• Impact: How big is the potential impact on the project?  We’ve seen this measured in a vague terms as “High, Medium, or Low” or as precise as a dollar amount or specific time the project will be delayed.  In our minds the more precise the estimate the better.  This is not necessarily because the more precise measure is more accurate but because the thought process required to come up with a precise estimate will help better define the risk.
• Likelihood: What chance is there that this risk will turn into an issue for the project?  Are the “odds” high?  As with Impact, the more precise measurement the better, to a degree.  While high, medium, or low may be a bit light, 27.56% is an estimate that gives an illusion of precision.  Likelihood is predicting the future and false precision will give the impression you have a better handle on risk than you ever could.  In general we find risk expressed as a fraction with 4 or 5 in the denominator to be sufficient.  So for example theres a 1 in 4 (1/4) chance this risk will occur or a 4 in 5 chance.  This also provides sufficient detail should you choose to build a mathematical model for risk prioritization (more on mathematical models of risk in another post).
• Immediacy: How soon will the risk occur?  Projects are often about prioritizing what’s important today.  Having a handle on when you think a risk will occur will help you prioritize when to start worrying about them.  This is the most difficult of the aspects to estimate and is the least precise.  Generally we think in terms of immediate (defined as within the next 3 months), mid-term (defined as between 3 and 6 months), and long term (greater than 6 months).
• Triggering/Preceding Events: What visible events will precede the risk becoming an issue or indicate the risk is becoming an issue?  Be concrete, for example, if we see Milestone X is missed or have an indication it will slip it will indicate that the risk of late product delivery has turned into an issue.  Often risks will have several triggering or preceding events.  The biggest issue our clients sometimes have here is being too vague about defining the events.

There are, of course, other aspects of risk you want to capture when performing risk analysis and management on a project (for example: risk management strategy and tactics).  We’ll be more specific in a later post, but the aspects above are the most often missed on projects and some of the most beneficial in dealing with risks. Remember overall it’s less the list of risks you come up with in the end but the process of periodically identifying and analyzing risks that is of most value to the project.

Symptoms

So how do you know if you have project zombies on your team?  Here are a few symptoms:

• A measurable drop in individual or team performance;
• A general drop in morale;
• Long hours being put in on the project well before that final push;
• Grumbling, complaining, or dead silence about assignments; and
• Missed milestones and deadlines.

Causes

If those are the symptoms what are the real causes?  We’ve seen many but the top six in our experience are:

• A high level of politics in a project (we’ve noticed a lot of this lately around anything to do with the Affordable Care Act!);
• Unrealistic goals and desired outcomes for the project;
• Unrealistic timelines and scope (asking people to do more than is possible in time allotted);
• Working staff above or below their skill level (asking them to routinely perform tasks they feel overqualified to do or that they are not skilled enough to do);
• Constantly changing deadlines or scope (moving the goal posts); and
• Outside forces (vendors, management etc) pushing the use of “silver bullet” tools or techniques to justify unrealistic deadlines or outcomes.

We know there are more but there are always at least one of these on any project suffering zombies.

Impacts

So why care if your project is full of zombies?  Projects with even a single zombie can:

• Miss milestones and deadlines;
• Make good staff leave the project;
• Result in poor quality work; and
• Fail outright.

As a sponsor or manager of a project it is your job to cure project zombies.  We’ll discuss some cures to “project zombie-izm” in the second (and final) part of this series.   In the mean time you might want to read  Ed Yourdon’s book “Death March“.   Though targeted at software projects much of the insight it provides generalizes to any project.

The CIO was engaged in the procurement of a Medicaid Management Information System (MMIS). The project was stretching his resources thin and he was relying on us (PK) to supplement his staff with MMIS procurement expertise. We were leading a discussion of procurement strategies and the question came up “Why can’t we just outsource the whole thing, why do we need to buy an MMIS – can’t we just rent one like other people rent applications like Salesforce?” The CIO had been reading a lot about Software as a Service (SaaS) and this seemed to make some sense to him. The potential benefits are large:

• He’s already being asked to cut his capital (one time expenditure) budget and this could provide a significant reduction. It may even offer operating budget cuts as well;
• He has been worried about getting and keeping the staff required to implement and maintain a large system. He has had a lot of staff attrition due to retirement and difficulty in recruiting and training new staff;
• He has wanted to devote his staff efforts to more strategic projects (as opposed to the operational nature of an MMIS) that would better support the agency.

There were some obvious roadblocks:

• A waiver from CMS would be required – the law technically says states have to construct and maintain an automated system to handle Medicaid claims;
• Most MMIS vendors, despite what their marketing literature tells you, are not prepared to run Medicaid as a software service;
• He believed vendors would try and create lock-in with their product through proprietary data formats and unique features. After some discussion the realization dawned this is the case with the way things work now.
• There was a long discussion about privacy and security. How would that be ensured? The technical staff in the discussion assured us through the use of Virtual Private Network technology such a set up would be no less secure than their existing systems.

Overall it was a thought provoking discussion. Though we didn’t reach any definitive conclusions we all realized this approach has significant potential. The recent elections emphasized government agencies will have to live with less. This CIO is on the forefront of identifying ways to deal with these budget shortfalls and on effectively using technology to further the mission of his agency.  We’re continuing to work with the agency to flesh out the implications of this strategy.

Public Knowledge has a history of assisting its customers with the planning and development of Health Management Programs that improve quality of care, improve health outcomes, lower total costs, and better-educate providers and Medicaid clients.

Recently, we helped a State implement a unique Health Management program for its entire Medicaid population.  The program included even healthy Medicaid clients, who are usually ignored in traditional disease management programs.  The program itself consisted of:

• A Disease Management component for certain chronic diseases such as asthma, diabetes, and others;
• A preventive education and outreach component for all Medicaid clients; and
• A comprehensive case management component for catastrophic/high risk medical cases.   The broad scope of this program is unique.

So what have the results been?  In its first 6 months of operation the program saved the State’s Medicaid program more than $15 million.   Greater savings are being realized in its first few years of operation.  Further, based on our regular reviews of the program, the quality of care to clients has improved.  Pretty much a win/win.

We recently ran across this article from stateline.org which describes how Vermont sat down with their unions to jointly resolve part of their budget crisis. A little outside the box thinking went a long way. Kudos to Vermont for thinking creatively and turning a potentially adversarial situation into a win for both parties.

Are you applying creative solutions to your problems?

• Are tired of consultant bait and switch strategies where superior resources are bid (and may even start) on the project but less experienced staff show up and do the bulk of the work;
• Want rapid access to known consulting resources for projects; and
• Want to make sure there’s continuity on project issues and tasks provided by the consultant.

There are however downsides to having consultants devoted exclusively to your project. Consultants:

• Become myopic over time and miss critical issues and solutions a fresh pair of eyes might catch;
• Are costly resources that should only be on board when they are needed, when they’re not fully utilized (and there are always those down times on projects) you don’t want to pay for them;
• Stop bringing in new ideas and experience gleaned from other projects that might be just what you need to thrive; and
• Become viewed as staff and their unique experience and voice is no long heard.

Of course we’re not suggesting the elimination of consistent consulting staff on your projects. You do need continuity and responsiveness. And we are also not suggesting consultants should be swapped out regularly. Just be aware there are hidden costs to demanding consultants be devoted full time to your project (particularly on longer projects) and benefits to having “fresh legs” in the marathon that projects can be.

Focus on simplicity – you’re not likely to look for the “Cadillac” solution, you can’t afford it. Simple solutions tend to be easier to implement.

Encourage staff participation – you won’t be able to afford, nor will you need, an army of consultants to implement your simple solution. Your staff will have to take on added project responsibility to get things done. There’s nothing like having skin in the game to make your staff fight for success.

Use the wisdom of your own people – you can’t buy your way out of the problem so your approach likely has to be home grown. You’ll be relying on the creativity that exists within your organization to complete this project. When solutions are home grown they are easier to sell internally and generally a better fit for your needs.

Better utilize the funds that do exist – when resources are scarce you pay greater attention to them. You are forced to track every dollar spent on the project which in turn means you are likely to spend your money where it will do the most good.

Of course lack of funds will limit the kinds/size of projects you take on. You’re not likely to re-engineer your entire Medicaid system. But…what about rewriting those out-of-date procedures manuals? How about revisiting your policies? What if you could re-engineer a few of those inefficient processes? Lack of funding, while not ideal, is the reality we all now face. It shouldn’t stop your projects and can even help them to be successful.

The video shows a few things: States ended up with budget shortfalls from similar causes and solutions involve draconian cuts to services.

Professionalism. Cutting-edge public procurement agencies are raising the level of professionalism among their staff and supervisors through training, certification and the adoption of clearly defined standards.

Innovation. Progressive procurement agencies look for ways to improve their processes and to be more effective and efficient. Some best practices include:

• In the area of IT purchasing:
  • Writing solicitations that describe a problem and ask for a solution, which allows suppliers to propose innovative ideas that could provide better value to the state.
  • Making purchasing decisions based on overall value rather than price alone (best value).
  • Forming long-term strategic partnerships with qualified suppliers.
  • Sharing risks and benefits with suppliers.
  • Creating a pool of qualified suppliers.
• Focusing on sustainable/green procurement.
• Directing state resources to strategic sourcing and cooperative purchasing to gain volume pricing from suppliers.
• Making use of reverse auctions, purchasing cards and multiple award contracts.

E-procurement. Successful procurement entities use electronic systems to run the procurement process from solicitation development to contract administration. The optimal systems include the following features:

• Supplier management, electronic notification of bids, reverse auctions and electronic catalogs.
• A system linked to government accounting systems with automated electronic invoicing, evaluated receipt settlement and accounts payable processes.
• Online supplier registration, electronic posting and distribution of solicitations, e-mail notification of solicitations, electronic bidding, posting of tabulations and awards, online auctions, and electronic purchase orders.

Productivity. Well-regarded procurement agencies have tools and policies designed to increase productivity and decrease strain on existing resources. Some of those tools are listed below.

• Web page with a “how to do business” guide.
• Formally established ethics policy with enforcement and training.
• End-user and supplier outreach and education.
• Master contracts to permit rapid low cost acquisition.
• Performance measures.
• Procurement manual that has been published or revised recently.
• Internal and external customer service and supplier surveys.

Leadership. Best practices indicate a preference for a center-led organizational structure, defined as: The central procurement authority focuses on training and education, performance measurement, dispute resolution, system oversight and supply-chain management. Agencies are empowered to conduct procurements over which they are subject matter experts while the central authority consults, provides support, and reviews compliance with state rules and policies.