Nuances of Project Management: A Physician’s Experience


By Dr. Richa Uppal

Oregon, USA

Calvin: They say the secret to success is being in the right place at the right time. But since you never know when the right time is going to be, I figure the trick is to find the right place and just hang around!

Hobbes: Being with you, it’s just one epiphany after another.

(from The Days Are Just Packed by Bill Waterson)

The objective of project management is to provide the foundation and structure for repeatable project success. As a physician asked to take a leadership role in restructuring and standardizing workflow at our institution, I was able to apply some project management principles to a process improvement project. My objective is to share my journey in order to bring it alive for other physicians, who may not have been introduced to this powerful tool, and may benefit from it. Often in the healthcare field, outside consultants and IT professionals design changes which impact the daily work practices of physicians and nursing staff. While this brings needed skills and professionalism, it can cause knowledge loss and lack of alignment with the organization’s overall goals. Consequently, it would be useful to start building project management competency within the healthcare profession.

I had taken an elective in project management as part of my Master’s program in clinical research at Oregon Health Sciences University (OHSU). OHSU is unusual among medical schools, to offer courses in project management. Around the same time, I was asked to chair a team to standardize workflow for rooming patients.

Patient rooming is a pre-visit preparation process. It involves obtaining records for emergency room and specialist visits, medication information, preventative health screening tests, vaccination and social history, and then taking the appropriate vital signs in preparation for the doctor’s visit. When this is an efficient process, the doctor can focus on treating the patient, instead of looking for information or materials and wasting time and healthcare dollars in the process. It would be analogous to having executives research meeting venues and make their own travel arrangements while being paid top dollar.

Our leadership council had determined that standardization of nursing activities in preparing for a physician visit would be the first step toward streamlining the clinical workflow. This project was mandated after a switch to a new complex electronic medical health record (EMR), when it became evident that the current workflow was grossly inadequate. Physicians were spending a lot of time entering data in EMR that could be collected by nursing staff.  A twenty-member process improvement (PIT) team was created, which consisted of two senior partners, their staff, six nurse managers from each branch of our institution, a Human Resource Manager, an IT and electronic health record specialist and the Chief Information Officer. Six months into its inception, I was asked to join — the co-chair left a week later.


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About the Author

pmwj21-apr2014-Uppal-AUTHOR IMAGEflag-usaDr. Richa Uppal

Oregon, USA

Dr. Richa Uppal practices Internal Medicine at the downtown Portland Clinic in Portland, Oregon, USA. She attended medical school at Manipal University in India, and completed her Internal Medicine Residency at New York Downtown Hospital. After moving to Portland in 2010, she completed a Master’s in Clinical Research from OHSU. According to Richa, “I believe in a common-sense approach to medicine, one where the provider collaborates with the patient to achieve great physical and mental health. I try to stay on the learning curve and improve continuously, so I can provide the best care to my patients. I have a special interest in LEAN, project management methodologies and professional communication in the setting of health care.”

You can reach Dr. Richa Uppal at [email protected]