How might disaster- or emergency-response planning be used to improve organizational processes?
The topics and objectives for Week Four focus on learning project management fundamentals for health care facility planning, design, and construction. The desired outcome is an understanding of the role of project management and cost estimation as they relate to the design planning phase (i.e., space, furniture, fixtures, equipment, etc.). Project management is in many ways the thread that moves a facility from concept, to design, to construction, and finally operations and maintenance. The detail implementation plan or Gantt Chart is one of the most critical outputs of the project management planning phase. Budget planning and cost estimates are also derivatives of the planning process and a well-developed implementation plan. To reinforce project management concepts, learners also will develop a standard operating procedure to address some type of operational process or emergency. Project managers along with the design and construction teams use design planning as a means to plan the budget and estimate cost. Changes in regulations or regulatory requirements can have an impact on the planning schedule.
What you will cover
1. Health Care Facility Project Management
a. Explain the five process groups used in project management.
1) The initiating process group includes processes performed to define a new project or phase of an existing project by gain approval from the project sponsor.
2) The planning process group includes processes that establish the scope, refinement of objectives, creation of work breakdown structure, schedule and project management plan.
3) The executing process group includes processes to carry out the work as described in the project management plan.
4) The monitoring and controlling process group includes processes that measure performance of the project and document change requests.
5) The closing process group includes processes to officially close the project or a give phase of a project. This could be the delivery of an intended project or cancellation.
6) Projects and ongoing operations should be clearly differentiated.
b. Evaluate budget planning and cost estimates in health care facility design.
1) Plan cost management by determining guidance for planning, managing, expending, and controlling project costs.
2) Estimate costs by using generally accepted techniques to approximate what capital resources are needed to execute project tasks and activities. To include but not limit to:
a) Expert judgment
b) Analogous estimating
c) Parametric estimating
d) Bottom-up estimating
e) Three-point estimating
(1) Most likely (cM) based on most realistic effort to assess the nexus of work, risk, and expenses
(2) Optimistic (cO) analysis based on the best case scenario of nexus of work, risk, and expenses
(3) Pessimistic (cP) analysis based on the worst case scenario of nexus of work, risk, and expenses
3) Determine budget by aggregating various project cost estimates and establishing the authorized cost baseline
4) Control costs by continuously monitoring costs and schedule performance information and updating cost baseline.
a) Understand planned value (PV)
b) Understand earned value (EV)
c) Understand actual cost (AC)
d) Calculate and understand schedule variance (SV=EV-PV)
e) Calculate and understand cost variance (CV=EV-AC)
f) Calculate and understand schedule performance index (SPI=EV/PV)
g) Calculate and understand cost performance index (CPI=EV/AC)
c. Explain the steps in an implementation plan.
1) Complete initiation process group processes to get the facility project approved.
2) Logically group tasks and develop work breakdown structure (WBS).
a) Identify planning tasks and decompose to specific activities or work packages.
b) Identify design tasks and decompose to specific activities or work packages.
c) Identify construction tasks and decompose to specific activities or work packages.
d) Identify facility opening tasks and decompose to specific activities or work packages
3) Translate WBS to project schedule.
a) Estimate the duration of tasks/activities.
b) Estimate the planned start date for tasks/activities.
c) Estimate the planned finish date for tasks/activities.
d) Determine predecessor tasks.
e) Understand schedule tasks/activities dependency relationships.
(1) Start-to-Finish (SF)— A logical relationship in which a successor activity cannot finish until a predecessor activity starts.
(2) Start-to-Start (SS)— A logical relationship in which a successor activity cannot start until a predecessor activity starts.
(3) Finish-to-Finish (FF)— A logical relationship in which a successor activity cannot finish until a predecessor activity has finished.
(4) Finish-to-Start (FS)— A logical relationship in which a successor activity cannot start until a predecessor activity has finished.
d. Explain standard operating procedures for waste management, fire and safety, and disaster management for health care facilities.
1) Waste management
a) Regulatory standards for waste management originated with the World Health Organization (WHO).
b) The Occupational Safety and Health Administration (OSHA) and the Environmental Protection Agency (EPA) govern many of the U.S. waste management requirements.
c) The waste management plan includes five items.
(1) Sorting of waste (where it is generated is best)
(2) Handling (as little as possible)
(3) Interim storage—short term (1 to 2 days) before final disposal
(4) Final disposal
(a) Solid medical waste
(b) Liquid medical waste
(c) Contaminated sharps
(d) Waste anesthesia gases
(e) Radioactive materials
(5) Required record keeping
2) Fire and safety
a) Compliance with applicable fire and safety standards
b) Fire evacuation and egress plans
c) Fire drills and alarm testing
3) Guidelines for disaster planning or emergency management defined by the Department of Homeland Security
a) Sample disaster or emergency management plans and guidance for developing plans are available from many states.
(1) Research example plans from different states and facilities.
b) Guidelines should address business continuity planning as well as specific disaster conditions that might occur
c) Health care facilities also should address their role for providing assistance when disasters occur elsewhere in their community.
d) Disaster plans should include a section on responding to fires.
e) There are a number of key points in business continuity planning.
(1) Carefully assess how your organization functions and create a business flow chart if none exists.
(2) Identify operations critical to survival.
(3) Include emergency payroll, expedited financial decision making, and accounting systems.
(4) Determine management succession.
(5) Identify your suppliers, resources, and other business partners.
(6) Develop additional professional relationships in case primary suppliers are unable to service needs.
(7) Create a contact list to use in emergencies and keep it with emergency supplies at an off-site location.
(8) Plan what you will do if your building is not accessible.
(9) Plan for payroll continuity.
(10) Define crisis management procedures and individual responsibilities in advance.
(11) Review and update the plan annually.
(12) Develop a plan for maintaining communication with employees.
(13) Keep important records like building plans, insurance policies, employee contact, and identification information in a safe off-site location.
(14) Ensure you have employees who are able to work.
f) Consider what supplies will be needed.
(1) Focus first on the basics of fresh water, food, clean air, and warmth.
(2) Create a plan for having essential medical supplies on hand or available.
g) Create evacuation plans.
h) Develop policies and procedures about deciding whether to stay or evacuate.
i) Ensure all employees are well trained in the procedures.