction management Discussion topic: Strategies of activities of organizing a strategic direction, formulation of objective differentiation, pricing and promotional, attracting human resources giving examples of recently concluded hospital projects. Methodology: Lecture discussion

Readings 1. Project Management, Dennis Lock, 1996
2. Hospital Architecture, Christoper Schirmer , Phillip Meuser, 2007 3. Step by Step, Hospital Designing & Planning, Sangeet Sharma, Purnima Sharma, 2008 4. The Art of Medical Equipments & Furniture Planning, Universal Hospital services, 2007

15.01 Introduction to Hospital Projects and its Components

What is a hospital? Hospital is a place where :
“all patients and their loved one are received, treated and released in a friendly, dignified , and ethical manner maintaining the professional and institutional policies and standards thus preventing, investigating, treating and rehabilitating patients Supports training and research with a view to exceeding patients and institutional expectations”

WHO Definition An integral part of the Medical & Social Organization
Which produces complete healthcare for the community Both curative & preventive and outpatients services to reach out to family in environment It is also a center for training of healthcare workers for Bio- social research

06 key Functions of a Hospital
Preventive Investigative Curative Rehabilitative Training Research

Uniqueness of hospital projects
It is one on of the most complicated projects Many specialists needed Proper and precise coordination is needed Medical administrator has to take the responsibility of the total project All Stake-holder participation is essential High cost

Hospital projects Project phases Project functions Project activities
Project Tasks

Hospital Project phases
Project development Hospital design Approvals Site Management Construction - Civil, Mechanical & Engineering Equipment Management HR planning , recruitment and training Supplies Management Establishing systems - Policies and Protocols IT planning , commissioning and training Commissioning and Hand over of the hospital Operational Management

A. Project Development

Justification of Management idea to enter to hospital industry
Feasibility study Conceptualization & strategy Location Medical Brief or the Medical Plan of Services

1. Justifications of XXX entry in to hospital sector
Widening demand gap Government beds per population 5 ( Colombo) Private beds per 1000 population 3 ( Colombo) Growth of private sector hospitals Average revenue growth 15% Sector vision to be the leader in health care business Platform to enter other areas in the Healthcare sector Favourable impression in the market & among professionals about XXX entry to hospital sector

2. Feasibility study Demography Epidemiology Health Services Market
Financials Environmental assessment To identify the concept and type of the hospital

1. Demographic Identify the market population
General population ,000 Feeding population ,000 Expected population – 900,000 Comment : Average market population for a private hospital in Jaffna – 360,000 Jaffna Province 1250 SqKm – Vadamarachi, Thanamarachi, Jaffna Islands, Valakama 84% Hindus , 99% Tamils , 79% more than O/L, 70% Productive population, 16% elderly, 44% employed - 15% Govt employees & 29% private /self

2. Epidemiological Communicable diseases Non communicable diseases “ Multispecialty services with special focused specialties and high demand / revenue ”

3. Health Services Available hospital beds Government - 1000 beds
JGH – Occupancy rate 110 / Turnover rate – 81 / ALS – 4.9 Private beds – Mainly nursing homes Out patient services “Main service provider are government hospitals & in the private sector CNH along with many small out door care services”

4. Market Middle income group Government servants , bankers , farmers
44% employed : 15% Govt. employees & 29% private /self Government servants , bankers , farmers Elders and families with foreign support – 16 % Foreigners , NGOs, construction company workers , new businessman High patient migration to Colombo ( 10 % Col. Beds) “Most rapidly growing health market with no major player at the moment “

5. Financial Low capital infusion Well planned medical services
Well controlled project management High revenue services Manageable model High quality care High asset utilization Faster turnaround time Project IRR - 25% / Equity IRR – 30% Start as general services and expand on to focused areas most feasible model in Sri Lanka BOI concessions year tax holiday

6. Environmental analysis
External environment Internal environment

External Environment Assessment
Opportunities Threats Political 1. End of civil war – best time to invest 2. Government support 3 NGOs / Businessman 1. More opening in the market 2. Improved infra structure – easier to access Colombo Facilities 3. New health regulation Economical 1. Improved income 2. Channeling of money 1. Culture of spending Social 1. Willingness to spend for health 2 . People coming back to Jaffna 1. Perception regarding local hospitals Technological 1. No technologically sound hospital 2. Travelling to Colombo even for basic investigations 1. New investors of Laboratory and Non invasive technologies Health sector 1. Lack of private sector beds 2. 15% Colombo Beds occupied by Northern Patients 1. Many big players coming to the market 2. Improvement of exiting players – Govt. and private

Internal Environment Assessment
Strengths Weakness Leadership 1. Owners willingness 2. Thinakural brand equity 1. Medical director’s mindset 2. Social project 3. Medical Administrator Personnel Consultant specialists GP practice Accounts Out side consultants’ willingness 1. Nursing 2. Para medical 3. Marketing Service delivery 1. As the only pvt. hospital 2. Brand name of 25 years 1. Existing facility MIS 1. Accounts 2. Medical records 1. Lack of Hospital Specific MIS Quality 1. Technical quality Poor service Quality Finance Owners equity Bank willingness Cash & stable business 1. Long term returns Cost Low cost operations Low fees charged Development 1.Experinece & capability of Micro & GHC 2. Closer to the Medical Faculty & Hospital Lack of frontend Big players of faster project implementation

C. Conceptualization

Conceptualization Mode of entry Hospital model Project model Strategy
Vision Mission Objectives

Objectives of the XXX hospital Project
To established a Multi-specialty hospital in Colombo district. To establish 2-3 satellite hospitals in selected outstations. To support related special projects identified by Hemas.

Project model Multi-specialty hospital Group of hospitals
Colombo (01) , initially Selected Outstations ( 03), later Partnership with existing hospitals Outsource unavailable facilities Reach outstations

Multi Specialty Hospital Vs. Single Specialty hospital
Disease pattern in Sri Lanka Direct patient care & Supportive care Capital investment Hospital utilization Attracting doctors & patients

Group of Hospitals Vs. single hospital
Feeding hospitals Demand in the Outstations

Hospital Model New concepts to attract doctors & patients
Use of IT in patient care & administration Controlled infrastructure High quality of care with minimal waiting time & cost Comfortable environment for doctors & patients Focused on the largest (60%) middle income group Concentrate on the general specialties Combination of Medical management & Hotel management

Three basic models According to bed strength Large Medium Small

Hospital Model A Bed strength 100 Cost: Rs. 1000 million
Multi-specialty General hospital Curative, preventive & rehabilitative care Services General specialties No high end,capital intensive services Facilities Inward & outdoor care Special care units Diagnostics ,up to CT scanner

Hospital Model B Hospital Model C beds -75 Beds -25
Project cost :Rs.750 million Tertiary care facilities Outdoor: all related specialties Diagnostics up to CT scanner Hospital Model C Beds -25 Project cost :Rs.250 million Inward: 04 General specialties Outdoor: all related specialties Diagnostics up to an US Scanner

The Strategy

Selected Strategies CORE STRATEGIES B. GENERIC STRATEGIES
Integration - MERGE WITH A FOREIGN HOSPITAL Restructuring – NEW EFFECTIVE STRUCUTRE B. GENERIC STRATEGIES Cost leadership – LOW COST & HIGH QUALITY Value chain – ADD VALUE to EXISTING BUSINESS

Vision Mission ……… “To be the best
Patient Centric hospital in Sri Lanka “ Mission ………

Project model Build a hospital for 30 years
Multi- specialty hospital – Two stage development 50 bed could upgraded to 100 beds Service level Match Colombo Standards Services offered Preventive / Investigative /Curative Rehabilitative care / Training development Tie up with foreign hospital

C. Location & Site Location
People - Area economies, population density Demand gap - Government hospital & competition Access to doctors Access to patients Access to Staff Availability of land Supplies

C. Location & Site Site Site visibility Access to patients – transport
Environmental assessment Access to material Disposal of waste water Ventilation Access to water Light Site soil and surface

D. Medical Plan /Brief

Medical plan Main responsibility of the hospital administrator / manager Medical services – 30 years Areas of specialties for next 30 years Number of Services delivery per unit with time scales Quality standards of the planned services Other related services Out-sourcing Linking of services

Medical plan Put up Initial plan
Discussion with the respective specialists Discussion with equipments/ supplies managers Identify new trends in treatment / investigation methodologies

Project costing 01 Conceptual costing of the hospital project
Use market data Previous project cost data Validate with today's rates Sample 01

Operational Finances 01 Revenue for the next 10 years IRR ROI NPV
Dividend plan

Establishment of a company
Company incorporation Appointment of the Board Regularity clearance for the company

Project finance Mode of financing

B. Site Management Confirm Feasibility Survey plan Title search
Soil, Water testing Approvals UDA BOI Assessment of the site Water supply Electrical supply Effluent disposal Road access Weather pattern Work force Agreements Acquisition Fencing Security

C. Hospital Design Confirmation of the Medical Plan Master planning
Unit planning ( done later ) Process Analysis of the respective services out put of services allocation Space, HR , equipments Confirmation of the policies and strategies Architects Brief 4. Schematic design Civil M & E Project Costing II 5. Detailed design Project Costing III 6. Functional design Process Systems Confirmation with AP

D. Approvals Project Approval Site approval ( Survey Plan)
MOH Local Gov UDA BOI Site approval ( Survey Plan) BOI Approval Preparation and signing of agreement Submission and approval of the Equipment & the Building material and M & E List Submission of Detailed Plans and BOQs Building Plan Approvals Local Government UDA Atomic Authority Fire Department Traffic Impact Assessment Water, electricity & Telephone CEA MOH RDA Operational Approvals Certificate Of Conformity MOH registration

E. Construction Preparation of B.O.Q.s of Civil & M& E contracts
Preparation of agreements Bonds and guarantees & signing of agreements Initial payment Mobilization Initiation , monitoring of the construction Project financial and logistic management Commissioning and Hand over Insurance

E. Construction Civil M & E Piling Structural Masonry
Interior decoration Crash bars Landscape Staff Quarters Service building M & E Electrical Plumbing AC Medical gas STP Incinerator Morgue Ceiling Flooring Fire PA IT

F. Equipment Management
Equipment Planning Selection of the equipments Project Costing IV Layout & Process confirmation Should be Completed before detailed civil construction Tendering & Selection of Suppliers Preparation of Agreements Supply & Installation Training Servicing Insurance Importation Installation Protocols for management Commissioning & Hand over

G. HR Management Confirmation of the process activities relation to HR
Job Analysis - Planning of the Number , Profile and the Job descriptions Medical staff Doctors, Nurses and Para Medical and Medical assistants and Nurse Aides Technicians - Incinerator, CSSD, OT & ICU, Endoscopy, Radiology Facility staff PR, Security ,, Kitchen, Laundry, House Keeping Maintenance Civil , M & E (STP, electrical, Water supply, AC, Incinerator Administration Medical Administration Finance Marketing HR 3. Market Analysis & Preparation of packages Salary Perks Quarters Meals 4. Advertising & Recruitment 5. Training Basic organizational concepts , policies Special –protocols 6. Continuous training & Development plan

H. Supplies Management Confirming the Supplies aspect of the process analysis organizing the supplies chain Management process the process and policies HR Space and special requirements Initial estimation through AP Formation of the Supplies Management board Drug regulatory committee general supplies management committee Selection of Items, quantity of the products Negotiations and selection of the suppliers Agreements Purchase and storage

I. Establishing Systems
Systems , Policies & Protocols Medical Administration Patient care services General Administration HR Marketing Financial Management Facility Management IT

K. Commissioning and Hand over
Civil M & E Equipments IT Promotions

Hospital Design

Where to Start?

Early Planning The Team – ICT + project team Patient care services
Process of delivery Use Government reports and guidance WHO, international guidelines Decisions were made on the number of bays, single rooms, bed spacing, utilities and toilet

The Planning Stage Architects, builders, engineers and project managers have little or no knowledge on infection control ICT - Infection Control Team Participation of the ICT professionals in early stages Microbiologist, Medical director, Nursing director, Unit heads (doctors, nurses, others) Infection control risk assessment should be done at the initial stages

Hospital Design Conceptual design Detailed design Master plan
Master functional design Unit planning Equipment planning Detailed design Specifications Roof Floor Walls

Hospital Design Conceptual design Detailed design
Final functional design

1. Conceptual design Master plan Unit planning
Primary functional design

A. Master plan Type of the hospital – Special / General
Medical service plan Building structure & size Vertical transport & natural light Placement of clinical units Critical, High risk – OT, ICU, NICU, LR Medium risk – wards, Investigation units, OPD, blood bank Low risk – General - Patient waiting, landscape

A. Master plan Placement of Support services - administration, facility services Facility engineering – Sewer treatment plant, water treatment, medical gas Waste management system – solid, liquid waste Stores – Medical and General

10 11 9 8 7 3 1 6 3 1 2 5 1 3 2 4 OT BLOOD BANK & LAB ROOMS 4. ETU 5. RADIOLOGY 6. RECEPTION 7. ADMIN & PUBLIC RELATION 8. OPD 9. CANTEEN 10. KITCHEN 11. SERVICE

B. Unit Planning Layout of the units
Isolation rooms, ward to room ratio 80: 20 Bay concept (wards) – MRSA , Meningococcal Ideal for developing counties due to issues in cost effectiveness 4- 5 beds per bay Spacing of beds – Ideally 2.5 meters ( center to center ) Space for Bystander One way traffic ,natural light Unit waste management Dirty utility, Clean utility, linen store

B. Unit Planning Organize functional design - Unit patient flow Identify potential areas of contact and intervention General infection control polices Special infection control protocols

C. Primary Functional Design
Need to structure the guidelines chronologically, so that the key action points are identified for each stage of the developmental process. Through Process analysis Look at the Patient flow & identify the critical areas / high risk areas of infection transmission

C. Primary Functional Design
Develop, strategies, policies, protocols to counter the threats posed General infection control polices Special infection control protocols Use Government reports and guidance WHO , international guidelines

2. Detailed Design Demarcation of units
Environment - Air – Ventilation, Water, Floor, Ceiling , walls & furniture, supporting Hand washing Equipment planning

A. Demarcation of Units Color coding of the units and areas according to the risk levels Maintain one way traffic Restriction of people Special procedures

B. Environment - Ventilation
Common HAI – Aspergilosis , TB, Legionellosis Fungi – Aspergillus – Aspergillosis -Lobar Pneumonia - Spores Immuno-compromised patients, are at no greater risk for infection within the hospital than outside. Cancer/ HIV/AIDS Organ / bone marrow transplant

B. Environment - Ventilation
Filtered ventilation – Use of HEPA filters in all Critical areas Use central Air conditioning Use of air conditioning & humidity Use positive air pressure – prevents corridor air, coming in to clinical units

B. Environment-Ventilation
Preventing - TB Isolation rooms with an air lock room Use negative air pressure Sealed rooms – windows, self closing doors

B. Environment-Ventilation
Preventing Legionellosis Legionella is an important cause of community and hospital-acquired lower respiratory tract infections Storage tanks, cooling towers of AC Clean water - Chlorination, Thermal eradication, UV light

B. Environment - Water Water born disease – Enteritis
Disinfecting water sources Chlorination, Thermal eradication Water treatment plants Policies to supply safe water to patients

B. Environment- Floor Avoid Tiles and corrugated surfaces as much as possible Use heavy duty floors in general areas – Granite Make it washable Keep the flow dry all the time Carpeting – Avoid in high risk areas, vacuum daily and periodical steam cleaning

B. Environment- Floor Bacteria on hospital floors predominantly consist of skin organisms,- e.g., coagulase-negative staphylococci, Bacillus spp.and diphtheroids , S. aureus and Clostridium spp. Floors need to be dry and smooth with no gutters Use vinyl floors in patient areas - cleaning, maintenance , sound, replacement, use of proper wheels

B. Environment - Ceiling & Walls
Pathogenic microorganisms adhere walls or ceilings when the surface becomes moist, sticky, or damaged Walls and ceilings should have a smooth, impervious surface that is easy to clean , wall pictures Wall coverings should be fluid resistant and easily cleaned, especially in areas that contact with blood or body fluids False ceilings Harbor dust and pests that may contaminate the environment if disturbed. Avoided in high-risk areas unless adequately sealed.

Daycare Centre

OPD Waiting area

B. Environment - Furniture and Fittings
Furniture is thought to be a minor infection risk, but prolonged survival of VRE MRSA and VRE have also been recovered from privacy curtains, scrub suits, and plastic aprons Possibility of their being acquired by patients or health-care workers and spread from one person to another. Surface of future Use of curtains – Vinyl and regular washing Beds - Power coated, remote Bed head panel

B. Environment -Furniture and Fittings
Surface of furniture, should be easy to clean Use of curtains – Vinyl and regular washing Beds - Powder coated, remote Bed head panel Railing on corridors, door handles Entertainment systems - key boards Waste management system and the process

Typical room

C. Hand Washing Hand washing is the single most important method to prevent hospital infections. Each patient room, examination room, and procedure room needs at least one sink placed close to the entrance Large enough to prevent splashing. Shallow sinks may cause contamination of hands by bacteria residing in the drain- linked to a hospital outbreak of multidrug-resistant gram-negative bacilli Each sink should be equipped with a hands-free control, soap dispenser, and paper towel holder.

C. Hand Washing Get more natural light near the sink
Wash Basins were stand alone so any splashes fell on the floor rather than a work top. Long handle taps Hands free taps for the Critical Care Alcohol hand gel mounted on the ends of beds. Access to examination gloves and a trash receptacle should be readily available

D. Equipment Planning Use equipment with smooth surfaces which are easy to clean Plan the layout for minimal spills and contamination Protocols for effective use of equipments Do’s Don’ts CSSD

3. Final Functional Design
Finalize Hospital infection control policies Train staff & Place controlling mechanism Quality standards & Reporting systems Quality audits Organizational culture for infection control Align infection control polices to performance evaluation system of the human resource department Educate visitors Output specifications

Output Specification Output specifications for support services
Cleaning Catering Laundry Waste disposal Pest control Utilities management. Model output specifications available on - www. dh.gov.uk

Hospital Unit Planning

Planning a hospital Project Scope Plan services
Space and Physical Requirements Constructional Details Service requirements

Mechanical Service Requirement
Air-conditioning Refrigeration Illumination Lightning Protection Ventilation Gas Supply Telephone and Intercom Fire Protection Waste Management System Water Supply Drainage and Sanitation Power supply

1. Project scope Specialty – Uni / multi Number of beds
Quality Standards Place Tentative budget Master plan “ To build a multi Specialty hospital of 100 beds according to the WHO standards in Colombo South for Rs. 1 billion”

2. Functions of the hospital
Number of patients for services bed distribution among specialties

Main functions of the hospital
Receiving & Discharge Ambulatory care Investigation care In - Patient care Critical care Administrative & support Services Education & Research Green Services

A Patient care services
OPD Inward Critical care Investigative care Rehabilitative care

a. OPD Care (Capacity >1000)
Consultation Channeling 15 rooms General specialties Supra specialties GP Practice General clinics Special Clinics Dental clinic Eye clinic Wound care clinic Vaccine clinics Wellness clinics Fertility clinics Out reached services -25 Home nursing care Home investigations Patient transport Disability care

b. Inward care units Day Care/ transient care - 7 beds / 15 patients
Wards ( twin beds ) rooms/ 08 patients Rooms ( single ) rooms / 30 patients

c. Critical care Units Emergency treatment Intensive care - 03 beds
03 beds / 02 couches – 40 patients a day Intensive care beds 3 patients Neonatal Intensive care 03 cots / 03 babies Operation theater 02 general beds – 8 major & 20 minor surgeries 01 day bed – 20 day surgeries

d. Investigation Units Medical Laboratory- Haematology, Histo-pathology, Clinical Pathology, Biochemistry, Microbiology tests Radiology - X-rays, US Scanning, CT Scanning - Cardiology- ECG, Stress ECG, Echo tests Neurology - EEG ,EMG tests Endoscopy- Colonoscopy, Gastro copy tests Ophthalmology tests

e. Rehabilitative Units
Physiotherapy patients Speech therapy patients Drugs and Alcohol abuse – 10 patients Psychotherapy - Counseling- 15 patients Wound care patients

Administrative Financial Facility
B. Support services Administrative Financial Facility

1. Administrative Services
Management of Clinical services General Administration Marketing / Promotion Medical records Legal Media CSSD Blood Bank Infection control Quality management

2. Financial Services Accounts department Supply chain Cashiering
Banking Audit IT Out sourced services Supply chain Medical Surgical consumable Non Medical /general

3. Facility Services Public relations Facility management Security
Reception Telephone Facility management Room service Kitchen / canteen Laundry Janitorial Security Transport Staff rest / quarters Engineering services Civil M & E

OPD Care Consultation Channeling GP Practice General clinics
General specialties Supra specialties GP Practice General clinics Vaccine clinics Wellness clinics Fertility clinics

OPD Consultation rooms Pt waiting Reception Registration & Payments
15 X 15 Hand washing Pt waiting Reception Registration & Payments Medical records Health information Car park , canteen, book/ flower shop It centre / Jim

OPD Waiting area

OPD & Investigation

Canteen

Inward care services

b. Inward care units Day Care Preliminary care units (PCU) Wards Rooms

Planning a General ward
Entrance Reception Registration Examination Beds – General ,HD Procedures Treatment area Bleeding Nurse station Hand washing Wash rooms Staff officers Communication Utility CU, DU, Linen Equipment bay Ventilation

Special requirements Medical Surgical
isolation rooms Access to isolation room Surgical Wound cleaning & dressing Access to OT Obstetric – Feeding areas , special requirements for patients, labor room Ante natal , post natal units

Surgical – special requirements Pediatric
Access to OT, ETU , ICU Pediatric Space for Mother , play areas Near neonatal unit Isolation

Inward care Ideal number of beds for a ward Bed
24 Bed Size – width 3.3 Gap – 6 ft Toilet – single , including the bath 6 X 6 Single room size Including toilet – 13 X 24

All toilets – ventilation fan / fan light
All corridors Min of 07 feet Well ventilated / well lit Wall Height 10 feet / 12 feet with ceiling All toilets – ventilation fan / fan light

Typical Room

Typical room

Daycare Centre

c. High Dependency Units
A & E E & R ICU NICU OT MICU SICU

A & E / ETU Easy access to entrance , OT , ICU, to ward and OPD
Investigations – Radiology Less crowded area Trolley bay Security Washing area Waiting area Utility & procedure rooms

OT Pt transfer zone Staff entrance Pre operative area
Operation theaters Size 25 X 25 Post operative area Instrument supply Equipment bay Dirty corridor Staff changing Patient changing Reception & discussion Sterile zone CSSD Rest rooms Utility rooms CU DU Linen

Baby Delivery room Transfer Examination Enema Stage units
Delivery rooms – size - 20 X 16 Recovery unit CU/DU/ Linen

Support services Morgue Administrative Services Laundry services
Diet services Water & Sanitation Electricity Cleaning - Janitorial Landscape Security Medical & Consumable stores Transport Medical records Infection control CSSD Blood Bank Morgue

d. Investigation Units Laboratory Radiology Cardiology Audimetry
Ophthalmology

Thank you!

What Is a Project? A project is a temporary endeavor undertaken to accomplish a unique purpose Attributes of projects unique purpose temporary require resources, often from various areas should have a primary sponsor and/or customer involve uncertainty Copyright Course Technology 1999

The Triple Constraint Every project is constrained in different ways by its Scope goals Time goals Cost goals It is the project manager’s duty to balance these three often competing goals Copyright Course Technology 1999

Figure 1-1. The Triple Constraint of Project Management

What is Project Management?
Project management is “the application of knowledge, skills, tools, and techniques to project activities in order to meet or exceed stakeholder needs and expectations from a project” (PMI*, Project Management Body of Knowledge (PMBOK Guide), 1996, p. 6) *The Project Management Institute (PMI) is an international professional society. Their web site is Over 315,000 copies of the PMBOK Guide were in circulation by June 1999. Copyright Course Technology 1999

Project Management Framework

Project Stakeholders Stakeholders are the people involved in or affected by project activities Stakeholders include the project sponsor and project team support staff customers users suppliers opponents to the project Copyright Course Technology 1999

Project Management Knowledge Areas
Knowledge areas describe the key competencies that project managers must develop 4 core knowledge areas lead to specific project objectives (scope, time, cost, and quality) 4 facilitating knowledge areas are the means through which the project objectives are achieved (human resources, communication, risk, and procurement management) 1 knowledge area (project integration management) affects and is affected by all of the other knowledge areas Copyright Course Technology 1999

Project Management Tools and Techniques
Project management tools and techniques assist project managers and their teams in various aspects of project management Some specific ones include Project Charter and WBS (Scope) Gantt charts, PERT charts, critical path analysis (Time) Cost estimates and Earned Value Analysis ( cost ) Copyright Course Technology 1999

Sample WBS for Intranet Project in Chart Form

Sample Gantt Chart *This template file comes with Project 98 WBS

Sample PERT Chart Each box is a project task from the WBS. Arrows show dependencies between tasks. The tasks in red are on the critical path. If any tasks on the critical path take longer than planned, the whole project will slip unless something is done. Copyright Course Technology 1999

Sample Earned Value Chart

Advantages of Project Management*
Bosses, customers, and other stakeholders do not like surprises Good project management (PM) provides assurance and reduces risk PM provides the tools and environment to plan, monitor, track, and manage schedules, resources, costs, and quality PM provides a history or metrics base for future planning as well as good documentation Project members learn and grow by working in a cross-functional team environment *Source: Knutson, Joan, PM Network, December 1997, p. 13 Copyright Course Technology 1999

How Project Management (PM) Relates to Other Disciplines
Much of the knowledge needed to manage projects is unique to PM However, project managers must also have knowledge and experience in general management the application area of the project Project managers must focus on meeting specific project objectives Copyright Course Technology 1999

Project Management and Other Disciplines

History of Project Management*
Modern project management began with the Manhattan Project, which the U.S. military led to develop the atomic bomb In 1917 Henry Gantt developed the Gantt chart as a tool for scheduling work in job shops In 1958, the Navy developed PERT charts In the 1970s, the military began using project management software, as did the construction industry By the 1990s, virtually every industry was using some form of project management * August 1999 PM Network has good articles on history of PM Copyright Course Technology 1999

The Project Management Profession
A 1996 Fortune article called project management the “number one career choice” Other authors like Tom Peters and Thomas Stewart stress that projects are what add value to organizations Professional societies like the Project Management Institute have grown tremendously Copyright Course Technology 1999

Project Management Certification
PMI provides certification as a Project Management Professional (PMP) A PMP has documented sufficient project experience, agreed to follow a code of ethics, and passed the PMP exam The number of people earning PMP certification is increasing quickly Other groups, like the Gartner Group and the Singapore Computer Society, have their own IT PM Certification programs Copyright Course Technology 1999

Figure 1-6. Growth in PMP Certification, 1993-1998
Over 12,500 by May 1999 Copyright Course Technology 1999

Code of Ethics PMI developed a project management code of ethics that all PMPs must agree to abide by Conducting work in an ethical manner helps the profession earn confidence Ethics are on the web at Copyright Course Technology 1999

Thank you!

HM 15: HOSPITAL PLANNING & PROJECTS

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