7.2 Project and Change Management

Project Management Fundamentals

A project is a temporary effort with a defined start, end, and deliverable — for example, implementing a new computer-assisted coding (CAC) system. Every project is governed by the triple constraint (the project management triangle):

• Scope — the work and features to be delivered
• Time — the schedule and deadline
• Cost — the budget and resources

These three are interdependent: expand scope and you must add time or cost; cut the budget and you must reduce scope or extend the schedule. Quality sits at the center and suffers when any constraint is squeezed. Recognizing this trade-off is a frequently tested concept — if a sponsor demands an earlier go-live without more money, scope must shrink.

Scope creep — uncontrolled addition of requirements after the project starts — is the classic cause of project failure. A change-control process prevents it.

Scheduling Tools: Gantt Charts and the Critical Path

Projects are decomposed into tasks with dependencies, then scheduled.

The critical path is the longest sequence of dependent activities; any delay on it delays the whole project. Tasks not on the critical path have slack (float) — they can slip without affecting the end date. Milestones are zero-duration markers of major checkpoints (e.g., "go-live approved"). On the exam, if asked which delay pushes the deadline, the answer is the task on the critical path.

The Systems Development Life Cycle (SDLC)

HIM professionals participate in selecting and implementing information systems through the SDLC, a structured five-phase model:

1. Planning — define the problem, feasibility, and project scope.
2. Analysis — gather and document requirements (often via workflow analysis).
3. Design — specify the system, screens, data flows, and build or select the product.
4. Implementation — install, test, train, convert data, and go live.
5. Maintenance / support — fix, optimize, and eventually retire the system.

A frequent trap: end-user training belongs to implementation, while requirements gathering belongs to analysis.

Change Management

New systems and processes fail when people resist them, so HIM leaders apply structured change management.

Lewin's three-stage model is the foundation:

1. Unfreeze — create awareness that change is needed; reduce resistance.
2. Change (move) — implement the new process, communicate, and support staff.
3. Refreeze — embed and reinforce the change so it becomes the new norm.

Kotter's 8-step model expands this with a sequence that begins by creating urgency, then building a guiding coalition, forming a vision, communicating it, empowering action, generating short-term wins, consolidating gains, and anchoring change in the culture.

Resistance is reduced through communication, involvement, education, and identifying change champions among respected staff.

Workflow and Process Mapping

Before automating or redesigning a process, HIM analysts document it.

• A flowchart uses standard symbols (oval = start/end, rectangle = process step, diamond = decision) to map the steps of a process such as deficiency analysis or the ROI workflow.
• A process map distinguishes the "as-is" (current) state from the "to-be" (future, improved) state.
• A swim-lane diagram adds columns showing who performs each step, exposing hand-offs and bottlenecks.

Never automate a broken process — map and fix the workflow first.

The Project Life Cycle and the Work Breakdown Structure

Projects also progress through a project management life cycle of five process groups defined by the Project Management Institute (PMI): initiating (charter the project and name a sponsor), planning (define scope, schedule, budget, and risk), executing (do the work), monitoring and controlling (track progress and manage changes), and closing (deliver, document lessons learned, and release resources). Do not confuse this with the SDLC, which is specific to building information systems.

During planning, the team builds a work breakdown structure (WBS) — a hierarchical decomposition of the total work into manageable tasks and deliverables. The WBS feeds the schedule, the cost estimate, and the assignment of responsibility. A project charter formally authorizes the project and names the project manager, while a scope statement documents exactly what is and is not included — the chief defense against scope creep.

Managing Resistance and Communication

Change fails most often because of people, not technology. HIM leaders plan a communication strategy for each stakeholder group, identify the drivers and barriers to adoption, and use change champions — respected peers who model the new behavior. Resistance commonly stems from fear of the unknown, loss of competence, or increased workload during transition; it is addressed with education, involvement, two-way communication, and visible executive sponsorship.

Go-live support — super-users on the floor, at-the-elbow help, and a feedback loop — is part of Lewin's change stage, while ongoing audits, refresher training, and updated policies accomplish refreezing. A change that is implemented but never reinforced regresses to the old workflow.

Rummler-Brache and other process-mapping disciplines, along with business process reengineering (BPR) — the radical redesign of a process rather than incremental tweaks — round out the toolkit a leader chooses from depending on whether the goal is continuous refinement or a clean-slate overhaul.