Today we're featuring an interview with Joe Middleton, an expert in healthcare project management. Joe holds specific experience overseeing facilities, planning, and providing efficient and strategic corporate support to all users within a large and geographically dispersed health system -- including multiple campuses and facilities, from hospitals to clinics. Joe's comments below reflect his experience while with , which he retired from earlier this month. Here's Joe's bio:
Joe Middleton recently retired from Bassett Healthcare Network in Cooperstown, New York after serving the system for nearly 24 years. He served in a variety of project/program management leadership roles, completing his career as VP of Facilities Planning & Corporate Support Services. A Certified Facilities Manager with extensive expertise in multi-campus facilities development and master planning, Middleton was accountable at Bassett for more than 6 million square feet of health care and other facilities dispersed in multiple states. He holds extensive experience in health care facility development, project planning and implementation within vertically integrated delivery systems. Middleton is a member of the American College of Healthcare Executives, the American Society for Healthcare Engineering, the International Facilities Management Association, and the National Fire Protection Association.
1. What makes a technical project manager adept in a clinical setting?
Most people do not have formal project management training. This is without a doubt a key reason so many projects fail by either financial or scheduling metrics. The process is not difficult but does require rigor in its implementation. I teach an introductory project management course for our organization and almost always have participants asking how to recover from a failed project without having developed basic skills.
I find that many people have promoted to positions that require project management skills, which are assumed to exist because the person is a high performing technician or clinician. Many cannot write a basic scoping statement let alone develop a comprehensive project plan.
2. Do you think it matters for a project manager to have been through a more formal, rigorous protocol to know how to manage a project than to have already technically managed a project?
Formal training is definitely a plus, assuming high quality curricular. I work with staff who have achieved the PMP designation but who are not good project managers due to weaknesses in various skills such as communication, decision making, etc. I also work with staff who have many years of experience without formal training who are highly effective. The overall highest performers are individuals who have solid management skills PLUS formal project training. These individuals, having had some structured experience, are the core of a comprehensive project team. They are natural leaders and resource managers who have good communication and decision making skills.
I have established this training and development structure for my team.
3. Are those technical projects or facilities projects?
These staff lead both technical, e.g. I.T., projects and facilities projects. The project management skills are a foundation upon which specialized skills such as building design & development, clinical or I.T. skills are layered. Institutionally we have standardized many elements of the project management process and actively encourage the teams and project leaders to share ideas, forms, troubleshooting tips, etc.
4. Do technical project managers from outside of healthcare recognize the value that they could bring to healthcare?
I don't think managers external to healthcare appreciate what they may have to offer. Although the "mystique" of healthcare is dissipating there is still a belief that the complexities of the clinical environment are a major barrier to those outside the system. This is no longer true and those who are making the transition to healthcare are becoming quite successful.
5. So don't even let the prospective PM's convince themselves they can't do it?
Some prospectives do convince themselves that they cannot work in that environment. That is unfortunate. I think one key to recruitment is focusing on project management and the related metrics then applying the specific healthcare program parameters.
6. One hospital I spoke with has resigned itself to spending more than they think they should for contracted project managers, but they're frustrated with the talent level of the project managers they get, and they don't think they can afford to fire any of those resources either. Does that sound familiar?
I absolutely believe that this scenario occurs in many organizations every day. Some project managers may have experience with the technical material or processes but lack formal project management training. Unfortunately, many companies are offering "project managers" as contractors or consultants based on clinical or technical expertise without due consideration of project management skills and evidence of continuing education in BOTH project management and clinical/technical areas. I believe the lack of skills and training are one key reason that many projects are over budget and behind schedule.
I have been involved in several project recovery processes where this is very evident. The challenges begin with poorly developed scoping statement and continue through the process with inadequate communication and resource management. I am surprised that organizations cannot define specifically the deliverables and the measures by which they are deemed complete. It is too common that the deliverables, or the functionality, continue to vary throughout a project not due to intentional change but rather due to poor definition.
7. Is there an area within hospitals where this need isn't applicable?
No. What I do when I get into a situation like that is I say, Okay, we're going to meet for three hours. And what I do is go through a mini-project management course, and say here are all the tools. Here's how they relate to you operationally, here's how they relate to you from a systems perspective, and here's how they relate to you from a particular project perspective. And get us all on the same page.
Because I find that even some of our so-called [project management] experts that we hire through third parties are saying, Oh yeah, I'd forgotten that [at the program level] which is really another way of saying I never learned that in the first place. That's one of the first things I do, is put everybody through this program so that we are all working on the same product.
8. And by doing that, you're saying to the project managers, you've got to interact with each other with an eye on a larger scope?
That is correct. And probably the most useful component of that training is I've got a whole section that is on project recovery. And what I do is I go through and say, here's what happened, here's the recovery tool. Now, don't look at it as a fix, let's go back and look at how this would be a preventive measure. What should've been done to prevent this from occurring? So it becomes a set of preventive tools, checks and balances, questions that people can ask themselves and say, Well did I do this? How did I do this? Do I really have the authorization, approvals, and buy ins - all of those basic things. Project management is not rocket science, but nobody does it correctly.
These folks should've worked for a guy I used to work for named Ray Minnick. He always let you run your first project on your own, and then after that he would do a debrief, and then if you had a project that got very far out of kilter - either time, money, or other resources, you answered for it. His whole point was it could've all been prevented with careful planning and coordination. And you know what, he's right. I have to say after almost 35 years of using project management he's absolutely correct. And while the tools have changed, you know programs like Six Sigma and Lean have come in, definitely a different set of tools, but the fact of the matter is, it's all about planning, communication and metrics and resource balancing. That's it.
9. Something like a project post mortem, there at the end?
Project post mortems are essential elements of all projects. It is a key opportunity for learning and development of the team, the stakeholders and those on the periphery of the project.