Project Management for Public Health Professionals

1. Project Managementfor Public Health Professionals • February 2011 • David Sabapathy, MD, MBA, PEng • Department of Community Health Sciences • 3rd floor TRW building • Faculty of Medicine • University of Calgary • Calgary, Alberta • Canada T2N 4Z6 • david.sabapathy@albertahealthservices.ca

2. Section 2Project Definition

3. Learning Objective • Acquire practical skills to develop a Project Management Plan to effectively and efficiently achieve a health objective Initiation  Definition  Planning  Execution  Close-Out

4. Course Map Idea Authority Project Charter Design Schedule Resource Plan Project Outcomes Evaluation Project Management Plan Initiation  Definition  Planning  Execution  Close-Out

5. 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

6. Steps in Project Definition • Project charter • Project design • Preliminary design • Detailed design Initiation  Definition  Planning  Execution  Close-Out

7. Specific Learning Objectives • Outline how to complete the following steps in the project life cycle • Project Definition • 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 • 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

8. 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

9. Learning Method Case Study Activity Modules x 3 Project Management Plan Initiation  Definition  Planning  Execution  Close-Out

10. Project Charter Initiation  Definition  Planning  Execution  Close-Out

11. 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

12. Project Charter • The project charter serves two purposes: • 1. Organizes our thoughts (e.g. project overview) • 2. Formal approval from Sponsor to begin Initiation  Definition  Planning  Execution  Close-Out

13. Project Charter Components Initiation  Definition  Planning  Execution  Close-Out

14. MIP Case: Project Charter • Let’s build a project charter for our Measles Immunization Project Initiation  Definition  Planning  Execution  Close-Out http://www.measlesinitiative.org

15. 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

16. 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

17. 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

18. 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

19. MIP Case: Project Charter • Deliverables • Identification of key opportunities to improve measles immunization coverage in children • Policies and practices to enhance immunization coverage • Strengthened partnerships between public health, immunization providers and the community Initiation  Definition  Planning  Execution  Close-Out

20. Deliverables • In the Project Charter don’t over-commit to project deliverables. Project Deliverables will be defined later during the Project Design. Initiation  Definition  Planning  Execution  Close-Out

21. 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

22. ‘Scope Creep’ • 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. Initiation  Definition  Planning  Execution  Close-Out

23. MIP Case: Project Charter • Constraints • Time = 6 months • Resources • Budget = 46,000,000 TZS (50,000 USD) • Staffing – Project team, clinic managers The ‘Triple Constraint’: Outcomes = Time + Resources Initiation  Definition  Planning  Execution  Close-Out

24. MIP Case: Project Charter • Approvals • Sponsor • Project Manager • Client(s) • Owner(s) Initiation  Definition  Planning  Execution  Close-Out

25. 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

26. Project Design Initiation  Definition  Planning  Execution  Close-Out

27. Course Map Idea Authority Project Charter Design Schedule Resource Plan Project Outcomes Evaluation Project Management Plan Initiation  Definition  Planning  Execution  Close-Out

28. 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

29. Project Design • One of the most common reasons for Public Health projects to fail is poor attention to the Project Design Initiation  Definition  Planning  Execution  Close-Out

30. Preliminary Design Iterative process: Determine best way to achieve idea Initiation  Definition  Planning  Execution  Close-Out

31. 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

32. 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 evaluation Initiation  Definition  Planning  Execution  Close-Out

33. 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

34. 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

35. Preliminary Design • The Preliminary Design produces a list of the Project Deliverables Initiation  Definition  Planning  Execution  Close-Out

36. 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 progress Initiation  Definition  Planning  Execution  Close-Out

37. Work Breakdown Structure Graphical format Outline format 1.0 Name of Project 1.1 Task 1 1.1.1 Task 1a 1.1.2 Task 1b 1.2 Task 2 1.2.1 Task 2a 1.2.2 Task 2b 1.2.3 Task 2c Initiation  Definition  Planning  Execution  Close-Out

38. Building a Work Breakdown Structure • Begin at the top • Level 0 – Project Name • Level 1 – Deliverables from Preliminary Design • 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.) • Organize the WBS • Create summary tasks as necessary • If needed reorganize entire WBS by project tasks or process Initiation  Definition  Planning  Execution  Close-Out

39. 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

40. MIP Case: Detailed Design Level 0 Level 1 Level 2 Work Packages Level 3 Initiation  Definition  Planning  Execution  Close-Out

41. MIP Case: Detailed Design Level 0 Measles Immunization Project - WBS 1.1 Project Management 1.1.1 Monitor progress 1.1.2 Communicate status 1.2 Strengthen Partnerships 1.2.1 Identify partners 1.2.2 Draft and sign agreement 1.3 Enhance Accessibility 1.3.1 Secure vaccine supply 1.3.1.1 Review agreements 1.3.1.2 Analyze deficiencies 1.3.1.3 Develop contracts 1.3.1.4 Sign contracts 1.3.2 Resolve cold-chain 1.3.2.1 Perform root-cause analysis 1.3.2.2 Improve process 1.3.2.3 Communicate process 1.3.2.4 Evaluate process 1.4 Provide Education 1.4.1 Survey population 1.4.1.1 Design survey 1.4.1.2 Conduct survey 1.4.2 Develop program 1.4.3 Deliver program 1.4.3.1 Recruit volunteers 1.4.3.2 Provide education 1.4.4 Evaluate program Level 1 Work Packages Level 2 Level 3 Initiation  Definition  Planning  Execution  Close-Out

42. 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

43. 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

44. Apportionment • If the project’s time and resources cannot be reasonably apportioned across the WBS, repeat the Preliminary Design and develop a newlist of Project Deliverables Initiation  Definition  Planning  Execution  Close-Out

45. MIP Case: Detailed Design Apportionment 6 months, 46M TZS, 6 FTEs Level 0 -,-,- 1,6,1 3,10,3 2,30,2 Level 1 -,-,- -,-,- 0.5,1,0.5 0.5,5,0.5 0.5,10,2 0.5,10,2 0.75,8,2 0.25,2,2 Level 2 1,10,2 2,0,1 0.25,0,2 0.25,10,2 0.25,4,2 0.50,4,2 Level 3 0.5,0,1 0.5,0,1 0.75,0,1 0.25,0,1 0.25,0,2 0.25,10,2 0.25,0,2 0.25,0,2 Initiation  Definition  Planning  Execution  Close-Out

46. 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

47. 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

48. Project Life Cycle  Idea Authority Project Charter Design Schedule Resource Plan Project Outcomes Evaluation Project Management Plan Initiation  Definition  Planning  Execution  Close-Out

49. End of Section 2Project Definition

50. Project Managementfor Public Health Professionals • February 2011 • David Sabapathy, MD, MBA, PEng • Department of Community Health Sciences • 3rd floor TRW building • Faculty of Medicine • University of Calgary • Calgary, Alberta • Canada T2N 4Z6 • david.sabapathy@albertahealthservices.ca