The quality guru W. Edwards Deming said ‘In God we trust, all other bring data’. However, recent developments in the Victorian Government health system offer a salient reminder to any PMO manager on the value of data.
Victorian hospitals are rewarded for good performance and fined for poor performance. One measure being the length of waiting lists another is the time patients wait in casualty/emergency area before admittance. Rumours have been circulating for several months that some administrators were manipulating data to avoid fines and win bonuses – both adjusted against the hospital’s funding for the year (ie, no one personally benefitted from the manipulation). An audit report has confirmed many of the rumours and has found behaviours that in many cases are worse for the patients and worse of the hospital than if nothing had occurred.
One example is transferring patients from emergency care to the operating theatre waiting area to avoid a fine for failing to admit the patient within the prescribed maximum time. The consequences of this action include:
- The patient being removed from an area focused on emergency care to an area with little monitoring capability – a reduction in care to the patient.
- The reduction in throughput in the operating suites due to overcrowding and skilled theatre staff having to spend time on patient care rather than operations.
- A net reduction in the overall delivery of service by the hospital; but improved statistical reports to Government.
This farce was in the interests of everyone except the people the Government and hospital are supposed to serve, the public needing hospital care. Some of the vested interests include:
- The government’s desire to look good by reducing waiting time.
- The hospitals desire to achieve the maximum budget income for the year.
- The administrators’ desire , both in the hospital and the government, to avoid ‘rocking the boat’.
- The built in bias in government spending to fully spend each year’s budget allocation.
Apart from the obvious issue around the intelligence of a system that removes funding from an institution that probably needs more funding to meet the demands on its services – the only practical way to treat more patients is to provide more beds and staff which cost money… there are a number of important lessons for all PMO managers to consider when setting up ‘project dash boards’ and the like:
- What you measure will change behaviours. Focus on things that matter like value and benefits not easy to measure statistics like time.
- Make sure the data you use is validated.
- Identifying a problem is not enough! You should work with the project team and management to make sure an effective solution is crafted. It’s not the PMOs job to solve the problem but it can be a powerful facilitator of solutions by measuring the right statistics and asking the right questions.
This is a more challenging role but also one that can really contribute to the overall performance of you organisation.
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