An Executive's Guide to Advanced Project Management in Healthcare

<p>what we really need to understand is the work we do is not just for us it's for the communities and the people we serve and we need to continue to invest in those communities and the resources they [Music] need hello everyone this is Cole from the American Journal of healthcare strategy joined by a really special guest today we've been trying to get episodes that are kind of specific to the problems and questions that some of you are asking so the theme of this episode is is pretty targeted it's expert executive project management techniques and we brought on Mitchell Fong Mitchell has so much experience the LinkedIn resume is is very long but you know 15 20 years of experience doing this kind of leadership and project management and now he is doing kind of Serial entrepreneurship in the Consulting space is what I like to call it because you're working on so many different projects uh Mitchell if you don't mind just introducing yourself and and telling us what you're working on yeah thank you I really appreciate that background after years of experience on the health system side on the Innovation and digital Health really wanted to pursue how do I continue that journey and help create equable access to Quality Care for all leveraging technology to innovate within healthc care and so that's kind of what I've pursued that mission to do in Consulting and so I work on both sides on both the vendor side as well as the provider side looking at ways to kind of match make and evolved technology to truly Drive value in a meaningful way for the providers the patients and the health systems that they serve because that was one of the largest gaps I saw with technology was really the ability for great technology to be paired with sustainable processes that allow them to be adopted well because it's like we have this technology that's really good and it works really well and it might even work well at and I was just talking to someone at rush about this it might even work well at a hospital but when you try to expand it to your second 3rdd 18th 20th hospital it can be unsustainable and fall apart and that's why we really wanted to bring you on is because executives are handling these huge systems at this point you know it's not just a single hospital that you're a CEO of now you got CEOs that are the you know Executives over you know 40 hospitals and you know a 100,000 employees and that's why I wanted to bring you on I wanted to ask the first question is about Innovation under pressure and that's because during covid you were part of this really important team can you explain what that team did during covid and then also some of the lessons that you learned in terms of how to innovate and really get stuff done in a big way while under that kind of extreme pressure of covid and everything that was going on yeah absolutely be happy to and I love what you said earlier to kind of frame the question of the consolidation the m&amp;a really creating a different level of capacity and need for project management at an executive level uh and so I commend you for that I think during covid we all were challenged with different processes emergency timelines but the need to really collaborate and figure out what is the need evolving need with the change in regulations and and the change of new information we learn about covid so rapidly I think all of those required a lot of project management techniques but really the ability to be flexible and agile so I'll start there I think that's one of the biggest needs is to always look at the project and understand at a high level what are your goals are they shifting and changing and how are you evolving with that um that comes with data metrics kpis but also understanding what your guard rails are to make sure that um you're able to achieve the value propositions um but collaboration I think particularly in that setting during Co what we did was as a community hospital in our area we were able to secure Federal funding and a lot of resources so we actually collaborate not just as a system but truly as a community with Partners all over the state all over the community and FAL funding Partners as well to convert a parking garage into a alternate Care Facility we actually created uh two floors of it we didn't ever have to use that many um but the bottom floor was a negative pressure unit really had to enclose the parking garage that was an outdoor parking garage and do a lot of things from an infrastructure perspective to allow technology to be used there effectively to treat patients and so we essentially created a an alternate Care Facility out of a parking lot within a twoe Time frame again it was a large large undertaking with many different stakeholders but engaging each of them and having opportunities to align on the project status was extremely important because we had to divide and conquer and we had so many different areas of expertise there that needed to work synergistically to create the right infrastructure that it was important um things that I was particularly focused on during that transition was ensuring that we had the right technology um and compatibility so did we have Wi-Fi in the parking garage enough to sustain all the devices did we have enough um of the devices so we can do our virtual consults we did use that as a um covid pre-discharge Lounge for those patients that still required oxygen support um but we're essentially relatively stable and getting near their discharge timeline um so we're able to use different technology there to centralize the monitoring and try to limit exposure for our staff as much as possible uh and so that were some of the things that we were really focused on there but we really wanted to take that as a step towards the future and what we wanted to do Beyond then having a strategic plan that included evolution of Technology there and so that I I will say was kind of the starting point and at a necessity we took a lot of the principles we use although at very different infrastructure Downstream to ensure that we didn't just rinse and wash away but kind of think about how do we use this and then recycle it in a different way to repurpose it and help it grow can I ask you a personal question about this and this is a bit kind of off topic a little bit but is there anything that you did to keep yourself um like on track during that time because I know that you know I work with about four different teams uh sometimes three or four and that can be challenging right um but you're talking about dealing with you know way more than four different teams and you're also dealing with a crisis situation and you're also with a political situation where at the time you know this had not happened in the United States for a hundred years at this point and so people were very going back and forth on the regulations and the laws and you had state governments doing different things in the federal government and then again you're not necessarily building a new facility you're you're retrofitting kind of The Barking garage and that brings its own policy challenges and safety challenges any advice on on how an executive can keep their head straight during this time without getting you know pulled in different directions all the time yeah you know I think that it's a great question and it's definitely a challenge uh techniques that I used one I was very transparent and with communication I think that's extremely important top down and bottom up I want to hear all the concerns all the rumors that people are worried about that's trick um trickling through the team so I can understand address them if possible but further I also expected that from my leaders and the executives around the state and the community to share that same update on what's going on what are the new regulations and how have our protocols shifted or evolved because of those uh so I think that constant communication finding those venues but also understanding and continuing to preach that it is an evolving situation that we don't have the answers to I think being very vulnerable and honest was extremely important and helped me manage but also helped gain the trust of the team so we can stay aligned on what the mission is early on I think that we didn't do do as great a job communicating as frequently and regularly and that left a lot of gaps in what was being communicated uh and unfortunately that sometimes leads staff to jump to conclusions or hear rumors and start thinking about the worst thing that could happen or that we don't know what we're doing when really in this case particularly with Co it was no one really understood and we were learning as a globe really as a world together what was going on and so being very upfront about that I think was extremely important and then just really trying to remove my emotional bias from it I think a lot of times you put so much effort into project a and then as the priority shifts and regulations change and now project a is no longer the priority It's Kind sometimes hard for people to be fully invested in that shift I think removing your personal bias was extremely important because it was for the greater good I know that I always looked at this I'm not a military or veteran at all commend all those that served and I looked at this as my opportunity to serve our country and get back and so for me I kind of appreciated that almost emergency leadership style that was a very much top down um authoritative approach because we kind of needed that structure at that time to really guide us on what is this process and change that we all need to align on and if we weren't all aligned it wouldn't have been successful and it's the community that suffers and so I think thinking from that lands and always communicating and putting the community at the Forefront allowed us to really take a step back and think about how do we do what's best for the community and how we focus on that communication that message and that action together really important advice because I know I enjoy when people are transparent and I enjoy it especially as you said it's not just top down it's also bottom up I really need the people who are you know working under my direction to really be very clear it's very important that they're very clear in the feedback even almost especially if it's negative feedback um because you know I am only a leader because was uh we need someone to to organize things and I was the person to do it right and so you know I think it's so important and like you said I really appreciate that on this kind of agile approach to where you're saying you weren't just kind of a oneandone project you know I like agile but a lot of the listeners might be nervous hearing about that because they're going to say you know how do I budget for an endless project how do I you know not it sounds like I'd run into burnout where I'd be tired all the time you know all these things so can you just explain a little bit more about this agile approach did you face issues with budgeting or burnout or or confusion and how did you define one when one project started and and when the next one beun you know or ended yeah it's really great question because what you described is I think the unintended consequence of innovation sometimes you want to do so much and because as perfectionists we always think and this is the way I think that whatever was perfect yesterday is out of date today U and we need to evolve it tomorrow and that's just kind of the way that I always think about process Improvement and continuous process Improvement so I like to think of that agile process as the guiding principle for how I continue to evolve and innovate and ensure that the programs today truly meet the needs of today and hopefully for tomorrow um now that being said I think your question is really more on how do we frame this so that it's well adopted and how do we communicate it with the team so they understand where we're going with that I think uh there where a lot of challenges there honestly we learned through the process I think the first iteration of we need to do project a and now it's evolving to A2 um I think there was a lot of hesitancy and to your exact point some burnout some frustration some Challenge and it really took a deep conversation we took a step back from planning we had to ask the questions of what's our concerns what's our burnout rate what have what does everyone feel like today and what we're doing and let me share why we need to do this and I think when we were able to unpack that conversation that helped us as Leaders understand um the communication but also the plan and having to have outlines for what we're doing and why um as we evolved we then also had to take a pause and ask our team do we have capacity to evolve can we hit this timeline if we delay if we don't what's the consequence and we really brought them into that planning process to really understand where we're coming from as administrators trying to represent the community but additionally it's not going to be successful if the boots on the ground and the team aren't bought into that vision and so it really tried to create that alignment um as far as kind of Shifting between projects I think it really came with kpis and metrics that's a big way of how we kind of I would say I defined the project scope shifting is when we got new metrics or when we were looking at rolling it out to a new care location um that's a clear evolution of it and we kind of put in the new parameters ERS of the guard rails as well as our kpis for our success metrics um and I think it really helped as we started also putting in the guard rails that allowed us to take a pause I think that was the biggest concern in that exact instance that our staff had where we had all these kpis and principles and at the early onset of Co it was just drive drive drive drive drive and try to hit your kpis what we started rolling out were also some kpis that were guard rails to help us say hey we're pushing so hard are we pushing up against an unintended consequence if so let's pause and let's re-evaluate what that unintended consequence is and if there's a way we can either um refresh what we're doing or update what we're doing and augment it to kind of address that so hopefully that adds a little bit of color to that process so kind of what you're saying is similar to how it's possible to overtreat patients there's also that risk of of that in business I mean I think you know like McDonald's doesn't need to offer a five Star Restaurant you know experience every time and it's going to burn out the employees doing so right but it needs to offer a fstar experience for what it is um how do you define that because in medicine and in healthcare we always want to provide the absolute best for the patients so how do you put a guard rail I understand you can put a guardrail kpi for the bottom that's easy right but how do you put one for the top yeah you know I think it's it's a challenge but you have to think about what you're trying to do um I always look at what are some unintended consequences and that's really hard to think about there um but when you're really looking at the top uh I think you're looking at end goals kind of your lagging metric so to speak and so at that point I look at are there any leading metrics that might help us determine if we're not on track for that lagging metric um and I think that's kind of how we thought about developing guard rails a precursor to what this outcome is and other ways that we can quantify and measure that so that's kind of what we did what we did to kind of find that along the Continuum is we really worked in those meetings with the large team on value stream mapping and looking at the process where value is delivered where maybe unintended consequences or risks might be occurring and I think that helped us think about what are some of those metrics that we can use as guard rails along the entire process leading all the way to the outcomes I mean you know me I'm a huge fan of of values I'm a huge fan of value chain in general um in Six Sigma and this reminds me of this is the course we just took um at Jefferson through vinovia Villanova was a doctor's office and and he spent a lot of time with the patients and they loved that but because of the amount of time he was spending with the patients doing extracurricular things like filling out chart notes Etc it was creating waiting room increases so that people were unhappy and it was kind of this constant cycle right and so the issue was you needed to figure out a way to optimize the amount of time to spend with patients while also not reduce the amount of time so much that uh the patients were going to say oh he only saw me for five minutes and charge me 100 bucks so I I appreciate that and that's a real challenge for people to do I think but that value stream is so important because it asks what do the people actually care about what is actually adding value to this you know where is their losses in motion where is their their inefficiencies that's so important uh kind of one of the other questions I have for you is why does how did agile benefit you compared to standard kind of project management where you complete a project and then everyone never talks to each other again how does how does this agile approach work right because you are working with so many different departments and then like I said usually when these projects are over I'm not going to be talking to you know John in in EVS or you know Marie in infection control again until there's another problem but with this agile approach there's a bit more con you know contact there's a bit kind of a continuation what are the benefits of that how did that benefit the organization yeah absolutely and kind of tying to the last point you made I think prioritizing customer value and with that generally we look at patient as the customer but the beautiful part of this iterative development agile is everyone is your customer right and so because of that I had all these touch points with different departments and divisions to ensure we were made in contact but further we started to brainstorm on how we're delivering and driving value efficiency quality but also looking at that burnout as a part of that and culture I think that allowed us to look at various different approaches to really improve our processes and that was valuable because we were able to address culture at the root and communication with respect I think things along those lines are are ways that allowed us to collaborate at different levels both up and and down and that creates a community where it's not it's a safe place to share your honest thoughts and feedback and that was a big part of that continuous Improvement or your iterative development however you want to frame it is we're still continuing to solicit feedback and people are willing to give that feedback because hey they don't think they'll be penalized they can share their thoughts and they can voice their frustrations it might even just make them feel better about what's going on uh but then B you you create a forum that you can demonstrate your Tak the feedback and you're using it for continuous Improvement and I think that was a key part of it is we had continuous checkpoints and updates and from those we would select some of the issues that were brought back up as areas to whether explore or to make changes and we would come back with recommendations or just research on where we are finding the gaps and allow us to brainstorm across different stakeholders to continue to iterate and improve and I think that's what also led us to say hey let's take this even when we didn't need the park garage as alternate Care Facility we still have patients that are getting discharged with oxygen support and respiratory conditions how can we evolve what we've done for a different population but continue what we're doing and and continue evolve and I think that's kind of how we saw that project continued to shift and we brought in more respiratory therapists and all these other teams to be able to continue that Vision so I think that's how it really helped us look at ideation um but continuous process Improvement in culture and now from what I understand it it has turned into kind of a larger part of the organization in terms of remote care you know the command center then that's grown into its own kind of thing in another area of the organization as well right it's kind of grown into multiple different different vertical and also provided a lot of lessons learned right absolutely I think when we we looked at Innovation with technology in itself what was kind of Novel for us but then we were looking at centralizing the transfer center into doing something different into what we called kind of the transfer center 2.0 um historically we thought about transfer centers is where you take patients that need to come to you and you figure out how you can help place them but patients are coming to you and what we thought about is hey what we're doing during covid is figuring out how do we bring care to you as patients or other communities that we support and so we kind of elevated our vision for the transfer center to incorporate this virtual nursing this virtual monitoring some of these different programs that we've develop virtually to figure out how we can better serve our role in transferring partners by delivering care to them and collaborating in that fashion and I think that we saw a huge evolution in growth and the opportunity to collaborate across the community but also provide better support and care to the patients in their home and and I like that again going back to like Six Sigma this new rework or not as much rework involved you know you think about manufacturing terms and you're not retooling the entire Factory every single single time uh health conditions change in your community right you're just trying to find ways to to make it adjust um really important I want to leave you kind of with with the last question really appreciate your time um heading we're heading into 2025 when this episode releases it might actually be 2025 uh but we're in the the final days and so uh of 2024 and so I want to say what assignment could you give me and members of our audience as Executives on what strategies to tr to employ for 2025 because without without giving us kind of an assignment or a dare to do it we're going to forget about it so what are your what are your thoughts on like what things should we really absolutely try to employ this year uh and we can make it as part of our our New Year's resolutions that's a great question super open-ended too I'll leave with one I think is always do good for your community and look at that from a population Health lens I think a lot of times particularly now when we're looking at all the &amp;ad and consolidation bottom line is at the Forefront for a lot of Executives and I understand that that's extremely important but what we really need to understand is the work we do is not just for us it's for the communities and the people we serve and we need to continue to invest in those communities and the resources they need look at our needs assessments and ensure that we're developing something to create that equital access for all of those within our population that we serve um not just those with the commercial payers but I I really think that that's an extremely important part and my challenge to everybody is just to do better today than you were yesterday I think it's really easy to kind of sometimes forget to do better every day and get better but I like to push everybody to continue that growth path and look at how you're making yourself better and how you're achieving your mission um so I'll say look at the community build for the community focus on the community but always look at how do I get better every day along that Journey that is so important Mitchell thank you for coming on and great advice and we're going to have to have you on again next year to review how everyone has done over over this past year uh or this future year in 2025 so I hope we can have you back on again and and really appreciate your time yeah would love to come back on again Cole thank you so much for having me and I really appreciate the opportunity to share my thoughts</p>