Roughly five years ago, Roanoke, Va.-based Carilion Clinic recognized the need for an organizational pivot to better align system strategic plans with major operational initiatives. That led to the creation of its Enterprise Project Management Office, which leaders say has already yielded results.
At the outset, senior leaders sought to build an internal group that could consistently implement and support the organization’s strategic plan.
Carilion — an integrated health system with seven hospitals, home health services, imaging, pharmacies, urgent care centers, a ground and air transportation network and a more than 800-member multispecialty physician group — had previously housed pockets of project management within various departments, Webb Burns, vice president of business development at Carilion, told Becker’s. However, the health system’s goal was more standardization, as many project managers were splitting their time between project management and day-to-day operations.
“There was a desire to bring a focused, centralized group together that could deliver project management in a standardized, replicable fashion across the organization, and that could also take advantage of lessons learned from one project to the other,” Mr. Burns said.
Thus, Carilion launched its EPMO in 2021, and the office serves as that centralized support structure for executing large, strategic projects across the system.
“We’ve taken the approach that, if it’s a project, and if it has, say, more than five to 10 people, if it crosses multiple areas, if it’s longer than six months in duration, it’s a project that we’re going to support,” Mr. Burns said. “So I never like to be in the business of saying ‘no’ or ‘well, we’ll get to it at some point.'”
While the EPMO provides full-on project management support for complex, multi-departmental projects, it also provides advisory services for internal teams that may require the office’s support. There are six full-time project managers as well as two EPMO specialists.
In addition to project management, the EPMO is designed to enhance the level of understanding of project management across the system. This means holding training courses during which operational leaders may learn more about project management.
For the purposes of the EPMO, a “project” is “something that has a start, has an end, so it has a defined time frame. But most important, it’s unique,” Mr. Burns said.
“Now, that may sound easy, but the analogy I like to use is: When Amazon started building warehouses, I’d say the first ones — two to three — those were projects, because those were new. They’d never really done them before. But at some point, that transitions to operations, and it becomes part of someone’s day-to-day job. Now, warehouse number seven or eight might involve different regulatory matters that they have to deal with because of the specific jurisdiction they’re in, but at that point, it’s really more of just day-to-day operations. That’s what a project is.”
In terms of successes, the EPMO has completed 139 projects and seen tangible outcomes. For example, it created freestanding COVID-19 vaccination clinics.
“We had an EPMO project manager doing that during COVID,” Mr. Burns said. “We had another project manager actually leading a project to develop novel personal protective equipment and aids — so a very unique face shield [for Carilion Life-Guard Helicopter crews].”
Mr. Burns said Carilion has also had project managers supporting the health system’s major capital projects, from a new ambulatory pediatric center to a new tower, which is slated to open in July.
“We’ve had the same project manager, [Brent Lorton], lead the pediatric center project, the tower project,” he added. “Now that project manager is going to go on and support our new oncology building. The value there, by having that one individual oversee that work, is important.
“Certainly, there are many other project managers involved. The EPMO is [not] running the whole thing. We’ve got project managers from our construction area. We’ve got project managers from our technology area. We have a lot of clinical leaders involved. But one of the real benefits of the EPMO is being able to apply those lessons learned from one project to another.”
Mr. Burns said another benefit is Carilion has shortened considerably the time needed to launch a project.
“Because now we don’t have to look for and find a project manager somewhere in the organization that has capacity,” he said. “Our senior leadership and other leaders can go right to the EPMO and get that work started.”
Paul Davenport, system senior vice president at Carilion, knows the program’s successes firsthand, as he has been a consumer of EPMO resources. He specifically pointed to a project in which these resources facilitated a three-year engagement with a consulting firm, which concluded about six months ago and resulted in significant improvements in hospital flow, throughput and length of stay.
“One of the key reasons we were able to execute — in addition to that great consultant company and our people adopting and doing some different things — is that we had an EPMO project manager assigned to the consultant engagement. They were the interface from the consultants to our organization. That person streamlined all the asks from the consultant group, aligning and organizing things — such as meetings with technology groups, meetings with analytics — [and] attending and hearing the buildup of what is occurring in the consulting engagement.”
Mr. Davenport said the EPMO also allowed those working on the project to catalog and have a repository of the meetings, briefings, strategic documents, and meeting minutes, creating efficiency in terms of accessing information throughout the project. This particularly helped amid leadership shifts related to the project, which had a scope focused on creating improved access — at Carilion’s tertiary care center and its other community hospitals — by improving length of stay and care progression, among other goals.
Mr. Burns and Mr. Davenport encouraged other systems to consider how they deliver project management, if they have not already. More specifically, they advise systems to examine how complex projects are being delivered.
“Sometimes in healthcare, we’re talking about what we’re doing and there’s a lot of resistance,” Mr. Davenport said. “Someone might say, ‘Oh, I don’t think …’ or, ‘I’m not sure.’ If somebody’s pushing for EPMO or wants that — the price of not having this is that you are choosing, as a healthcare system, to slow down your change management efforts, potentially introduce risk of loss of connection or loss of results, and you’re going to use leadership bandwidth to navigate complex project management. That’s the choice.”
