Project Steering is a framework for decision making that provides expertise, guidance and assistance to the Owner. Through project steering Milestone defines the issues, objectives, requirements and goals to enable the Owner to make decisions quickly and with confidence.

The tenants of Project steering are to fully understand the people and positions, policies and procedures and project objectives (cost, schedule, market strategy, etc.).  By building your knowledge bank while familiarizing yourself with schedules, project cost estimates,  and contracts, the project manager becomes armed with the basic information of the “ground rules” of the project and then can craft an implementation strategy supported on that foundation.

Collaboration is the key to continuously refining the project data and assigning tasks and accountability to the project team.  We ask your team members for commitments and hold them accountable for their actions.  We lead meetings – communicating and facilitating discussions for decision making and information gathering – these are the core functions of a Milestone project manager that is implementing Project Steering.  We believe that the Owner, through the project manager, should maintain the project documentation and be responsible for meeting minutes and action items.  We are accountable to our team, we provide timely information, seek out questions and answers and remain accountable after the project is completed and occupied.

We invite participation in lessons learned sessions and when required we provide constructive criticism and implement plans for improvement.

One of the most important things we do is say “please” and “thank you.”  We also Smile – it sounds trite and perhaps a little naive, but its one of the key components to this philosophy, and its very easy to do every time.

Milestone recommends that every project manager read Barbara Bryson’s “The Owner’s Dilemma” for more detailed information on the philosophy of Project Steering.

Success is defined through metrics.  We work to quantify success based on the Owner’s measuring the basis in objectives: time, cost, project requirements and objective/definable goals.  We also seek to quantify the intangibles such as the level of satisfaction with the outcomes and the willingness to work together on future efforts.

You must establish:

• Common Ground
• Shared Goals and Objectives
• Metrics of Success

The advantages of our approach:

• Experience-based management decision support
• A collaborative effort

• All team members are valued
• Early team involvement optimizes the potential value of the team

• Definable and measurable goals and objectives
• Cost and schedule control are inherent to the process
• Involvement is welcomed and encouraged
• Predictable and exceptional results

Early on, we discovered that each user (architect, client, contractor, etc) needs to have a training session on how we access, present and post information to the site.  We build this 45 minute session into our project scope and use it as a team building exercise.  I think it has really “paid off in spades” when it comes to collaboration on the project.

Id like to share with you some thoughts that one of our architect participants has on our transparent and online solution.

David McLemore, AIA, ACHA of Kirksey Architecture, says “Everybody talks about the need for strong communication because we are all trying to find ways to better integrate our processes and better share the information we are utilizing to design, construct and successfully finish our projects. Working with Milestone and St. Luke’s we have just begun to “tap” into the potential for web based project communication, and we are already seeing positive results…in my opinion. Tasks are communicated clearly to all relevant stakeholders, discussion of key issues can be tracked and held without the need for a conference room… and critical documents can be accessed by the entire team, from just about anywhere, without the need of having to track someone down to find them. It will be interesting to see just how much this methodology can be employed to everyone’s advantage in the future…”

As of this writing, we currently have over 35 projects on our web based site, and more importantly we have closed six since the first of the year.  I think that this is significant since we have initiated all six and have closed them out….we have run the entire lifespan of these projects using this web based collaborative tool.  Our Team has learned alot along the way, and we have built a very strong foundation of how we are moving forward with our new and current projects by standing on the shoulders of these completed projects.

The developers of the site we are using to host our projects have been very collaborative to work with by taking our suggestions and working them into their platform.  A very lovely feature is the iPhone application.  With this app, members of our team can access dates, action items, team member status, and if activities are on-time or over due.  This information is crucial to our Owners who are stopped in the hallway and asked about project details…the answers can come straight away during that brief interaction.  No more waiting to get back to someone.  Amazing!

In the era of instant communication (twits, smart phones, and instant messaging – email is so 1996), we at Milestone have been pushing the envelope of how we communicate with our clients and project team members, to provide access to project data (timelines, issues, files, “threaded conversations”, etc) quickly and easily.

In the past articles, I have discussed a few hosting services that we explored and did some “beta testing” on, but in this article, I wanted to really drill down on what we are doing to put the philosophy of “Cloud Project Management” into action.

Currently, we are tracking over 25 projects with three clients using TeamworkPm.  Through some easy customization, we are tracking action items, schedules and milestones, sharing files (floorplans, space programs, product data) and “threaded” conversations.

We have had great feedback from not only from the Client’s senior leadership, but from our hospital directors and architects and engineers.  I think we all would agree, our emails or telephone calls about “where are we with this project?”, or “have you called Peter about the chiller” emails, have really dwindled.
In using the project timeline and milestones, we communicate the upcoming dates of projects.  We work in collaboration with the contractors uploaded construction schedule and our posted Project Development schedule, so if the “high level” milestones are not enough information, the Client can pull up the more detailed construction or our development schedule to see when the MRI is going to be delivered.

Of course, the information is only as good as the frequency of when it is input to the website, but by simply responding to a message that is generated by the hosting service, the information is uploaded and disseminated automatically.  No need to remember who to cc on an email….the project profile does that for you.

Currently, we at Milestone have standardized this approach to project management and are looking for ways to “passively” inform our clients and team members of the current status of projects.

Look for my next blog in a few weeks about how we are tracking Action Items and Issues Lists.

Have a terrific Project!!,

Scott

Dear Gentle Reader (tip o’ the hat to Dear Abby),

Over the past two weeks, we at Milestone Project Management have continued to review “web based/cloud based” sites that offer project collaboration tools for the various stakeholders for our complex healthcare projects.

The evaluation process was rather informal,but extensive.  We talked to the site developers, viewing online demonstrations/webinars, in some cases, downloading demo’s or trial memberships to “test drive” the capabilities of the systems.

We have decided to move forward for the next six months with TeamWorkPM.   While not as typically robust as other project management sites, we felt that TeamWorkPM had the right balance of detailed and overview information that made it very flexible and easy to use (see October 17th blog about tracking necessary and not-so-necessary information to an Owner) .  Being intuitive to use which was a “must” for us as our stakeholders on a project have a wide disparity of computer skills and/or time to spend trying to find information quickly.

Additionally, one of our clients is moving forward with using the site to not only track their Capital Projects, but also to monitor their leasehold contract terms and minor tenant improvements.  This is one example of the flexibility of this system.

Over the next six months we plan to move forward with over 12 projects on this site.   The project types will range from conceptual – long term projects, to short duration “patch and paint” or equipment switchouts.  We will even use TeamworkPM to assist in the collaboration of some minor electrical projects.

Currently, our “test drive” of the system allowed us to collaborate with our architects and user groups to disseminate project sketches, equipment lists, action items/issue tracking, milestone dates and decision documentation.  I was quite surprised how the team embraced the system and how easily the designers able to uploading sketchs and solutions to the site.  With the release of Teamwork’s free (yes, free) iPhone app, I expect our team members to be able to communicate and to pull up specific project status from the palm of their hand.  If you think about it, what a powerful concept for an Owner to be able to do….sitting at a board meeting, the discussion unexpectedly turns on the specific architecture of an inpatient room , you did not prepare for this conversation – but, you can quickly pull up the drawing and support documentation right on your iPhone or better yet, your iPad – powerful stuff.

As we move forward into 2011, watch this blog for my candid experiences using “cloud” project management (I should coin and trademark this term – a tip o’ the hat to Gene Simmons).  I also welcome comments from you, dear reader – let me know your thoughts.

The journey continues….

Scott

What I really want to discuss, is my relentless search for tools to manage strategic capital projects from the Owners perspective using websites and “cloud” computing.

Currently at Milestone, we are experimenting with a few of the lesser known project management “tools” that are out there. From my colleagues at work, we have a company history of working with E-Builder, Skyre, Buzzsaw, etc.

For the most part, these platforms require a long learning curve, some require software on each users desktop, expensive user fees, and quite frankly functions, that from an Owner’s perspective, are low priority features (tracking RFI’s, Submittal’s, ASI’s, etc).

What we are searching for is the “big picture”, the “50,000 foot level view”, as Owners, we are guiding the overall direction of the project. Our role in the typical RFI tracking, while important (as it could lead to cost impacts), is usually relegated to ensuring that questions are being tracked and answered in an acceptable amount of time.

Most platforms seem to focus on this aspect a little too much, and I would categorize them as “Builders” or “Contractors” platforms.

As we move into 2011 and test a few of these project management systems, I would really like your candid comments about systems that you have used, and recommendations on platforms that worked well. Perhaps together we can find “project management utopia”

Im looking forward to the journey,

Scott

Both of these programs will require the hospital to select a lender, as the programs offer mortgage insurance (HUD) or a loan guarantee (USDA), not an actual loan.  The hospitals and the selected lenders or mortgage bankers will be co-applicants to the appropriate agency.

Step 1)  Planning & Preparation

Step 2)  Facility Design & Financing

Step 3)  Endorsement

Step 4)  Construction

These seem like easy steps, but in reality they are comprised of many smaller steps that are costly and time consuming, and which can vary depending on the particular program selected.  However, if the candidate hospital decides very early on in their scoping process, to apply for funding under these federal programs, then the project can align itself with the requirements of these programs during the natural evolution of the project.

It should be noted that all of the upfront development costs will be borne by the hospital, so the path forward should be planned very carefully and milestones set for both schedule and budget adherence. The HUD program (and USDA) allows for these costs to be included in the financing; thus they can be refunded to the hospital if the insurance/guarantee is eventually approved.  The USDA and HUD urge the candidate hospital to get knowledgeable and experienced project management and design teams involved to assist with achieving goals and expectations of these federal programs.

Step 1:  Planning & Preparation – duration 6 – 12 months

The action steps in this phase represent the starting points for community support, determination of the debt capacity of the hospital, financing strategies, physical plant requirements, and the selection of the project team, among others.  Some will vary depending on the requirements of your State and local jurisdictions (ie:  if your State requires a Certificate of Need “CON”, bond offerings: type of feasibility/market study, etc.).

At the end of this Step, the hospital should have achieved these goals:

• Obtain approval from the Board to investigate replacing the hospital
• Filed the CON application (if required) with the State
• Obtained debt capacity analysis
• Completed market demand analysis for a new hospital
• Implement Financing Strategy
• Discuss hospital relocation with CMS
• Engage local USDA or HUD representatives
• Interview and hire financial, project management and/or architectural professionals
• Apply for interim funding with a lender (if applicable)
• Complete land acquisition
• Draft the architectural programming and space planning
• Develop Total Project Budget (including land, professional fees, equipment and construction costs)
• Engage community and community leaders
• Implement community capital campaign (if necessary)

Step 2:  Facility Design & Financing – duration 3 – 12 months (with some overlap to prior step)

The financial models completed in Step 1, will be built upon and enhanced.  At the completion of Step 2, the hospital should be able to obtain financing proposals from lenders.  The federal program applications will also be submitted during this Step.

At the end of this Step, the hospital should have achieved these goals:

• Obtain financing proposals from lenders
• Obtain approval on the CON application (if required)
• Submit applications to the USDA or HUD
• Engage bond consul and issuing authority (if necessary)
• Completed architectural construction drawings
• Bid/Award the construction work to a general contractor

Step 3:  Endorsement – duration 1 – 2 months

The federal programs will review and either accept, ask for clarification/re-submittal or deny the applications.  If your project team has been working with the local government authorities during the previous Steps, the CAH should not be surprised by the requirements of this phase or the outcome.

At the end of this Step, the hospital should have achieved these goals:

• Closed on the Bonds (if applicable)
• Closed on the Loan
• Receive initial funding and approval to begin construction
• Begin construction
• Continue capital campaign with the community

Step 4:  Construction – duration 12 – 26 months

Project management will be key during this phase to ensure the construction is completed within expected milestone dates and budget.  At the close of the project, the costs will be finalized and loan amortization begins.

At the end of this Step, the hospital should have achieved these goals:

• Substantial Completion of the facility
• Occupation of the Hospital
• Cost certification
• Final Closing of Loan

My deepest gratitude to Mr. Calvin Green, former CEO of Franklin Foundation Hospital.  Without Mr. Green’s support and leadership, Franklin’s replacement hospital would not have been such an enjoyable, successful and delightful project.  The City of Franklin truly has a hospital reflective of the magnificent people and history of their community.

For more on the HUD and USDA programs visit these websites below:

HUD

http://portal.hud.gov/portal/page/portal/HUD/federal_housing_administration/healthcare_facilities

USDA

www.ruralhealth.hrsa.gov

Current Book:
1) Wine and War: The French, the Nazis, and the Battle for France’s Greatest Treasure by Donald Kladstrup and Petie Kladstrup

Past Favourites:
1) Guns, Germs, and Steel: The Fates of Human Societies by Jared Diamond
2) Getting Things Done: The Art of Stress-Free Productivity by David Allen
3) Duty: A Father, His Son, And The Man Who Won The War by Bob Greene
4) Being Digital by Nicholas Negroponte

When I have more time, ill give a bit of a synopsis on each of the books and why I recommend them.

I would like to present a few of them here, and open up this post for your thoughts and perspectives.

To begin, I would like to recap the three basic goals that President Obama made in his September 9th address:

1) To provide more security and stability to those who have health insurance.
What this means: a) it will be against the law for your insurance company to drop you because of a pre-existing condition, b) insurers cannot place an arbitrary cap on the amount of coverage in a year or a lifetime, c) a limit will be placed on out of pocket expenses, and d) insurers will be required to cover, at no extra charge, routine and preventative care.

2) Provide insurance for those who do not have access.
What this means: a) if you loose or change your job – you’ll be able to get coverage, b) small businesses will get tax credits to offset the costs of providing insurance, c) a new insurance exchange will be created to assist individuals and small businesses have access to affordable insurance and d) individuals will be required to carry basic health insurance (similar to auto insurance) – provided by themselves or through their employers.

3) Slow the costs of healthcare for our families, businesses and government.
What this means: a) the President will not sign a bill that increases the deficit to fund these programs, b) most of the costs of these plans can be paid for by savings within the healthcare system itself, c) reducing the waste and inefficiency in Medicare and Medicade and d) revenues from drug and insurance companies that will benefit from millions of new customers.

Now what does all this really mean? Can we do it?

A big part of the problem may be if Congress can act in a bi-partisan fashion and implement a roll out of this plan in the current economy. This is no small act.

Additionally, how do you pragmatically change the system without healthcare professionals becoming nervous?

How does this really effect the small business owner and, as stated above, the individual who will be required to obtain basic health insurance. And just what is “basic health insurance”?

I do not think anyone believes that the system can continue to operate like it has done over the past 20 years, and that reform is much needed.

I’d like to open this forum up and have our community provide perspective and constructive feedback on the goals of the White House.

Thank you in advance for your time and comments!

Today, the historic Hospice building is the center piece of Beaune, and is the site each year of the “Vente aux enchères des vins des Hospices de Beaune” wine auction.  This Burgandy wine festival features the auctioning off of that year’s grape harvest right after its first fermentation. These wines are from only from the lands and vineyards that have been donated to the Hospice over the last 5 centuries.

This year will be the 149th edition of the fabled wine auction.  This wine auction’s proceeds support most of the financial needs of the hospital each year.

For more information, please use the link to the official site, and to see more photographs of one of Europe’s original hospitals.

Barrell Tasting

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