Anticlue

Knowing the difference between process and performance problems

2009-11-06T13:15:42Z

One of the best pieces of advice I have received over the years is to be wary of process problems, and 90% of the problems are process based. As a leader and a manager, one has to be constantly cognizant of the difference between a process and performance problem.

One of the truths in life is that we tend to tell tales about our daily life. These are not tall tales, but the way we perceive the world. In most of our stories, we are the hero and someone else is the villain. Truth be told, the world is not like the comic books. There are some "bad" people in the world. However, at least in the environments I have been blessed to work, most people come in everyday to get a job done. Some individuals truly throw their all into the job, a few others put in just enough effort to qualify, and most everyone else ends up in between these extremes. So there should be a few performance problems, which place most of the problems into the process bucket.

Process problems take effort and a teaming attitude to resolve. One has to look at the big picture and then deep dive into the smaller part of the process. Hospitals have a process improvement or quality management department to help this effort. Additionally, lately several organizations have started to utilize the lean six sigma methodology to improve workflow.

So when you are sitting back, relaying a story to your friends and co-workers, perhaps one should start to look at the process as the villain, not an individual. Additionally, the stories one relays are the basis of your culture, so throw in some good ones about teams working together.

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Taming Chaotic Project Management - growing up from a Functional to a Matrix Model

2009-11-03T17:03:01Z

As you continue to sweep the firing flames of chaotic project management, one of the items leadership needs to consider if it is time grow up from a Functional organizational model to a strong matrix organizational model. Now this does not occur immediately, but it speaks to having an established model of empowered project managers and a transformational PMO which drives the strategic projects of the organization.

Historically, IT and the business developed into functional divisions, departments, and teams. Currently throughout the organization, there will be concerns regarding over-utilized resources and the constant pulling of resources in multiple directions.

A decision needs to be made of whether having a division drive all health system projects, including IT and business projects. After all now-a-days most projects are business projects with an IT component, so it makes some sense to have a division drive the projects through to realization of the benefits.

If this is the course of action your organization chooses, then the next decision at which management level does the PMO sit. Obviously the further into the weeds the PMO is the less it can drive results strategically. Most enterprise transformational PMO are under the CEO, and have a staffing model. A single PM reporting to a director would just be enabling departmental standards in pm, training for pm, and toolsets. It really depends at which degree the leadership is willing to empower the PMO and the project managers.

Further Readings on Taming Chaotic Project Management:

The Top Ten Characteristics of a Chaotic Project Management Environment

Find out how many active projects are in flight.

Establish your organization's current and desired need of Healthcare IT

Collaborate on Prioritization Decision Criteria

Have a defined and approved process to accept work.

How to stop running the daily meeting marathon

Using the WBS to define deliverables

How to know when you have a project and when you do not

8 Training Tips on how to develop project schedules

Introduce a Scope Change Management Process

Introduce a Benefits Management Process

Top 5 benefits to a project dashboard

Understanding the DIKW model and knowledge management

2009-11-02T20:20:45Z

Ever get a spreadsheet filled with just Data, and then have the analyst say. "Is that what you were looking for?" Over on the ITIL Community site, a recent discussion on DIKW elegantly clarified the model.

<-- Snipped from discussion -->
The DIKW model assumes the following chain of action:

Data comes in the form of raw observations and measurements (used as a basis for reasoning, discussion, or calculation).

Information is created by analyzing relationships and connections between the data. It is capable of answering simple "who/what/where/when/why" style questions. Information is a message, and consider the audience and the purpose.

Knowledge is created by using the information for action. Knowledge answers the question "how". Knowledge is a local practice or relationship that works.

Wisdom is created through use of knowledge, through the communication of knowledge users, and through reflection. Wisdom deals with the future, as it takes implications and lagged effects into account

Data has commonly been seen as simple facts that can be structured to become information. Information, in turn, becomes knowledge when it is interpreted, put into context, or when meaning is added to it. The common idea is that data is something less than information, and information is less than knowledge. Moreover, it is assumed that we first need to have data before information can be created, and only when we have information, can knowledge emerge.

According to these definitions, data is the basic unit of information, which in turn is the basic unit of knowledge, which itself is the basic unit of wisdom. So, there are four levels in the understanding and decision-making hierarchy. The whole purpose in collecting data, information, and knowledge is to be able to make wise decisions. However, if the data sources are flawed, then in most cases the resulting decisions will also be flawed.

The reason for a knowledge management system are to validate, to direct, to justify and to intervene or put simple "to make decisions".

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Useful Information Management

Understanding the technologies which help reduce Adverse Drug Events

2009-11-01T16:25:09Z

About 9 years ago in to Err is Human the Institute of Medicine recognized the need to improve workflow through technology and reduce Adverse Drug Events. This is still a struggle in several hospitals. Let's talk a bit about the technologies which can help reduce Adverse Drug Events (ADEs), and what is needed for the adoption of these practices.

What causes an Adverse Drug Event

First item to understand is what are the causes of Adverse Drug Events (ADEs) ADEs are caused by one of the following accidents, circumstances or challenges, these are a few not all;

Providers don't have all the patient information when a clinical decision is needed - may be due to missing home medications or just the timing of pushing paper. The clinical decision may also be urgently needed.
Providers orders are just unreadable, and need to be verified.
Providers have a lag time from when the order is know to be need, and when the order is documented to be needed. The knowing-ordered gap.
Paper pushing meets the paper monster. Every once in a while a piece of paper gets "misplaced" in the process.
The in-house formula and agreeing to use what is in house. Also knowing what is in house, cause that hospital down the street which the physician visited earlier may have different items, and may not
The time it takes to process an order based on the availability of the meds and location of availability
Dispensing Errors related to the wrong medication, wrong dose, wrong amount, wrong frequency, wrong time
Documenting the administration on paper not in a timely manner. Sometimes this needs to be in one place, sometime 2, sometimes 3 or more.

Enlightening and scary, a good topic for all saints day knowing the nurses, pharmacists, and physicians who work diligently everyday to prevent these events - They are saints.

How can technology help

The good news is that technology is out there which can assist. The other good news is that through proper phasing and establishing a collaborative team to make the systems sings. These adverse drug events can be reduced significantly, and other improvement opportunities will come to light.

Common Technology Solutions	Purpose	Outcome if adopted
Pharmacy Ancillary System	Manages the workflow in the pharmacy has a feed of where patient are in the hospital. It is best to have the same pharmacy system vendor as your hospital information system.	Most organizations have a pharmacy system. These may even be getting a little old and fully depreciated.
Smart Pumps (Wired or Wireless)	Manages the IV and assures the complicated infusion calculation is done by a computer. Newer models are wireless and can interface bi-directionally.	Reduces IV ADEs and harmful infusion rates
Automated Dispensing Systems	These system receive order and exchange cart fill lists. In the pharmacy, carousels and a robot can be used. Up on the floors there is a automated dispensing machine or a locked cabinent	Reduces the FTE effort for dispensing, and assures the meds are in the right place
Barcoding the drugs	A barcode is placed on the drug.	Improves accuracy with the automatic dispensing system
Automated Dispensing Systems	These system receive order and exchange cart fill lists. In the pharmacy, carousels and a robot can be used. Up on the floors there is a automated dispensing machine or a locked cabinent	Reduces the FTE effort for dispensing, and assures the meds are in the right place
electronic Medication Administration Record (eMAR)	Digitizes the drugs a patient is taking and when the patient has taken them.	Provides up to date order and administration to all practitioners.
Repackaging and Re-labeling the meds with 2D barcodes	Assures all the meds have readable accurate barcodes on them	A precursor step for barcode medication administration
Barcode Medication Administration with Positive Patient ID	The system populates the eMar by having the nurse identified, the patient identified, and drug identified. Barcodes need to be on the nurse's badge, the patient wristband, and the drug. This is one of those implementations were it is expensive, but so worth it..	Every effective in eliminating administration errors.
CPOE	Computerized Practitioner Order Entry - no more handwritten unreadable orders.	Eliminates the handwritten orders thereby reducing the ordering and transcribing errors. Also a precursor for Medication Reconciliation
Electronic Medication Reconciliation	These system enable the review of home medications and expedite the ordering/reordering while at the hospital.	Reduces the time spent ordering when incorporated into the ordering process.

Transformation isn't just about the Technology

There are a lot of business changes to workflow which need to be done to reduce adverse drug events. We need to be congnizant about traversing the change river to assure each piece of the pie is enjoyed and has lasting positive affects.

Implementing and adopting these solutions are a team effort, and the buy-in of all will help make it successful.

Hopefully you enjoyed this post, I'd welcome hearing your insights and suggestions below in the comments. Please check out these other posts, they may pique your interested.

Barcoding at the Point of Care

Strategies for Pharmacy Integration

An XML Formulary

How to Manage Whining with no Problem Solving

2009-11-01T00:11:52Z

A well performing team can accomplish great things. Teams are comprised of individuals who at times are tired, scared, stressed, and driven. As a leader, I spent a decent amount of time nurturing and developing my team. Every moment is well spent and worth it. Recently we have all agreed on a policy of venting, whining, and the problem solving cheese.

There are times where we just need to vent. It's a burst, normally due to a straw however it is a burst. This is venting, it is complaining in a controlled burst not to last more than 10 minutes. My team and colleagues can release in their first venting on any subject matter and trust in having someone who will listen and hear their concerns.

However when we get to the second or third time a venting occurs on a topic. It is time to bring the discussion around to problem solving. As individuals begin to focus on the negative and don't engage in problem solving, this behavior is unacceptable. Life is short, and we have important things to accomplish. Let's begin to talk about how to improve the state of affairs.

People normally whine about items they don't feel empowered to change. They focus on what they can't do, instead of what they can do.

The first time, it is a venting and commonly a subject matter problem. The next time we have a trend occurring, and this is where we need to coach our team player to be constructive process improvement artists. If the whining continues, we may be dealing with a negative attitude which has begun to permeate our colleague. It is time for a discussion on the consequences of a negative attitude, before it permeates our team.

So in summarization, when faced with venting, whining, and missing in action problem-solving try these tactics:

Listen - Normally the first time, this may just be vent. It is important as a leader to listen our teammate. A supportive ear is crucial.

Question - For the second time, whining is now official, it is time for Socratic leading questions. These questions should be poised based upon what the individual can do to solve the problem. On the third time, explore the previous solution's outcomes; help the individual to be empowered to resolve the issue. If it is absolutely above the teammate authority, offer to help and commit to actions. Check up with your associate on their activities and check back with what you have committed to do. Have the conversations focused on problem solving.

Discuss Consequences - As we extend into the forth and fifth time, this is beginning to be a negative attitude. It is time for a behavioral discussion, which the consequences of a negative attitude.

If you enjoyed this post, please check out these posts

Managing Conflict

Approaches to managing conflict

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IT Competencies

Conference Review - Mighty Muse at Newport, RI

2009-10-31T17:31:05Z

This past week, I had a chance to check out the MUSE Conference in Newport, RI. This conference is one of the gems of Healthcare IT.

Previously, my experience for Healthcare IT educational opportunities has been the yearly HIMSS conference, in Atlanta next year, and a couple Siemens Educational Courses. The cost of the HIMSS conference honestly is the travel expense, if you register ahead of time, things are a bit economically. HIMSS just packs A LOT into 3 days. Educational opportunities need to be balanced with networking time, volunteerism, and leading SIG discussions. The Mighty Muse conference really has balanced that mix.

Why it is so valuable?

The Mighty Muse is a great mix of shared experiences and educational opportunities.

One of the harder things to do is to walk a mile in other's shoes through implementation. However one of the key items at this conference was to provide presentations from other roles perspectives. I'll highlight just one of the plus 50 educational slots to illustrate the value.

The pharmacy sponsors insights from a BarCoding and eMAR patient safety was enlightening.

The shared lessons learned were:

Make Sure everything in the pharmacy is bar-coded, checked, verified, and verified. Nursing will assume mistakes are with the Pharmacy bar-coding.

2-D barcodes have a higher correct scan rate and take up a smaller footprint.

Make sure the project leaves in place a team of Nursing Managers and Pharmacists in place to make process improvements in a quick and timely manner.

Have a bar-code validation process, even when drugs are received direct. There may be a blip here and there from the vendor.

This educational opportunity is hard to obtain in any other format for a good ole healthcare PM like me. The other great item is that the questions from the crowd helped to bring other considerations to light from other environments. Each session had room for under 100 attendees.

The layout was for warm cosy educational sessions, plus a decent vendor hall worth the time.

My final opinion

Opportunities like this are few and far between, and with the price at a 150 plus travel expenses, these conferences are an excellent training opportunity for all.

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HIMSS 2008 - Final Thoughts

Opening Day at HIMSS 2006

How much time should I spend managing this project?

2009-10-30T11:36:42Z

I was lucky enough to get several good questions on the art of accidental project management over in Newport, RI this week. The first of which is above. How much time should I anticipate to spend managing this project?

In this case the project was an upgrade. The individual was wearing several hats, that of a systems analyst, a system administrator, a DBA, and project manager. The team sounded to be composed of me, myself, and I.

Here is the key tip to the trade, do the amount of project management that is necessary which address the areas in the project which need to be managed.

Within full blown execution after the charter, scope, and schedule have been developed, for this type of project the weekly pm workload should not be significant.

Bi-Weekly Status meeting on the project, with meeting minutes

A 10 minute weekly review of the schedule

About 5 - 10 minutes deriving a quick weekly status email

About an hour of follow-up calls

About an hour review and following up on the RAID log.

A 15 minute weekly discussions with the sponsor

Assumptions here is that the other roles are taking time, but the communication needs are smaller because the impacted individuals are smaller. Additionally, since the pm is the individual also doing the project work, there is a self managing aspect to the activities.

Project Management efforts have been calculated from 10% to 25% of the total project work, depending on the type of effort. So if you are doing a small upgrade, you should anticipate spending a small amount of time managing the project.

Hope you enjoyed this article, perhaps you would also like:

How do you handle being told to do a scope change by your manager

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Tip of the Trade - Clarify roles and responsibilities

2009-10-29T11:59:14Z

A clear role of management should be to clarify which roles are accountable for what actions. I'm talking a little broader here. There is this infamous saga of the confused team.

Four colleagues named Everybody, Somebody, Anybody, and Nobody worked together. Important research needed to be done and Everybody was sure that Somebody would do it. Anybody could have done it, but Nobody actually did it. Somebody got angry, because it was really Everybody's responsibility. Everybody thought Anybody would do it, but Nobody realized that Somebody wouldn't. As it turned out Everybody blamed Somebody when Nobody did what Anybody could have done! Without doing the research Everybody spent a lot more time of this solution, when with the research it would have been simply done.

This happens quite frequently when roles and responsibilities are vague, and in a couple of individuals with Teflon coating for accountability and you have a real spaghetti monster.

As leaders and managers figuring out what the DBA group is responsible for and what the client server team is responsible should be done. When the lines are harried and crossed, problems arise and critical tasks are never carried out. The end result is that your applications and infrastructure will end up being a variation - riddled brittle structure with 15 different ways to accomplish the same function, and no one monitoring the controls.

If you find yourself in this situation, take a week and write up a single operating level agreement for one of your preceived responsibilities. For the remainder of the month, vet the operational level agreement with the management team to assure everyone agrees this is your team's responsibility and is satisfied with the agreement. Make sure you have good discussions if you do not have the staffing to meet the demand. At least you will be leading by example and hopefully start a trend. Worst case is that you end up with a responsibility for which your team has a skillset gap.

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Why IT governance fails

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Tips of the trade - Actively Manage Assumptions

2009-10-25T17:31:15Z

While planning a project, there are decisions which are based upon presumed truths. These presumed truths need to be in place for the project to be successful. As a project manager is it your responsibility to manage the assumptions within your control and properly escalate others.

Assumptions are those common placed truths which have a nasty habit of wacking the project execution with a wreaking ball when they are found not to be true. So let's talk about some common place assumptions in healthcare projects.

Common Assumptions in Healthcare Projects

The department is supportive of changing how they work

The product is stable and able to quickly change to meet our needs

The technology is well known among our it department

The technology will work with our legacy infrastructure.

Everyone is available for training and testing whenever needed.

Managing Assumptions should be aligned with how you manage risks, the key here is to assure the assumptions are transparent, well defined, and have an individual accountable who is empowered to assure the assumption holds true.

There are three key practices in managing assumptions:

Identify Planning Assumptions - We first start by reviewing business case, charter and high level scope definition. Here we pull out those planned truths. Don't just stop if there is a section, labeled "assumptions". Review all existing documentation for assumptions. Once you have them, let's be sure to clean them up. Applying our smart methodology to assumptions, resources will be made available as needed becomes. From October through January, the nursing manager, director of medical informatics and 2 system analysts will review the future workflow. The resources will commit 8 hours a week to this effort which will be measured by reviewing the time logged and deliver a completed workflow for each service on a bi-weekly basis. Now let's place these either in our RAID sheet or our risk register.

Analyzing Planning Assumptions - The next step is to review the assumption, determine a leading event to show that the assumption is failing. For example on the above if the weekly workgroup meetings are canceled, there is a high probability the output will not be obtained. Also identify an accountable individual for managing this assumption. Here it would not be project manager but perhaps the director of nursing and medical informatics. If this does not happen, what is the impact to the project.

Develop Action Plans - Here is how the accountable owner of the assumption will be managing it. Perhaps there is a control put in place, like a notice to the directors before the meeting is cancelled to eliminate the conflict, or another standing meeting has time carved out to make the participants available. If this is going to be a continual problem, perhaps another resource is assigned to walkthrough the new workflow with each participant individually, with a 3 day turnaround for agreement.

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Pre-Charter

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Taming Chaotic Project Management - Top 5 Benefits to a Project Dashboard

2009-10-22T14:55:32Z

One of the quick wins for taming chaotic project management is to have a project dashboard. The project dashboard should be a comprehensive listing of all active project status reports within your department. The dashboard should be easily viewable and show up in individual's mailboxes to be viewed. It should be placed in from on the organizations leadership team from director level up at least every two weeks. This is a push communication, not a pull.

A project dashboard has several benefits, however in my experience the top 5 have been:

Transparency- Having to see the entire picture, brings new insights. Epiphanies will occur over higher level governance items. If your IT infrastructure is old, customized beyond belief, and not well intergrated, there will be a lot of "surprise" red obstacles. This helps to realize that funding to improve the foundation is needed. Yet another benefit to transparency, if resource allocation is not done well, it will show on the dashboard. Finally, the organization will get the need for governance. Transparency is like having chocolate cake, you know the diet is around the corner.

Communication- Another great aspect is the communication. If the organization has invested or has expectations on projects, communicating helps to inform everyone on their status. If it is not being worked on, it is not active. If it is active here is how it is going. This helps everyone know the business changes around the corner.

Accountability- It is simply amazing when project need to be quantified in red, yellow, and green lights. Accountability is kicked up a notch, as sponsors, project manageres, and team members strive to overcome the barriers. Awaiting for decisions status are communicated to the entire leadership team.

Barriers Jettisoned- If your project is on the board and has a barrier which is clearly labeled. Such as a risk high a high proability and a large impact, the executives will see this in a concise manner. All of a sudden, help is on the way for those problems too big for a project manager to handle.

Alignment- Finally, emailing the project dashboard eliminates the question of what all those geeks in IT are doing for us. Now the question becomes how come you are doing that and not this? We need this. How do be become better aligned is the question of the day

The Top Ten Characteristics of a Chaotic Project Management Environment

Find out how many active projects are in flight.

Establish your organization's current and desired need of Healthcare IT

Collaborate on Prioritization Decision Criteria

Have a defined and approved process to accept work.

How to stop running the daily meeting marathon

Using the WBS to define deliverables

How to know when you have a project and when you do not

8 Training Tips on how to develop project schedules

Introduce a Scope Change Management Process

Introduce a Benefits Management Process

4 Reasons to Use Fishbone Diagrams

2009-10-21T00:00:30Z

The fishbone diagram, or the cause and effect diagram, is a simple graphic display that shows all the possible causes of a problem in a business process. It is also called the Ishakawa diagram.

Fishbone diagrams are useful due to how they portray information. There are 4 Main Reasons to use a Fishbone Diagram:

Display relationships - The fishbone diagram captures the associations and relationships among the potential causes and effects displayed in the diagram. These relationships can be easily understood.
Show all causes simultaneously - Any cause or causal chain featured on the fishbone diagram could be contributing to the problem. The fishbone diagram illustrates each and every possible cause in an easily comprehendible way; this makes it a great tool for presenting the problem to stakeholders.
Facilitate brainstorming - The fishbone diagram is a great way to stimulate and structure brainstorming about the causes of the problem because it captures all the causes. Seeing the fishbone diagram may stimulate your team to explore possible solutions to the problems.
Help maintain team focus - The fishbone framework can keep your team focused as you discuss what data needs to be gathered. It helps ensure that everyone is collecting information in the most efficient and useful way, and that nobody is wasting energy chasing nonexistent problems.

Getting Ready for the Meaningful Use EHR - Spread the EHR Fever!

2009-10-19T01:24:49Z

When I was over in the Chicago Convention center, they use a great concept to remember which parking area you used. Instead of naming areas by the good ole AJ14, they used songs. As you walked in the area, the tune played over the speakers and by the elevator. The name of the song was used on the signs, to indicate your location. Remember the tune, singing in the rain? It resonates, brings a smile to ones face, and will stick with you. Great communication overcomes information saturation, and resonates with the audience. A common problem with EHR initiatives is that they are not communicated as the awe inspiring acts, which they are.

Imagine the pitch for increasing your EHR's functionality, the good ole line,

"It is the right thing to do!"

Just does not cut it. In this scenario, the CIO will be the lead, adoption won't occur, and finally this tragedy is in the making. Technology Advances without leadership do not lead to prolonged success. Good Leadership will help to spread the benefits and establish a project structure which will eventually succeed.

Reviewing some tactics which can help to spread the word and inspire leadership:

Imagine a Day in the Life - it is best to paint the picture. Cerner does a great job of this with a trip of the CMO and CNO to Kansas City's HeadQuarters. The other way to to offer the benefits to each role in the organization.

Simple resonating goals - There is a knowing gap when we say the terms EMR, however stating the goals in a simplified resonating manner, helps to make sure the receiver gets it. Some examples are
- Eliminate illegible orders and medication errors
- Useful Information available whenever and wherever you need it.
- Jettison paper expense from our budget.
- Improving Care through the right reminders at the right time.

Engage the FireStarters - There are change agents within organizations. These are those individuals who will spread the EHR Fever. They will get others on board

Hear the No-Nos - We will always have dissenters or the "No-Nos". Have a place to hear them out and address the concerns. Sometimes a No-No's philosophy is based upon urban legends.

Couple excitement with excellence - We can be excited, but we have to strive to provide excellent care to those in our community who visit us in their sickest times. The electronic healthcare record will only augment our best practices.

The key sign of an engaged organization is that colleagues begin to suggest improvements or ways to do something. These suggestions are wonderful, and should be reviewed and implemented wherever possible. The more individuals looking to help make the change the better.

If you enjoyed this article, you may also like other entries in our Getting Ready for the Meaningful Use EHR Series:

Accessing your nursing organization's capacity for change

Assessing your current infrastructure

Using Rules to support clinical decision support

Assessing your vendor management skillset

Assessing your project execution ability

Discovering the organization's perception of an EHR

Getting your physician leadership engaged

The 5 levels of healthcare IT Credibility

Understanding the refinement of meaningful use

Taming Chaotic Project Management - Introduce a Benefits Management Process

2009-10-17T19:48:06Z

IT Value is what IT is all about now adays. Organizations do not buy systems, just to have the accomplishment of implementing a new system on its yearly report. System solutions are purchased for one of two reasons - either to resolve a business pain point or to obtain a business strategy. The benefits of a project are not realized with the implementation of the new system. The benefits of the project are realized when the business problem has been resolved or the new strategy has been obtained.

Benefits management is the practice of defining and realizing the benefits which a project attains. The key processes to implement a benefit's management approach are:

Identify Anticipated Project Benefits - While planning for the project, it is a good idea to review the proposed project for business benefits. Developing these benefits is best the responsibility of the project sponsor, as they are advocating for the project. Once the benefits are declared, develop clear concise measure and verification for these benefits.
Implement a Benefits Value Register - After you have identified the project benefits, it is a good idea to have a Benefits Value Register. The Benefits Value Register is to review through out the project the desired benefits, how their value is mapped to the project, and how they are anticipated to be realized. This register should be a part of your monitoring and control phase.
Transition Benefit Realization - As a part of project closure, it will be necessary to setup the transition of the benefits into production support. Commonly the entire IT team is not needed at the same rate of effort after the system is in first productive use; however it may take a couple of months or years to achieve the desired benefits. Having the support needs established before hand is key, and normally already documented in the Benefits Value Register.
Capture and Communicate Benefits Realization - The project sponsor should be held accountable for assuring the benefit is captured and communicated according to schedule. If the benefit is not being achieved, corrective action should be applied to help realize the desired affect.

Further Readings on Taming Chaotic Project Management:

Nine Principles of Agile Project Management

2009-10-16T12:25:14Z

Principles set the stage for how something is to be used. We have guiding principles of IT to help organizations understand how to utilize and get value from IT. Along a similar scale, Agile project management has principals to guide usage. In reading the list, it sets the stage for a collaborative creation of something which will be fined tuned into a singing fully adopted tool.

The Nine Principles of Agile Project Management are:

Deliver Something Useful
Cultivate committed stakeholders and sponsors
Employ a leadership-collaboration management style
Build competent collaborative teams
Empower team decision making
Use iterative, feature-driven delivery
Encourage adaptability
Champion technical excellence
Accelerate throughput

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Health Wonk Review

2009-10-15T23:37:35Z

A great round of thanks out to Hank Stern for his "Lean, Mean, and Clean" edition of Health Wonk Review - it's another great read. Here is the link

http://insureblog.blogspot.com/2009/10/health-wonk-review-lean-mean-clean.html