OPIM5894 Final SP14 (Answers)

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 PROJECTS

FINAL 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 the work 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____


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 to
suggest 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 ending with 26 for
the last step. Write your ranking in the third column on the worksheet.

Step
Step description Ranking

ID

A. Develop work breakdown structure (WBS) 11

B. Generate a list of activities and assign responsibility 7

C.
Replan and reschedule as required
17

D. Establish functional personnel qualifications 4

E. Organize procurement for services, equipment, and works 19

F.
Review WBS costs with each functional manager
13

G. Measure progress 24

H. 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, 1

and scope

L. Coordinate ongoing activities 22

M.
Close out functional work orders
21

N. Conduct endofproject audit 26

O. Negotiate for qualified functional personnel 5

P. Prepare final report 25

Q. Modify the schedule accordingly to meet time and resource

Constraints 16

R.
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 8

sequence of activities

V. Obtain management final approval of project schedule, budget and

resource plans 18

W.
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 be
obtained 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 months
2) 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 duties
5) 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


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 the
patient 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


(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
patients side.

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.


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 t
for 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


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 Functions
a. 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 between
components, 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.


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 from
time 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.


Question 4 Risk process management (15 points)

A project team at Scanda Pharmaceutical is using FMEA to assess risks for a celebration
to be held when a major project milestone, completion of clinical trials for a promising
new drug in a country where the disease prevalent, is completed. The celebration will be
held on the gardens of Scandas headquarters in Bergen, Norway. Project team members,
top company officials, and representatives from major customer groups will attend the
event, which will include a gourmet meal, elaborate decorations, speeches, and live
entertainment. The team responsible for planning the event decided to use FMEA, and
members 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, which
are shown in the matrix following the risk list.
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Top Five Ri.sks

Effect on the Project as It Is

Risk Currently Planned Possible Causes

1. Invited VIP guests Major embarrassment to Invitations sent to incorrect

don't attend the company. Loss of marketing addresses. Invitations don't

event. opportunity. convey a sense of the impor-

tance of the event.

2. Guests get food Bad image for the company. Food spoils in hot weather.

poisoning. Could hurt sales. Careless caterer.

3. Clinical trials prove to Bad publicity in the market. Researchers giving falsely

be unsuccessful but it Delay in getting to market. optimistic reports during

is too late to cancel Stock analysts produce nega- the trials. Error in data

the event. tive reports. analysis not caught soon

enough. Event scheduled

prematurely.

4. Another major event
hosted by a 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
event outdoors wit hout
everyone getting wet.

Insufficient investigation
of potential conflicts.
Intentional move on part
of competitor.
Atmospheric conditions
outside the control of the
team. Weathe r patterns
characteristic of the time of
year

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 for

Detection Individual

Milestone Celebration

Risk# Rater# Severity Likelihood Difficulty RPN

1 Evelyn 9 3 4 108

Arve 8 5 6 240

Kyrre 6 6 2 72

Sindre 3 6 3 54

2 Evelyn 10 2 7 140

Arve 9 4 5 180

Kyrre 6 4 3 72

Sindre 8 5 2 80

3 Evelyn 10 4 6 240

Arve 9 4 9 324

Kyrre 7 2 4 56

Sindre 8 5 3 120

4 Evelyn 8 5 1 40

Arve 7 6 1 42

Kyrre 9 3 4 81

Sindre 5 8 1 40

5 Evelyn 10 5 2 100

Arve 9 6 1 54

Kyrre 5 3 3 45

Sindre 8 8 2 128


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 Individual
RPN
Aggregate
RPN
Mean
RPN
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.


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 allocate
responsibility 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


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 invited
incase the primary guests dont turn up and also there needs to be response risk avoidance
by asking the VIPs to endorse the project and their endorsements be prominently displayed
during 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 by
taking insurance policy of the event success and also keeping a medical personnel as backup
for 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 risk
impact and hence it would be in the red zone. Similarly Risk number 1 and 2 will have medium impacts
and 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 of
the 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.


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 the
design 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 rural
community. 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 communitys contract 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 traffic
and 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 emergency and 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 communities contract 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 land
levels 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


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.
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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 of
services. Generally, the most appropriate source selection depends upon a variety of
factors like expertise, cost, availability, local knowledge, past experience of similar
projects, ability to handle such projects, knowledge of the field in which the study has to
be 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 private
partnerships which have a good background in conducting eco-engineering projects and also
they 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,


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


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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APPENDIX A

Good Health Hospital Elective Admissions Project

Project Background

Congratulations! The Good Health Hospital Process Improvement Steering Committee has
approved your request to study and improve the admitting process for elective hospital
patients. (Elective patients are non-urgent, non-emergency patients for whom hospital
admission reservations are made in advance.)
Your study has attracted the attention of Dave Wait, chief executive officer of the
hospital. 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 key
candidate for improvement. Apparently, Dave has been the recipient of numerous
complaints 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 a
district with an approximate population of 100,000 people. Opened in 1972, Good Health
has 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 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.
Your project began as the result of casual lunchtime conversation among the managers
of nursing, environmental services, and admitting. In recent brainstorming meetings with
their individual staffs, these three had discovered that problems in processing
elective 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 wait
and, as the first point of contact in the hospital, admitting personnel must interface
directly with dissatisfied customers. The admitting department, in fact, had recently
gathered data on average elective patient wait time and had found it to be over an
hour. They defined patient wait time as the elapsed time between a patients arrival
at the hospital reception desk and his or her arrival at either a room or one of the
hospital departments for tests or procedures.
Admitting personnel also experienced frustration because parts of their jobs (for
example, 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 additional
information from the physicians offices and sometimes patients had to wait in
admitting 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


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.


8 | P a g e

Letter from the CEO - MEMORANDUM

TO: Elective admissions process improvement team
FROM: Dave Wait, CEO

I am pleased to learn your group will be tackling the important process of elective
admissions. As you may know, Good Health's increasing occupancy rate (over 85%) coupled
with our successful efforts to reduce average lengths of stay, has resulted in an
increasing number of admissions. I am concerned by physician, patient, and nurse
complaints about the excessive time required to admit an elective patient. I understand
it 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 frequent
source of dissatisfaction among elective patients was "long wait time in admissions."
Increasing patient satisfaction is one of several key initiatives at Good Health, and
improving the elective admissions process will certainly contribute to
achieving this important strategic objective.
Because we have some control over the schedule of elective admissions, I am
confident your team will be able to significantly reduce wait times. At recent
Directions in Health Care CEO Symposium, I learned that the best hospitals in our size
and occupancy category are able to process incoming elective admissions in about 20
minutes. I am disturbed that we are nowhere near that figure. However, it is critical
that, in reducing elective admission times, we do not compromise the quality of
admission 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 at
an average of two hours a week for the duration of the project to address this
important problem. In addition, a small budget of $2,000 is available to the team to
cover 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.


9 | P a g e

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 government
and nongovernmental 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 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).


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.
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 by
the 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 components
within the bounds of the controls of their own ministries/agencies.

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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 PROJECTS

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