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PM Essence

Mapping of PM process groups, Knowledge Areas in a Medical Surgery

By Shikha Vaidh, PMP
Unlike in a Pilot's operation, there is no checklist in surgery, it is just the surgeon's experience and intuition that dictates how a procedure is performed.

As we understand, everything which has a start and an end and has a specific goal is said to be a project. So a surgery which happens for a specific goal can also be considered as a project.

It can be the operations for a Surgeon who is specialized in doing the surgeries as it may be his daily task, but still each surgery can be different for him with a unique start and an end.

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So the question arises, do the surgeons follow the PM guidelines stated in PMBOK guide - or let's narrate in a different way - is it possible to apply the project management standards in a surgery where there is a question of life and death for someone?

I tried to correlate the steps which doctors usually take, patient and their family/ friends go through during a surgery with the PMBOK standards, and understood like any industry, these standards works in Medical Science as well. Though we all know this and you may not find anything new here, but in our day to day life style we do not give much thought to these.

What is a Surgery?
As a general rule, a procedure is considered surgical when it involves cutting of a patient's tissues or closure of a previously sustained wound. As a general rule, a procedure is considered surgical when it involves cutting of a patient's tissues or closure of a previously sustained wound. Patient is the customer here and the doctors, hospital staff is the Project team who is going to work on it.

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Initiating – The time when “Doctors say the surgery is required and the patient agrees to it”. After complete diagnosis of the problem reported by the patient, doctors decide to go for the Surgery and convey to the related family members (important stakeholders), which is where the initiation starts. Surgery is scheduled. Patient and the physician will sign the “Informed Consent Form” - Develop Project Charter (Integration) for a surgical procedure. Preauthorization for surgery may have to be obtained from the insurance company. Identify Stakeholders (Communication): Identifying the important stakeholders with whom the communications needs to happen during the entire life cycle of the project.

Planning Duration between the day when the initiation i.e. the date is been given till the actual Date of surgery, planning happens.

Develop Schedule Next step, they do the planning when they decide to go for it. Surgical procedures are commonly categorized by urgency, type of procedure, body system involved (e.g. known allergic reactions, diabetes), degree of invasiveness, and special instrumentation.

a. It all depends -if it is very urgent then planning happens in different ways, and if not that urgent, they actually prepare the patients to undergo surgery by giving the medicines and attending to any special testing that has to be done prior to the surgery, verification of medical history, allergies and all medications and supplements patients are taking. Develop Project Management Plan (Integration).

b.
Do they have all the necessary instruments which are required for the surgery, making the plan to keep the OT ready, Preparations before Surgery. Collect Requirements (Scope), Define Scope (Scope).

Fasting before your surgery (NPO)- What this means:
• NO FOOD after midnight the night before your surgery
• No gum, breath mints or chewing tobacco after midnight
• Fasting limits on clear liquids and water will have been explained by the Pre-Surgery Testing.
• You may brush your teeth, but DO NOT SWALLOW THE WATER
• Call your surgeon's office if you develop a cold, sore throat, fever or any other illness that occurs within 24 hours of your surgery.

c. Getting all the required tests done, Pre-surgery Testing. Define Activities (Time), Sequence Activities (Time), and Estimate Activity Resources (Time), Estimate Activity Duration (Time).

d. How much blood needs to be arranged etc... Create WBS (Scope), Plan Procurement (Procurements).

e. Who all should be available on that day, during the surgery, depends on kinds of operations. Which team of doctors and supporting staff to be available? (Resource Calendars) Develop HR Plan (HR), Plan Communication (Communication).

f. Understanding the cost of the complete surgery. Estimate Cost (Cost), Determine Budget (Cost).

g. Identifying the risks and impacts of the surgery on the patient as well as the stakeholders. This can be done from both ends - doctors as well as family members. Plan Risk Management (Risk), Identify Risk (Risk), Perform Qualitative Risk Analysis (Risk), Perform Quantitative Risk Analysis (Risk), Plan Risk Response (Risk).

h. Plan for a Smooth Recovery. Ask the physician what the patient should expect in the days and weeks after the procedure. Purchase any necessary supplies in advance, and make sure you have adequate post-operative help, whether from a family member or professional caregiver. Plan Quality . . .Continued in Next Issue