Macro Strategies to Enable Occupation/Project management

Managing Projects: An introduction
Prepared by: Tracy Fortune Senior Lecturer, Occupational Therapy La Trobe University

Objectives
 * 1) To develop an understanding of the scope of project management in the health field
 * 2) To differentiate between research and project management
 * 3) To develop an appreciation of the link between projects, health policy and the work of health service organisations
 * 4) To understand the major phases of project management

Why Project Management
''I was overseeing someone who was doing a project who just didn’t know how to do it. Even though he was a great (professional), he’d worked in the hospital a long time, he just didn’t have the skills to put 	  it all together, and to know how to consult with people and how to run 	meetings and how to communicate and how to write a project plan and all of that stuff. I think its valuable to have the learning, otherwise it takes a long time and you’ve got to learn the hard way”'' (Hospital Clinical Leader)

The above quote from Dwyer, Liang, Thiessen and Martini (2013, p 11) captures wonderfully, the importance of health professionals having project management skills.

What is project management? What does it entail and what is it not?
Projects:


 * Create or deliver a tangible result that addresses a problem or an opportunity (Hartley, 2003)
 * Are NOT ongoing – they have start and end dates.
 * Are not routine (Saan, 2004)
 * ‘Are limited in scope and purpose’
 * Fit in a larger ‘picture’ – policy, context, program

Projects:


 * ‘a set of methods and tools designed to enable organisations to plan, manage and achieve one –off tasks or goals’
 * ‘involves turning a good idea into a successful outcome’
 * ‘organised time limited, one-off effort toward a defined goal’ (Dwyer et al 2004)
 * ‘unique and non-repetitive’ (Munns 2001).

Projects come from a


 * Need to explore an ‘issue’ impacting on routine practice or core business
 * Need to address a current or perceived future need

Projects can be vehicle to ‘trial’ out something that may or may not be ongoing….when the issue or need changes….time for a new project…

Dwyer, et. al. (2013) highlight that community health service staff “began defining much of their health promotion work as projects in the 1970s and 1980’s…These methods have proven effective, and are now standard practice in the field” (p. 6).

Please familiarise yourself with Chapter 1 of Dwyer, Liang, Theissen & Martini (2013) – Why project management? (or first edition, 2004)

Is project management relevant to health and occupational therapy? How?
If you take a look at job seeker search engines catering to health, welfare, local government (the council), or community service careers, and the major newspapers in Australia – for example, The Age in Melbourne, you will find that a range of employers are seeking project officer/managers, or are requesting skills of project management. Not only that, a reasonable number of positions exist for graduates to manage projects related to health, and many of these positions demand capabilities that you have already, and will now begin developing through your project based learning.

Project Management is a practical process with associated tasks and skills that will enable you as an occupational therapy graduate to work at a MACRO level to influence health.

A research project conducted by Fortune & McKinstry (2012) that explored (among other things) health professionals’ perceptions of the value of project management learning for occupational therapy students, revealed that in order to manage projects in their agencies students


 * need to have an understanding of the broader political context of the way organisations like ours operate. . . getting their head around a complex culture to work within.


 * communicating regularly and communicating well. . they need to be able to facilitate discussion or contact with others within the organistion that may not be their supervisors


 * they have to use all their OT skills to suss us all out, what makes us tick, how they’re going to fit in with us. . . and then plan a project, go through all the phases, meet all the deadlines and make sure it was achieved . . . with all the little hiccups that are going to happen

This community health manager identified the leadership element of project management:


 * [project management] really challenges the student to be a leader because they are . . . . sitting on the steering committee and having to . . . . direct and set the agenda. I think that’s quite a big challenge. . . .but I think it’s a really good learning curve Fortune & McKinstry (2012).

Many opportunities exist for occupational therapists to work as project managers, although, typically many clinically based therapists have moved toward macro level roles after a number of years working in micro level roles. A number of authors have proposed that in the tightening job market, occupational therapists need to cast their net well beyond typical hospital/clinical roles (see for example, McKinstry & Fortune, In Press), and it is philosophically appropriate to do so.

So what do these jobs look like? For examples of typical project management type jobs take a look at http://careers.vic.gov.au/vacancies/

Lets look at some of the demands and capabilities of project managers from real (but no longer available jobs in health project management).

Project Management - Role examples
Wanted: Project manager - Living Well Program

Do you have? Excellent communication & interpersonal skills? Experience in service planning within the health sector? Extensive experience in project management?

The Project Manager will oversee a service planning project as part of a small team that undertakes service development and planning activities within metropolitan Melbourne. The project will review specialist mental health services for young people in the western suburbs of Melbourne. The position will involve management of the project, including oversight of the work undertaken by consultants and working with the Steering Committee for the project.

Wanted: Project Officer - Living with Hep C We are seeking a highly motivated person to join our team. You will have excellent communication and interpersonal skills, with a proven ability to plan and deliver education, workforce development and capacity building services, consult stakeholders and maintain and develop networks. You will have shared responsibility for planning and implementing workforce development strategies and programs for healthcare workers across the region, representing the agency on a range of advisory committees and working groups. You will also have Relevant qualifications or experience in health, social services or education. An ability to develop a thorough understanding of hepatitis C infection and a commitment to harm minimisation concepts relating to injecting drug use.

Project Management capabilities
A content analysis of project management job descriptions reveals the following tasks to be critical to the role. Many of these tasks are also needed by health professionals (including occupational therapists) working at the macro level
 * Develop
 * Implement
 * Design, evaluate
 * Communication and interpersonal skills
 * Liaise, collaborate, engage with stakeholders
 * Coordinate, Provide leadership
 * Consult and engage communities
 * Advise, develop, analyse policy
 * Develop tenders, proposals
 * Oversee, drive, coordinate

For examples of typical project management type jobs take a look at http://careers.vic.gov.au/vacancies/ - select the Policy and Strategy Link (it lists jobs across all sectors that have a macro focus).

How do projects fit with the usual work of health organisations?
For many health organisations ‘projects’ are becoming an increasing focus, whereby projects related to short term change or development supplement the delivery of usual or what we might call “core” business. As an example, an assessment service for people with upper limb trauma staffed by OTs might be part of the ‘core business’ of the OT department. If the OT department supplemented their individual downstream approach (doing individual upper limb assessments and providing splinting or oedema reduction etc.), with an ‘upstream’ approach, they might propose and manage a prevention project, which would undertake a needs analysis of a population of workers in a nearby factory, perhaps a factory whose workers were over-represented in the clinical population receiving hand assessment and therapy. This more short term ‘project’ work would provide a valuable health promotion facet to the work usually done, perhaps providing information of how the existing service should expand or adapt its ‘core business’ However, the project would be time limited.

The link between health projects and health policy
Projects and funding to conduct projects usually arise from 'policy'. Projects in health that seek to trial out a new program or initiative are one way of governments implementing their NEW policies.

You are encouraged to read Chapter 2 of Dwyer et al (2013) – The industry, the organisation and project success, to understand more about why organizations and particularly governments engage in project work.

What about the ‘management’ part of project management?
Being a good project manager, involves having management skills, which should not be foreign to occupational therapists, these include:

Planning, organising, leading, controlling

Project management = Management of activities that lead to the successful delivery of a desired outcome or set of outcomes – on time!

This is not unlike the process of managing individual clients and their families toward a favourable outcome (the achievement of agreed goals). In project management, our client is not usually an individual – it is an organisation, a community, a group of occupational therapists etc.

How are projects different from research?

 * On the face of it, these processes are very similar, they both follow a systematic process for achieving objectives, involve thorough planning, and many projects seek to obtain ‘data’ in formalised ways, as is the case with research. One major difference is that projects relate very clearly to a practical deliverable in the short term.  A product is usually produced, or clearly defined, pre-specified outcomes are delivered.  In research the emphasis relates more to providing an answer to a question.  Research may have no immediate or even short term utility.


 * Dwyer et. al convey that once something that becomes routine, even if it has a limited operating period, it has become a program – they quote an informant for their text who said “ projects are often used as a tool to trial an idea before a large investment is made in programs and services” (p53)

The difference - In a nutshell:


 * Projects: time-limited activity toward a specific goal, practical outcome.
 * Program: established as a permanent (or semi-permanent) part of an agency’s structure/service (ongoing)
 * Research: primarily about knowledge generation, not necessarily with an immediate practical outcome

Phases of project management
According to Hartley (2003) there are 4 key phases of PM


 * Concept- idea/feasibility/scoping stage, which involves the consideration of goals, problems, alternatives, and a research phase
 * Schedule -whereby, following the decision to proceed- all tasks are scheduled re when they will start/finish
 * Process – in this phase, you will commence tasks and manage the project including – track progress, monitor and control
 * Outcome – this phase includes completion, and tasks associated with finishing up and handing over the deliverable

According to Dwyer, et al. (2013) the project life cycle includes the following phases:


 * Initiate – needs analysis; lit review
 * Plan – set goals, objectives, define tasks & timelines
 * Implementation – hire/train staff, conduct workshops, prepare materials
 * Closure – evaluate and review (pg 51)

You can see that while the terms for the phases in both of the above are different, the tasks are more or less similar. Many authors will use slightly different words

By far the most important phase of project management is the initial stage, where the project idea is being conceptualized, scoped or defined. Mistakes at this stage will usually reverberate throughout the project to the end. In this subject we will refer to this all important phase as the Scoping phase however, please be aware that other resources you may access might use terms such as concept phase or research phase. Please access the video presentations on Project Scoping to explore what this is and how to do it.

The "all critical" scoping phase
The outcome of this initial - scoping - phase should be a clear agreement re what, why, how and when. This means, that by the end of the scoping phase stakeholders MUST agree on the initial justification for the project, its objectives and deliverables.

A project 'scope' is also an outcome in its own right:

a broad document designed to capture the essential inputs and considerations prior to commencement – defines boundaries – is the ‘quote’ gives info on time, cost and resources…(Hartley, 2003).

Also known as a: Scope of Works; Scope Document, Project Brief

Pro’s and cons of project management
Projects and funding released by governments for short term projects can enable cash strapped services to acquire and use resources for innovation (including prevention work). However, there is a danger that project funding can become driver of performance of an organisation, rather than the vision or the mission of the organisation being the driver. If projects detract from core business
 * Innovation may be favored over routine?
 * Failure to establish routines may be detrimental to clients (Dwyer et al)

Finally, Please view the following youtube clip which summarises what project management is, and gives you a taster of the practical elements of project management that we will build on in the project scoping lecture.