NR 631: Nurse Executive Concluding Graduate Experience.
NR 631: Nurse Executive Concluding Graduate Experience.
Deliverables and Critical Success Factors
Project deliverables and critical success factors (CSF’s) play an important role to
successful project management. Following a large number of hospital acquired pressure injuries
(HAPI) (Stage 2 or greater) acquired by patients while in the care of one of the units within the
Critical Care Division (Medical Intensive Care Unit, Surgical Intensive Care Unit, Cardiac
Intermediate Care Unit, or Neuro-Trauma Intermediate Care Unit) during the preceding fiscal
year – a decision to implement HRO (high-reliability) principles in conjunction with traditional
HAPI prevention strategies as a strategy to reduce HAPI was made.
HAPI’s can be a source of discomfort, pain, and altered body image for a patient. HAPI
development can negatively impact patient experience. Some studies estimate that the
prevalence of HAPI development within Critical Care could be as high as 43% (Krapfl, Langin,
Pike, & Pezzella, 2017). HAPI development within Critical Care can be extremely costly – costs
which will not be reimbursed by Centers for Medicare and Medicaid Services (CMS) (Boyle,
Bergquist-Beringer, & Cramer, 2017).
ORDER CUSTOM, PLAGIARISM-FREE PAPER
Most HAPI’s are highly preventable and as clinicians -we
have an ethical and moral responsibility to prevent harm to our patients. In the paper below,
discussion surrounding project deliverables, critical success factors (CSF’s), and summarized
conclusion will be provided.
Project Deliverables
Project deliverables, for the HAPI prevention plan utilizing HRO principles in critical
care, include the following: scope statement, project charter, literature review, formal
communication plan, and critical success factors plan. The scope statement is developed at the
start of project planning; however, should be continuously reviewed and updated as
applicable. This is a crucial document for project planning and provides a comprehensive
DELIVERABLES AND CRITICAL SUCCESS FACTORS 3
outline of the project including project objectives, justification, implementation plan, resources
needed, project timeline, and measures of success (project goals/expected outcomes). Successful
resource planning, as detailed within a project scope statement, can be evaluated through
teamwork, organizational culture/receptivity to change, leadership support, development of
business plan/project vision, effective communication, and identification of project champions
(Orouji, 2016). These aspects can be measure through surveys (pre and post project) as well as
through organizational culture of safety surveys and employee engagement/satisfaction
surveys. Additionally, improvements within quality aspects of care are often indicative of clear
vision, sufficient resources, utilization of staff champions, and clear communications of
goals/outcomes.
Project’s charter is another key deliverable for any project. The charter provides
information in detail on key stakeholders as well as roles/responsibilities and project approach,
goals, and budget. Selection of the right stakeholders is essential for the success of any
project. Employees that are engaged can become empowered through the project management
process. Engaged project team members are more likely to collaborate, share information, be
more flexible and open to ideas, develop mutual respect and trust, and have improved problem
solving ability (Hietschold, Reinhardt, & Gurtner, 2014). Employee engagement is measured
within most organizations on an annual or biannual timeframe. Active participation and
attendance at project meetings, meeting project timelines, and active interactions with other
project team members can be a measure of individual project member’s level of
engagement. Review of the literature is important in project management, as it can provide the
most up to date, peer reviewed, best practices related to HAPI prevention strategies and the
inclusion of HRO principles. A key aspect of HRO principles is deference to expertise so this
DELIVERABLES AND CRITICAL SUCCESS FACTORS 4
fits well with identification of the correct stakeholders which does not necessarily mean the
individual with the highest title. Factors that aid in the success of a project include alignment
with organizational strategic initiatives as well as alignment with expectations from key
stakeholders (Carpim-Besteiro, de Souza Pinto, & Novaski, 2015). Current relevant literature
related to HRO principles in conjunction with HAPI prevention strategies to prevent HAPI
development in critical care patients can be measured through a comprehensive literature search
utilizing several key terms and search engines.
The project communication plan and identification of key critical success factors (CSF’s)
are important to the success of the HAPI prevention project. Communication is needed to
establish understanding of project goals, build trust, establish team coordination, and develop
support from a variety of individuals that may come from many different departments
(Muszynska, 2018). Without a thorough, well thought out communication plan – a project will
not be successful. Project communication planning is crucial to define who should receive
communication, what information should be communicated, the frequency and tools to
communicate with, and the most convenient method(s) to all parties involved (Muszynska,
2018). Communication can be measure in a number of manners; specifically, compliance with
opening emails, meeting attendance, posting by a certain timeframe on collaborative sites, and
electronic notification of review of meeting minutes/huddle notes. CSF’s represent best
practices and key indicators that drive a project’s and organization’s success (Hietschold et al.,
2014). CSF’s can serve as parameters to reach/quality measures to be achieved. Many different
CSF’s exist and are utilized based on the project, industry, and ultimate goal. There are a
multitude of CSF’s that can impact a project’s success or failure and can include human resource
DELIVERABLES AND CRITICAL SUCCESS FACTORS 5
management, supply/equipment, training/learning, quality planning, and benchmarking
(Hietschold et al., 2014). CSF measures are discussed more in detail in the section below.
Critical Success Factors by Priority
Critical success factors by priority for this project include an expected HAPI reduction to
be seen in both quarterly NDNQI (National Database of Nursing Quality Indicators) HAPI
Prevalence Reports as well as Monthly HAPI Incidence Reports. HAPI Prevalence is measure
on a quarterly basis on the first Thursday of every third month and benchmarked against other
like units. Benchmarking represents the analysis of best practices as demonstrated by other
leading competitors with like units/patient populations and is utilized for comparison purposes
(Hietschold et al., 2014). Monthly HAPI Incidence Reports are also able to be entered into the
NDNQI database for benchmarking comparison and provide a more comprehensive view of unit
activity over a month’s timeframe.
Another CSF’s for this project includes weekly project status update reports to provide
project team members, the project sponsor, and pertinent individuals within the organization – an
overview of the project’s progress, interventions implemented thus far, compliance with budget
and timeframe, and ultimate alignment with project goals. This would be completed by the
project manager and an electronic weekly ‘push report’ would be forwarded to key
stakeholders. Communication of the project’s progress is the most important critical success
factor within an organization (Carpim-Besteiro et al., 2015). Other CSF’s include an updated
project scope and charter documents. Measures of completion include team members as well as
organizational awareness of project existence, progress, and ultimate goal(s). This could be
measure through pre and post project survey. Additionally, this can be measured through project
team member engagement and empowerment. Empowerment fosters a bottom up identification
DELIVERABLES AND CRITICAL SUCCESS FACTORS 6
of problems, rapid response, and authority to implement corrective actions to prevent harm
which are all aspects of HRO principles (Hietschold et al., 2014).
Budget planning is important to any project and provides a detailed list of project
expenses, revenues, and other miscellaneous costs. The budget plan clearly details required
resources (human resources as well as supplies, equipment, etc.). Budget plan is integral to the
success of the project and should include budget compliance, variance explanation, reward
systems as applicable, and definition of restrictions as identified (Carpim-Besteiro et al.,
2015). Budget plan should be clearly and logically measured on an ongoing manner (at least
monthly) through an electronic program or minimally an excel spreadsheet. Lastly, the project
governance document provides important information related to compliance with team member
education (measured through completion of online, educational class) as well as team member
attendance at project meeting at the defined frequency listed within the project charter.
Conclusion
In conclusion, identification of both project deliverables and critical success factors
(CSFs) are crucially important to the success of any project. Project deliverables for the HAPI
prevention project utilizing HRO principles include scope statement, project charter, literature
review, communication plan, and critical success factors plan. Whereas, the critical success
factor’s plan is comprised of HAPI reduction as evidenced in both the NDNQI HAPI quarterly
prevalence audit as well as the NDNQI HAPI monthly incidence report. Both these reports are
able to be benchmarked against like units for comparison of project progress. Other CSF’s
include weekly project status update reports, updated scope and charter documents, revised
budget plan based on project revenue and expenses, and project governance plan. CSF’s can
serve as reference parameters for a basis to leverage the success of a project (Carpim-Besteiro et
DELIVERABLES AND CRITICAL SUCCESS FACTORS 7
al., 2015). Within this paper, a discussion of the importance of both project deliverables as well
as critical success factors was completed and a summarizing conclusion provided.
DELIVERABLES AND CRITICAL SUCCESS FACTORS 8
References
Boyle, D. K., Bergquist-Beringer, S., & Cramer, E. (2017). Relationship of wound, ostomy, and
continence certified nurses and healthcare-acquired conditions in acute care hospitals.
Journal of Wound, Ostomy, and Continence Nursing , 44(3), 283-292.
http://dx.doi.org/10.1097/WON.0000000000000327
Carpim-Besteiro, E. N., de Souza Pinto, J., & Novaski, O. (2015). Success factors in project
management. Business Management Dynamics, 4(9), 19-34. Retrieved from https://eds-a-
ebscohost-
com.chamberlainuniversity.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=20&sid=7097951
5-9855-4850-a62e-26c162ee693f%40sdc-v-sessmgr03
Hietschold, N., Reinhardt, R., & Gurtner, S. (2014). Measuring critical success factors of TQM
implementation successfully – a systematic literature review. International Journal of
Production Research, 52(21), 6254-6272.
http://dx.doi.org/10.1080/00207543.2014.918288
Krapfl, L. A., Langin, J., Pike, C. A., & Pezzella, P. (2017). Does incremental positioning
(weight shifts) reduce pressure injuries in critical care patients? Journal of Wound,
Ostomy, and Continence Nursing, 44(4), 319-323.
http://dx.doi.org/10.1097/WON.0000000000000340
Muszynska, K. (2018). A concept for measuring effectiveness of communication in project
teams. Journal of Economics and Management, 33(3), 63-79.
http://dx.doi.org/10.22367/jem.2018.33.04
Orouji, M. (2016). Critical success factors in project management. Journal of Project
Management, 1(1), 35-40. http://dx.doi.org/10.5267/j.jpm.2017.1.001
NR 631: Nurse Executive Concluding Graduate Experience.
DELIVERABLES AND CRITICAL SUCCESS FACTORS 9
Appendix: Deliverables and Critical Success Factors (CSF)
Project: Hospital Acquired Pressure Injury (HAPI) Prevention Plan Utilizing HRO Principles in Critical Care
Project Manager: Karen G. Niewood Date: October 7, 2018
Deliverables (Include Scope, Charter)
Description
Scope Statement
Comprehensive document outlining project and includes specific information related to project objectives, justification, implementation plan, required resources, timeline, measures of success, assumptions, and constraints.
Project Charter
Charter document provides overview of pertinent information related to budget, measurable project outcomes, project approach, stakeholders and associated roles and responsibilities.
Literature Review
Detailed, comprehensive listing of relevant, peer reviewed, best practice literature that is less than five years old and details specific information needed for project success (namely, information on project management, application of HRO principles, and strategies to reduce HAPI’s within the critical care patient population.
Communication Plan
Communication plan is critically important and details parties to communicate with, frequency of communication, preferred method(s) of communication, information to be shared, and tools that support effective team/organizational communication on an ongoing basis.
Critical Success Factors (CSF) Plan
Details specific factors that contribute to the likelihood that the project will be successful. These may strategic implications. CSF represent best practices and key indicators that drive organizational success.
DELIVERABLES AND CRITICAL SUCCESS FACTORS 10
Critical Success Factors (CSF) by Priority
1. HAPI Reduction as evidenced within HAPI Prevalence Reports – Quarterly prevalence report collected the first Thursday of every third month and submitted to NDNQI (National Database of Nursing Quality Indicators. Reports with graphs received from NDNQI on a quarterly basis listing benchmark comparison.
2. HAPI Reduction as evidenced within Monthly HAPI Incidence Reports – Compiled data from HAPI incidence event reports entered by specific unit staff each day.
3. Status Reports – Project status update reports noting pertinent project information, results of interventions, and compliance with project timeline and project budget. Status report to be shared with project sponsor, project team members, key stakeholders, and all other appropriate team members that should possess project update information.
4. Updated Scope Document – Updated communication document for all project members providing information on project objectives, justification, implementation strategy, project resources, timeline, measures of success, assumptions, and constraints.
5. Budget – Project associated revenue, expenses, and miscellaneous costs. Project budget will be maintained within five percent or $2500 of original approved budget and include realistic, reasonable projections.
6. Charter – Project charter will include all scope changes as well as budget information, measurable project outcomes, project approach, and specific roles and responsibilities. The updated charter will be approved by all stakeholders as well as management and will be communicated to all.
7. Governance – Governance will include bedside nurse involvement in the project which will include timeliness of education completion (measured through online educational program completion), project involvement, ownership of decision- making aspects/interventions, identified concerns addressed in a timely manner. Governance defines meeting frequency, location, and required participation. The project will be completed on time and within budget. NR 631: Nurse Executive Concluding Graduate Experience.