Nursing Informatics Project: Telehealth System

Part 2

Implementation

A: The Need for Tracking

This second part largely concerns itself with the tracking of project progress. It is important to note that this is a crucial undertaking in as far as the successful implementation of the project is concerned. Gunduz and Almuajebh (2020) make an observation to the effect that project tracking ought to be perceived as the process of monitoring and measuring the progress of all activities that together compose a project (57). As the authors in this case further indicate, the overall objective on this front happens to be seeing to it that the progress made synchronizes with the project plan as initially conceptualized. With this in mind, the current activity is especially crucial for this particular project in efforts to ensure that it is not derailed by factors that can be addressed in good time. Further, there will be need to ensure that resources are in this case managed prudently and that all the crucial tasks and roles are executed by those persons deemed crucial for the success of the project.

There is need to see to it that the various key tasks are executed as per the initial plan. The relevant modifications could, however, be made going forward in efforts to ensure successful achievement of all the relevant milestones as well as successful project delivery. Prior to the conduction of an examination on how to apply the various tracking documents developed in the first part of this undertaking, there would be need to come up with a rationale for this particular undertaking.

Rationale

a. Proper Utilization of Resources

There will be need to ensure that the various organizational as well as human resources are being put to proper use. Thus, tracking project progress will help lower the chances of delays, task dependencies, as well as resource deadlocks.

b. Enhanced Risk Control

In seeking to track the progress of the project, we shall be able to have better comprehension of diverse scenarios and eliminate the probability of black swan events. In this case, any adverse outcomes identified so far can be dealt with via the application of a well thought out plan.

c. Team Motivation

I am also convinced that there is a dimension of team motivation whose relevance when it comes to the overall success of the project cannot be overstated. In essence, fewer drawbacks and ability to stick to project schedule will motivate all those responsible for the various tasks, i.e. as identified in the RACI chart, and ensure that they are intrinsically motivated and committed to achievement of positive project outcomes.

d. Better Coordination

Tracking of project progress will also be instrumental in efforts to ensure that all stakeholders are informed about the milestones achieved so far. Further, all those involved will have an opportunity to deliberate on various tangibles and intangibles of relevance to this particular project. This results in better coordination of tasks and the relevant project undertakings going forward.

B: Alignment with Project Scope

The present projects scope has been identified as being instrumental in seeking to ensure that the execution of the project is successful. This is more so the case given that it helps ensure that there is no misalignment between the identified project objectives and project elements. Detailed assessment of the relevant project parameters indicates that it is still within the scope. This is in relation to all the aspects of the scope including; scope description, project deliverables, criteria for acceptance, exclusions, as well as constraints. These will be further assessed below;

a. Scope description

The project sticks to its mandate to deliver a Telehealth System that will help in efforts to reduce not only the occurrence, but also the frequency of physical interactions between patients and healthcare providers.

b. Project deliverables

i. The creation of a digital information and technology platform to connect healthcare providers with patients in virtual settings is on track

ii. The development of a resilient system capable of handling high volumes of data, so as to minimize the probability of downtimes during periods of increased utilization is on track.

c. Criteria for Acceptance

i. Progress being made towards the successful implementation of a virtual platform meant to connect healthcare providers with patients

ii. Progress being made towards ensuring that that the operation of the system is seamless

iii. Progress being made towards ensuring that there is significant reduction of in-person or onsite visits by patients

d. Project exclusions

There is sustained cognizance or awareness about the following out of scope aspects of the project:

i. All aspects of in-patient operations

ii. All aspects of lab work and radiology

e. Project Constraints

There is sustained awareness about the following project constraints:

i. Time limitations

ii. Resource limitations

iii. Personnel limitations

C: Assessment of Progress in terms of Current State vis--vis Future State

It is important to note that in the first part of this undertaking, GAP analysis came in handy and was instrumental in the identification of the various factors or deficiencies that the organization ought to focus on in its efforts to achieve the target state which in this case happens to be the delivery of a Telehealth System that will help in efforts to reduce not only the occurrence, but also the frequency of physical interactions between patients and healthcare providers. A total of four factors were identified via the development of a fishbone diagram. The said factors are;

i. Staff shortage

It was established that like other organizations in the healthcare realm, our organization has been impacted by the negative effects of a retiring workforce. Indeed, this happens to be a national concern (Iriarte and Bayona, 2020). Over the last 12 months, the facility has lost 15% of its workforce to what we now refer to as the retirement drain. To be more specific, it should be noted that at the end of 2020, the facility had in its employ a total of 27 registered nurses. At the end of 2021, a total of 4 nurses had retired out of the original tally of nurses. Although we have not established any connection between the said drain and patient mortality, further assessment indicated that this has resulted in increase workload for nurses and decreased motivation among the remaining workforce. It was also established that the facility lacks skilled nurses in some specific areas. This is especially in relation to geriatric nurses, pediatric nurses, orthopedic nurses, and oncology nurses. This is a concern further complicated by the retirement drain.

ii. Overcrowding (Outpatient)

It was established that patient overcrowding was as a direct consequence of the increased need for care, and size of the hospital relative to the population being served. In as far as increased need for care is concerned, a finding was made to the effect that the COVID-19 pandemic triggered a 3-fold increase in the number of people seeking treatment for the condition or other related concerns. This was especially the case during the first year of the pandemic. There was however decreased utilization of healthcare services during the years 2021 and 2022. This was more so the case following the implementation of the nationwide social distancing and stay-at-home regulations. It should also be noted that over the last two decades, the community in which the facility is located has experienced a surge in population. This has not been accompanied by a corresponding increase in the number of healthcare facilities. It therefore follows that the facility presently serves the needs of a community whose population has almost tripled. This inevitably overstretches the resources of the said facility.

iii. Onsite Covid-19 Measures

As has been stated elsewhere in this text, there are various measures that have been put in place by the government as well as individual institutions in efforts to rein in the spread of the COVID-19 pandemic. The said measures are inclusive of, but they are not limited to; the implementation of social-distancing, limiting of overcrowding, appointment-based visits, etc. In our facility, we have specifically been keen on social distancing and proper ventilation. This effectively means that the optimal utilization of facility resources is largely limited.

iv. Facility Procedures

In the past, a wide range of procedures and initiatives have been deployed in efforts...

2. QA test engineer

3. Physician advocate

4. Nurse advocate

1. Super users

Software/hardware selection

1. Application developer

2. QA test engineer

1. Project manager

1. Physician advocate

2. Nurse advocate

3. Super users

Table 2: Application of RACI framework to planning and software/hardware selection project activities

Assessment

In seeking to assess the performance of the team members indicated above, the 5-point performance rating scale was utilized. Items on this front were;

1-unacceptable

2-needs improvement

3-meets expectations

4-exceeds expectations

The performance of the three team members in as far as responsibility is concerned has been evaluated in the table below;

Planning

Software/hardware selection

Project Manager

4

N/A

Application developer

N/A

4

QA test engineer

N/A

3

Table 3: Assessment of the responsibility of team members

G: Communication Assessment

Alberta, Balve, and Spank (2017) are of the opinion that communication ought to be one of the priorities of the project manager. According to the authors, communication in project management ensures that each professional working on the project is aware of the goals and expectations (798). With this in mind, a communication plan was formulated with the intention of ensuring that the success of the present project is enhanced. In so doing, the purpose, medium, as well as frequency of communication were identified. The said communication plan also indicated those who are targeted at any given point. The three bases of communication highlighted in this case were; commencement meeting, project progress recap, and other engagements. All three were applied with respect to the two project tasks have been accomplished so far.

a. Frequency

The commencement meeting was held once. The project recap meetings continue to be held on a weekly basis. So far, a total of three impromptu meetings have been held to address other engagements that do not fall within the purview of project status review.

b. Attendance

All those classified as audience in every meeting have been in attendance in every meeting held. To a large extent, this is an indication of commitment to the success of this particular project.

c. Relevance of Medium

In-person meetings have been identified as being largely inappropriate as they call for the convergence of all those involved in a single location. This may be largely inconveniencing. For instance, two of the weekly project progress recap meetings have taken an average of 1 hour. For this reason, it was proposed that tech-mediated engagements be prioritized for convenience purposes.

H: Change Management Plan

A change management plan was deemed instrumental in efforts to document and highlight the change process. A change management plan is an instrumental resource in efforts to promote order, minimize costs, and enhance consultations through the change process (Atkinson, 1999). It was established that in the absence of a clearly defined change process, there would be high likelihood for chaos and poor coordination in case of adaptations to the project scope, project draft revisions, meeting rescheduled, etc.

So far, there has been a single proposed change. On this front, the process highlighted was invoked. At present, the proposed change is being assessed and evaluated. The team members responsible in this step of the process are; the project manager and the change requestor. To be more specific, the proposed change in this case involves the expansion of the capacity and capability of the Telehealth system to cover a wider geographical region than the one originally conceptualized. It therefore follows that during the assessment and evaluation of the proposed change, the utility and relevance of the said proposal is subjected to greater scrutiny Also, the impact it would have on project objectives, scope, cost, and timelines is considered.

I: Risk Management

An assessment of the risk management plan indicates that in addition to all the risks being highlighted, an ideal mitigation plan has been formulated. The two key risks indicated in this case are the developing COVID-19 situation and the size of the hospital relative to the community it serves. However, the need to rate the risks highlighted in order of priority has been identified.

Final Take

In the final analysis, and based on the findings of the discussion above, the implementation is essentially proceeding as planned. It should, however, be noted that in as far as the communication plan is concerned, the need for tech-mediated engagements has…