Building Agility in a Healthcare PMO

4 Things I learnt from Introducing an Agile Mindset to a Healthcare PMO

August 9th, 2021 – Guy Thorpe – (5 min read)

Over the past 10 months I have been lucky enough to partner with a progressive thinking New Zealand District Health Board (DHB) and experiment with how developing an Agile mindset might benefit the delivery of an NZ Healthcare PMO.

With the backdrop of New Zealand’s largest health reforms in 30 years taking place, the COVID-19 vaccination programme rollout and a once-in-a-generation capital investment in building new hospital infrastructure all coinciding at once at the DHB. The ability to integrate agility into the DHB’s project portfolio and enable them to respond more quickly to an ever-evolving and uncertain environment made complete sense.

Before kicking off with the Healthcare PMO, I had envisaged that it would be an excellent opportunity to evolve the PMO’s own day-to-day delivery practices, enable the PMO to better support a wider variety of project delivery approaches within its portfolio and embark on becoming a multi-modal PMO. Lastly observe how agility could be applied at a DHB’s Portfolio level, in particular to the prioritisation of a large backlog (pipeline) of projects. Here are some of my observations so far….

 

Pivoting the PMO's approach to work

 

(1)    Pivoting the PMO’s approach to work 

One of the early shifts for the PMO team was to establish a new cadence to the delivery of their central PMO work. We pivoted away from the standard weekly team meetings where the team would give long status updates on pieces of work transcending multiple months. The team adopted a regular cadence of two-week Sprints (a timeboxed period of 10 working days), complete with Sprint Planning (breaking down and planning the activity for the team for the next 2-week sprint), Stand-ups (daily 15 minute updates), and Retrospectives (a review of activity and performance at the end of the 2-week sprint).

The team quickly adapted to this new way of working and the upsides were obvious from the get-go. The PMO made their workflow transparent to their stakeholders and invited feedback; there was also improved management of the amount of work in progress (WIP) which resulted in the PMO team removing impediments for themsleves and increasing their throughput of work. Surprisingly there was also the emergence of a more flexible team culture with a willingness to experiment and try new things.

Part of the PMO’s project remit is to supports both IT delivery and Innovation Lab projects. As a result of the shift in the PMO’s own working practices, the team was able to personally experience a different way of working more in tune with the way that the IT team and the Innovation Lab naturally operated. Just like the iconic Kiwi band Super Groove said– “You got to know to understand”.

The overall upshot is that the PMO’s delivery has improved, there is much more transparency around what they are doing and the value that they provide to the DHB’s project community. Interestingly, teams that previously would actively seek to work around the PMO were starting to open up and seek out the PMO’s involvement.

 

The Power of Retrospectives

 

(2)    The Power of Retrospectives

With the introduction of retrospectives every two weeks whereby the team would reflect on their own way of working and looked for opportunities to continuously improve. The team really started to embrace the practice and in a recent retro one of the team members said that she found that having done a few retros now she was really starting to connect emotionally with each post-it note. In the past they were one-word answers on a scrap of paper but now each one meant something personal to her.

When I probed a bit more, she said that she wouldn’t normally express how she was truly feeling with the team as she thought she needed to always bring a strong, focused, and professional persona to her work. But retro’s were giving her the space and opportunity to express how she was truly feeling, good or bad.

It is awesome to see that the retros are creating a culture of team trust and providing an opportunity for people to bring their “whole-self” to their work rather than leaving their personality at the door on the way in.

 

Portfolio Backlog Review

 

(3)    Portfolio Backlog Review

Enabling the DHB’s Executive Leadership Team to have more agility in their decision-making around what to execute was critical for them as they dealt with COVID-19 impacts, a significant infrastructure programme, and an ever-present need to balance the repair and replacement of deteriorating critical hospital assets. Traditionally the Exec team had gone through an annual planning process to identify and plan projects for execution for the next 12 months.

As the PMO got comfortable with the idea of constantly refining their own backlog of activity we looked to experiment with lifting this up and apply it at the Project Portfolio Level. The team challenged themselves to create as much transparency as possible by developing a backlog (pipeline) of initiatives within the organisation. This is easier said than done when looking at the breadth and depth of an organisation with well over 8000 people and the range of both Opex and Capex projects totally close to 600.

The outcome the PMO team was able to develop was a clear and transparent project backlog (pipeline) with well over 80 initiatives that were highlighted as being close to “ready” for further development or less so. The DHB’s Investment Committee was then able to on a monthly basis (or in some cases weekly) review the backlog and prioritise, accelerate or pause initiatives for delivery based on changing needs.

This meant the DHB moved from an annual project portfolio planning process to a monthly one which allowed for greater agility in the face of a changing healthcare environment.

 

Running Experiments with Training Capability

 

(4)    Running Experiments with Training / Capability 

One of the functions the PMO previously performed was the scheduling of classroom-based training in a bid to build project capability across the DHB. In an organisation where individuals are typically on rosters or completing shift work, cementing the commitment for classroom-based training proved difficult.

Rather than continue to try and force people into training slots we decided to meet them where they were at and adopt a different training strategy through the use of digital mediums.

Encouraging The PMO team to start experimenting with developing short 90-second “Video Guides” in a more Social Media type format. Rather than spend money on expensive production equipment the PMO team focused on developing a Minimal Viable Product (MVP) using an iPhone and tripod to test out whether this training format would be successful.

The first video was a success and through feedback from staff at the DHB the team has embarked on building a second series of video training content.

The PMO team is already well on their journey to building agility into the DHB’s Project Portfolio and through continuous experimentation and building on the learning’s that surface, the team has been able to create an approach that works well in a NZ Healthcare context.

More Articles

The Words We Choose Matter…

In the Project Management arena, we love nothing more than throwing around terminology that relates to the technical things we do.

Delivery Culture

For me, an organisation’s Delivery Culture is the difference between “Ordinary” and “Outstanding”….

Project Delivery Methods

How often is an organisations chosen project delivery method thrown out, as it’s perceived as “not working” with little thought given to the competence of those using it?

Lessons Learned

In the Project Management arena, we love nothing more than throwing around terminology that relates to the technical things we do.

Project Pathways

Every time I hear the words “Development Opportunity” I shudder, here’s why…

Your Best Work

What does it take to do your best work? The lift off thrust of the Space X’s Falcon Heavy rocket equals approximately “eighteen” 747 aircraft at full power.

Lagging Metrics

In the Project Management arena, we love nothing more than throwing around terminology that relates to the technical things we do.

Rethinking Project Sponsorship

In the Project Management arena, we love nothing more than throwing around terminology that relates to the technical things we do.

PMO’s & McDonalds

It’s long been rumoured that to save costs McDonald’s uses ground worms as filler in their beef patties. This rumour dates back to 1978 but still regularly does the rounds on the internet and social media still today.

Continuous Transformation

Is Continuous Transformation the new norm? When I started in project management “Run the business” (Operations) and “Change the business” (Projects) were considered as very separate sides of the same coin.

Project Status Reports

Do we place too much emphasis on Project Status reports? #Project status reports have long been seen as the lifeblood of information flow between Project Managers, Steering Committees, #PMO, and the org at large.

Problematic Pipeline

A while ago I watched an organisation carry out a project pipeline prioritisation. The Executive Leadership Team unanimously agreed on their strategic targets and measures, they universally agreed on the different weightings set for each target.

Project Sponsors

Effectively communicating your vision for a project and getting your Project Manager, Delivery Team and Organisational as a whole on board is no easy task.

Perceptions of PMOs

I was recently asked at an event I was attending what I did for a living by the person who sat next to me, I politely replied “amongst other things I help PMO’s.”

Risk Matrix

A couple of years ago a simple cartoon inspired me to think about #projectmanagement in a whole new way, here is what happened….

Small Experiments

I was introduced a while ago to the idea of coming up with and running small discrete experiments each week on the way I or my team approach our work, learning or relationships.

Project Sponsor Training

I was talking to a colleague recently who was making a big deal out of the fact that his organisation only hired PMs with “formal” PM qualifications…….

Project Sponsors as Visionaries

The greatest Project Sponsors I have worked with were visionaries, here’s what they did…..

The Power of Retrospectives

I recently experienced the power that “retrospectives” can bring to a team, here’s what happened….

Project Maturity Matters

Something has been troubling me about Project Management maturity. It’s not new news that project failure rates have been static for some time & #transformation programme success rates are a paltry 30%.

Being a Project Sponsor

I once worked with a Project Sponsor who everybody wanted to work with. And I found out why…

PMO Services

PMOs could take a leaf from the restaurant industry. Here’s how…

PMO as a Sherpa

Continuing the discussion about the #valueproposition of a #PMO, got Milvio D and I thinking of the parallels of a PMO to that of a mountain Sherpa.

The PMO Value Proposition

So what’s the PMO’s Value Prop? That’s the question a CEO of a major Healthcare organisation once asked me when I was in the initial stages of helping revitalise their existing PMO. It is an incredibly astute question as it cuts to the heart of what value/ benefit she could expect to get from engaging with their PMO.

Programme Manager as a Movie Director

In the Project Management arena, we love nothing more than throwing around terminology that relates to the technical things we do.

Portfolio Management Process

Milvio D and I continue to collaborate to simplify complex #portfolio, #programme, and #project concepts.

Cross Functional Teams

In the last few weeks, we have been lucky enough to be working side by side with the Radically crew Dan Teo, Matthew Laing and Marlene Stroj-Rullo.

Organisational Energy

Management of #Portfolios (MoP) highlights that the portfolio definition and delivery cycles are driven by #organisational energy.

“Strategic Alignment” the Golden Thread

Making sure the work you’re doing is aligned with the organisation’s overall #vision and #strategy is critical and often described as “Strategic Alignment”.

Responding to Risk

Milvio D and I continue to collaborate to simplify complex #projectmanagement themes. In this post, we look at how to write a #risk description using the event-cause-impact structure so both the cause and the symptoms are redressed.

Stakeholder Mapping – Planning a Party

As we continue our quest to bring a focus on “Simplicity” in #projectmanagement, here is Milvio D’s and my collaboration on #stakeholder mapping.

P3M3 Capability Uplift

When working with #organisations looking to uplift their Project, Programme, and Portfolio management #p3m3 #capability, often the question of “what’s the return on investment”? comes up.

Benefits Management

Many #organisations struggle with #Benefits #Management as a concept. So in a collaboration with Milvio D, we challenged ourselves to develop a simple infographic explaining the basics of Benefits Management.

ValueKey – Different PMO Types

There are so many different PMO Office types and functions available that an organisation can set-up. In this series of informative videos from ValueKey, we look at the different structures and value that these office types bring their organisation.

Covid 19 Response Office – Lessons Learned

ValueKey was involved in the process of supporting a large public sector client in their COVID-19 BCP response by running their COVID-19 Management Office. This opportunity has given us some clear “lessons learned” that we were keen to share with other organisations managing their own COVID-19 responses.

Project Management Method Melding

Why use just one Project Methodology on a project when you can combine the best bits of multiple methods? its called “Method-Melding”. Projects Teams are looking to tailor the delivery method and approach they use to the different types of projects they deliver rather than slavishly following a single prescribed Project Methodology.

PMO Service Sliders

At ValueKey we are big on helping other project and PMO professionals thrive. So, in the spirit of sharing, we are giving away FREE a key tool that we consistently use to help clients when setting up PMO’s and EPMO’s.

Hybrid Project Management Methods

Progressive organisations are empowering Project Teams to self-select the most appropriate project delivery method or combination of delivery methods to deliver their particular project. The focus is on the project outcome, not the delivery approach.

Nex Gen PMO’s

The role of the PMO / EPMO is rapidly changing and forward-thinking PMO’s Leaders are responding to their changing organization’s needs. Nex Gen PMO’s are embracing innovation, design thinking, method-melding and Agile delivery.

The Changing Playbook of the EPMO

Some once said that “sport imitates life” or something to that effect. Like a goalkeeper who cops it for letting in a late goal despite the fact that the goal scorer had expertly weaved their way through 10 defenders first before putting it past the keeper.

If your looking for real consulting value from the get go, think ValueKey