Defining an IT Project Governance for Decision Making
By Bonnie Ratliff

Whether an IT project is a full implementation, an enhancing upgrade, or a streamlining optimization, certain oversight structures are requisite: project charter, project plan, stakeholder identification, validation and approval process, proof of concept, and – eventually – go-live. The project charter serves as the platform upon which the project’s overall mission, vision, business justifications, objectives, scope, governance, methodologies, and “rules of the road” are established.

Of these, project governance, defined as the management framework within which project decisions are made, is paramount to the success of any project. Although the healthcare organization may have a strategic governance structure in place for business decisions, a similar framework for IT project decisions may never have been developed. Thus, it is incumbent upon the consultant to inform the client that such a principle is imperative.

Effective project governance depends on an approach that supports decision making. To assure that strategic initiatives and regulatory requirements are kept in mind as decisions are made for the project, a Project Steering Committee (PSC) must be formed from those individuals who are empowered to make decisions on behalf of the clinical staff, along with those who represent administration. A Clinical Advisory Group (CAG) can be used as a conduit for design decisions. This group would facilitate clinical staff (nurses, physicians, and ancillary) discussions about the design of the Electronic Health Record (EHR) to create an enterprise-wide product. User groups would also need to be mobilized to navigate redesigned applications or sub-apps. These groups would analyze workflow and determine essential content necessary to meet daily staff needs.

Project governance outlines the relationships between internal and external groups. Depending on the breadth of the project, these relationships can become rather complex because of many simultaneously moving parts during the life of a project. The governing body assures that required approvals and task direction for the project are obtained when needed.

Four key concepts for project governance must be understood by all parties involved and established by the PSC:

• Separate project governance from organizational governance
• Ensure a single point of accountability
• Project outputs must support service delivery needs
• Keep committee size manageable (decision making effectiveness can be inversely proportional to the size of the committee)

Central to any project governance, a communication plan is needed to define the frequency of reports from committee to committee. The reporting information between the CAG and the user groups would be more clinical in nature and contain details that the PSC might not need. Information submitted to the PSC should resemble more an executive summary that would:

• Determine whether the project’s time line and milestones are being met (If not, why?)
• Provide detail on budget and resources
• Apprise of project status
• Evaluate the project’s management scope (scope creep?)

Diagram 1 outlines an example of an efficacious project governance structure: