CONTROL SCOPE CREEP
By: Frank Eudy
Big and small, they happen all the time and out-of-scope requests (OSR’s) often happen for the best of
reasons. These requests may come before, during or after a project. When they occur, they can create contention,
disappointment, or an opportunity for mutual understanding. Under any circumstance, a little understanding and
management of your OSR will pay dividends at the end of your project.
As Project Managers, it is crucial to maintain perspective. Making the clinician’s job easier, more
efficient, and more accurate with ultimate benefit to the patient is the primary reason most information system
departments in clinical institutions are charged with project implementations. The involvement of clinicians on
these projects is integral to their success. As a project unfolds, clinical implementation team members (and
others) often identify areas of project augmentation. Clinicians are typically stakeholders, operating from
their perspective and within their own time and material constraints. They may not (and understandably so) be
familiar with the process and constraints that exist in the world of information systems and project
management.
Let’s take an example. A hospital wide automated medication administration project is in full swing. During
the implementation, a physician has identified anticipated contention for desktop PCs and has requested
additional devices be installed. These PCs are not included in the original scope functionally or financially.
The physician has simply stated the need. The expectation is the project manager will address the need.
Responses such as “you don’t understand the process” or “that’s not within the scope of the project” will be met
with a dim view. This situation requires a balanced response.
Regardless of the existence of a request process, or if the doctor is or is not a member of the
implementation team, the reality is these requests should be treated with the respect they deserve, and
realistic expectations should be established.
The immediate response may be: “Let me make some notes of exactly what you are requesting so that I can
appropriately document this request to the project steering committee. They actually make these decisions.”
Thus the give and take and exchange of information begins. With this first statement, “an offer to take some
notes,” information exchange begins to take place. An understanding is being established; I will work with you
on gathering the details and by the way, there is a higher power that will make the decision, so let’s provide
as much information as possible.
We have found that demonstrating a willingness to listen, discuss and document the request (or provide close
documentation assistance) is the best first step. The documentation process presents a key and significant
opportunity to begin diplomacy, explanation of process and the management of expectations. The follow-up
encounter seems to work best on an informal, conversational basis. Physicians rarely have the time for ad hoc
discussion. An appointment shows respect for time allocation and usually provides a more focused, conversational
atmosphere.
Most times Project Managers may wear several hats, and wear them at the same time:
1. Project Manager
2. Project Council
3. Department Ambassador
The Project Manager Hat:
The Project Manager follows the rules, gathers documentation, and ensures the OSR is presented to the
appropriate decision making entities. The PM knows the information is necessary and needs to be documented. The
documentation of a request is an opportunity to explore OSR components with the physician such as justification,
cost, benefit and intended use. The questions for discussion can be taken directly from an out-of-scope request
form. Make it clear that the request will be identified as coming from the physician and the physician may be
required to speak face to face to the sponsors or controlling committee. What you are actually doing is
reviewing components of the out of scope document whose submittal and approval will probably be required. The
discussion also presents an opportunity to begin knowledge transfer of request and review process. Reviewing
these components now will lessen the impact of formal completion of the document and working through the
approval\denial process when the time comes.
The Project Council Hat:
Project council reviews components of the requests and brings up the details to consider, alternative
perspectives and alternative strategies. Review of these components may stimulate the physician’s thinking
process and result in an adjustment or re-evaluation of the request. As Project Manager you also serve as
Project Council and Department Ambassador.
The Department Ambassador Hat:
The Department Ambassador represents the departments and their interests associated with the request in a fair
and just manor. Our physician needs assurance that the best interest of the project and the institution are the
priority. Never fail to express appreciation and thanks for the request. What is being requested may make the
difference between project success and failure.
So often requests to augment a project are perceived as a threat or risk. If handled properly, they provide
an opportunity for discussion, information exchange and establishment of realistic expectations. If care and
understanding is applied when requests are made and immediately followed-up on, it is likely that contention
and angst will never materialize and a greater understanding will be developed. Increasing the level of
understanding always results in an improved outcome and in the final analysis; physician or clinician requests
could just make or break the project.
Should you like to discuss this or other Project Management ideas, please feel free to email us at
vcs@getvitalized.com.