Evolution of IT Project Governance at the Tiger Insitute

Primary Goal: Leverage data to identify trends, improve processes, and assess outcomes

Initially, through the Tiger Institute, we achieved fewer, but more complex and far-reaching projects to drive Univeristy of Missouri Health System towards HIMSS compliance and Meaningful Use attestation.

As Tiger Institute matured, we began to see more specialty-focused initiatives, which typically are more expensive to implement.

While we had a rudimentary request-and-approval process in place, it became apparent that we needed a better system for reviewing and prioritizing requested projects.

Our motto? It’s not enough to simply “turn it on”.

Clear goals

As we reviewed our current and desired future states, we established several clear goals for our new project review system.

• The system must be structured, repeatable, and clearly documented.
• Only key stakeholders with decision making authority should be involved in the approval and prioritization process.
• There should a great deal of information transparency in regards to the projects being requested.

The framework we created to accomplish these goals is called Tiger Institute Prioritization and Steering (TIPS), which covers all aspects of project proposal, vetting, approval, tracking, and analysis.

A committee oversees the process and has final approval authority over any proposed projects.

Executive ownership

To begin the project review process, an executive project owner from the health system enters a request into an electronic form in our project tracking system.

This initial request form covers the who, what, where, when, why and how of the project. The purpose is to enable some initial analysis or a “smoke test” to determine whether or not the project aligns with organizational goals and whether we have the resources to consider it.

We also use the form to assign a hospital executive to the project who will “own it” throughout the process.

In sum, executive ownership is a key aspect of the TIPS process as it encourages high-level buy-in from the organization.

In-depth analysis

If the project passes this initial “short” approval step, we look at the request more closely.

At this point, we assign a project manager. He/she works with the executive owner and the Analytics at the Edge team to do a full project analysis, which includes:

• Expected benefits
• Required resources
• Timelines
• Hard and soft costs
• Risk and issues
• Dependencies

The project manager then presents this analysis to the TIPS committee for final approval and prioritization based on other ongoing or planned activities.

Measurement

If the project receives final approval, the project manager and executive owner work with the Analytics at the Edge team to establish a detailed measurement plan. This plan includes:

• Metrics for expected benefits
• Targeted outcomes
• Baselines
• A plan for getting the necessary data

We complete this plan before we begin the project to avoid losing crucial baseline data that may be destroyed or otherwise unobtainable after implementation (e.g. current-state workflows).

Once we create this plan, we follow standard implementation and project management procedures with the measurement plan overlaid on top.

Upon completion of the project, we measure the its quantifiable outcomes. It is important to establish target outcomes at the outset of the project to determine if it performed as expected.

Once we capture these outcomes, we put together an analysis and present it to the TIPS committee as a standing agenda item for the monthly meeting.

This closes the loop between vetting, approval and outcome and provides valuable insight to hospital leadership as to whether or not we are delivering on what we promised.

This approach also helps us foster a culture that stresses outcomes, which matches the health care industry’s emphasis on data-driven results.

Membership

The TIPS committee includes the full C-suite of hospital officials (CIO, CMO, CEO, CMIO, CNO, etc.).

We have limited committee members to include only those with decision-making authority and ensure we focus on taking action, rather than just discussion.

Overall, the TIPS framework has been well-received for its transparency and the insights it gives our decision-makers.