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Improvement Action Description: Developing a Work Breakdown Structure that identifies the steps needed in a procurement plan – to standardize and develop a Procurement “Acquisitions” Plan Standard Operating Procedures (SOP) guide for all of the CMOP Logistics Managers.
Purpose of Implementation: The CMOP organization did not have a consistent method established to gather information to forecast contracting opportunities and expenditures for the next Fiscal year. In the past, the Logistics Manager and/or Director guessed the future needs. This approach increased the likelihood of inaccurate projections and missed opportunities.
Implementation Results: The implementation has been completed, which resulted in an Acquisition Plan SOP guide that was shared with other sites within the CMOP organization. All key stakeholders, including department leads, got involved to standardize this process and now have a better grasp of their spending needs vs. wants. A quarterly review schedule has been established to update the plan, close-out/re-open items and to develop the plan for the upcoming fiscal year, along with having a 3 year and 5 year plan. This has improved their budget planning and has also allowed them to better manage their workload – because they can identify necessary lead time for procurements.
Next Steps: The new process now allows the sites to compare/share their data in a consistent method which is anticipated to have additional future benefits in how they track and report organizationally.
Improvement Action Description: Utilize mind mapping to focus requirements for the contract and WBS. Develop a Work Breakdown Schedule and Responsibility Assignment Matrix (RAM) to assign task responsibility to appropriate parties. Create a stakeholder list to ensure buy-in is obtained for project funding. Develop a matrix to identify all areas requiring equipment to be installed, the type of equipment required, and any construction or modifications to the facilities that may be necessary. Develop an equipment tracking matrix to help define the project critical path.
Purpose of Implementation: The VA implemented a major initiative to promote safe patient handling. In support of that initiative, the project was initiated to manage the purchasing and installment of patient lift equipment throughout the Medical Center. Due to lack of funding, effective coordination between stakeholders and planning to minimize the disruption to customers, the project faced challenges meeting: cost, schedule and performance targets – prior to training.
Implementation Results: All Action Plan improvement actions have been fully implemented. The initial project of acquiring ceiling mounted patient lifts in every patient room has been completed. As a result of properly executing and managing the project there has been:
- Improved utilization of resources – reduced resource requirements by one FTE, per action, to move a patient from the bed to a chair or to the bathroom.
- More efficient patient care – in-room installation allows for quick and easy access to move patients vs. portable stored devices not convenient for access or use.
- Lowered risk of injury to staff / patients and reduced compensation claims – review of reports from safety office and human resource office has shown the FTEE group with the highest number of recorded injury claims is employees involved with direct patient care. The primary causes for their injuries, resulting in time off or compensation claims, has been attributed to lifting and / or assisting patients who cannot or need assistance ambulating.
This project has lead to: patient lifts that have been added to the scope of work for a major remodeling project currently under way at the Medical Center, in addition to installation in the morgue and in treatment rooms for outpatients.
Next Steps: Mr. Nischalke plans to continue leveraging training tools and concepts and adopted practices. The participant now looks at every major acquisition as an opportunity to look for improvements and do realistic requirement planning and has learned that getting stakeholders involved early is extremely beneficial – in addressing different needs, mindsets and expectations.
Improvement Action Description: Initiate improved project planning, scheduling, and resource alignment. Conduct market research to compare VHA medical surgical consumable spend data with DoD and private sector healthcare. Improve cost estimation process for establishing contract prices for medical surgical supplies in VHA by using data driven information. Utilize training tools to improve presentation to stakeholders on the importance of incorporating spend analysis in the national procurement process.
compared to how other government agencies form procurement agreements or contracts, has brought to light that VA contracting must be redefined and revisited to be more strategic and take advantage of incentive agreements based on volume and purchasing commitments. Specifically, prior to training, there were challenges meeting some of the identified performance targets, due to lack of proper internal staff and stakeholder management. The overall process for the project needed to be clearly communicated – to assure the intentions, benefits, resource / funding needs, were understood and supported by stakeholders. Additionally, there was a need to implement a national cost estimation process to support more accurate budgeting, which would all for VHA to obtain the most competitive prices for contracts.
Implementation Results: All Action Plan improvement actions have been fully implemented. As a result of improved project planning, the participant was able to plan for and mitigate potential project risks, i.e., by defining the critical path and scheduling tasks accordingly helped to plan around bottlenecks. Additionally, through the application of training tools – to improve presentation skills – enabled the participant to successfully obtain leadership and stakeholder buy-in, i.e., delivery of the main point quickly and clearly allowed for more directed questions and appropriate follow-up to explain. The participant has now trained national contracting officers to use the new database for cost estimation – which provides price point for items currently purchased on the open market. As a result, when new contracts are established or new items are added to existing agreements, the contracting officers can use the information to set competitive prices for VHA – based on the prices the private sector and other government agencies have used to purchase. Other leaders have also been trained on how to utilize the database’s spend analysis functionality – to identify opportunities to standardize items, create new agreements and/or to expand coverage on existing agreements.
Next Steps: Mrs. Cocoma plans to sustain the improvements implemented by continuing to be available to train and provide guidance to new users on the database’s new spend analysis functionality, continuously identify new opportunities to standardize around nationally, for the region, and for the network, and also save money by re-negotiating current contract prices and expanding overall contract coverage. Additionally, the participant will continue to look for opportunities to improve the VA’s contracting practices.
Improvement Action Description: Develop an enhanced IT Inventory Management Process. Procure handheld scanners to assist with inventory management. Develop a Work Breakdown Structure (WBS) for the IT Inventory SOP Development. Train OI&T staff.
Purpose of Implementation: In order to develop enhanced IT Inventory Management processes, it is necessary to develop policies and procedures to meet current and future performance measures/metrics. An effective WBS will be essential for facilities to attain 95% compliance regarding equipment inventoried in the last 12 months, as well as having all required fields in the inventory file complete with correct information. This project will make it possible to readily identify equipment that needs to be replaced. This will be beneficial as we move towards the new PC lease program.
Implementation Results: As a result of the program they have successfully procured hand held scanners for customer support staff to be used for inventory control purposes; developed a clear WBS; and delivered a presentation outline for training using the formal presentation techniques learned in the Leadership and Interpersonal Skills Module of our training.
Improvement Action Description: Initiate stakeholder involvement for all project aspects from pre-construction through project close-out through the creation of an Integrated Project Team. Develop a work breakdown schedule to assign resource responsibilities. Improve development and vetting of contract requirements. Utilize Earned Value Management and costing techniques to improve the contract administration process.
Purpose of Implementation: The Bio-medical / SPD Renovation project involves renovation of the existing area to provide a better flow than what is currently available. In the past there were project challenges due to lack of coordination/communication between end-users, engineering, and the contracting office. This lack of coordination/communication often resulted in numerous change orders and project delays and general discord with the contracts scope and schedule.
Implementation Results: As a result of successful implementation, the project met all construction schedule milestones and reduced the amount of change orders. Stakeholders are more involved in the administration of the contract, are aware of the scope of work, and have a better visualization of the contract status and progress. The project will continue to increase stakeholder involvement and team development – to assure better outcomes are achieved.
Next Steps: Mr. Pollock plans to apply the project management best practices (stakeholder involvement, team development, WBS, earned value management, Cost-Benefit Analysis, etc.) used to improve his exiting project on all future projects. Even though many of his projects are Non-Reoccurring Maintenance (NRM&s) these techniques/tools have proven to be very valuable despite the project size.
Improvement Action Description: Development of an Integrated Master Schedule (IMS) for the HR database project. Clearly define project scope and development and reporting requirements with key stakeholders. Developed a high-level Work Breakdown Schedule to identify the various work products/deliverables for the project. Create a Gantt chart to manage project milestones. Integrate Financial Data to Central Reporting Database. Standardize and streamline the manual process to request new positions. Streamline organization of the budget (authority and spending).
Purpose of Implementation: The goal of the project was to improve Durham’s HR tracking and reporting with the use of a Staffing MS Access Database vs. maintaining and managing through MS Excel spreadsheets. Durham has numerous national programs, national/local initiatives, special projects, and regular staffing gains and losses that need to be tracked and reported to Medical Center Leadership. Challenges existed prior to training, because:
- Project schedule and performance targets were not being met because they were behind six-months.
- Consistent and reliable information needed to be shared across services (i.e., HR and Fiscal).
- There were data quality concerns due to lack of standardization of processes (i.e., several employees would be entering related data into the system at the same time).
- The quality of the management reports would not be trusted would without process/data controls in place.
Implementation Results: Improved management of project activities which has allowed the project to get back on schedule. Additionally, the quality of data has improved, the processes have been standardized and additional reporting capabilities have been built-in the database to support stakeholder needs. Indirect benefits have also been realized as result of the improvements, i.e., such as cost savings resulting from fewer resources required to enter data and generate reports and improved decision making resulting from more accurate information. The reports from the database are now widely used and relied upon for management briefings, including Durham’s regular budget briefings and resource management council.
Next Steps: The project roll-out and implementation was successful, but Mr. Mavraganis continues to monitor data quality and make updates as necessary – to ensure the results of the improvements are sustained and leveraged going forward. Specifically, as programs and initiatives change, changes in the structure of the database and output reports would need to be modified. As a result, they are making regular updates to reflect these changes. The database has also generated a lot of interest within the Medical Center, i.e., many Service Chiefs and other Medical Center staffs have requested user access to the reporting side of the database. This has created the need to create new user profiles and potential develop new report – none of which was originally anticipated but will be of a benefit to the Medical Center.
Improvement Action Description: Ensure timely return of critical and long-lead time submittals to mitigate delays and finger pointing that are common in most construction projects. Develop and publish a performance work statement (SOO or SOW) to ensure the requirements right and concise. Develop a project schedule to track activities, milestones and deliverables to assure the project runs smoothly and that tasks are managed effectively and necessary efforts are coordinated. Develop an effective vision statement to set goals for the project as well as motivate and empower the team.
Purpose of Implementation: This project will upgrade and retro-commission the heating, ventilating and cooling (HVAC) system in two areas that have changed space and or function due to the closing of the main medical center building following the flooding from Hurricane Katrina. Prior to training, there were significant challenges meeting schedule target – due to an unplanned events during the phasing discussing resulting from the multiple “moves” that had to occur. The project lacked clear direction and a schedule to support tracking of key milestones.
Implementation Results: Implementation resulted in maximized submittal review and approval time(s)) which have in turn maximized manufacturers’ delivery times to meet the project schedule. The development of a clear SOW provided the general contractor with a clear understanding of the project requirements and thereby reduced the potential for change orders during contract performance. Phasing of the project was completed prior to the Notice to Proceed which provided clinic managers with a realistic view of the project’s impact on patient appointments and location logistics associated with each phase. Additionally, stakeholder buy-in to the project Vision Statement indicates increased collaboration among project stakeholders.
Next Steps: Mr. Jackson plans to continue to increase his overall project performance. Through training, he has learned the importance of doing as much work as possible up-front and realized the benefit of identifying barriers, acquisitions needs, and risk prior to solicitation to help assure his projects success. Additionally it has provided him with the necessary skills and abilities (in regards to scheduling, knowing what information needs to go into a SOW, project goals and visions, determining evaluation criteria, critical elements, the triple constraint, how to develop project, risk, quality, change, and communication management plans, leverage EVM, as well as developing and presenting project status briefings and reports) – all resulting in a toolbox of skill sets he plans to continue to leverage in the management of projects. In his own words Mr. Jackson said, “I think I’ve become a better project/program manager by being able to scope out what I’ve learned. I believe I can help my project achieve the project goals through specified improvement actions… my business acumen and stature in the VA [has improved] as I’ve learned how to create a business case for projects/programs that support VA’s mission.”
Improvement Action Description: Developing an Integrated Management Plan (IMP), assign a new contractor project manager, and develop a cost/budget plan using Earned Value Management (EVM).
Purpose of Implementation: The Alameda BRAC transfer of the former Naval Air station at Alameda, CA to the VA is one of the most complex Real Property initiatives the Department has ever undertaken. This initiative primarily involves four Federal Agencies (VA, Navy, US Fish and Wildlife Services and the Environmental Protection Agency), local government and a Veterans Council, which represents a number of Veterans Organizations. The project suffered from many problems, complexities and delays, as a result of not utilizing proper management practices at project initiation. Development of the Integrated Master Plan would facilitate the identification and coordination of the required major steps to make progress on the project after years of delay.
Implementation Results: The implementation of all Action Plan improvement actions has been completed. As result, the Integrated Master Plan was developed and implemented and delayed tasks have been put back on track with active engagement by all key stakeholders. Through the use of EVM, the participant was able to identify areas within the initial contract, where the consultants’/contractors’ value was not aligned to what they were paid. As result, the contract was revised to incorporate EVM components and the under-performing contractor (project manager) has been replaced. Additionally, the supervisor indicated that this long delayed, $200M project has been revived. They have received external stakeholder buy-in from the city of Alameda (which was a major potential barrier), in addition to making head-way with some of the biological/environmental barriers that have contributed to the delay of this acquisition. The supervisor and participant largely attributed their current success to the FAC-P/PM training and how it forced them to step back and look at the big-picture and identify the appropriate project management strategies – to fix their project failures.
Next Steps: The participant plans to continue leveraging strategies from training to improve the overall project performance and increase the awareness of other team members on the benefits and applicability of the concepts (specifically EVM).
Improvement Action Description: Implement an Initiative Level IPT for the VLER IT Privacy/Records Management Program. Define roles and Responsibilities for Project Privacy/Records Managers. Provide training to the Privacy/Records Managers that includes roles, responsibilities, and knowledge required for a successful Privacy/Records Management Program. Develop a Responsibility Assignment Matrix (RAM) for the Program.
Purpose of Implementation: To provide improved service to service members, veterans, and their eligible dependents, the following legacy projects will be assimilated under the VLER umbrella: Information Nationwide (NHIN), Bidirectional Health Information Exchange (BHIE), Federal Health Information Exchange (FHIE), Lab Data Sharing Initiative (LDSI), Federal Recovery Coordination Program (FRCP), and CHDR projects. To reduce the risk of unauthorized release of Personal Health Information (PHI), each project will have a Privacy/Records Manager. These managers will have to undergo training to attain the knowledge required for a successful program. A Responsibility Matrix will define roles and responsibilities to ensure each project is protecting PHI and sharing only as allowed per the HIPAA Act of 1996 and the HITECH Act. The VLER IT Program Management Office is a new office under the VLER Initiative. Therefore, many documents need to be created, including a Responsibility Assignment Matrix (RAM.)
Implementation Results: Ultimately VLER will allow veterans, their dependants, beneficiaries, caregivers, clinicians, and benefits providers the ability to view all relevant information about the veteran seamlessly regardless of where it was documented in a single, secure, electronic record. As a result of the program they have defined and assigned roles and responsibilities as a team; trained personnel on Privacy and Records Management to include records disposition by employees and contractors; improved communication with stakeholders regarding Responsibility Assignment Matrix and project success/failures; and created an IPT charter including goals, scope, and authority.
Improvement Action Description: Review A/E scope of work for Amplification Review to clarify the A/E’s requirements. Develop a RACI Matrix (Responsibility Assessment Matrix) as a tool to communicate with stakeholders. Establish a performance measurement baseline to help the project stay on schedule. Ensure the project team has the appropriate members to provide the best design insight.
Purpose of Implementation: Design and construct a new Behavioral Health Building that has modern services in a Residential Environment. Successful completion of this project requires an effective and well-organized work plan. As such, a RACI Matrix will help align roles and responsibilities and ensure the all members can provide the best design insight. A performance measurement baseline will establish a clearly defined schedule. This project will provide for a better final product to the customer.
Implementation Results: As a result of the project the team has completed an effective RACI Matrix with approval from stakeholders; established a useful baseline schedule to keep the project on track; completed selection of appropriate team members; team members have written a vision statement in preparation for design development.
Improvement Action Description: Create WBS (Work break Down Structure) to allow for effective phasing of the project and maintain the construction schedule. Develop a Statement of Need to develop appropriate goals, establish requirements, and identify stakeholders. Develop a Control Account Plan to control budget and schedule. Develop a Change Plan to allow for an efficient transfer of knowledge and purpose.
Purpose of Implementation: This project is a warehouse renovation intended to accommodate the change in space requirements. Successful completion of the project will require an effective WBS, a statement of needs to establish goals and requirements, and a control account plan to plan for budget and scheduling needs.
Implementation Results: As a result of the project the team has developed a WBS for each phase in the renovation project; established clearly defined requirements, assumptions, interdependencies, and constraints; developed a control plan for each item in the WBS; produced a total life cycle cost estimate; established a vision statement and identified communication channels as part of the Change Plan to allow for efficient transfer of knowledge and purpose.
Improvement Action Description: Develop detailed/high level scope of work for project design. Develop statement of need and acquisition strategy plan for B/3 project. Evaluate and develop detailed contract requirements for WBS and the schedule associated with the progress payment approval process. Integrate requirement in B/3 A/E design requirements. Integrate medical center clinical executive leadership into comprehensive integrated design team for B/3 project.
Purpose of Implementation: This project will be multi-year/multi-phase project to renovate approximately 35,000 SF of building space on the medical center campus. A clearly-defined scope, statement of needs, and WBS will ensure the project is well planned and well organized.
Implementation Results: As a result of the project the team established interdisciplinary design team and developed a final scope of work which will result in improved project design, construction, quality, schedule, budget, and minimize risk to the government. The team also developed a finalized needs statement which will reduce errors and omissions, improve project quality, schedule and managed costs. The team developed detailed requirements to improve the accuracy of monitoring the actual project cost and schedule resulting in improved project management, contract performance and payment process.
Improvement Action Description: Verify that all medical supplies are captured in inventory and establish the 8 Medical Supply Primary Inventory Point to ensure accountability of all medical supplies - as it relates to the medical centers ability to provide patient care. Conduct market research for breast implants consignment / purchase - to support the increased demand for female veterans. Create / implement performance goals and matrix to track the product life cycle of medical equipment. Align performance plans/matrix with organizational goals.
Purpose of Implementation: The project was new and obtaining buy-in has been a challenge impacting their overall success. Additionally, there were no real controls in place for the inventory management which lead to individuals spending money (across the board) with no real concept of the consequences/perspective of the waste. Prior to training, the project that was worked on came in $ 2 million over budget due to poor management. As result, the purpose of the Action Plan will be to facilitate the reorganization of the group in order to improve its function and management.
Implementation Results: As a result of the implementation and an improved approach to manage the new project, structure and accountability was enforced which enabled staff to begin to perform better at their jobs and become more aware of their purchases. The project came in under budget the 1st quarter after implementation. The project the team also completed a 100% physical inventory and verified that all equipment are captured in inventory; trained inventory employees on the inventory system and increased cost efficiencies. Additionally, communication across the spectrum has become more effective and consistent and staff morale has increased. Initially the employees didn’t know how they fit into the big picture and were not aware of the direct/indirect consequences of their actions. Now they are more conscious of what they do and now feel more empowered because they know they are making a positive impact/difference. The customer service is also going up. They used to get 15-16 complaints a day and now they may get one a month. These improvements were largely attributed to the training experience and learning how to not put band-aids on a problem but instead create sustainable processes for a project.
Improvement Action Description: Develop an Executive IMP/IMS Diagram for CDS 2.1.3 and expand the diagram to HDR FY11 work. Perform an audit of the current Configuration Management (CM) contracted support for compliance with the contract. Migrate the VA Development Team to using Agile Scrum. Improve time management by reducing meeting attendance by 10%.
Purpose of Implementation: Develop, implement and maintain services to provide for an enterprise clinical data storage and retrieval system. The purpose of the data storage and retrieval system is to improve communication. It will serve as a useful tool to communicate the program at a non technical level.
Implementation Results: As a result of the project they have been able to migrate the CM staff to Agile Scrum; obtain training for the development team; and reduced meeting load by 10%. This initiative will improve communication between technical and non technical teams and the various oversight groups (IPTs, Data Consortium, TPD Office, ESM Office and Business Owners).
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