OPIM5894 Final SP14(Answers)

8/11/2019 OPIM5894 Final SP14(Answers)

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1 | F i n a l E x a m : V e n k a t a V i j a y a n a r a y a n a V a r a n a s i O P I M 5 8 9 4

OPIM 5894 MANAGING ID PROJECTSFINAL EXAM (April 2014)Instructor: Dr. M. Diaby

YOUR NAME: Venkata Vijayanarayana Varanasi

YOUR STUDENT NUMBER: 2094711

The take-home examination question paper has 10 pages (including the appendices)and contains 6 problems. The exam will count 20% towards the course average. One

point out of this will be deducted for each hour the exam is late.

I certify that thework I have submitted is my own work and

that I have not collaborated and discussed with any other

students on this examination

Signed: _________V. V. Varanasi_____________________ Date: __04.07.2014____


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Question 1: Project implementation life cycle (10 points)

You are an international consultant specializing in the management of development

projects. The government of a developing country has commissioned your firm to assist

in the development of a standard project implementation life cycle. The government has

developed a draft of a project implementation life cycle that has 26 steps. You are to

meet with several of your colleagues to review the governments latest draft and tosuggest revisions in the sequence of the suggested steps. This draft just arrived by

FAX, and you need to review the draft before you meet with the group.Provide the

sequence of the 26 steps, starting with 1 for the first step and endingwith 26 for

the last step. Write your ranking in the third column on the worksheet.

StepStep description Ranking

ID

A. Develop work breakdown structure (WBS) 11

B. Generate a list of activities and assign responsibility 7C. Replan and reschedule as required 17

D. Establish functional personnel qualifications 4E. Organize procurement for services, equipment, and works 19F. Review WBS costs with each functional manager 13

G. Measure progress 24H. Develop a plan to cope with potential problems caused by actors

And 14

I. Develop detailed schedules 15

J. Determine resource requirements 3

K. Clarify and refine the project's key parameters, objectives, 1and scope

L. Coordinate ongoing activities 22

M. Close out functional work orders 21N. Conduct endofproject audit 26

O. Negotiate for qualified functional personnel 5

P. Prepare final report 25Q. Modify the schedule accordingly to meet time and resource

Constraints 16R. Clarify organizational relationships, roles, and responsibilities 6

S. Authorize departments to begin work 20

T. Develop linear responsibility chart 10

U. Estimate the duration of each activity and establish the 8sequence of activities

V. Obtain management final approval of project schedule, budget andresource plans 18W. Develop gross schedule 9

X. Price out WBS 12

Y. Identify relevant actors and factors 2

Z. Determine means for measuring progress 23


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Question 2: Project initiation and setting up (25 points)

Read the minicase titled Good Health Hospital Elective Admissions Project provided

in Appendix A of this document and provide answers to the following questions:

(a) What is the problem or opportunity motivating this project? (2 point)

Answer: The main problem / objective for this project is to improve the patient

admission process and make it smoother and on par with other similar sized

hospitals.

(b) Develop the goals and objectives for the project. (3 point)

Answer: The following goals / objectives can be put for the project:

Improvement in the elective patient admission process

Reduce the admission wait times to as less as 20mins on par with the best similar-sized hospitals

Address concerns of the nursing, admittance and the environment(services)

departments regarding the admissions process Improve the hospital operational performance especially in admissions so that the

Joint Commission on Accreditation of Healthcare Organizations certification can beobtained easily

To finish this project in 6 month time period

(c)Identify the project boundaries (i.e., where does the project start and end)?

(3 points)

Answer: The project has to be finished in 6 month time period well before the

inspection of the Joint Commission on Accreditation of Healthcare Organizations for

accreditation. The inspection is going to happen in the next calendar year.

(d) Who are the stakeholders for this project? (3 points)

Answer: The following are the stakeholders for this project:

THE CEO of the Hospital The individual department managers( nursing, admittance and environment)

The elective patients who chose this hospital for getting health services

The families of the patients who have to attend to the patients

The nurses, physicians, etc who attend the patient

(e) Create a maximum of 10 project metrics for this project (3 points).

Answer: The following are the project metrics for this project as given below:

1)The project duration should not extend 6 months2)The admissions time should not be more than 20 mins for each elective

patient

3)A small budget of $2000 has been allocated which should not be exceeded.4)Each project team member will allocate 2 hrs per day to the project over

their regular job duties5)Patient Intake should be streamlined by no data missing on their forms

(f) Identify a preliminary set of project deliverables. For each deliverable you

identify, determine what additional information the team may need to precisely


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specify the deliverable (in other words, what questions does your team need to have

answered to clearly describe each deliverable? (5 points).

Answer: The following are the preliminary set of project deliverables:

(a)Elective patient forms should be fully filled by the time they reach

nurses table. So a check to perform this should be in place.

The question for the team would be that who performs this check before

the nurses division receive the patient and who will be receiving thepatient first?

(b)The schedule of elective patients arrival should be controlled by

allocating a certain time period when they can arrive and get admitted.

This has to be done at the appointment booking time itself. The question

for this deliverable is that who shall be doing it during the appointment

booking and who is in charge of the schedule maintenance?

(c)To showcase operations improvement by improving the patient admission

time in the hospital to the Joint Commission on Accreditation of

Healthcare Organizations committee. The question for this deliverable is

that who shall be made in charge of this process and who will guide the

whole project for the same?

(d)Streamlining and reduction in the patient admission time to 20 mins. The

question will be who is going to decide on this project metric and who

will be the process owner for this. Who will be in charge of this after

the project is handed over and regularized into daily operations?

(g) Develop a plan for communicating with Dave Wait, the CEO (use the model shown on

slides #6061 of the project initiation lecture notes). (3 points)

Responsible for creating this communication: Project

lead of the Elective Admissions Project with input from

team

Person Responsible for sending this

communication: Team Leader / Project

Lead of the Elective Admissions Project

Dave Wait, CEO of

the Good Health

Hospital

High-level information about the

project progress, the budget

utilized and the schedule.

Knowledge of any issues problems

and their proposed solutions that

may require his authorization or

intervention to resolve

Every week and

monthly

Email for weekly

updates and

monthly face to

face meeting with

elective admissions

project steering

team. Provide

minutes of the

meeting and

agenda.

Stake Holder What does this Person or Group Frequency of Medium

Elective Admissions Project

Project Management Office Project at Good Health Hospital


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(h) Critique the composition of the team as described in the project background

information in terms of area representation, size, and time available. Why did the

Hospital Process Improvement Steering Committee add a physician to the team? Do you

agree with this decision? Should a patient be added to the team? Why or why not?

What else might you want to know about each of these team members? (3 points)

Answer: The team consists of the admitting manager, two admission clerks, a

physician, two nurses, and an environmental services (i.e., housekeeping)supervisor. As individuals who work in or directly with admitting, you know the

critical role the admitting process plays in smooth hospital operations. The

admitting function, in fact, is a hub of activity that affects almost all other

hospital activities and departments.

The composition of the team is well represented by the concerned departments

however, there are no members of the other important departments in this project

team like from finance who shall discuss the costs involved in the whole project

and the subsequent changes to be made. It doesnt involve the IT department

personnel who shall be responsible for making the necessary software changes to

streamline the appointment and the admissions process and also make certain

elements of the admission like the form filling less tedious and automated so that

no errors and unfilled information is left. Also there are no representation from

the senior management side which will show that the management is quite strongly

backing this project initiative and also there is no representation from the

patientsside.

Adding a physician is quite valuable to this team as he shall be able to guide on

the technical aspects of the various diseases for which each patient gets admitted

like the duration of treatment, what information needs to be gathered, what can be

the expected cost etc. We would also like to add a patients representative to

highlight the real difficulties they face during the admissions process and how it

can be eliminated and it will give a firsthand information on customer satisfaction

to the team.


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Question 3: Project charter (15 points)

Review the sample project charter shown in Appendix B o f t h i s d o c u m e n tfor a development project. Discuss any weaknesses or omissions you see in the

charter and recommend changes you would propose.

Answer: The sample project charter should be given as below as taught from the class notes: I have recreated

the whole project charter again including points that have been left behind. As such the given charter is very

strong very few omissions and weaknesses. It is given very clear and concise manner and gives the roles and

responsibilities very effectively. Also the various functions and duties have been well defined. However, there

is no indication of the project timeline and when the project is expected. This would be greatly helpful in

creating a proper schedule and tracking and monitoring the progress of the project. The Project deadline can

be defined with the help of this and can be useful in having a proper project closure.

Also there should be a mention of the project steering board which helps in ensuring all the stakeholders who

go through the project charter that the project is well represented and well backed up by the senior

management team. A brief project objective / goal statement and also the indications of possible risk are

included in the project charter to give a high level understanding of the whole project.

Many a companies also include the project scope or the project priority matrix along with the project benefits

for the understanding of the project sponsor and the project team members in addition to the senior and top

management team.

Overall responsibility of the Project Manager

The project manager (PM) is responsible for the overall completion of the different components of the

development project, in a coordinated manner, within the cost, time, and quality parameters defined for the

project from time to time. The PM ensures that the overall project and component plans, schedules, and

budgets fit together and will accomplish the project's objectives. The PM also ensures coordinated action on

all components (including follow-up on decisions of relevant studies) for the effective utilization of the

programs supported by the development project.

Relationships

The PM reports directly to the minister and interacts directly with other government and nongovernmental


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agencies as needed to follow-up and resolve problems affecting the project.

The PM is supported by the project management unit (PMU) staff, which assists in the coordination and

monitoring as well as the procurement and accounting activities associated with project management.

The PM and all the component managers constitute the project team (PT), which will coordinate the work

programs and will monitor overall project progress.

Main Functionsa. Project Implementation Coordination Role

Regarding objectives and plans

Clarify objectives.

Prepare plans, schedules, and budgets.

Arrange commitment of resources.

Approve all changes in plans and scope.

Chair periodic PT meetings (preferably monthly), organized by the PM, for implementation coordination,

including taking operational decisions that flow from review and monitoring meetings on subjects, such as

delays and plans to make up lost time, cost overruns, progress according to linkages defined betweencomponents, and so forth.

Follow-up on previous decisions in review and monitoring meetings of PT. Direct coordination with individual

component managers (CMs).

b. Management of PMU

Recruit and hire staff.

Supervise the management of the computerized database for the project monitoring system

Supervise monitoring and evaluation (PMS).

Set up control system to measure progress versus plan for schedule and budget.

Prepare budget and financial and schedule reports.

Submit regular reports to ILA and the government.

Develop and maintain project files.

Manage the procurement function through the procurement officer.

Manage the project accounts, audits, and so forth.

Arrange training.


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c. The Role of the PMU

The PMU will provide the PM and CMs with the following services:

Coordination and monitoring Project and procurement accounting

Procurement for the identified components of the overall project

Maintenance of the computerized PMS, measuring progress versus plan for schedule, cost, and

performance and issuing reports and revised plans as necessary and when directed by the PM.

Delegation of Authority

The day to day management of the affairs of the project are directly dealt with by the project manager in

coordination with the CMs as needed. Similarly, the PM seeks approval and guidance from the minister fromtime and time as necessary.

The CMs have full authority to take all operational decision for their components within the bounds of the

controls of their own ministries/agencies.


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Question 4 Risk process management (15 points)

A project team at Scanda Pharmaceutical is using FMEA to assess risks for a celebrationto be held when a major project milestone, completion of clinical trials for a promisingnew drug in a country where the disease prevalent, is completed. The celebration will beheld on the gardens of Scandas headquarters in Bergen, Norway. Project team members,

top company officials, and representatives from major customer groups will attend theevent, which will include a gourmet meal, elaborate decorations, speeches, and liveentertainment. The team responsible for planning the event decided to use FMEA, andmembers generated a long list of risks, five of which are shown in the matrix below.Each team member had the opportunity to give his or her ratings for these risks, whichare shown in the matrix following the risk list.

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Top Five Ri.sksEffecton theProject asItIs

Risk Currently Planned PossibleCauses

1. Invited VIP guests Major embarrassment to Invitations sent to incorrectdon't attend the company. Loss of marketing addresses. Invitations don'tevent. opportunity. convey a sense of the impor-

tance of the event.2. Guests get food Bad image for the company. Foodspoils inhot weather.

poisoning. Could hurt sales. Careless caterer.3.Clinical trials prove to Badpublicity inthe market. Researchers giving falsely

be unsuccessful but it Delay in getting to market. optimistic reports duringis too late to cancel Stock analysts produce nega- the trials. Error in datathe event. tive reports. analysis not caught soon

enough. Event scheduledprematurely.

4. Another major event

hosted bya competi-

tor is scheduled for

the same day.5. Major rainstorm.

Dilution of publicity:

Some VIPs attend

competitor's event.

Not possible to hold the

eventoutdoors wit hout

everyone getting wet.

Insufficient investigation

of potentialconflicts.

Intentional move on part

ofcompetitor.Atmospheric conditions

outside the controlof the

team.Weather patterns

characteristic of the time of

year


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10 | F i n a l E x a m : V e n k a t a V i j a y a n a r a y a n a

V a r a n a s i O P I M 5 8 9 4

FMEA Ratings forDetection Individual

Milestone Celebration Risk# Rater# Severity Likelihood Difficulty RPN

1 Evelyn 9 3 4 108Arve 8 5 6 240Kyrre 6 6 2 72

Sindre 3 6 3 542 Evelyn 10 2 7 140

Arve 9 4 5 180Kyrre 6 4 3 72Sindre 8 5 2 80

3 Evelyn 10 4 6 240Arve 9 4 9 324Kyrre 7 2 4 56Sindre 8 5 3 120




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a. Calculate individual and aggregated mean RPN scores for each of the five risks. (3

points)

Ans: The individual RPN, Aggregate RPN and the mean RPN have been calculated in the

table below:

Risk# Rater# Severity Likelihood Difficulty IndividualRPN

AggregateRPN

MeanRPN

1 Evelyn 9 3 4 108 474 118.5

Arve 8 5 6 240

Kyrre 6 6 2 72

Sindre 3 6 3 54

2 Evelyn 10 2 7 140 472 118

Arve 9 4 5 180

Kyrre 6 4 3 72

Sindre 8 5 2 80

3 Evelyn 10 4 6 240 740 185

Arve 9 4 9 324

Kyrre 7 2 4 56

Sindre 8 5 3 120

4 Evelyn 8 5 1 40 230 57.5

Arve 7 6 1 42

Kyrre 9 3 4 108

Sindre 5 8 1 40

5 Evelyn 10 5 2 100 327 81.75

Arve 9 6 1 54

Kyrre 5 3 3 45

Sindre 8 8 2 128

b. Based on RPN scores, identify the risks most relevant for further consideration. Would

you completely trust the numbers, or would you seek further discussion or

investigation? Why? (4 points)

Answer: Based on the above scores, we can identify that risk number 3 is the highest

priority and most relevant for further consideration as it has the highest aggregate RPN

and the Mean RPN amongst all the risk raters.

However, I would definitely like to have a further discussion or investigation as many of

the risk raters have shown a lot of variability in the their ratings for the same rating.

For eg. In risk 3, the range of RPN is from 56 to 324 which is a huge variation. Other

risks also have similar variations. Hence a further discussion will narrow down the

variations and let us focus on the most relevant risks better.


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c. For the three most relevant risks, describe the actions you would take. For each action

you recommend, identify which of the four unfavorable uncertainty action categories

best describes what you are recommending. (4 points)

Answer: From the above table, we can clearly see that risk Number 3, risk number 1 and risk

number 2 have the highest relevancy in that order respectively based on their aggregate

RPN.

For risk 3:Risk Uncertainty and Response( Mitigate)

3. Clinical trials prove to

be unsuccessful but it

is too late to cancel

The event.

Bad publicity in the

market.

Delay in getting to

market.

Stock analysts

produce negative

reports.

Researchers giving

falsely

optimistic reports

during

the trials. Error in data

analysis not caught

soon

enough. Event

scheduled

This is a technical uncertainty action

category and hence the action taken

here can be either to re-launch the

studies or training of the researchers

against to avoid future such

occurrences.

prematurely.

For Risk 1:

Risk Uncertainty and Response ( Mitigate)

1. Invited VIP

guests don't attend

the event.

Major

embarrassment

to

company. Loss of

marketing

Opportunity.

Invitations sent to

incorrect

addresses. Invitations

don't

convey a sense of the

importance of the

event.

This is a Customer oriented

uncertainty and in this case the

action taken can be to get marketing

people to get commitments about

the VIPs and make them endorse the

product to associate the product and

VIP hence making them participate.

For Risk 2:

Risk Uncertainty and Response (Avoid)

2. Guests get food

Bad image for the

company.

Food spoils in hot

weather.

This is a contract uncertainty on part

of caterer. Hence food inspection

needs to be done and damages

claimed.

Poisoning. Could hurt sales. Careless caterer.

d. Prepare a risk-response matrix. (4 points)

Answer: From the given details we have to create a risk response matrix and allocateresponsibility for each action.

For risk number three which is the highest risk we can use the response of mitigating the

risk and the action needs to undertake by the Clinical trial Manager who is responsible for

the overall authenticity and results of the clinical trial


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For risk number 1 where important guests are not arriving we can use the response of

mitigating the risk by keeping a backup list of celebrities and VIPs who shall be invitedincase the primary guests dontturn up and also there needs to be response risk avoidance

by asking the VIPs to endorse the project and their endorsements be prominently displayedduring the launch which will ensure the other guests about their association with the

product to be launched.

For the risk number 2 where the food can be spoiled due to carelessness can be avoided bytaking insurance policy of the event success and also keeping a medical personnel as backupfor any eventuality. Also the food needs to be thoroughly inspected before the event

begins.

From the above diagram of a risk response matrix we can see that Risk number 3 has the highest riskimpact and hence it would be in the red zone. Similarly Risk number 1 and 2 will have medium impactsand hence they will be in the yellow boxes and the risk number 4 and 5 with low risk consequences will

be in the moderate 2 improbable C green zones.

The risk response matrix is a very easy pictorial manner of depicting risk and gives a visual analysis ofthe risks and their likelihood along with consequences.

The risk response matrix and the risk responses have been answered in the previous section of the

answer where the contingency answers have been elucidated.


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Question 5: Procurement of works (15 points)

What are the appropriate type of sourcing and contracting for each of the following

situations?

a. Provision of 20 timber roof girders for a new school assembly hall. Assume that thedesign of the girders is complete. (3 points)

Answer: This has to be a Cost reimbursement contract as it is the most common form of

contract where the usual project costs are usually fixed and in this case the girders are

like a raw material for the eventual construction.

b. Construction of a simple, single-lane earth road from a main highway to serve a ruralcommunity. The alignment has been laid out on the site, and it follows a watershed.

Thus, there is no need for bridges or culverts. (3 points)

This has to be a local communityscontract as the following are the benefits:

Enhances the sense of ownership and commitment to maintenance Increases speed and economy Increases the skills and capacity of the community Generates local employment

c. Removal of material from a landslide. A road has been blocked, and essential trafficand emergency vehicles cannot pass. Alternative routing does not exist. (3 points)

Answer: This has to be undertaken by way of a Department Works Contract with a cost reimbursement like a

Target contract. Usually by the Ministry of Roads of the government as it is a social emergencyand has to be

done on a priority basis and no bidding etc. can be done to avoid delay in implementation. Also cost is not a factor

and it will be supervised. Local communitiescontract can be subcontracted for faster speed and economy.

d. Leveling of a tract of land to be used in a new agricultural scheme. The existing landlevels and the proposed levels have been accurately determined. (3 points)

Answer: This has to be procurement of works through a measured Output contract

e. Design and construction of a manufacturing plant to produce specified grades and

quantities of fertilizer. (3 points)

This has to be a turnkey project contract because of the following:

Single-point responsibility

Savings in cost

Savings in time Lump-sum contract

Design by contractor

Lump-sum contract

Contractor obligation


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Question 6: Procurement of services (20 points)

According to the latest census, the city, Metropolis, has a rapidly growing population,

currently estimated at 5 million. Only one-third of the population has access to piped

water provided by the Municipal Water Authority; the remainder draws water from shallow,

protected wells or simply from polluted surface streams. The population is routinely

advised to boil all water used for drinking and cooking.

The city is built on flat terrain close to the sea. A system of canals from up-country

could possibly bring in more water for the city.

The distribution system has not been thoroughly studied. The authority distributes piped

water in rotation for a few hours each day to the districts of the city. Water is also

bought from vendors, but the cost of so doing amounts to about 20 percent of the earnings

of the low-income families who make up the greater part of the population.

In spite of universal metering, the water authority believes that unaccounted-for water

may be as high as 60 percent of the total, but it does not have the resources to

investigate the causes. Tariff collections, which are beginning rapidly to fall into

arrears, cover only a small proportion of the cost of production.

The city has a core sewer system that serves only about 20 percent of the population; the

rest of the city relies mostly on unsanitary methods of excreta disposal. Sewage is

currently evacuated from the city in open canals.

The city intends to provide a potable water supply and adequate sanitation for the entire

city and is about to seek consultant expertise to carry out a feasibility study that would

examine the options (technical, environmental, economic, financial, social, and

institutional) open to it for providing these services.6 | P a g e

Your assignment:

1. Consider all possible sources of consulting expertise and determine which would be

the most appropriate for executing the feasibility study. (5 points)Answer: There are various sources of Consultants that are available for any procurement ofservices. Generally, the most appropriate source selection depends upon a variety offactors like expertise, cost, availability, local knowledge, past experience of similarprojects, ability to handle such projects, knowledge of the field in which the study has tobe conducted etc. Some of the most common sources of consulting expertise are as below:

Private partnerships Public companies Government-owned firms Public sector and nonprofit organizations Universities and institutes Law, accounting, and engineering firms Individuals

Out of these sources, the most appropriate one for our case above would be privatepartnerships which have a good background in conducting eco-engineering projects and alsothey can hire some local geologists for this project for the local knowledge. There work

will be very professional and thorough.

2. Write an outline of the TOR for the study. In the TOR, the consultants should be required to

provide specific information on both the present condition of, and future needs for,


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potable water and sanitation. The consultants should be instructed, among other

matters, that their report would serve as a basis for

(a) Selecting appropriate levels of service, or a mix of service levels

(b) Evaluating future water needs and possible additional sources of supply

(c) Reviewing options for financing water supply and sanitation services and for

taking measures to improve the operating efficiency of the water authority.

(15 points)Answer: The TOR (terms of reference) is usually used to describe the purpose roles and structures of projects,consultants hired to conduct studies, the working groups, any reference groups and committees. They are

guidelines for the way the individuals or a group members will work with each other and are usually the first task

undertaken by the client as it gives the consultant with a clear definition of the scope of work and the expected

reports. They make a written basis for making decisions, confirming a common understanding between the

parties involved and how they shall work together.

A well prepared TOR is very comprehensive, detailed and unambiguous with clearly stated objectives and

determination of the scope.

For the above case, a sample TOR can be provided as given below:

Background (Introduction or Preamble): The city of Metropolis has a rapidly growing population with

the current population being about 5 million. Most of the citizens currently face an acute shortage of

water supply and whatever supply is available is much polluted. The distribution system has never

been studied properly and there is a lack of accountability of the water supplied. The tariff collections

are rapidly dipping and are not covering the cost of production.

The citys sewer system only serves 20% of the population and that too through open canals. The city

intends to provide a potable water supply and adequate sanitation for the entire city and hence wants

to conduct a feasibility study for the same.

Objectives (What: Specific Outputs) : The city wants to seek consultant expertise to carry out a

feasibility study that would examine the options (technical, environmental, economic, financial, social,

and institutional) and have the following major objectives fulfilled in the study:

1. Selecting appropriate levels of service, or a mix of service levels

2. Evaluating future water needs and possible additional sources of supply

3. Reviewing options for financing water supply and sanitation services and for taking

measures to improve the operating efficiency of the water authority.

4. The water distribution system should be accounted for and the ways to improve tariff

collection

5. The sewer system should be modernized and elimination of the open canal system.

6. Water supply and sewer system amenities should be available for the whole population


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7. These amenities should be planned in such a way that they should account for the

rapidly growing population and be adequate in the future as well.

Scope (How): The hired consultant enterprise should do a ground study involving the technical,

environmental, economic, financial, social and institutional aspects and give a feasibility report. The

team doing the study will have to spend their time on the site at least 5 days a week and will have to

provide their report within 3 months. All necessary equipment and personnel will have to be sourced

by the team themselves. Facilities and access to all the required information including the

transportation will be provided by the city government.

Requirements for training and skill transfer: Since majority of the team will be involving foreign

nationals for their expertise, it would be advisable for the team to hire local personnel for ease of

communication, knowledge of geology and geography, and dealing with the local officials. Such

people will have to be trained through the study such that further such studies can be undertaken

indigenously. All the requirements for training and skills and the important intelligence data will have

to be deposited with the city at the end of the study.

Reporting and approval procedures: A thorough final report fulfilling all the above objectives will have

to be presented at the end of the study. All necessary access to information and locations will be

provided. Necessary approvals will be provided on a need basis as required and will have to be

obtained prior to commissioning of the feasibility study.

Clients contribution: The client, in this case the city government, shall provide a lump sum

remuneration at the end of the feasibility study upon being presented the final report. Also it will

provided all the necessary transportation to the various locations and access. Local talent can be

provided if requested by the team where necessary.


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7 | P a g e

APPENDIX A

Good Health Hospital Elective Admissions Project

Project Background

Congratulations! The Good Health Hospital Process Improvement Steering Committee hasapproved your request to study and improve the admitting process for elective hospitalpatients. (Elective patients are non-urgent, non-emergency patients for whom hospitaladmission reservations are made in advance.)

Your study has attracted the attention of Dave Wait, chief executive officer of thehospital. Recent customer survey data reveal that "long waits in elective admissions"are a major source of customer dissatisfaction. Dave regularly reviews the minutes of

the steering committee and has long felt the elective admissions process was a keycandidate for improvement. Apparently, Dave has been the recipient of numerouscomplaints from physicians and their elective patients about the long waits in

admissions. He has sent your team a brief note of encouragement (see below).Good Health Hospital, located in a rapidly growing semi-metropolitan area of

northern California, is a 250-bed general hospital helping serve the medical needs of adistrict with an approximate population of 100,000 people. Opened in 1972, Good Healthhas as its mission to provide quality health care serving the inpatient disease and

injury needs of the Santa Rosa community.Your team consists of the admitting manager, two admission clerks, a physician, two

nurses, and an environmental services (i.e., housekeeping) supervisor. As individuals

who work in or directly with admitting, you know the critical role the admitting processplays in smooth hospital operations. The admitting function, in fact, is a hub of

activity that affects almost all other hospital activities and departments.Your project began as the result of casual lunchtime conversation among the managers

of nursing, environmental services, and admitting. In recent brainstorming meetings withtheir individual staffs, these three had discovered that problems in processingelective patients into the hospital were particularly frustrating to each area,

although for different reasons.Nursing complained that patient records that accompanied the patients from admitting

were incomplete. Patients also arrived at nurse stations unexpectedly. In addition,according to nurses, elective patients seemed to arrive at the most inconvenient times.

Environmental services complained that everything is always in a rush.Admitting department personnel are frustrated because rooms seem never to be

available. Patients and their loved ones get anxious and upset when they have to waitand, as the first point of contact in the hospital, admitting personnel must interfacedirectly with dissatisfied customers. The admitting department, in fact, had recentlygathered data on average elective patient wait time and had found it to be over anhour. They defined patient wait time as the elapsed time between a patients arrivalat the hospital reception desk and his or her arrival at either a room or one of thehospital departments for tests or procedures.

Admitting personnel also experienced frustration because parts of their jobs (forexample, verifying insurance and tracking down missing test results) took lots of time.

And, in some instances, these tasks had to be completed the day the patient arrived for a hospital stay. Occasionally, admitting personnel had to gather additionalinformation from the physicians offices and sometimes patients had to wait inadmitting because no escorts were available to transport them to a room or test-procedure location.

In follow-up conversations, the admitting, nursing, and environmental services


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staffs agreed to collaborate on a joint improvement project; they were all involved in

the process in one way or another, so a cross-departmental effort seemed to make sense.

The three managers submitted a request, with a list of proposed team members, to the

hospital Process Improvement Steering Committee. The committee approved the project,

adding a physician to the proposed team. Everyone agreed the problem was an important

one. Improving this process should increase external customer satisfaction and have a

positive impact on internal hospital operations as well.


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8 | P a g e

Letter from the CEO - MEMORANDUM

TO: Elective admissions process improvement teamFROM: Dave Wait, CEO

I am pleased to learn your group will be tackling the important process of electiveadmissions. As you may know, Good Health's increasing occupancy rate (over 85%) coupledwith our successful efforts to reduce average lengths of stay, has resulted in an

increasing number of admissions. I am concerned by physician, patient, and nursecomplaints about the excessive time required to admit an elective patient. I understandit has taken some patients as long as two hours to be admitted. I am especially

disturbed that, in a recent customer satisfaction survey, the number one most frequentsource of dissatisfaction among elective patients was "long wait time in admissions."

Increasing patient satisfaction is one of several key initiatives at Good Health, andimproving the elective admissions process will certainly contribute toachieving thisimportant strategic objective.

Because we have some control over the schedule of elective admissions, I amconfident your team will be able to significantlyreduce wait times. At recent

Directions in Health Care CEO Symposium, I learned that the best hospitals in our sizeand occupancy category are able to process incoming elective admissions in about 20minutes. I am disturbed that we are nowhere near that figure. However, it is criticalthat, in reducing elective admission times, we do not compromise the quality ofadmission service. The information admitting provides to the rest of the hospital must

remain timely, accurate, and complete.Finally, you may be aware that we expect a visit from the Joint Commission on

Accreditation of Healthcare Organizations sometime next calendar year. Because of their

interest in efforts to improve operational performance, it would be ideal if you could

complete your work and be able to demonstrate some real improvement in this area within

six months. Doing so would provide us an opportunity to showcase a successful

improvement effort.

I have encouraged your managers to provide you with the time you need estimated atan average of two hours a week for the duration of the project to address thisimportant problem. In addition, a small budget of $2,000 is available to the team tocover expenses associated with meetings, data gathering, benchmarking, and the like.

I wish you the best of luck in your efforts. I hope you will keep me informed as the

project unfolds, and I look forward to reading your final report and recommendations,

and to hearing your team's final presentation.


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APPENDIX B

Development Project:

Roles and Responsibility of the Project Manager and

the Project Management Unit

Overall responsibility of the Project Manager

The project manager (PM) is responsible for the overall completion of the different

components of the development project, in a coordinated manner, within the cost, time,

and quality parameters defined for the project from time to time. The PM ensures that

the overall project and component plans, schedules, and budgets fit together and will

accomplish the project's objectives. The PM also ensures coordinated action on all

components (including follow-up on decisions of relevant studies) for the effective

utilization of the programs supported by the development project.

Relationships

The PM reports directly to the minister and interacts directly with other governmentand nongovernmental agencies asneeded to follow-up and resolve problemsaffecting the project.

The PM is supported by the project management unit (PMU) staff, which assists inthe coordination and monitoring as well as the procurement and accounting

activities associated with project management.

The PM and all the component managers constitute the project team (PT), which willcoordinate the work programs and will monitor overall project progress.

Main Functions

a. Project Implementation Coordination Role(i) Regarding objectives and plans

Clarify objectives. Prepare plans, schedules, and budgets. Arrange commitment of resources. Approve all changes in plans and scope.

(ii) Chair periodic PT meetings (preferably monthly), organized by the PM, for

implementation coordination, including taking operational decisions that flow

from review and monitoring meetings on subjects, such as delays and plans to

make up lost time, cost overruns, progress according to linkages defined

between components, and so forth.

(iii) Follow-up on previous decisions in review and monitoring meetings of PT.Direct coordination with individual component managers (CMs).

b. Management of PMU Recruit and hire staff.

(i)Supervise the management of the computerized database for the project

monitoring system.

(ii) Supervise monitoring and evaluation (PMS).


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Set up control system to measure progress versus plan for scheduleand budget.

Prepare budget and financial and schedule reports. Submit regular reports to ILA and the government. Develop and

maintain project files.10 |

(iii)Manage the procurement function through the procurement officer.

Manage the project accounts, audits, and so forth.

(iv) Arrange training.

c. The Role of the PMU

The PMU will provide the PM and CMs with the following services:

Coordination and monitoring Project and procurement accounting Procurement for the identified components of the overall project Maintenance of the computerized PMS, measuring progress versus plan for schedule,

cost, and performance and issuing reports and revised plans as necessary and when

directed by the PM.

Delegation of Authority

The day to day management of the affairs of the project are directly dealt with bythe project manager in coordination with the CMs as needed. Similarly, the PM

seeks approval and guidance from the minister from time and time as necessary.

The CMs have full authority to take all operational decision for their componentswithin the bounds of the controls of their own ministries/agencies.

OPIM5894 Final SP14(Answers)

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