Question

Your hospital has a major problem with duplicate medical record numbers. You are implementing a new her and need to get this problem solved before implementation. You decide to hire a consultant to act as the project manager and to use temporary staff to do the actual work. The use of temporary staff is at the suggestion of the consultant. You must train the registration staff on ways to avoid creating duplicate medical record numbers. Some of the temporary staff members have to be trained to pull and file charts. Other temporary staff members are trained to review the charts and determine if there is a duplicate and combine the physical chart where appropriate. A temporary Registered Health Information administrator is responsible for conducting data quality checks. You have a significant amount of temporary staff turnover, resulting in constant training and fluctuation of productivity daily. This results in the RHIA having to do a 100% audit for the entire project, instead of just the beginning as planned. You really have had to speed up the process over the last 2 months to complete the project on time. The project is completed 2 days ahead of time; the quality of the work is great. Now you need to review the final budget for the MPI clean-up.

MPI Clean-UP Budget
Actual Monthly Expenses
Line Item	April	May	June	July	Budgeted	Actual	Variance $
Temp Staff	12345.44	13764.45	21546.63	24454.44	60000	72110.96	-12110.96
Equipment	602.67	0	0	0	1000	602.67	397.33
Project Manager	5000	5000	5000	5000	20000	20000	0
Training	2000	1200	300	300	8000	3800	4200
Total	19948.11	19964.45	26846.63	29754.44	89000	96513.63	-7513.63

Based on the project description and the budget shown, what problems do you see?

Answer 1

Based on the information given in the case, we can see that the project manager did not do enough risk mitigation and detailed planning for the project execution. While getting temporary staff to complete the project was a wise move since the future overheads can be avoided, what the project manager failed to consider was the turnover of the temporary staff. The manager might have considered the chances of few staff leaving but might not have expected such a huge turnover. This led to additional training and the RHIA having to do complete audit for the project. If the project manager had made proper risk mitigation strategies of the project he would have anticipated the increase in cost and time due to such staff movement. But the project manager identified this and took steps to realign the project back on track. This is what helped the project manager in completing the project 2 days ahead of time with good quality. The budget analysis shows that over the last 2 months the cost involved in temporary staff almost doubled the initial days. This could mean that the more staff was taken and higher experienced staff was also brought him who demanded higher charges. The training cost also decreased over period which indicates that the staff who remained on the project could manage to speed up the project and help in supporting other members who might have helped other new members. The budget overshot significantly and this is down to poor planning among the staff hiring.

The major problems in the case is down to the lack of expertise in managing the staff and poor risk mitigation startegies. If the manager was aware that many staff would quit soon then he would have ensured either higher timeline was taken or more staff was kept as backup. the budget analysis shows that there has been significant increased in the cost allocated to temp staff and this is causing major delay in the project. While the manager had anticipated a higher budget for training the staff who were hired in the last months knew the system better and this is what led the reduction in training costs. Apart from that the project manager was experienced enough to ensure the project`s operational issues were identified and rectified.