project management for public health professionals

Project Management

for Public Health Professionals

February 2011

David Sabapathy, MD, MBA, PEng

Department of Community Health Sciences3rd floor TRW buildingFaculty of Medicine

University of CalgaryCalgary, AlbertaCanada T2N 4Z6

david.sabapathy@albertahealthservices.ca

Section 2

Project Definition

Learning Objective

Initiation Definition Planning Execution Close-Out

Acquire practical skills to develop a

Project Management Plan to effectively

and efficiently achieve a health objective

Course Map

Initiation Definition Planning Execution Close-Out

Initiation Definition Planning Execution Close-out

1. Idea

2. Authority

3. Project Charter

4. Design

5. Schedule

6. Resource Plan

7. Project Outcomes

8. Evaluation

Project Management Plan

Project Definition

Great idea! Now what? We need to: Define WHAT we want to achieve

– Obtain stakeholder agreement to begin the project

Decide HOW we want to achieve it– What solutions could make it happen?

– What solutions work best within our constraints?

Initiation Definition Planning Execution Close-Out

Steps in Project Definition

1. Project charter

2. Project design

1. Preliminary design

2. Detailed design

Initiation Definition Planning Execution Close-Out

Specific Learning Objectives

1. Outline how to complete the following steps in the project life cycle Project Definition

2. Use the project life cycle to address a health priority for a developing country Project Definition

– Develop a project charter– Complete a preliminary project design by selecting a solution– Complete a detailed project design with work breakdown schedule and

apportionment

3. Develop a strategy to implement project management for a health priority in a developing country in a way that is culturally-suitable and enables uptake

Initiation Definition Planning Execution Close-Out

Topics

Project Life Cycle: Stage 2 – Project Definition Project charter

Project design – Preliminary– Design options– Design evaluation

Project design – Detailed– Work breakdown structure– Apportionment

Initiation Definition Planning Execution Close-Out

Learning Method

Initiation Definition Planning Execution Close-Out

CaseStudy

ActivityModules

x 3

Project Management

Plan

Project Charter

Initiation Definition Planning Execution Close-Out

Project Charter

Project charter “a written instrument or contract”

High-level look at the project

Formal recognition by Sponsor that the project will proceed

Initiation Definition Planning Execution Close-Out

Project Charter

Initiation Definition Planning Execution Close-Out

The project charter serves two purposes:

1. Organizes our thoughts (e.g. project overview)

2. Formal approval from Sponsor to begin

Project Charter Components

Component Description

Project Name Formal name including acronyms

Stakeholders Stakeholder roles: Sponsor, Project Manager, Project Team, Clients, Owners, Other Stakeholders

Background Relevant details about how project came to be

Purpose Explain the idea. What is not working? Why is it needed?

Objective High-level goal Operational definition of all terms

Deliverables The tangible outcomes of the project

Out-of-Scope What will project not accomplish?

Constraints Time, Resources (budget, staff), other

Approvals Sponsor, Project Manager, Clients and Owner

Initiation Definition Planning Execution Close-Out

MIP Case: Project Charter

Let’s build a project charter for our Measles Immunization Project

http://www.measlesinitiative.orgInitiation Definition Planning Execution Close-Out

MIP Case: Project Charter

Project Name Measles Immunization Project (MIP)

Stakeholders Sponsor - Chief Medical Officer

Project Manager

Project Team – Designer, Client/owner representative, Implementer

Clients - One year-old children and their mothers

Owners - Clinic managers

Other Stakeholders– Leads of other programs i.e. National Malaria Control Program– Others?

Initiation Definition Planning Execution Close-Out

MIP Case: Project Charter

Background Measles virus

Global, national, local burden of disease

Effectiveness of vaccine

Millennium Development Goals and Measles Initiative

Concerns regarding local immunization coverage (2010 65%!)

Initiation Definition Planning Execution Close-Out

MIP Case: Project Charter

Purpose Good relationships with local network of immunization

providers; bottom-up ideas of how to improve

Top-down strategies to be identified through literature search

Opportunity to apply both bottom-up and top-down strategies to improve coverage rates

UNICEF and Office of the Chief Medical Officer supportive

“The purpose of this project is to identify and implement strategies to increase measles vaccine coverage for children in the community”

Initiation Definition Planning Execution Close-Out

MIP Case: Project Charter

Objective “To minimize the risk of measles for children under five

years of age by increasing immunization rates for one-year old children using bottom-up and top-down principles applied to clinical operations of local immunization providers”

Initiation Definition Planning Execution Close-Out

Descriptive Term Operational Definition

Risk of measlesIncidence of measles (# new cases / individuals at risk / year)

Increasing immun. rates

From 2010 coverage rate to date (65%). Target is 2008 rate of 88%.

One-year old children < 13 months of age

Bottom-up and top-down strategic principles

Bottom-up clinic-driven and top-down evidence based strategies

Clinical operations One-on-one patient contact

Local immun. providers

8 existing clinics providing measles vaccine with a clinic manager

MIP Case: Project Charter

Deliverables

1. Identification of key opportunities to improve measles immunization coverage in children

2. Policies and practices to enhance immunization coverage

3. Strengthened partnerships between public health, immunization providers and the community

Initiation Definition Planning Execution Close-Out

Deliverables

Initiation Definition Planning Execution Close-Out

In the Project Charter don’t over-commit to

project deliverables. Project Deliverables will be

defined later during the Project Design.

MIP Case: Project Charter

Out-of-Scope Improving measles immunization coverage for children

> 12 months

Developing ways to improve reporting of measles immunization

Addressing measles immunization coverage for providers external to the 8 identified clinics

Evaluation of ways to reduce complications of measles (tertiary prevention)

Initiation Definition Planning Execution Close-Out

‘Scope Creep’

Initiation Definition Planning Execution Close-Out

Projects must protect against ‘Scope Creep’.

All scope changes must be carefully evaluated

and approved by all Project Stakeholders in

accordance with the Triple Constraint.

MIP Case: Project Charter

Constraints Time = 6 months

Resources– Budget = 46,000,000 TZS (50,000 USD)

– Staffing – Project team, clinic managers

Initiation Definition Planning Execution Close-Out

Outcomes

ResourcesTime

The ‘Triple Constraint’:

Outcomes = Time + Resources

MIP Case: Project Charter

Approvals Sponsor

Project Manager

Client(s)

Owner(s)

Initiation Definition Planning Execution Close-Out

Activity Module #1: Project Charter

Handout Activity Module #1: Develop a Project Charter

Clarify Project Team roles

Start activity module…

Initiation Definition Planning Execution Close-Out

Project Design

Initiation Definition Planning Execution Close-Out

Course Map

Initiation Definition Planning Execution Close-Out

Initiation Definition Planning Execution Close-out

1. Idea

2. Authority

3. Project Charter

4. Design

5. Schedule

6. Resource Plan

7. Project Outcomes

8. Evaluation

Project Management Plan

Project Design

Two steps Preliminary Design

– Selection of best way to achieve objective

– Iterative process

– Produces the deliverables for the project

Detailed Design– Scope, time and resources for best method

– Produce detailed work breakdown for the deliverables

Initiation Definition Planning Execution Close-Out

Project Design

Initiation Definition Planning Execution Close-Out

One of the most common reasons for

Public Health projects to fail is poor

attention to the Project Design

Preliminary Design

Iterative process: Determine best way to achieve idea

Initiation Definition Planning Execution Close-Out

Design Options

Evaluation

Generating Design Options

Many methods Referencing previous solutions used in similar

projects

Review of literature

Structured analysis of best methods to achieve idea

Benchmarking how other organizations implemented the idea

Expert advice

Survey

Brainstorming

Others…Initiation Definition Planning Execution Close-Out

MIP Case: Preliminary Design

Objective: “To minimize the risk of measles for children under five years of age by increasing immunization rates for one-year old children using bottom-up and top-down strategic principles applied to clinical operations of local immunization providers”

Generate design options: Enhance accessibility

Improve enabling technology

Provide parental education and counselling

Strengthen partnerships

Strengthen provider training and education

Strengthen public education and awareness

Strengthen research and evaluationInitiation Definition Planning Execution Close-Out

MIP Case: Preliminary Design

Evaluate options Enhance accessibility

Improve enabling technology

Provide parental education and counselling

Strengthen partnerships

Strengthen provider training and education

Strengthen public education and awareness

Strengthen research and evaluation

Initiation Definition Planning Execution Close-Out

Outcomes

ResourcesTime

MIP Case: Preliminary Design

Outcome of Preliminary Design = Three Strategies

Enhance accessibility

Provide parental education and counselling

Strengthen partnerships

These 3 strategies are now the 3 Deliverables of the project which, when completed, will achieve the project objective

Initiation Definition Planning Execution Close-Out

Preliminary Design

Initiation Definition Planning Execution Close-Out

The Preliminary Design produces a list of

the Project Deliverables

Detailed Design

Work Breakdown Structure (WBS) Defines scope of the project (if not in WBS, doesn’t get

done)

Breaks project work into discrete, manageable tasks

Organizes project work in a logical hierarchy

Benefits Detailed illustration of scope

Clear assignments to project team and workers

Accurate cost, resource and schedule estimates

Monitor project progressInitiation Definition Planning Execution Close-Out

Work Breakdown Structure

Graphical format

Outline format1.0 Name of Project

1.1 Task 11.1.1 Task 1a1.1.2 Task 1b

1.2 Task 21.2.1 Task 2a1.2.2 Task 2b1.2.3 Task 2c

Initiation Definition Planning Execution Close-Out

Level 2

Level 1

Level 0 Name of Project

Task 1

Task 1a Task 1b

Task 2

Task 2a Task 2b Task 2c

Building a Work Breakdown Structure

1. Begin at the top Level 0 – Project Name

Level 1 – Deliverables from Preliminary Design

2. Break tasks down in a hierarchy to a manageable size Break each Level into smaller tasks, each with a verb and

noun (e.g. Conduct Survey, Educate Parents, etc.)

3. Organize the WBS Create summary tasks as necessary

If needed reorganize entire WBS by project tasks or process

Initiation Definition Planning Execution Close-Out

Work Package Size

Stop breaking down work packages when: Task time = Smallest amount of time you want to schedule

i.e. if scheduling in days then smallest task = 1 day

Other rules of thumb: 8/80 rule: Work packages should be >8 and <80 hrs

No task longer than the distance between two status points

“If it’s useful” rule:– The task is easier to estimate– The task is easier to assign– The task is easier to track

Initiation Definition Planning Execution Close-Out

MIP Case: Detailed Design

Initiation Definition Planning Execution Close-Out

Measles Immunization

Project

Project Management

Monitor progress

Communicate status

Strengthen Partnerships

Identify partners

Draft and sign agreement

Enhance Accessibility

Securevaccine supply

Review agreements

Analyze deficiencies

Develop Contracts

Signcontracts

Resolvecold-chain

Performroot-cause analysis

Improve process

Communicate process

Evaluate process

Provide Education

Survey population

Design survey Conduct survey

Develop program

Deliver program

Recruit volunteers

Provide education

Evaluate program

Level 0

Level 1

Level 2

Level 3

Work Packages

Measles Immunization Project - WBS1.1 Project Management

1.1.1 Monitor progress1.1.2 Communicate status

1.2 Strengthen Partnerships1.2.1 Identify partners1.2.2 Draft and sign agreement

1.3 Enhance Accessibility1.3.1 Secure vaccine supply

1.3.1.1 Review agreements1.3.1.2 Analyze deficiencies1.3.1.3 Develop contracts1.3.1.4 Sign contracts

1.3.2 Resolve cold-chain1.3.2.1 Perform root-cause analysis1.3.2.2 Improve process1.3.2.3 Communicate process1.3.2.4 Evaluate process

1.4 Provide Education1.4.1 Survey population

1.4.1.1 Design survey1.4.1.2 Conduct survey

1.4.2 Develop program1.4.3 Deliver program

1.4.3.1 Recruit volunteers1.4.3.2 Provide education

1.4.4 Evaluate program

MIP Case: Detailed Design

Initiation Definition Planning Execution Close-Out

Level 0

Level 1

Level 2

Level 3

Work Packages

Estimation of Time and Resources

Before Stakeholder signoff on Design…

Recall the triple constraint WBS defines your scope!

Now check if this work can be completed within our schedule and resource constraints

Initiation Definition Planning Execution Close-Out

Outcomes

ResourcesTime

Apportionment

Apportionment = Top-Down Estimation Start with total project estimate for time and

resources

Moving top-down through WBS, assign time and resources to each summary task / work package

Each level of WBS must add up to the level above

If clear indication triple constraint unbalanced, go back to Preliminary Design!

Initiation Definition Planning Execution Close-Out

Apportionment

Initiation Definition Planning Execution Close-Out

If the project’s time and resources cannot be

reasonably apportioned across the WBS,

repeat the Preliminary Design and develop a

new list of Project Deliverables

Measles Immunization

Project

Project Management

Monitor progress

Communicate status

Strengthen Partnerships

Identify partners

Draft and sign agreement

Enhance Accessibility

Securevaccine supply

Review agreements

Analyze deficiencies

Develop Contracts

Signcontracts

Resolvecold-chain

Performroot-cause analysis

Improve process

Communicate process

Evaluate process

Provide Education

Survey population

Design survey Conduct survey

Develop program

Deliver program

Recruit volunteers

Provide education

Evaluate program

MIP Case: Detailed Design

Initiation Definition Planning Execution Close-Out

Apportionment6 months, 46M TZS, 6 FTEs

Level 2

Level 3

-,-,- Level 0

Level 1

1,6,1 3,10,3 2,30,2

-,-,- -,-,- 0.5,1,0.5 0.5,5,0.5

2,0,1 1,10,2

0.5,0,1 0.5,0,1 0.25,0,1 0.75,0,1 0.25,0,2 0.25,10,2 0.25,0,2 0.25,0,2

0.5,10,2 0.5,10,2 0.75,8,2 0.25,2,2

0.25,0,2 0.25,10,2 0.50,4,2 0.25,4,2

Completion of Project Design

When is the design complete?

TROUBLE: “The only way to tell is by executing

the plan”

BETTER: “If you come to a point in the planning

process where you don’t know how you to proceed because some key design decision hasn’t been made, your design is incomplete”

Initiation Definition Planning Execution Close-Out

Activity Module #2: Project Design

Handout Activity Module #2: Project Design

Time to gather the Project Team

Be prepared in your design to respond to “news” from the Sponsor / Stakeholders…

Initiation Definition Planning Execution Close-Out

Project Life Cycle

Initiation Definition Planning Execution Close-Out

Initiation Definition Planning Execution Close-out

1. Idea

2. Authority

3. Project Charter

4. Design

5. Schedule

6. Resource Plan

7. Project Outcomes

8. Evaluation

Project Management Plan

End of Section 2

Project Definition

Project Management

for Public Health Professionals

February 2011

David Sabapathy, MD, MBA, PEng

Department of Community Health Sciences3rd floor TRW buildingFaculty of Medicine

University of CalgaryCalgary, AlbertaCanada T2N 4Z6

david.sabapathy@albertahealthservices.ca