Laura Aziz says that everyone thinks they are the boss. “Everyone thinks that they are the boss.” Laura Aziz says this as she manages the IT systems for a 7-star hospital in the Middle East. It includes wifi, electronic medical records, and video conferencing. It’s a multiyear, multi-phase project that involves a multi-layered matrix structure to provide the chain of command. While technology is complex, managing the people side of things is also important. She adds that technology alone is not enough. “Hopefully technology and people will get us through. It’s something that we do every day.”
Laura explains the definition of complexity to the screen:
Complexity is often linked to the concept system – a set or elements that have relationships among them. Complexity refers to the condition of many elements in a system, and multiple forms of relationships among them.
She defines complex projects as:
There are many complicated inter-relationships
Interdependencies
Unknowns
Uncertainty
Laura’s Microsoft Project Plan has 7000 lines and a 5-year duration – and that’s just IT stuff. The actual hospital building is not mentioned in the timeline or on the list. To even understand what this meant, she set up an IT project management department. They had to create a new approach to quality, risk, and establish operating models that were more effective than the ones they had before. She is “still not satisfied” with the tools the PMO provides. They use Microsoft Project to schedule and Outlook. They are not necessarily helping us reduce complexity, but they are helping us keep things under control.
Laura discusses the difficulties of obtaining the right knowledge and expertise for the IT PMO, which now has 12 employees. She says that staff motivation is a key factor in keeping your team loyal for at least four to five years after you go live. She hopes that some members of the technical team will remain on board after go live.
Motivation is not a problem for staff: there are many exciting new technologies available. The hospital-to-be has 250 applications in its IT inventory. Hardware includes all the usual infrastructure and network stuff, as well as more modern gadgets like RFID, bar coding and hand-held devices. Then, there’s all the clinical equipment.
It is also important to consider clinical workflow. The hospital must have processes in place to manage outpatients, inpatients, and clinical order forms. To ensure that the requirements are met, there is a double loop feedback system. Because patient safety is paramount, all IT systems go through two cycles in integration testing.
Although it sounds exciting and modern, the hospital opening is still several years away. Medical technology changes at a rapid rate. Laura claims that she knows what is cutting-edge will be outdated two years before the hospital opens. She is not aware of the full extent of the future IT infrastructure because the suppliers she uses are all contracted to provide the latest software and equipment. Her project is complicated because of the unknowns in the IT sector.
Unusually for an IT project the schedule lasts a full year after the systems go live. The project structure will close down in the end. Although the hospital is expected to open in 2012, the IT effort continues for 12 months. It takes time to stabilize, maintain, and evaluate the hospital. This is a valuable lesson that can be applied to other projects: it’s impossible to close down a 4-year-old piece of development in a matter of weeks. It seems absurd to me that the hospital will need to wait another year to implement the IT systems.