Translating project management into practice in government

from project to pilot to corporate PMO

Hello, my name is Jennifer Aiello Quaglietta. I am a Senior Project Management Consultant at the Ministry of Health and Long-Term Care, within our province of Ontario, Canada. Today I am speaking on my behalf, to share my personal reflections and insights with you.

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My presentation is titled Translating Project Management into Practice in Government: From Project to Pilot to Corporate PMO, and will provide you with:

  1. The general context of the publically funded healthcare system within our province;
  2. An overview of my role as a project manager on the excellent care for all strategy;
  3. The pilot program that my project supported; and
  4. My insights and critical success factors for a corporate PMO, with lessons learned and best practices leveraged throughout.
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In Ontario, our public healthcare system serves about 12.81million people and is projected to cost over CA$47 billion dollars of the province's CA$124 billion dollars of expenses2 as listed in the 2011–2012 budget. This amounts to 423 cents of every dollar in provincial government spending. The healthcare system is complex, with many layers of governance, multiple stakeholders, and service providers — across a large geographic area. In addition, as our population ages, the demand for more fully integrated healthcare services will continue to increase. Don Drummond4, an economist, sums up the context quite well, stating: “Healthcare is at once the biggest item in the Ontario government's budget, the issue of most concern to Ontarians, the source of the most intense and emotional public policy debate, and the center of the most complex delivery system of any set of programs financed by the provincial government.”

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Almost three years ago, I was granted the opportunity to be the project manager of the “Excellent Care for All Strategy” file; broadly speaking, Ontario's “Excellent Care for All Strategy” means that:

  • The patient is at the center of the healthcare system.
  • Decisions about patient care are based on the best evidence and standards.
  • The healthcare system is focused on the quality of care and the best use of resources.

This project had many components and was comprised of a large team, spanning multiple divisions and branches. As a project manager, I was tasked with supporting the effective planning, development, and implementation of a suite of system improvement initiatives under the strategy. Initiatives included legislation and policy work, as well as communicating with stakeholders and implementing the discrete components of the legislation. As project manager, I ensured that all the moving parts of the strategy were aligned, that the critical path was known, and that all of the components of the project would be delivered on time. The strategy was co-created through extensive dialogue between staff from the ministry, health system partners, and stakeholders; one of the most interesting and important roles that I had was to ensure that collaborative partnerships were created both internally and externally to engage, gain, and maintain support for the project. This collaborative vision was grounded in evidence and a shared understanding of what was needed to effect sustainable, system-wide change in Ontario healthcare.

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At that time, many years ago, and having little experience in government policy, processes, and standards, I knew that the task ahead of me was considerable and that I would face many challenges. I started off by gaining an understanding of the culture for project management within the ministry and what I found was interesting.

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First, there were small pockets of the organization using some variations of project management. What could be seen by some as a challenge really represented an opportunity to think about a standardized project management framework.

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In addition to the small pockets, there was a project management office (PMO) for IT projects and some efforts were made to create a more formalized PMO, but at that time nothing had yet launched.

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Further, in government, the fast-paced and driven environment must accommodate for changes in scope, timelines, and funding at any given time. This challenge posed the potential to have delays in approvals to charter-type documents.

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Finally, with over 30 people comprising the core “Excellent Care for All” project team, and upward of 100 people working on the expanded team, working at diverse locations across the province, information is protected due to confidentiality and contentious policy work, making collaboration a challenge.

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With that understood, my goal would be to foster a culture of effective and efficient delivery through an applied project management approach. This would entail the development of a framework and toolkit to implement and deliver one of the Ministry's priority projects.

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The approach I took was integrative. Taking all the applications of project management that I could come across, including those found in our ministry, other ministries, as well as from my previous work in other sectors of the healthcare industry, I attempted to create a model that was custom to the project environment. I developed a methodology and framework, in collaboration with my colleagues that encompassed the language that was common to the ministry. Most importantly, given the environment, it was critical that the framework I developed would accommodate for policy development and change.

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Next I created a toolkit that embraced the key concepts and principles from the methodology and contained the most important tools required throughout the life cycle of the project. A few key items included:

  • a milestone mapping tool that allowed the team to identify interdependencies and linkages;
  • and a work breakdown structure that enabled all team members to “tell the strategy's story”
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Further, to launch a platform to collaborate and share information, I created an internal project communications plan. This would involve the team meeting regularly but not frequently, in different forums and with various audiences. To support this, a unique visual in the form of a wheel was created, again in collaboration with team members, which helped the team members understand how information would be disseminated and allowed for honest reporting to be shared.

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Finally, in order to prove value in the standardized approach, I parachuted out to each area to document work and create new processes. For example, I assisted each of the team leads with documenting status reports and updating work breakdown structure components. Once each lead saw the work in action, he or she organically began doing it himself or herself, and soon thereafter training his or her staff.

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After working on my project for just over one year, I learned many lessons. I had to:

  • Prove value to foster adoption
  • The toolkit proved to be a great success, and allowed the team to adopt the project management concept.
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  • I learned to conform to the culture rather than change it
  • The methodology created was easy to follow and not comprised of unnecessary documents. It was customized, flexible, and aligned to the ministry's specific processes.
  • Most importantly, documents were created to ‘tell the story' rather than act as a template populated to satisfy the approach.
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  • I learned that I had to make the decision makers believers
  • Senior management buy-in was needed from the beginning to ensure a common voice, to keep momentum, to build awareness, and to create alignment
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  • I also learned that if you simplify your collaboration platform, sharing will flourish — similar to the twitter phenomenon
  • Creating a time and space for collaboration also proved to be a success. Rework was prevented and stakeholder engagements were aligned because everyone wanted to participate.
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  • Finally, I learned to introduce new and foreign concepts by demonstration.
  • For example, once the work breakdown structure concept was understood, every individual on the team brought it with them, serving as a key communication tool that broke down a complex project into a logical and structured series of linked initiatives.
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As I continued on with the project management of the strategy, and with lessons learned, I was asked to support a pilot called the “Project Delivery Program” by applying the best practices created from my project. This smaller project team was comprised of a number of project management experts across the ministry, who came together with the goal of developing a curriculum and training other staff who worked on priority projects, using a number of projects as best practice examples, including the “Excellent Care for All Strategy.”

However, with a new project came a new set of challenges, of which I thought the top ones included:

  • Having to prove value to a large number of staff
  • And having to take a nimble approach, because the staff had mixed levels of project management knowledge and the types of their projects varied in scope, scale, and complexity
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That said, the pilot went forward and was launched with tremendous success; however, with its completion, came more lessons learned and insights gained. Now, assuming that many of us understand the ins and outs of project management, my insights, or rather impromptu checklist, is centered more around what it takes to move an organization in terms of people, resources, and the demonstration of value, and how I would apply this to my current project and those to come.

  • To add more ministry examples and bring a broader perspective of the work and processes, I learned that it was critical to include other pockets of demonstrated excellence from across the organization, as each team or individual brings shared experiences to the table that are relatable, comparable, and translatable.
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  • I learned that to develop an effective training curriculum, education had to be based on core concepts and proven results like those from my project and other projects within the ministry. In addition, uptake and adoption occurred quickly and more effectively when delivered by colleagues
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  • I learned that to create awareness, drive expectations, and champion change, all senior management had to be on board. This was accomplished, particularly with the pilot program, by engaging them in a project management discussion and sharing key concepts and best practices.
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  • I learned that to have staff adopt an open and honest communication philosophy, common guiding principles had to be instilled, including workplace collaboration, honest feedback, and dedication to delivery.
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  • I learned that, as a team, we had to have a nimble approach
  • And that was done by aligning and standardizing tools that could easily accommodate for the inevitable scope creep environment.
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  • Finally, I learned that customization makes work manageable and realistic
  • and allowed for staff to communicate in a clear, compelling, and memorable manner
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Finally, with two series of lessons learned and best practices applied, there was an interest in building a business case for the Ministry's first official corporate PMO. Through this time, I was asked to assist with the creation of the business case, and am now an official member of that office. Given that, I would like to share with you my thoughts on what I believe are the key building blocks or elements to project management maturity.

  • First, use evidence to support best practice standards
  • and you can do so by using examples that are applicable to the environment, proven to work, and are relatable to the audience
  • Second, leverage experiences from colleagues because
  • learning from them allows for organic uptake and adoption of new processes
  • Third, accommodate for different modes of uptake
  • As there are different ways that people learn, when developing the curriculum for the PMO, a dynamic approach in which the curriculum comprised of lecture style, case studies, group activities, online self-directed learning, and short video clips was created
  • Fourth, embrace the environment
  • Flexibility is the key enabler of the methodology. In addition to allowing for teams to request customized templates, a simplified methodology placemat to show the five phases of the project life cycle and how policy development is accounted for was developed
  • Fifth, foster a philosophy of diplomacy and communication
  • With guiding principles, including: continuous improvement, shared responsibility, and accountability.
  • By using good judgment and political acuity, implementation becomes easy and incorporates time for feedback and input from all.
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  • Finally, share.
  • The more you share, not only will you be acknowledged and recognized for your efforts but you will also provide others with help they need to improve and leverage what has already been done
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Looking forward, and to parallel Dr. Kerzner's beliefs, I have tried to implement a philosophy that will drive the ministry toward project management maturity.

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Understanding that we are only at the beginning, there is a tremendous commitment to cultivating effective communication, cooperation, and the trust to get us there.

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Just remember that it is a journey, and the value of instituting a project management framework is more than just standardizing a group of templates and thought processes. It is about integrating a team of people who work in different functional areas and have different areas of expertise, to work together in a cohesive and collaborative manner. It is about creating interdependencies, so that work completed is linked; so that no parts have been missed, nor completed more than once; and that the final product, whether a new product, or in my organization, an improved service within a complex system, is one that is used, adopted, and superior to all the rest.

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I would like to take the time to thank Project Management Institute, the International Institute for Learning, and Dr. Kerzner for granting me this incredible opportunity. I can only hope that these lessons learned and best practices leveraged from my journey will motivate others to adopt project management methodology as a key enabler to success in any industry around the world.

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1 http://www12.statcan.gc.ca/census-recensement/2011/dp-pd/hlt-fst/pd-pl/Table-Tableau.cfm?LANG=Eng&T=101&S=50&O=A

2 http://www.fin.gov.on.ca/en/budget/ontariobudgets/2011/ch2h.html#c2_secH_FTC

3 Budget

4 http://www.fin.gov.on.ca/en/reformcommission/chapters/report.pdf

This material has been reproduced with the permission of the copyright owner. Unauthorized reproduction of this material is strictly prohibited. For permission to reproduce this material, please contact PMI or any listed author.

© Jennifer Aiello Quaglietta
Originally published as part of the 2012 PMI Global Congress Proceedings — Vancouver, BC, Canada

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