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					Attachment 3:

National Incident Management Project

Project Scope and Structure
Version: 0.5

Prepared by Waikato District Health Board for District Health Boards CEO Group

14th February 2008

For National Quality Improvement Programme CEO Group paper For meeting 25/26 Feb 2008

Project Scope and Structure

National Incident Management Project

Table of Contents
Introduction .............................................................................................................. 3
About this document ................................................................................................................3 In summary ..............................................................................................................................4

Scope Statement ....................................................................................................... 5
Purpose and objectives .............................................................................................................5

Project Brief.............................................................................................................. 7
Project strategy.........................................................................................................................7 Work breakdown structure .......................................................................................................8 Deliverables ...........................................................................................................................10 Project Governance structure .................................................................................................11 Resource requirements ...........................................................................................................13 Project control ........................................................................................................................14

Prepared by: Waikato DHB 2008

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Project Scope and Structure

National Incident Management Project

Introduction About this document
Purpose

The purpose of this document is to outline the high level scope of the National Incident Management Project objectives, deliverables and structure.

Audience

The intended audience for this document includes:  Mr Craig Climo  Mr Kevin Hague  Mr Gary Smith  Mr Chai Chuah  Geraint Martin  Ms Ruth Wiltshire

Preparation

This document has been prepared by Waikato DHB

Associated documents

Associated documents are:  Business case for national quality improvement projects – Management of Healthcare Incidents. September 2007  Scoping the Priorities for Quality in the Health and Disability Sector. November 2006

Document information

The following table provides details about this document and file.
Item Change Control Type Version Author Content Approval Electronic Physical Electronic Area Version 0.5 Neville Hablous First published version Name Project Files SharePoint/Business Development/Waikato DHB/National Incident Management Ver 0.5
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Distribution Location

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Project Scope and Structure

National Incident Management Project

In summary
Key objectives

The key project objectives of the National Incident Management Project are to:  Review current policy and redevelop a national policy for the co-ordinated management of incidents across the country  Provide an education and training programme to all DHBs to implement the policy and train staff in incident management.  Deliver the business and technical requirements for a nationally co-ordinated incident information management system.

Approach

The high level approach taken in this project will be to:  Develop the policy; this will then inform both the education programme that will need to be developed and delivered and the information system requirements  Develop and deliver the training programme after the policy components have been finalised  Whilst the education is being delivered, and informed by the new policy and other requirements, undertake a process to identify the requirements of an information system to support the DHB and Ministry business process for incident management.

Project structure

The project structure will include:  A Project Steering Committee  A high level National Policy Committee  Five Workstreams 1. The national policy stream 2. The education and training stream 3. The national incident information system stream 4. Project management stream 5. Communications stream The Project Management Group that will manage the five work streams will consist of the Project Director, Stream Managers and Project Officers. All these officers will be appointed by Communio. The Project Director will be responsible to the Project Steering Committee and ultimately to the Project Sponsor. Project Co-ordinators will be identified in each of the DHBs. The Project Sponsor will be the CEO, Waikato District Health Board.

Duration

It is expected that the project will commence in early March 2008, with the development of the detailed project plan and approval thereof and can be completed by August 2009.

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Project Scope and Structure

National Incident Management Project

Scope Statement Purpose and objectives
Purpose

The purpose of the National Incident Management Project is to achieve a nationally consistent approach to incident management across all health and disability services in New Zealand. The Primary objectives of a national system are1: 1. Reduced harm caused to patients, their families and to clinicians 2. Development of a culture and environment within which incidents can be identified, reported, investigated and acted upon to prevent recurrence and fear and defensiveness are reduced 3. Implementation (eventually) of an information system that will support the culture and assist providers in the above process. The Secondary objectives are:  Identification of as many incidents in the health and disability sector as possible  Prioritisation of incidents using a common tool  Notification of all incidents to the right person (people) for action  Review and investigation of incidents to identify causes and mitigation strategies  Classification of incidents using a common hierarchy and taxonomy  Action, both local and national, to prevent recurrence  Truthful and open disclosure of adverse events  Support for patients, families and staff involved in incidents and adverse events.
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Key national system objectives

1

Scoping the Priorities for Quality in the Health and Disability Sector – A Report Prepared for the Minister of Health Nov 2006 Prepared by: Waikato DHB Page 5 of 14 Version Date: 14th February 2008 Version: 0.5

Project Scope and Structure

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Purpose and objectives, Continued
Project objectives

The key project objectives will contribute to the measurement of the overall project success. They are to: 1. Review current policy and redevelop a national policy that  considers all the requirements of best practice in incident management  satisfies legal and legislative requirements  is practical and able to be implemented in the DHBs. 2. Provide an education and training programme to all DHBs that:  assists DHBs and providers to effectively and efficiently implement the national policy in all DHBs  ensures that the majority of health and disability care providers understand incident management  provides high level skills and knowledge to a group of providers in each DHB for the investigation of serious adverse events  establishes a level of ongoing education and support for incident management in all DHBs. 3. Deliver the business and technical requirements for a nationally co-ordinated incident information management system that:  supports the implementation of the national policy  satisfies legal and legislative requirements  supports the requirements of providers of health and disability services for the effective management of all healthcare incidents.

Interfaces

The key interfaces for this project are:  The Ministry of Health o Sector Capacity and Innovation o Information Technology  The Health and Disability Commission  The District Health Boards o The National CEOs Group o The national Board Chairs group o The national CMOs Group o The national Quality and Risk Managers Group  The Accident Compensation Corporation  Coroners.

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Project Scope and Structure

National Incident Management Project

Project Brief Project strategy
Approach

The approach to be taken in this project will be for Waikato District Health Board to manage all three components of the project. There will be 5 phases of the project over 18 months. There will be 5 work streams and 2 governance committees – one strategic and one operational. The Project Director will manage all the workstreams and establish strict communication, engagement and reporting lines to the appropriate people and bodies to ensure that the project employs the right strategy and is managed well with all deliverables achieved, on time and on budget.

Phases

The following table provides a brief description of each project phase.
Phase Initiation Timeframe High level scope 25 January Finalises the project purpose, requirements and 2008 – 3rd April vision for the project and sets the administrative and 2008 reporting framework (starting with this document). Scope approval Agreed project scope and approval to proceed with a high level project plan. Detailed project work stream plans and overall 25th January project plan will be developed during this period. 25th February 2008 Execution of agreed strategies and processes. This 3rd March 2008 will also include all project management and – 26th July 2009 communications. All post implementation activities will be completed 1st June - 15th at this point. Quality assurance of all ongoing August 2009 components of the project, final documentation, sustainability plan and hand over. Close-out includes: 15th August  Lessons learnt 2009  Project close – close out reports, project acceptance.
th

Description

Planning

Execution

Handover

Close-out

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Work breakdown structure
Diagram

The following high level Work Breakdown Structure (WBS) represents the breakdown of project activities into manageable groups in a logical manner.

Workstream 1 National Policy Start 3rd March 2208 Finish 27th June 2008 o Establish and meet with National Policy Committee o Establish Stream workteam o Research best practices in other jurisdictions o Consult with key stakeholders o Agree scope and key components of the policy o Develop draft policy o Disseminate for comment o Undertake amendment process o Develop final policy o Submit for approval o MoH issue policy

Workstream 2 Education and training Start 1st April 2008 Finish 26th July 2009 o Establish Stream workteam o Consult with key stakeholders o Agree objectives of programme o Undertake analysis of individual DHB readiness status o Develop education programme o Identify and train educators o Develop programme resources o Develop resources for ongoing sustainability of the programme o Schedule training in each DHB o Deliver training to each DHB o Provide follow-up training and support process at 6 after initial training in each DHB

Workstream 3 Scoping the Information system Start 1st May 2008 Finish 15th August 2009 o Establish Stream workteam o Consult with key stakeholders o Survey larger group of stakeholders o Research standards and best practices in incident information systems o Identify absolute requirements established by the policy, legislation and external organisations o Scope current practices and systems in all DHBs o Develop draft functional and technical specifications o Disseminate for comment and feedback o Amend specifications o Gain agreement on final specs o Research methods for implementing these specs in all DHBs o Develop plan and recommendations o Report on findings and recommendations

Workstream 4 Project management Start 14th February 2008 Finish 15th August 2009 o o o o o o o o Project set-up Agree final project objectives and outcomes Develop detailed project pan and Gantt Develop risk management plan Develop project budget Establish the project governance structure Manage all aspects of the project throughout Provide reports as required

Workstream 5 Communications Start 3rd March 2008 Finish 15th August 2009 o Develop communications plan o Identify key stakeholder groups o Develop key messages and media o Establish project web site o Deliver communications plan throughout the project

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Work breakdown structure, Continued
Extra time

The policy development, provision of the education and training to all DHBs and identification of the specifications for the information system are planned for completion by mid August 2009. This is possible, if the project is able to commence by early March 2008. However, an essential component of the project for sustaining the gains achieved involves follow-up and support by the Project Team and education providers to each of the District Health Boards at approximately 6 months after the initial education has been delivered. This has not therefore been included in this timeframe for the project. A final completion date can be calculated when the detailed Project Plan and Gantt are developed at project start-up.

Risks

The most significant and obvious issue/risk to the project timeframes being met is a suggested above is the time that is often required for approval, sign off and issue of policy. Effective management of this risk will be dependent on a commitment from the National Policy Committee members at their first meeting, to prioritising this policy, developing it in short timeframe and assisting in shepherding it through the ‘system’. If this is achieved, the delivery date for the final draft policy of 27th June is achievable. The remainder of the timeframes identified for the project allow for little if any waste. They have been determined based on the assumption that the policy approval process can be relatively short. The timing of the other components of the project is within the control of the project team. The development of the education programme can commence before the finalisation of the policy; before the policy is approved and issued. However the finalisation of the content of the training and the delivery of the programme cannot commence until the policy is approved.

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Project Scope and Structure

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Deliverables
Overview

The high level deliverables that support the objectives are aligned to the project work breakdown structure, to clarify the responsibility and requirements for deliverable completion.

High level deliverables

The draft project deliverables are outlined in the following table.

Workstream
1. Policy

Deliverable
Initiation Execution

Description
Committee terms of reference Summary of research Discussion paper on recommended policy components Draft policy for consultation Final draft of policy Training Programme plan Draft curriculum Detailed programme curriculum Training materials (paper) Delivery of the training programme in all DHBs Final report on Education programme Sustainability plan IS system identification plan Stakeholder consultation report Report on DHB systems and capacity Draft Report on Specifications for consultation Final report on Specifications Final report on recommended system/way forward Project scope and structure (this document) Project plan and schedule (including Gantt) Budget estimate Issues and risk management process Status Reports Change control process Centralised project documentation Project close out report Summary of key messages Internal communication/awareness strategy External communication strategy Branding and brochure Website Newsletters

Due date
07.03.08 28.03.08 04.04.08 25.04.08 27.06.08 09.05.08 27.06.08 25.07.08 26.09.08 15.08.09 15.08.09 15.08.09 27.06.08 02.01.09 27.02.09 30.04.09 15.08.09 15.08.09 25.01.08 25.02.08 25.02.08 Monthly Monthly As required Continuous 15.08.09 25.04.08 25.04.08 25.04.08 27.06.08 25.04.08 2nd monthly

2. Training

Planning

Close out 3. Incident Management IS Planning Execution

4. Project Management

Initiation Planning Project Control

5.Communicatn Strategy

Administration Close out Planning

Execution

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Project Governance structure
Introduction

A robust project governance structure is required to support clear accountability for project deliverables, project management and internal/external communication activities.

Structure

The following outlines the reporting structure for the National Incident Management Project. 1. The Incident Management Project Steering Committee This committee will be responsible for steering the project, reviewing progress, ensuring that the project is being delivered on time and on budget and managing high level risks of the project. The membership of this committee should be o 2 members of the Quality Improvement Committee (QIC) o 2 representatives of the Ministry of Health o 1 representative of the Quality and Risk Managers o 1 representative of the Chief Medical Officers o 1 representative of the national CEOs o 1 representative of DHBNZ. 2. The National Policy Committee This will be a high level small committee that will be responsible for i. providing advice to the project team that is researching and developing the national policy for incident management ii. approval of the policy strategy iii. approval of the final policy It is anticipated that this committee will only need to meet two to three times and only in the first 6 months of the project. The membership of this committee should be o The Deputy Director-General, Sector Capacity and Innovation, Ministry of Health o The Health and Disability Commissioner o The Project Lead CEO o The CEO of the Accident Compensation Corporation o The Chief Advisor to the Minister on Quality o Project Director All streams will be run by a project team established by the Project Director. The roles of the various members of the team are identified under Resource Requirements (pg 13). The project team will co-opt subject matter and local experts to assist in the development of each of the project components. A project Co-ordinator will be identified in each of the DHBs. Short term Project Reference Groups may need to be established in each DHB.
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Project Governance structure, Continued
Key Groups

As identified earlier there are some key groups that already exist that will provide linkages for this project with the DHBs and all the provider groups that need to be involved in the policy implementation and use. They are: o o o o

The National CEOs Group The national Board Chairs group The national CMOs Group The national Quality and Risk Managers Group

It will be essential to engage all these groups in the development and implementation of this project and to keep them informed of progress. This will be achieved in the following ways: o The Project Director will attend the first meeting of each of the groups that takes place after project initiation. The purpose will be to inform the groups of the project plan, engage their assistance and answer any questions they may have about the project. o The project will provide a one page progress report to each of the meetings they hold during the course of the project o The Project Director will be available to attend further meetings as required and/or requested.

The following is a diagrammatic representation of the project governance structure
PROJECT SPONSOR

PROJECT STEERING COMMITTEE
NATIONAL POLICY COMMITTEE

PROJECT DIRECTOR

STREAM MANAGER

STREAM MANAGER

STREAM MANAGER

STREAM MANAGER

DHB PROJECT CO-ORDINATORS DHB REFERENCE GROUP

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Resource requirements
Staffing

The exact project staffing numbers required are yet to be determined.

Roles and responsibilities

The following table outlines the roles and responsibilities for this project. Role
Project Sponsor Steering Committee Project Director

Responsibility
To provide executive support and funding for the project. To provide strategic direction and support for the project management group and project sites. To provide structure direction and support for the project coordinators. To centralise communication of project status reporting to the project sponsor and Steering Committee. To manage all aspects of the project workstream To provide coordination and control of the project in a collaborative manner. To support the project sponsor and project coordinators with robust project management methodologies. To provide active project management for their respective project sites, manage and escalate issues and progress to the project director and management group. To coordinate Project Reference Groups and internal communication processes. To provide executive support / advice for the project team and to identify relevant project and service interfaces.

Stream Managers Project Management Group Project Officer Project Coordinators (in DHBs)

Project Reference Group (in DHBs)

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Project control
Communication Internal

The following internal project communication processes will be utilised:  Monthly status reporting from each project stream  Weekly Project Management Group meetings  Two monthly Project Steering Committee meetings  Fortnightly teleconferences with DHB Project Co-ordinators (commencing when the policy is near completion)
External

The following external communication processes will be utilised:  2-3 National Policy Committee Meetings during first 6 months  Two monthly status reports to Ministry of Health and the DHBNZ

Change control process

A formalised change control process will be utilised to ensure that any change requests to the project scope are reviewed and approved prior to implementation.

Issues and risk management process

A formalised issues and risk process will be utilised, involving identification, management, mitigation and monitoring. If identified issues become potential risks they will be escalated to the Project Sponsor and Steering Committee for risk mitigation or agreed change control processes. A full risk management process flow chant has been developed.

Quality assurance

To ensure that the project adheres to a high level of quality, the following processes will be utilised:  Structure project planning and approval process  Consistent project structure across all project work streams  Project Director to ensure assessment, communication and review of all relevant internal issues  Phase end review/approvals to proceed to next phase  Project evaluation.

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