Children’s Hospital Richard Ivey School of Business, Essay Example

A Riverview Children’s Hospital Presentation to the Finance and Audit Committee of the Board of Directors on the status of implementation of the newly acquired ICS-A1 Computer System.

Introduction

Riverview Children’s Hospital, while in the process of implementing its newly acquired ICS-A1 Computer system, has encountered a number of difficulties that has forced a critical rethinking regarding the attainment of the established deadline for the project.

This paper will highlight these problems, the reasons for them as well as the implications resulting from these deficiencies, before presenting alternate solutions, and the reasons why the selected one has been chosen, in hope of getting approval from the august body in a timely manner.

Abstract

The Riverview Children’s Hospital Computer Evaluation Committee identified six critical reasons why the institution should replace the present micro-computer systems, and after identifying a short list of prospective suppliers, eventually chose Integrated  Computer Systems ICS)  as its providers of the requisite hardware ,software, and the training and implementation process for  $449,000.00

The institution was targeted to receive a mainframe with 25 terminals and the software package consisting of an automated Patient-Care as well as a Medical Records component, with low cost training to ensure an efficient and smooth transition from the old, unreliable, outdated and low capacity micro-processing system.

Within a period of three months the hardware was installed, a Project Manager hired, and this set the stage for a six to seven months implementation period, with a budget of $64,000.00. However, this was the beginning of a number of problems for this institution, and is the main reason why your AED is making this presentation today.

Problem Statement

The conclusion of an in-depth analysis and assessment of the implementation status of Riverview Children’s Hospital newly acquired ICS-A1 computer systems has revealed a number of operational difficulties and roadblocks that will seriously jeopardize the institution’s chances of meeting the deadline as well as be in a position to accommodate the annual audit and inventory count, if they are not corrected or new options are not adopted.

Operating Issues

The operating issues identified were:

1. The Project Manager was appointed nearly three months after the hardware and software were acquired and therefore was not on hand to give directions
2. The Budgetary allocation of $64,000 was established without proper research, and as such was far below the industry standard for such a project.
3. The training recommendations were unrealistic bearing in mind the limited computer knowledge among the staff
4. Riverview Children’s Hospital Organizational structure was weak and not designed for the system that was acquired
5. No prior research was done before the purchase was made to ascertain system compatibility.
6. The training offices designated to the hospital had no hospital training and implementation experience
7. There frequent staff shortages in critical areas of operation during the period
8. There were no established communication channels and frequency for the project
9. Coordination between departments were almost non-existent
10. The levels of supervision across department were sub-standard and infrequent.
11. No punitive clause were in place to apply against ICS , should it fail to meet the implementation deadline, and as such the hospital has been robbed of revenues it now needs
12. Erratic preventive maintenance programs with respect to the old system
13. Low .morale among staff
14. Poor job fit as it relates to the Coordination and Communication Department, Inventory Department, Materials Management section and the Payroll Department
15. Frequent system failures as a result of the low capacity of the old micro-processor
16. Error of assigning of project responsibility with respect to Finance the Patient-Care system. They should have been assigned to one person to ensure better oversight and accountability.
17. Poor quality of training delivery by the ICS personnel- staff learning curve not rising.
18. No Cost Monitoring System was inserted
19. The training schedule was abused for personal gains by the ICS training officer
20. No background checks were made on ICS implementation performance among other clients in the hospital industry before the signing of the contract
21. Significant time loss was experienced when the Project Manager was changed
22. Employees were unreliable dishonest in the feedbacks given regarding the status of their work
23. No Gantt chart or Critical Path Method was utilized throughout the process to date.
24. The institution lacked proper system protection against virus, malware and other threats
25. The Material Management failed to run its month-end for November
26. The Financial Statement showed Accounts Payable and Inventory at $1.4 and $1m respectively, and three months inventory issues included as expense in the month of November.
27. Outsourcing of Payroll Accounts at the rate of $1,300 per month continued despite the presence of ICS training personnel
28. Riverview Children Hospital had no human resource specialist, and hence no proper evaluation system as well as cost training opportunities to enable\ job continuity in cases of staff shortages.

Implications

These issues overall led to:

1. low productivity
2. Great staff inflexibility with respect to taking on new assignment
3. High operational cost
4. Excessive time wasting
5. The institution becomes unable to meet its implementation deadline and audit as well as stock count.
6. A need for a re-evaluation of the services provided to the hospital as well a  new strategy with respect to how the implementation can be achieved going forward
7. The need to employ new personnel and refit the team becomes as necessity

Problem Identification

Riverview Children’s Hospital does not have the organizational structure, level of awareness, mental preparedness, relevant computer knowledge, skill, attitude, and management capability to work with poor quality of training provided to ensure the new computer system was implemented in a timely manner, without any significant cost overruns. The institution is in danger of not meeting this deadline unless a new strategic approach is designed and adopted by the hospital board.

Decision Options

The AED of the hospital has three alternatives to consider before arriving at a decision after identifying the real problem and not any symptoms relevant to the implementation procedures examined.

They are:

1. Should the system be made parallel from November to February bearing in mind the number of weaknesses observed
2. Should a fresh start be made with the audit and year end stock count be deferred until sometime in April
3. Should the implementation be delayed until May or June and a Roving Team (Human Accountability Partnerships, 2012) of experts consisting of Dovetail trainers, external specialized recruits and a chosen number of Riverview employees be recruited and deployed to correct all errors  required to make the system go live in time.

Choice

The AED for the hospital chose option C and provide reasons, which he tied to actions that will be taken to ensure the requisite objectives are achieved within the stipulated timeline

The AED reasoned to the Board that:

1. Should the decision be accepted all future equipment, material, software acquisitions and recruitment will be delayed for the next 3 months
2. Request will be made top ICS to re-insert the original training requirement or offset the present expenses that have incurred by a similar amount
3. Secure the service on an employment agency to recruitment 5 temporary personnel, with 2 allocated to the Computer and Communications Department, I, to replace Jim Withers, 1 to do the work of the Materials Managers and the last one to be assigned to the Payroll Department
4. A new Project M anger will be assigned for the period and will be mandated to provide a weekly status report as well as design and make current a           Gantt Chart and a CPM  as they relate to each department and the hospital overall
5. A Human Resource Manager will be recruited to cover all the personnel management deficiencies that prevented the institution from reaching its implementation goals.
6. In terms of organizational restructuring, the Finance portion of the system will be amalgamated with the Patient-café component and assigned to Mark Thompson, while the Computer department will become the responsibility of the AED, and Payroll made a part of the Accounts department effective immediately.
7. The outsourcing contract will then be terminated saving the company as much as $15,360 annually
8. ICS will be asked to perform a capacity measurement exercise to evaluate the old micro-processor and advise loading specifications until the end of the implementation.
9. Mark Thompson will be assigned the task of daily supervising Wilma and the two recruits
10. Visit will be taken by the AED to locations where ICS has made similar installations to gather information that may reduce future operating difficulties
11. Patient Management Information Systems will be first targeted by the roving team for completion within 2 months, and this will be followed by the financial system be made to provide support to hospital management 1 month later.
12. The budgetary implementation allocation will be revised upward to ensure consistency and proper accounting standardization
13. The Roving Team will consist of 4 Dovetail trainers, Pam Smythe, Susan Green, the new Project Manager, the new ICS trainer, Mark Thompson, and the Human Resource Manager.
14. Specifically the Roving Team will identify sources of errors in all department and effect their solutions, ensure the system runs parallel to the old system, and install standards that will make Riverview compliant with the Canadian Hospital Association MIS Guideline
15. Conformance Test will be conducted by both the Project Manager and the AED following the submission of each weekly report
16. Each department will be communicated with on a weekly basis using the weekly report and the CPM and Gantt Charts to ensure they are cognizant of their expectations regarding the implementation deadline. Finally,
17. Val Richards will be assigned to work with Ruth Wu for three weeks, to develop his computer knowledge and then be given the Task Monitoring Control responsibility, where he will be under the direct supervision of the Project Manager. This will ensure cost control remain a vital tool throughout the life of the project, and the Project Manager will have information on a daily basis to effect ongoing changes that will ensure strong management are in place

Future Directions

It is anticipated that under this current leadership and with the implementation of these policies and procedures, Riverview Children’s hospital will be in a position to meet its implementation deadline as well as the annual audit and stock count.

In the long term the hospital will also be able to secure and maintain its present three year accreditation from the Canadian Health Association under the auspices of the Ministry of Health, as well as serve as a model for other hospitals that are at lower development stages.

Conclusions

Riverview Children’s hospital should be able after the successful completion of its implementation exercise, be ready to handle future exercise of a similar nature, as well as be empowered to deliver even higher quality services to its patients and other stakeholders.

The hospital made a number of errors leading up to the acquisition of the new system and one of them was to trust ICS with recruitment of the training officer, who it was later revealed had no experience in hospital implementations of this nature and was merely exploiting the system.

In addition, the institution did not ensure its employees had the necessary skill to embrace the new technology that it was acquiring, as well as restructure the organization to make it more compliant with the training demands.

Hospitals like Riverview should never operate without the services of a human Resource Manager, as it may ignore the basic needs of its key assets and cause low morale, low productivity, massive inefficiencies, and a lack of the basic staffing to deliver value to customers

The institution also failed to realize the importance of the role a Project Manager plays in the life of a project. Project Managers, according to JISC INFO.Net (2012) are totally responsible for their projects from start to finish and are usually the ones held accountable by the Project Sponsors; therefore they should be on the job from day one, and not three months later, like in the case of Riverview Children’s hospital.

Cost overruns can destroy any project, and unless s system is in place to measure and monitor it, institutions can suffer significant losses that may lead to closures, massive layoffs, and reduction of vital services to the population.

Riverview Children Hospital inserted no clause in the contract signed with Integrated Computer Systems to ensure they are held liable should they fail to deliver the services they agreed to and to finish the implementation on time. This led to a loss in revenue for the company, but had they had legal advice this would have been averted.

It is hope that the institution will learn from the experience and institute the change going forward

The company AED should he held responsible for the number of operational issue that was found in the organization. This shows a lack of a proper system where employees are assigned responsibilities and should be held accountable for the outcomes through timely performance evaluation where they are either rewarded for their performances or punish to ensure the goals and objectives of the institution are achieved.

The actions taken by the AED to analyze and evaluate the status of the hospital with respect to its implementation process; could be regarded as being reactive rather than proactive.

In the former significant losses may have occurred, while in the latter actions are to ensure operational issues like poor supervision, low morale, low productivity, poor job fit, and improper organizational structures are identified and corrected before vital decisions are made.

The Hospital Board should not be judge as innocent with respect to the operating problems as they should have insisted that a highly qualified Project Manager be appointed to the Hospital staffing as well as a Human Resource Manager, but did nothing to influence this decision

Finally, should all leaders concerned with the Riverview Children’s Hospital operation conduct objective personal introspections and make the changes that are needed , the hospital will grow in leaps and bound in the years ahead.

Reference

Dixon, B.J. (1991). Riverview Children’s Hospital Richard Ivey School of Business The University of West Ontario, Canada

NWCG IRM Project Management Office (2012) White Paper Guidelines www./nwcg.gov/pmu-archive/products/document/White_Paper_Guidelines.pdf , 09/19/12

Human Accountability Partnership (2012). Accountability Advisor www.hapinternational.org/pool/files/accountability/advisor-roving-team-job-description.pdf , 09/19/12

JISC INFO.Net What is Project Management? www.jiscinfo.net.ac.uk/infokits/project-management , 09/19/12