Managing Services and Improvement

1. 7 Managing Services and Improvement Cambridge Management and Leadership School

2. Defining and mapping processes

3. The outcome of a process mapping exercise would be the process map and any associated reports, together with action plans based on the recommendations of the process mapping. • A process consists of a number of activities that are organised into an appropriate sequence and coordinated to achieve a specific purpose. Input  output • A service is made up of a number of processes that work together to deliver the service. • System describes all the services, processes, activities involved in the delivery of a particular aspect of health or social care

4. Select Define and Map the Process for effective service delivery

5. Map the process • Identify • The people involved • Any travel or transport required • Any professional or service boundaries crossed • Sources of feedback and information • Points at which decisions have to be made • Points at which delay occurs • Any specialist equipment required • Other factors that are important in your success Remember – you have to consider project management tools and techniques to define, and deliver the project

6. What is a Project? • Project Defined • A complex, nonroutine, one-time effort limited by time, budget, resources, and performance specifications designed to meet customer needs. • Major Characteristics of a Project • Has an established objective. • Has a defined life span with a beginning and an end. • Requires across-the-organizational participation. • Involves doing something never been done before. • Has specific time, cost, and performance requirements.

7. Defining the Project Step 1: Defining the Project Scope Step 2: Establishing Project Priorities Step 3: Creating the Work Breakdown Structure Step 4: Integrating the WBS with the Organization Step 5: Coding the WBS for the Information System

8. Project Scope: Terms and Definitions • Scope Statements • Also called statements of work (SOW) • Project Charter • Can contain an expanded version of scope statement • A document authorizing the project manager to initiate and lead the project. • Scope Creep • The tendency for the project scope to expand over time due to changing requirements, specifications, and priorities.

9. Step 2: Establishing Project Priorities • Causes of Project Trade-offs • Shifts in the relative importance of criterions related to cost, time, and performance parameters • Budget–Cost • Schedule–Time • Performance–Scope • Managing the Priorities of Project Trade-offs • Constrain: a parameter is a fixed requirement. • Enhance: optimizing a criterion over others. • Accept: reducing (or not meeting) a criterion requirement.

10. Step 3: Creating the Work Breakdown Structure • Work Breakdown Structure (WBS) • An hierarchical outline (map) that identifies the products and work elements involved in a project. • Defines the relationship of the final deliverable (the project) to its subdeliverables, and in turn, their relationships to work packages. • Best suited for design and build projects that have tangible outcomes rather than process-oriented projects.

11. Work Packages • A work package is the lowest level of the WBS. • It is output-oriented in that it: • Defines work (what). • Identifies time to complete a work package (how long). • Identifies a time-phased budget to complete a work package (cost). • Identifies resources needed to complete a work package (how much). • Identifies a person responsible for units of work (who). • Identifies monitoring points (milestones) for measuring success.

12. Step 4: Integrating the WBS with the Organization • Organizational Breakdown Structure (OBS) • Depicts how the firm is organized to discharge its work responsibility for a project. • Provides a framework to summarize organization work unit performance. • Identifies organization units responsible for work packages. • Ties organizational units to cost control accounts.

13. Step 5:Coding the WBS for the Information System • WBS Coding System • Defines • Levels and elements of the WBS • Organization elements • Work packages • Budget and cost information • Allows reports to be consolidated at any level in the organization structure

14. Responsibility Matrices • Responsibility Matrix (RM) • Also called a linear responsibility chart. • Summarizes the tasks to be accomplished and who is responsible for what on the project. • Lists project activities and participants. • Clarifies critical interfaces between units and individuals that need coordination. • Provide an means for all participants to view their responsibilities and agree on their assignments. • Clarifies the extent or type of authority that can be exercised by each participant.

15. Project Communication Plan • What information needs to be collected and when? • Who will receive the information? • What methods will be used to gather and store information? • What are the limits, if any, on who has access to certain kinds of information? • When will the information be communicated? • How will it be communicated?

16. Developing the Project Plan • The Project Network • A flow chart that graphically depicts the sequence, interdependencies, and start and finish times of the project job plan of activities that is the critical path through the network. • Provides the basis for scheduling labor and equipment. • Enhances communication among project participants. • Provides an estimate of the project’s duration. • Provides a basis for budgeting cash flow. • Identifies activities that are critical. • Highlights activities that are “critical” and can not be delayed. • Help managers get and stay on plan.

17. Ten or fewer team members Voluntary team membership Continuous service on the team Full-time assignment to the team An organization culture of cooperation and trust Members report solely to the project manager All relevant functional areas are represented on the team The project involves a compelling objective Members are in close communication with each other Conditions Favoring Development of High Performance Project Teams

18. Building High-Performance Project Teams • Recruiting Project Members • Factors affecting recruiting • Importance of the project • Management structure used to complete the project • How to recruit? • Ask for volunteers • Who to recruit? • Problem-solving ability • Availability • Technological expertise • Credibility • Political connections • Ambition, initiative, and energy • Lesser Familiarity

19. Managing Quality in Service Delivery • Quality is • Fitness for purpose (Juran, 1986); • Conformance to requirements (Crosby, 1984); • The totality of features and characteristics of a products or service that bear on its ability to satisfy or implied needs (ISO, 1986); • The degree of conformance of all the relevant features and characteristics of the products (or service) to all aspects of a customers’ need, limited by the price and delivery he/she will accept (Groocock, 1986).

20. Quality is about meeting the needs of all customers, internal and external

21. Difference perspectives on quality

22. Why is Quality Important? • It is important to service users • It is important to your staff / team • It helps you to reduce costs • Good quality may not always save money, but poor quality always cots and usually wastes money (Carruthers and Holland, 1991)

23. Quality Problem Adapted from Martin, Charlesworth And Henderson, 2010

24. Dimensions of Quality in Care Services Adapted from Martin, Charlesworth And Henderson, 2010

25. Analysing the causes of Quality Problem • A useful technique for analysing the causes of any quality problem is to use a cause and effect or fishbone diagram. • It helps in sorting out and make a sense of relationship between various possible causes that may lie behind the problem. • Drawing a fishbone diagram allows you and others to focus on the issues involved and to see how they might relate to each other.

26. Drawing basic fishbone diagram – it looks like

27. Constructing a fishbone diagram - stages • Write the quality problem on the right hand side of a large piece of paper or a whiteboard and draw a structure with a few branches that look like the bones of a fish (previous slide diagram) • Use your own notes or discuss with your team al the possible causes of the quality problem you are experiencing • Write the first possible cause on one of the branches – it does not matter which one. • Then take another of the possible causes you have identified and decide whether it is a similar or related to the first one. If it is, put it alongside the first one on the same branch. If it is different or unrelated, put it on another branch

28. Constructing a fishbone diagram - stages 5. Work through all possible causes you have identified, clustering relating problems on appropriate branches. You may find you need extra branches, or that more possible causes occur to you while you are building up the diagram. Add them in when you need to. 6. The final stage is to look at the branches, decide what categories of causes they represent and add labels to each branch to describe the categories.

29. Example – click on the link below to see how to develop a fishbone diagram • http://nexus.som.yale.edu/ph-tanzania/?q=node/131