CSU Mod 2 Managed Care and Health Care Delivery in The US Project The overall goal of the Session Long Project in this course is to examine health care del

CSU Mod 2 Managed Care and Health Care Delivery in The US Project The overall goal of the Session Long Project in this course is to examine health care delivery in the United States from a personal perspective and provide recommendations for improvement.

According to the United States Census Bureau (2016), rural areas cover 97% of the nation’s land area, but contain 19.3 percent of the population (about 60 million people). Access to health care services is vital to good health; however, U.S. rural residents face a variety of access barriers. For rural residents to have sufficient health care access, necessary and appropriate services must be available and obtainable in a timely manner.

Rural Health Information Hub. (2017). Healthcare access in rural communities. Retrieved from https://www.ruralhealthinfo.org/topics/healthcare-access

United States Census Bureau. (2016). New census data show differences between urban and rural populations. Retrieved from https://www.census.gov/newsroom/press-releases/2016/cb16-210.html

For Module 2 SLP, you are employed at a non-profit organization in rural Minot, North Dakota (population ? 49,000). As the Lead Health care Project Manager, you have been charged with developing a project charter for the new “Rural Health Improvement” project. This project goal is to increase access to health care services in the area. Based on your module reading and your own research, include the following in your project charter:

Factors of your project (i.e., aim, time frame, cost, scope, etc.).
Major stakeholders and each stakeholder interest in the project.
At least two innovative approaches to health care delivery.
At least two expected outcomes of your project.

You may use this template as a guide to create your Project Charter.

Use this Guide to Completing Your Project Charter.

Conduct additional research to gather sufficient information to support your project charter.
Limit your paper to 2 pages.
Support your SLP with peer-reviewed articles, using at least 2-3 references. Use the following source for additional information on how to recognize peer-reviewed journals: Guide to completing your
Project Charter
The Project Charter is your first opportunity to define the scope and identify approach,
resources and timeline for your project. Completing this at the outset (as part of the Initiate
phase) will pay dividends throughout the life of your project. The Project Charter serves as a
guide for the conversations you will need to have with your Project Sponsor, Executive
Sponsor and other key stakeholders.
Page 1 of 11
Guide to completing your
Project Charter
The process of completing your Project Charter is an important first step in bringing
awareness to all of the key stakeholders who will need to be involved or are impacted by the
project, and confirm their desire and commitment to participate and support the project.1
The dialogue you have in this process is as important as the Project Charter itself.
1. Project Leadership and Timeline
For your project, you will need to identify the key individuals who will provide leadership to
successfully implement and sustain the change. The responsibilities for all project roles will
be described in more detail in Section 4 (“How will we manage and deliver the project?”).
Key Considerations
• Who is the member of the Senior Leadership Team (SLT) that is most
accountable for the project’s overall outcome?
• There can only be one Executive Sponsor.
• Is this person accountable and have demonstrated commitment to the project’s
overall outcome?
• Is he/she available and committed to be a visible and vocal champion for the
• Is he/she available to provide support in resolving issues as they arise?
• This role is always required.
Clinical or
• Who has the business, operations and/or clinical expertise to lead the
development of the solution and how it needs to be implemented?
• Who will likely play a key role in the operational sustainment of the change being
• To what extent are physicians required to be aware of and involved in the
• Who has the accountability and influence on the physicians that need to be
engaged for this project?
• Does this person have the required level of experience to manage the project
based on its scope and complexity?
• Does he/she have the capacity to manage this project?
Be willing to challenge whether you have the appropriate person as your Executive and
Project Sponsors. An early indicator of whether this is the case is your Sponsors’ willingness
and ability to dedicate time to meet with you to review the Project Charter.
Taken from Prosci’s ADKAR (Awareness/Desire/Knowledge/Ability/Reinforcement) model for change. See Appendix A for an overview of
this model.
Page 2 of 11
Guide to completing your
Project Charter
2. What are we trying to accomplish?
This is the most important question to answer up front. It is critical that all key
stakeholders for the project have a shared understanding of why this project is being
initiated. To define the Project Purpose, use the following questions in your conversations
with your stakeholders – especially your Project Sponsor and Clinical/Business Lead(s):
1. What is the problem we are trying to solve?
2. What is/are the target outcome(s) we are looking to achieve?
3. Why is it needed?
4. What if we don’t do this?
5. What will be the benefits for patients, staff and the organization as a whole?
Consider naming your project based on the project’s purpose or target outcome.
State your Project Purpose with as much specific information as known at this time, applying
the SMART approach:
• Specific
• Measurable
• Attainable
• Reliable
• Time bound
In identifying how your project’s benefits support the strategic goals of Providence
Health Care or your program, refer to PHC’s 5 strategic directions and 3 foundational
strategies from the 2012-15 Providence Plan:
Page 3 of 11
Guide to completing your
Project Charter
In addition to identifying how your project aligns with the Providence Plan, you may also wish
to highlight how it enables/supports specific goals within your program and at a regional,
provincial and even national level.
To define the Scope and Boundaries of your project, consider the following:
1. What processes or functions will be impacted?
2. What sites, departments and programs will be affected?
3. What roles or positions will be impacted?
Be explicit on what is out of scope based on your answers to the scope questions on the
previous page, particularly for areas where people have been unclear or expressed a desire
to include within the scope.
Identify the key assumptions that are being made for this project (e.g. availability of key
resources, people, funds), and how you will validate these assumptions. Any assumption
that cannot be validated should also be highlighted in Section 4 as Risks/Opportunities.
Page 4 of 11
Guide to completing your
Project Charter
3. How will we know the change is an improvement?
The Project Charter has three types of measures:
Purpose of this measure
Demonstrate that the project’s purpose or
target outcome is being achieved (usually
from the perspective of the patient, resident
or client).
In some cases, the purpose may also be
related to achieving a financial outcome,
such as cost savings.
Reduce incidence of VTE (venous
thromboembolism) by X%
Reduce the overall department budget
by $X
Show that the key processes or steps that
lead to the overall outcome are being
Training for procedure X completed by
all staff
Procedure X checklist completed
100% of the time
Ensure that any potential negative impacts
(unintended consequences) are avoided.
Often, these can be identified from the key
risks to the project.
Level of patient satisfaction
Level of staff satisfaction/
Finding ways to demonstrate that your project has achieved is purpose in a concrete way can
be challenging! As a general rule, aim to have no more than 3 to 5 measures (for an extra
challenge, see if you can identify the single most important measure for your project).
Here are some tips for addressing some of the most common challenges with measures:
Tips to address this challenge
“We don’t have
the data for the
Use a proxy measure. Identify other initial indicators or measures such as
qualitative feedback from informal surveys or 1:1 interviews to get a sense of
whether the change your project is implementing is improving things.
As a part of the sustainment plan, identify any new data that needs to be
collected and reported on to demonstrate the impact of your project on an
ongoing basis.
“The outcome
measures are not
(fully) within the
control of my
The overall outcomes we are looking to achieve are often dependent on a
myriad of contributing factors. Driver diagrams can be helpful to show the
relationship between the overall target outcome and the change your project is
implementing, along with other projects or areas (see Appendix B for an
example of a driver diagram).
Recognize that there may be a significant lag in the outcome measure
demonstrating improvement – therefore consider whether a process measure
is more appropriate for determining the end of your project.
Page 5 of 11
Guide to completing your
Project Charter
Tips to address this challenge
“The attention to
the key
measures will
stop once the
project ends.”
As a part of your sustainment plan, clearly identify who will be accountable for
monitoring and responding to key process and outcome measures in an
operational state. Identify ways to associate the measures for the change from
your project with PHC’s Balanced Scorecard and/or other existing
management processes.
4. How will we manage and deliver the project?
This section identifies:
1. The overall approach and guiding principles for the project;
2. Who will be on your project team and their expected roles and responsibilities; and
3. The phases of work, major tasks and milestones, and overall timeline for the project.
In describing your overall approach, consider the following:
• As all projects involve change, there needs to be a communication strategy to
ensure that the messaging is consistent and targeted to each group or individual as
• How the project will support them in adopting the change; and
• How the change will be supported and sustained on an ongoing basis – this specific
point will be addressed in Section 5 (“How will we sustain the changes implemented
by the project?”).
The Project Team section includes a project organization chart which provides an
excellent visual overview of the key roles. You can update the chart included in the template
or create one using software such as PowerPoint, Visio or MS Project and import (or copy
and paste) it into the Project Charter.
The template provides a minimum list of the essential roles and associated responsibilities.
For a more extensive list of potential roles for your project, refer to Appendix C of this guide.
It is critical to review this section with the individuals identified for each role to confirm:
• their understanding of the role and associated responsibilities;
• their ability to fulfil these responsibilities;
• their availability (as identified under the Expected Level of Engagement column).
The Project Timeline provides a visual representation of the major tasks, milestones and
timeline, and can be created using PowerPoint, Visio, Smartsheet or MS Project and then
imported or paste into the Project Charter document.
In addition, this section includes the identification of the project’s key dates (which should be
reflected as the milestones on the timeline), and your project budget.
Page 6 of 11
Guide to completing your
Project Charter
In the risks/opportunities section, be as specific as possible about what the risks and
opportunities are. For each risk and opportunity, identify the specific actions you intend to
take (or require others to take) in order to manage the risk or opportunity. These actions will
be included in your Project Workplan in the Planning phase of your project.
5. How will we sustain the changes implemented by the project?
The sustainment plan identifies what actions will need to be taken and by whom in order to
transition any key support activities from the project team to individuals in their ongoing
operational roles. This transition will need to be included as a part of the Project Workplan. If
it is not possible to identify who will take ongoing responsibility for sustainment at this stage,
then you can identify who will need to be involved in defining the sustainment model, and
when this will be done within your project timeline.
Sustainment requires people to have the knowledge and ability, which can be supported
through initial training, as well as ongoing reinforcement.2 Example of key things to
consider in your sustainment plan include:
• Providing opportunities to get feedback from people experiencing the change. Use
staff meetings to check in on whether staff feel they have been given the appropriate
training and support to implement and sustain the change.
• Remove access to processes and equipment that reinforce the previous way of doing
6. Project Charter Versions and Updates
This section tracks any major changes to the Project Charter, such as a change in the scope,
approach or timeline of the project.
Taken from Prosci’s ADKAR (Awareness/Desire/Knowledge/Ability/Reinforcement) model for change. See Appendix A for an overview of
this model.
Page 7 of 11
Guide to completing your
Project Charter
Appendix A – Prosci ADKAR Model
The Prosci® ADKAR® Model is an individual model for managing change at the individual level. It is composed
of five building blocks that must be addressed before someone can change the way they do something.
What it means
Awareness of the need for change
Does the individual know the reasons for changing?
They will need to before they can decide to take on the
Desire to participate and support the
When awareness is built, it’s up to the individual to
make the personal decision to change. Are we
supporting them while they make their decision?
Knowledge on how to change
Next, the individual must learn the new skills needed to
make the change.
Ability to implement required skills
and behaviors
The individual must be able use and apply the new
skills learned in the Knowledge phase.
Reinforcement to sustain the
Are there systems in place that will keep individuals
proficient in the new way of doing things and prevent
individuals from reverting back to the old way?
Source: http://www.change-management.com/tutorial-levels-of-cm-mod4.htm
Page 8 of 11
Guide to completing your
Project Charter
Appendix B – Driver Diagram Example
Source: “Driver Diagram Tutorial Presentation”
Page 9 of 11
Guide to completing your
Project Charter
Appendix C – Project Roles and Responsibilities
Expected Level
of Engagement
• Provide overall direction and senior level decisions required by the project,
including confirmation and approval of project scope, timeline and budget
• Provide support to ensure that the required resources are available
• Accountable for ensuring the SLT, PHC board committees and external
stakeholders are updated on the overall status of the project as required
• Address and resolve critical barriers and issues that require executive input
and/or support, particularly those that cross over multiple programs,
services and areas
• Confirm/approve any changes to project scope, timeline and budget
• Champion for the project, ensuring appropriate visibility of the project
across the organization and to other organizations as appropriate.
• Ensure that the appropriate people and resources within the directly
impacted areas are available as required by the project and for sustainment
after the project ends
• Provide overall direction on the project
• Provide regular status updates to the Executive Sponsor (frequency to be
agreed up front and adjusted as required)
• Address issues and barriers that have been escalated by the Project
Manager and engage the Executive Sponsor as required
• Provide direct input into key decisions and resolution of critical issues
throughout the project
• Provide support to the Project Team as requested by the Project Sponsor
and Project Manager
• Facilitates the definition and delivery of the project, leading/guiding the
project team through the process of executing the project.
• Provide direct guidance and support to the Team Leader(s) in the
identification and engagement of key stakeholders, resources, approaches
and tools required to successfully deliver the project.
• Develop project scope, timeline and approach with the Team Leader(s) and
confirm approval by Executive and Project Sponsors
• Ensure that the required work and engagement of stakeholders is done and
tracked on a regular basis throughout the project
• Ensure regular project updates are provided to the Project Sponsor and
Executive Sponsor
• Identify, highlight and facilitate addressing issues, barriers and risks that
impact the project
• Provide and ensure that the required content expertise is brought into the
• Make key design and implementation decisions based on his/her business
or clinical subject matter expertise
• Provide specific direction on the project approach and deliverables
• Identify and lead engagement of key stakeholders and resources required
to successfully deliver the project
• Lead all key meetings with their staff and other key stakeholders throughout
the project, including confirmation of the agenda for meetings and taking on
the role of chairperson at the meetings
• Lead engagement of key stakeholders to sustain outcomes following the
• Lead engagement of physicians for the project
Project Sponsor
Project Manager
Team Leaders
(Operations and
Page 10 of 11
Monthly meeting
to confirm key
Ad hoc meetings
for senior level
input as required
Every 2 weeks to
review project
status and
address issues
Monthly meeting
Guide to completing your
Project Charter
Expected Level
of Engagement
Project Advisor
• Provide overall guidance and support to the Project Manager
• Provide input and guidance in the development of the project approach,
proposed changes and implementation of changes
• Conduct an assessment of the readiness of stakeholders for the change
• Lead the development and delivery of stakeholder engagement and
teambuilding required by the project
• Establish a system for performance tracking
• Assist in gathering and analyzing evidence as needed
• Guide the team in applying QI tools and processes
• Assist in the development of a communication and education strategy as
• Develop agreed approach for tracking and reporting financial targets
• Validate estimated and actual savings
Quality and
• Identify implications of proposed changes from a labour relations and
collective bargaining agreement perspective
HR Advisor
• Provide guidance and technical support for HR processes and staff rotation
• Identify implications of proposed changes from a labour relations and
collective bargaining agreement perspective
• Develop new rotations required by the project
• Provide guidance on communications strategy to staff and other
stakeholders throughout the project
• Develop key communication deliverables for staff and patients
• Ensures the audience has awareness, builds desire, communicates
knowledge and builds expertise and helps reinforce the messages for
• Provide guidance and advice on the plan for how to implement the new
staffing model as well as communicate, educate and support staff
• Support the development of new workflows and processes
• Provide expert facilitation with groups such as diverse stakeholders,
patients/clients, or if external consultation is required.
Page 11 of 11
Project Charter
Project Name
Project ID/Number
Date Prepared
Project Sponsor
Project Manager
Program Manager
Team Members
Other Key Stakeholders
Page 1 of 5
Project Charter
Business Need and Problem Statement
The ABACUS program team is incorporating the Horseshoe House into the BrandForehand organization so that it can increase Project Share and grow the business.
The ABACUS team responsible for the integration of the Horseshoe House is
experiencing challenges in communication, both geographical and technical. There is a
need for the team to work from a standardized technological platform and software
base and allow team members to communicate without face-to-face meetings.
Project Goals and Objectives (Deliverables)
Install Microsoft Office 2007 on 90% of team member desktops within one month of
Sponsor approval and funding, and 100% by end of second month after approval.
All team members will be trained in coordination with the installation of Microsoft
Install Microsoft Office SharePoint Server (MOSS) 2007, and distribute the server
URL so that clients can access it within one month of project approval.
Reduce travel costs by 25% within three months of project completion.
Reduce communication costs by 20% within three months of projec…
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