From the bottom up

It all began with a chance elevator pitch.

At the not-for-profit healthcare consortium Kaiser Permanente, projects are evaluated at monthly meetings to address the need for additional resources, funding and the like. After a presentation in 2009, I ended up alongside the senior vice president of the infrastructure management group. I seized the opportunity to tell him about an idea that could save substantial infrastructure operating costs. At the organization, innovation and creative solutions have become part of the culture, but its sheer size can make escalation and implementation challenging.

That brief exchange blossomed into an action plan for a multi-year, multimillion-dollar cost-savings initiative that is helping achieve one of the organization's key strategies.

1. Align with the executive vision.

As in many industries, executives in healthcare are tasked with doing more with less. Improving cost structure was a recurring theme in our CIO's message at town hall meetings. I saw value in reducing operating expense tied to that vision—and therefore determined my idea would likely be welcomed by the senior leaders governing project funding.

I began discussions with project team members about details. There would be a high level of complexity and risk in dismantling a large, restrictive-legacy, private wide-area network. It had been patched with hundreds of expansions spanning more than a decade and equipment made by a bankrupt supplier. After preliminary analysis, we began to see scenarios in which the network cost savings would indeed be substantial and new patient care technologies could roll out much sooner.

With that preliminary analysis and an informal vote of confidence from the senior vice president, we intensified the effort.

2. Assemble a skilled exploratory team.

Leaders at the bottom of the org chart can be highly influential. You make the first move, and others gradually join in. My team pulled a few people together for weekly strategy meetings. I began by reminding everyone that our mission was tied to the CIO‘s vision of reducing operating expense. Quantifying cost savings, scope of work, resource requirements and schedule was our initial focus. Naturally, the team's enthusiasm grew as we began to see how our work would improve the organization. The initial scope was cost savings for one specific region, but senior managers agreed to expand the scope to the entire enterprise and requested an action plan.

3. Present a compelling action plan.

When the time came to put the enterprise-wide action plan in front of management, the goal was to cover all bases. I didn't expect many follow-up opportunities to impress. The action plan targeted senior management in all relevant departments and included material for finance management and customers. Senior managers had to have a firm enough grasp of the activities and benefits to be able to convey the value proposition to others. As a practical matter, they also needed to understand how the benefits (e.g., cost savings, increased productivity, improved quality, etc.) would be measured and statuses tracked.

I used my understanding of governance processes and interdepartmental relationships to develop a resource model encompassing project team members throughout the organization. The IT structure was dynamic, so I continued to share the resource plan with team members to ensure accuracy.

The action plan was developed with three principal goals:

1. Provide sufficient background to understand what was required to complete the key milestones and demonstrate command of the technical tasks
2. Explain the total quantitative and qualitative benefits
3. Specify the resources required

We developed an easy-to-follow, leave-behind document after each meeting with management to facilitate their communication with others.

4. obtain organizational buy-in.

There's an old saying that goes, “If it's to be, it's up to me.” But while leading change as an individual contributor in a large organization, that couldn't have been further from the truth. For example, I relied heavily on the vice president of network services to lead a coalition of senior managers over vital engineering resources. I struggled with how and when to follow up with executives to whom I rarely had exposure.

Review meetings with senior managers in other departments sailed along smoothly, though.

Buy-in from the finance department was a whole different matter. Like most successful companies, my organization requires solid financial justification before bringing on additional resources.

Because of the scale, developing the spreadsheets with finance to validate the short- and long-term financial benefits took an enormous amount of time. The scope of this program impacted more than 1,000 locations in eight regions of the country, and the resources to support the work were spread throughout 10 departments.

5. Build high-performance project teams.

Once the business case was finally approved, it was as if a party that started in my garage had morphed into a full-blown ballroom gala. The project management office (PMO) was brought on board to track the financial benefits. Eventually, we welcomed its tracking and reporting because it was an independent validation of millions of dollars in savings.

The first challenge in the execution phase was how to structure more than 20 project managers into manageable teams so that hundreds of planning and analysis meetings with specialized technical resources were conducted in an organized fashion. Looking at the entire organization, we created focus groups, and established regular status and planning meetings with project managers in different regions to discuss schedule, budget and change requests for more funding when necessary.

Furthermore, if project managers were going to replicate this effort and build support, they needed to be trained to present the project objectives and key milestones to their team members, business partners and customers.

I also chaired weekly analysis meetings with technical resources to discuss schedule issues and review network analysis proposals to maximize savings.

In the first year, our customers began expressing approval as they began to see cost benefits. Monthly commitments were consistently met or exceeded. The annual savings commitment was exceeded two-and-a-half months early by 155 percent, translating into additional savings of several millions of dollars—confirmed by the PMO.

Phil Patrick, PMP, leads a network strategy team at Kaiser Permanente Information Technology in Pleasanton, California, USA. He can be reached through his blog at leadfromthebottom.blogspot.com.

Competitive Forces

Without leaders at every level, organizational transformation becomes impossible. Rapidly changing market conditions and fierce competition pose unprecedented challenges to an organization's market standing—and perhaps survival. Action plans and strategies from organization-savvy workers paying attention to executive vision enable energies to be channeled into projects with the most benefit.

Sometimes the great ideas come from a project manager at the bottom. Such opportunities are rare—so when a promising idea comes your way, be ready to start the party. PM