High Performance Project Management | E.23

Lisa Miller (00:00):

Project Management isn't a one-time thing a week, it's not like catching up, it shouldn't be burdensome. It really is the vehicle if set up correctly and done like, "What are the next two or three things I need to do?" Is the vehicle for success. And the biggest reasons why initiatives fail, or they take way too long, and they become way over budget is because of project management.

Speaker 2 (00:33):

Welcome to The Healthcare Leadership Experience, a place where healthcare leaders will share proven strategies and innovative approaches to leading the clinical and business side of healthcare. This show is sponsored by VIE Healthcare Consulting who's proudly helped hospitals save over $700 million in non-labor costs since 1999. Here is your host, Lisa Miller, Founder and CEO of VIE Healthcare.

Lisa Miller (00:56):

Hi, this is Lisa Miller and you're listening to the Healthcare Leadership Experience. Today's episode is high performance project management, and we have Pandush Mitre here today who is one of our Senior Business Analysts, he's also helped lead our technology team. I wanted to invite him in today because he has so many projects and he does work closely with a lot of projects with our clients and our system, so welcome Pandush.

Pandush Mitre (01:24):

Thank you, Lisa. I appreciate that introduction and having me on the podcast.

Lisa Miller (01:28):

And of course we have Lisa Larter, our producer. Welcome, Lisa.

Lisa Larter (01:32):

Thank you, good to be here.

Lisa Miller (01:34):

So project management, it's such an interesting topic, right? We have project management training, we have people who are employed by the hospital for project management. You know, they really are wanting to push key strategic initiatives — whether that's technology, whether that's performance improvement initiative — project management is so important. In fact, I think that one of the top reasons, if not the top reason, why strategic initiatives fail is because they fail to get implemented, so it is around project management.

And there's a lotta reasons for that, but it is a critical skill in healthcare. So, Pandush, as we jump in, can you give us your thinking around what does it mean to have a high performance project management approach?

Pandush Mitre (02:22):

Yeah, absolutely. And feel like there's so many different levels to project management. From my perspective, you know, it's internal project management with our organization that, you know, externally with hospitals and working with their project managers on the work that they're doing.

So, you know, I think one of the first things that you really have to consider is what your goals? You have to be super clear on the goals, in terms of project management. You know, I say that because if I'm helping someone at a hospital manage a project, you know, I need to understand exactly what they're trying to accomplish and how they're doing it with the structure, their leadership that they have there.

You know, and for example, if, if you go to a, a certain hospital that doesn't have a strong supply chain, they might have project managers, you know, that aren't getting approval to do certain work, and there's no alignment in the organization. So that would be an example of, you know, not having a high performing project management system in place and, you know, the way you fix that is to communicate and implement some sort of clear, realistic, and pragmatic goal that you can achieve.

So, you know, I think in order to do that too, you need to be able to prioritize. So, no combining, you know, clear goals with prioritization and having the ability to track your priorities in real time is what makes a high performance project management.

Lisa Miller (03:38):

Yeah, absolutely. And, and I love that nuance is the internal and external, right? So there are two things someone's juggling. Because when you have a project, you're juggling the internal team but you're also juggling the external team. So if you have some kind of implementation, or goals, and you brought on a company, there's two different elements. You've got to manage external and internal, which I don't think a lot of people talk about. They only think, "Oh, I gotta project manage my team." But you've gotta project manage all those balls, which is an external focus as well.

So one of the aspects of high performing project management is, as you mentioned, you know, you talk about an approach, we're gonna talk about what system you use. And a lot of times systems, you can use systems, you know, in Excel and there's different templates. We use Workfront. I encourage everyone to check it out.

We, we don't get any kind of reimbursement for, uh, mentioning them, but we've been using Workfront for years and it's actually one of the top project management systems, you know, and strictly for healthcare because of the HIPAA compliance and the highest standard used, yeah, they used at Workfront.

But when we brought on Workfront, the little bit of the prep time was to create a system for us. You mentioned that, you have to have your own system. So for us, we are managing these margin improvement, performance improvement initiatives and we have to track, literally, hundreds and hundreds of these initiatives, with many clients.

So, a client can pick, call us up and say, "Pandush, where's this project?" You know, we can go into our Workfront system and tell them where it is. You know, that requires a commitment from us and all the people working on the project to include their updates.

And while sometimes it may seem like oh, that's a, a necessary task to even quickly update it, we've made the system such that we have seven milestones that we use at VIE to measure different aspects or where we would be along the way in a project, in a margin improvement project.

So I think what makes high performing, you, you know, project makes the, what's the thinking and the approach? Like you talked about earlier, what system are you gonna use? We use Workfront, but we customized Workfront because we know there's specific milestones that needs to be met. And if we skip one, it's gonna cause a problem. We've got to go through them in such a way that makes us successful in helping our clients achieve their goals. So whatever system you're going to use, it has to be thought out, right? It's not just saying, "Okay, well, what do you think we should do?" (laughs)…kinda put it in.

Pandush Mitre (06:16):

Right.

Lisa Miller (06:17):

You know, while there's specific milestones you need to achieve and, typically, hospitals have also performance improvement goals, and those projects have to be put together, and they probably should have very similar seven steps of those milestones to be similar to what we use. If you're interested in that, you can email me and I can share our templates for those seven milestones. But they should have the same, cause it's gonna come up every time.

Pandush Mitre (06:41):

Yeah. No just to add to that, I think, you know, at the bare minimum, you need some sort of project management software to help you with what you're doing. And then from there, you can kinda build upon that, personally, what works best for you and, you know, keeping track of things and being able to measure them is so important.

And having the software allows you to create recording customized to the work that you're doing — whether it's, you know, through client or to look at it internally. And then personally what I do is, you know, on top of using Workfront, some people will use Outlook calendars, and some people track stuff in Excel.

And what I do is, you know, at the end of the day, I'll, I'll write down a list of tasks that I have that I need to accomplish and I'll prioritize the top three tasks that I need to get done in order to keep these projects moving. And it goes hand in hand with the project management software because you can visually see how far along you are with certain projects and I think that has a huge impact on the amount of work, and the tasks, and prioritizing to get these projects done.

Lisa Miller (07:38):

Can you talk about what you do at the end of the day? And the reason why I wanted to have you on this show talking about project management is because you are such a consistent, stable force here at VIE and you're able to do things that I just think are incredible and there's lots of reasons why but I believe your way of managing projects is probably high on that list.

Could you talk about at the end of the day, which I know you do 'cause I know you stay at the end of day a little later, and you're wrapping up things, and can you talk about that every single project, what are the three next steps? Does that take you a long time to do?

Pandush Mitre (08:17):

No, no not at all. And, and I think it's, it's so important because it can get really overwhelming really quickly when you have so many projects to do. You know, people will look at their projects and say, "Oh I have 10 things that I need to get done for these projects." And you have to really just bring it down to bite sized pieces and say, "You know, instead of having 10 projects to complete, what are three tasks that I can do right now to get one project done or two projects done?" And then consistently do that every single day and then eventually that helps build your prioritization and get you through these projects so you can actually implement.

And throughout that process, you get some clarity on what are the most important things you need to do and avoid all those unnecessary details that, you know, aren't really required for you to complete the projects.

Lisa Miller (09:04):

That's a really great strategy and there's some tactics in that, um, Pandush, so thank you. But you know, project management isn't a one-time thing a week, it's not like catching up, it shouldn't be burdensome. It really is the vehicle if set up correctly and done like you do that which is, "What are the next two or three things I need to do?" is the vehicle for success.

And to your point, the biggest reasons why initiatives fail, or they take way too long, and they become way over budget is because of project management, and there's lots of reasons why that happens. But if people would take a daily bite-sized approach, and really use a system, and are very thoughtful they can get through initiatives. It's not the big pushes, it's actually the, the small gains that get you the final success.

So I have another question. If you're starting out right now, where should someone start if you're not optimizing, you know, a project management system? Can you just talk through, you know, just quickly high level, how would you encourage someone to put a project management system in place. And I'm talking about that individual person that command a department, supply chain. This is, you know, this is not like a big platform or approach for the whole hospital, but this is the person that's like, "I'm overwhelmed with all these projects." What can they do right now?

Pandush Mitre (10:34):

Yeah, I mean, I think you have to try to educate yourself as, as best you can. You know, there's most likely there's someone you're working with that's also doing project management. So wanna get advice from them and try to figure out the inefficiencies that you have in your process for your project management and compare to, to others and then kind of build from there.

But I really think it comes down to, to just educating yourself on where you are and, and what areas aren't working for you. So you have too many projects. Okay so, you know, why do you have too many projects and do all these projects need to be done right away? So take it step by step, ask the right questions and I think, you know, talking to people about it that are other project managers is really helpful.

And, you know, that's part of the work that we do too. I mean, we go into hospitals and we, we talk to people about how they're managing their projects. And, you know, majority of the time we can tell right away how robust the project management is just by how these contracts are being handled, so I think that'd probably be a good place to start.

Lisa Miller (11:31):

No, it's, it's a good point. I do think that hospitals have, you know, they're resource constrained and so more people are doing more things. And, you know, I would encourage everybody as they're looking at starting out with their projects just to do exactly what Pandush said, I'm in full agreement and, you know, figure out a system that you like that makes sense.

It could start maybe by paper, you can move that paper to Excel or, you know, maybe jump right into a system that you could use online if your hospital has one. But it's really not the creation of a project management system, it's not a high performing project management system, it's using it. And it's using it and you gotta be in alignment and milestones and really letting that system be the accountability, the collaboration vehicle so that it gives visibility.

So if a, a senior leader says, "Where we are with the project?" It removes the emotion, the stories behind why things are getting done. You can go into the project management system and say, "Here's what the data says, this is what's going on." And I think that's a very useful tool because sometimes there's some finger-pointing about projects, what's going on here or there. And if you use a project management system, the finger-pointing goes away and you let the data speak for itself.

So Lisa, I have a question for you. You utilize a project management system. I know because I'm in your project management system because we have projects together and that has evolved over the years. I love, use Asana. Can you talk about your experience with projects, and a project management system, and your teams, and finger-pointing, and how you worked through that.

Lisa Larter (13:10):

Well, yeah, you know, it's interesting, I was listening to Pandush and Cassandra, who's my chief of everything, always says, "The profits are in the process." And I love that line because the profits really are in the process.

The more convoluted and the more labor intensive a process becomes, the more it costs. And so when you can simplify your processes and you can get things done faster by using sound project management practices, then you can actually increase your profitability on a project in business and you can improve your margins in healthcare.

The challenge that I have sometimes and, and what I'm trying to work through, and Pandush I'd love your insights on this is I wanna create a self-managing company. And that might sound really woo-woo or, you know, pie in the sky, but where I have a problem with the fi- ... I, uh, it's not so much finger pointing as hands off, "Oh, I didn't know that was mine to do. Oh, I didn't know I needed to take that."

And so people are more hands up versus finger pointing and what I would like for people to do is have more ownership over what needs to be done so that it's not just a project manager that needs to assign all the tasks, but individuals look at the tasks and say, "Oh, I know that one's for me, I'm gonna move the project along because I see that this other thing is done, I'm going to take the baton and move it forward." Versus waiting to be asked to take the baton and move it forward. That's where some of our challenges have been there.

When it works, it works great. You know, we've started setting up these forms for our clients to fill out when they have requests for us and that is something that works really, really effectively because those requests go to a specialized area where we can assign responsibility.

We've also started using the system for temporary tasks because we have a team inbox. And so when a client emails something to our team inbox, we can create a temporary task to ensure that the person who needs to respond to that email realizes that that task, that response, that activity is for them. And I think that's the biggest challenge that we face is really having clarity on who owns what and how do we gain greater self-management and self-ownership of the projects and all the moving parts?

Pandush Mitre (15:41):

Yeah, that's, that's really interesting and temporary management tasks that you have that come through. I haven't experienced that but that was interesting to hear. And I, and I think, you know, just from my perspective, in my experience, you know, the way we do it is we assign tasks, not only based on projects that we're familiar with, but also sometimes, you know, purposely for getting someone out of their comfort zone, giving them the responsibility to work on a, on a task that they've never worked for before.

And it's not to criticize or demoralize anyone, it's really just to get them to learn how to do new tasks so that everyone can kind of build that efficiency in, in having project management because it's like a positive correlation. You know the, the more people you have in your company that have the skills and efficiency to have a higher performing project management approach, the better your whole organization's gonna perform.

So the way we do it is we assign a task to someone in our project management system and then from there, you know, that person has the responsibility to manage that project. Whether that means going to someone for help that can be part of the project management, which is fine, but at least you're learning how to do that on your own.

And then, you know, we do have tasks that come through that we don't put in the project management system and that's, it's on a case-by-case basis. It goes to people individually and that's just part of your prioritization too. So I don't know if that helps, but that's just my experience. You know —

Lisa Larter (17:03):

Yeah, I find it ... And I'm not sure if it's the same in hospitals, but I find it is challenging to manage email and a project management system. So often there are emails that need to be moved into project management and people will communicate updates that should be in project management through email. And so it can often feel like you're having to coordinate an update in two different spaces. And that, to me, is not an efficient use of resources. Right? You talk about process is profitability, if you're now managing two different streams of communication, that's hard to do too. So it's almost like you have to have an all or nothing approach to how business gets done.

Pandush Mitre (17:49):

Yeah, no, that's, that's a really good point. And I think the thing that distinguishes a project versus a task is, you know, a project is revenue-based. Does it make revenue for your organization? And, and then if it is, that becomes a project that goes into your project management system.

And that's, you know, part of the reason why I use the Workfront for project management then I also keep, you know, either a spreadsheet or my tasks that I have separately. And that's, that's why it's, uh, there's a few layers to it.

But if it's a revenue-based project, it has to be in the project management system and then other tasks that are, you know, not necessarily revenue based or could turn out to be revenue based, you know, might not go in right away. But once you get through these tasks, you can kind of identify whether well it's, it's gonna be a project that's gonna need to be moved over or not.

Lisa Miller (18:35):

What a great discussion about emails and a project management system and having to update it both places.

Lisa Larter (18:42):

You experience the same pain that I do.

Lisa Miller (18:44):

Yeah.

Lisa Larter (18:45):

Like I'm trying to get an update on something and sometimes I just, I don't know where to find it, I don't ... Sometimes it's in my inbox and sometimes it's in Asana, and I just wish it was in one place and it was easier to manage.

Lisa Miller (18:56):

Yeah, I'm with you. And I think it's a great thing to think about and to solve for. One of the things that I decided to do a few years ago with the help of Hector Rodriguez, who really took over our project management system and wanted to level up it, and we owe him a huge debt of gratitude for taking that on and lifting us all up by his leadership there.

And, you know, the one input I had, and he had it all mapped out and collaborated with everyone on what it should look like, but really is tracking time. And tracking time is really important because we tend to not accurately assess things that take longer, shorter, or things that go on and data tells the truth.

So we hit a project and we time/date stamp it when it starts but then we're also saying, "Okay, we have this anticipated time and point to complete. We try to be realistic as possible based on our experience, depending on the initiative and we do like to get, complete initiatives within 30 days. Some of them, realistically, will take 45 or maybe 60, but really try to keep it in that timeframe.

But when you time/date stamp something, you put an estimated completion date and now you can measure were you accurate about your anticipation of when it would complete? You can measure, "Okay, we're getting to five days before completion date, where are you? What's your comfort level?" We can measure different milestones like I mentioned earlier where we added milestones and then we can measure really how long does it take someone to complete a project and similar projects?

Do we have variation in our own company, similar projects? Things are taking longer. Are they taking longer for specific reasons like Pandush said because we have more projects or is it just something's going, else is going on?

But the data doesn't deceive you. If I can look in and say, "Wait a minute, our projects are taking eight days longer or I'm getting more red flags. What's going on, do you need help, or how can we intervene, what's the real problem?"

Lisa Larter (21:01):

I love that Lisa. We do the same thing, we time track and it really allows us to a) get a sense of the average length of time it really does take to do something. Because, uh, you know, there's a, a saying inside of my company and might exist inside of yours too. But it's called working at the speed of Lisa.

Lisa Miller (21:01):

(laughing)

Lisa Larter (21:23):

And so because of my years of experience, I am often able to get things done a lot faster than other people inside of my organization. And so Cassie is always saying to me, "If it takes you five minutes, it takes someone else 15 because they don't operate at the same speed as you."

And so, time-tracking allows you to really see what the true time is if you're averaging certain tasks amongst the team members and it allows you to isolate the outliers of when productivity is really not where it needs to be.

Lisa Miller (22:02):

Yeah, and I think it's, uh, operated in this…Lisa works here as well. But here's the interesting point about that right. I think we go into default thinking or default operating system. So the example is your calendar invites are defaulted to an hour. I'll never have an hour meeting with my team unless it's something special. I'll never have an hour meeting with our clients unless it's something special.

And we tell our clients, "Listen, we value your time and then the time that we're spending, you know, working on projects, that's what you want us to do, not on meetings and calls unless, you know, they're necessary." So my default time to a meeting could be 15 minutes, 20 minutes, or a half an hour. Half an hour's a lot for me and Pandush knows that too, so I'm going to change the default and make it 15 minutes or 20 minutes.

The reason why it's so important is because I see it a lot with this default thinking of how long things should take. And I don't think I'm anything special, I just feel like okay, my way of thinking is like, "How do we shorten time for him?" I don't wanna shorten the result or shorten the outcome or, you know, but I wanna shorten time for him, so what can we do to do that?

And sometimes it's just saying, "Hey, listen, we're gonna complete this in 30 days." And I see everybody like look at me. Or I tell our clients, "We're gonna get this done in 30 days." So have some clients are like, "Wow, that's great." Others like, "That's impossible."

Fine to say it's impossible, are they going to be impossible? And I'm going to have to now, you know, really kinda work on their mindset. But I think project management and looking at timing sometime mindset and it, it doesn't require that much more effort it, but it just requires, "Where can I take the time out of this?"

Lisa Larter (23:41):

Well momentum loves speed and the more time you give somebody to waste, the more time that gets wasted.

Lisa Miller (23:46):

That's right.

Lisa Larter (23:47):

I do think there is a difference between how some people work, though. There's a, a podcast on, I think it's Revolutionist History, a Malcolm Gladwell podcast, where he talks about the difference between fast thinkers and slow thinkers.

And you know, we have been rewarded through the educational system for thinking fast and completing things fast. But in, in some cases, for some people, they need to think slower and they need to process and do the work slower. And a lot of times the people that do think slower and do the work a little bit slower actually finish the work with a lesser failure rate, so to speak, right? And so there's a balance between what tasks require deep, slow thinking and what tasks require speed, decisiveness, and momentum instead of that longer process.

Pandush Mitre (24:44):

Yeah, and just to add something to that. You know, I think it can be relative sometimes. We work with, you know, all different size health systems and, you know, sometimes larger health systems and we tell them, "We're gonna close a project in, you know, two weeks or 30 days." They tell us it can't happen because they have internal controls or processes wherein they need to get approval from certain committees in order to either, uh, get approval to work on these projects or to make any changes on certain agreements.

So, you know, whether we're ready to complete a project in 30 days, it might take them, you know, two months just to be able to get that approval to, to even do any of that work. So you know that, that leads to other questions like, you know, "Should your process or internal controls have to change in order to improve upon how you work on your projects and, and how you're aligning your goals?" But-

Lisa Miller (25:31):

That's a good point. And if the C-suite knew that the internal processes were creating a longer period of time for completion, you wonder if they would say, "Wait a minute, I can fix that for you." And you just wonder, uh, just because it's accepted because it de-, defaults because it's the way we do it, is that the way I would do it? But you're also saying the balance is there are times you need to slow down, do deep thinking, make sure it's done right and so that's the balance I think you were talking about too?

Pandush Mitre (26:00):

Yeah, absolutely.

Lisa Larter (26:01):

I think that what you just said is a really good point in terms of the bottlenecks that get created when you have to wait for people to make decisions and/or approvals. I think that happens in every organization and I think that the downside of that is the longer somebody is away from the project, the less memory recall they have and, therefore, it takes a lot longer to re-initiate the project when there's been a delay like that.

Lisa Miller (26:28):

So thank you Pandush for a great, great discussion and Lisa talking about high performance project management systems, and our approaches, and just some of our experience. It was, it was fantastic discussion.

I'd encourage everyone to listen to episode 22 where we talk about how to out negotiate your vendors. Our next show is healthcare analytics. And we love to get our listeners' input on what we should be speaking about, who we could bring on the show.

You know, it's really meant to be this diverse show of healthcare leaders and then those outside of healthcare just sharing ideas, thoughts, approaches that can make your careers, your organization better, you know, it's a place to share. So thank you for listening and we will be speaking to you soon. Thank you Pandush and Lisa.

Leah (27:18):

Hi, this is Leah. You are listening to my mom's podcast, The Healthcare Leadership Experience.

Fernando (27:25):

Hi, this is Fernando. If you would like to speak with my mom, just email her.