Nov 2, 2017 in Management


This paper is written with the purpose to make improvements in the efficiency in the functioning of the surgical ward by carrying out the business process re-engineering in the said ward. A case study performed on a surgical ward was used in order to develop this paper. There is a need in studying ways that will minimize inconvenience of patients in surgical wards where operations, scheduled as well as unscheduled, are often performed and managed. The paper presents a framework with the methodology with the base on event-driven process chains, as well as entity-relationship model together with event simulation. All of this is done in order to define and make analysis of the current condition of the surgical ward and develop a system that will be used in the future. All activities, processes, sub-activities that used to take the majority of resources of the ward were used in the model, therefore, this model allowed developing what-if analysis with the ability to simulate different scenarios, as well as assess the performance.

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Delphi Methodology

With the use of Delphi methodology, areas that needed improvement were identified: number of surgical sessions, the process of preparation of rooms before each operation, and the availability of instruments needed for surgery. In addition, the most efficient choices in management are easy to understand with the use of approach of discrete event simulation.

As for Delphi methodology used during the stage of collecting information before the process of BPR starts, it is possible to say that it is not found in the literature. Having used models with EPC methodology as their base, the experts managed to develop models in order to study and understand what resources were needed in medical units. Besides, it was possible to develop standards for the clinical managers and hospital developers.

Project initiation includes such activities as developing a business case, undertaking a feasibility study, establishing the terms of reference, appointing the project team, setting up a project office, and performing a phase review. Developing a business case is necessary to identify a business problem to be solved. It is created in order to define this problem in the following details: detailed description of the problem; a complete list of the alternative solutions that can be used; the benefits for business, expenditures, evaluation of risks, and other issues; determination of the most appropriate solution; the overall plan of the implementation process (Nowogrodski, 2008; Westland, 2007).

Undertaking a feasibility study is performed in some cases in order to evaluate alternative solutions stated in the previous step assess the proposed expenditures and understand if the desired solution is achievable in a reasonable time and financial terms. Establishing the terms of reference presupposes definition of vision, objectives, scope, and deliverables for the new project. In addition, this step describes the organization structure, activities, resources, and financing necessary to launch the project (Nowogrodski, 2008).

Appointing the Project Team

Appointing the project team is about creating the team of professionals led by the executives who will be responsible for the projects execution. During this step, the project manager creates a detailed job description for each member of the project team. Finally, the stage of setting up a project office draws the line that signals about the project start. Project office is the physical environment that is needed to run the next stages of project management life cycle. Phase review is necessary at the end of each stage, and it serves the same goal – to see what could be changed, improved, or fixed in order to improve the results (Westland, 2007).

Such a profound description of the project initiation phase is necessary to reflect its importance. Only appropriate understanding of what should be done and careful preparation for the next stages can guarantee success of the whole project. Thus, it builds the necessary ground for the next stage that, to be noted, should be even more detailed and comprehensive – project planning (Westland, 2007). Planning is essential in any activity if it is important to achieve particular results.

Planning Stage

Planning stage includes the following activities that should be undertaken: create a project plan, create a resource plan, create a financial plan, create a quality plan, create a risk plan, create an acceptance plan, create a communication plan, create a procurement plan, contract the suppliers, and perform stage-gate (Nowogrodski, 2008; Westland, 2007). The importance of planning is obvious. Thus, detailed planning is utterly necessary because all details should be considered before the actual execution of the project. Success of the project completion greatly depends on the planning level. Event-driven Process Chain (EPC) charts are very useful on this stage because they provide the necessary picture of what will influence the processes involved in project and how these processes will be initiated, by what events.

Project Execution and Control Stage

The next stage is project execution and control. This stage includes the following activities that are usually performed: building deliverables, monitoring and control, and performing of stage-gate. However, monitoring and control is a more complicated activity than it could look like. It falls into more specified activities to perform, which are as follows: time management, risk management, cost management, issue management, quality management, procurement management, change management, acceptance management, and communications management (Nowogrodski, 2008; Westland, 2007).

Project Closure Stage

The final stage is project closure. This stage could look rather simple, but it as important as any other is because it provides initiators of the project with results and conclusions regarding the degree of success of the entire process. It includes such activities as project closure and review of the project completion. The overall overview of the entire project management process within one particular project allows determining weak spots in each stage in order to avoid such mistakes in the future projects (Westland, 2007).

Husky Air consisting of a staff of 23 employees composed of pilots, mechanics and office staff currently uses a manual paper-based system to coordinate the air transportation efforts of Pilot Angels. Husky Air is currently in need of a computer-based system to track its Pilot Angels volunteers. The proposed initiative is the development a Husky Air Reservation System (HARS) to keep track of all Pilot Angels volunteer pilots to include their name, address, phone numbers, as well as their total hours, certifications and ratings. HARS is a complex system that requires thorough approach to its creation. In addition, its paper-based analog that is in action now can still be used to assure continuity of Husky Air operations. Therefore, it has been decided to choose prototyping model to develop HARS. The system has to be utterly reliable so each phase must be tested and revised until full compliance with initial requirements. DSC should be as follows:

As it has been already mentioned, the proposed initiative of the HARS development should provide Husky Air with the opportunity to control and monitor all business, community, and health care assistance activities. Currently, the system should be able to provide the following functionality: keep track of all Pilot Angels volunteer pilots to include their name, address, phone numbers, as well as their total hours, certifications and ratings; have information about the type of aircraft such as the type of plane, aircraft identification number, whether the aircraft is single or multi-engine, its capacity for carrying passengers and the number of aircrafts each pilot owns; easy input, storage, and output of information about the people, hospitals, clinics, and organ banks that request information about the patients, their passengers, and specific needs to help match volunteers with the request for transport; automate much of the scheduling process by providing a tool for collaboration between all parties involved, in addition to a flight tracking utility that will help in the effort to recognize Pilot Angels volunteers for their contributions.

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However, it might require changes to be made during the development process. Therefore, change requests are necessary to improve and optimize the project during every phase of its development.

The Process of Change Requests’

  • In general, HARS is a usual project that, however, will be implemented within the company’s distributed offices. In addition, the specifics of the Husky Air’s personnel on all levels will require extra efforts from the project training team to make sure that the system will be used by skillful and experienced operators. Therefore, it can be concluded that the peculiarities of the project increase its overall cots.
  • The most effortful modules of the project development should be considered interface module and database management system. They are to take the vast majority of time of the developers. On the other hand, the development of user interfaces will require less time. In addition, they will be continuously improved during the entire process of the project development thus the elapsed time cannot be considered in this case as the longest one.
  • DBMS and interface modules creation will require rather substantial effort to complete them. Therefore, the process of their development should be divided into a series of smaller activities. It will be necessary to perform because of the complexity and scale of the objectives to accomplish. These modules should be developed in stages: basic functionality development, additional modules, testing, improvement, closure. User interfaces for all modules can be completed together, but one team of developers and users should test them together, as well. It will provide the developers with opportunities to improve and fix any issues at once.
  • The project is large-scale. Therefore, the risks of different kind are inevitable. The major risks for interface module: inability to achieve acceptable results within timeframe given for this activity; inability to assure accurate scheduling and its analysis; low module performance. Therefore, in case of inability to achieve acceptable results within timeframe, the schedule of the project will have to be adjusted accordingly since it is one of the core modules of HARS. It means loss of time, which is unacceptable for Husky Air plans. As for the second risk, it could be even more dangerous for the company than any other possible risk.

The core function of Husky Air is transportation, commercial and other. Therefore, if the schedule is incorrect, it is impossible to perform business activities. This risk can substantially slow down the implementation of the entire project thus time loss is guaranteed. Finally, low performance of the module can slow down the performance of the entire company. It can be rather costly. As for other activities, the second biggest risk to occur is the inappropriately designed and configured DBMS. Other modules and related activities should not be considered in the light of risks they can provoke since their effects are minimal.

The likelihood of the risks occurring can be described as follows: inability to achieve acceptable results within timeframe given for this activity – moderate; inability to assure accurate scheduling and analysis – moderate; low module performance – low; and inappropriately designed and configured DBMS – low. The reason of such likelihood determination is in the efforts applied to avoid them. Project manager’s team should realize these major possible issues and be prepared accordingly.

Risk assessment



Inappropriate results within timeframe



Lack of accuracy of scheduling module



Low module performance



Inappropriately designed and configured DBMS



In order to mitigate possible negative aftereffects of the risks, it will be necessary to perform the following activities: software development team should hire only the best specialists in the area; the most advanced methods and tools should be applied to achieve accurate and correct results; in order to improve performance in case of its insufficiency, the additional hardware should be acquired; the most advanced but yet balanced DBMS should be reconfigured and installed, in addition to hiring the best specialists in this area. If risks did occur, the following steps should be performed: the additional specialists should be hired so solve the above-mentioned issues; in addition, more advanced hardware and software might be required to be purchased.

In order to mitigate possible risks, the following activities should be included into the project plan: it would be necessary to create the test versions of each module and evaluate the time needed for their development; in case of moderate likelihood of risks’ occurrence it the above-mentioned steps should be performed (hiring of the additional personnel, hardware purchase, etc.). All parties involved into the software development stages should be additionally informed regarding the importance of each issue during this stage. In case of necessity, the development stage should be delayed for the time needed for additional training of the developers’ teams.

Major Stages

Project plan presupposes three major stages: creation and implementation of HARS; development of the network infrastructure; and personnel training.

  • The first stage will be completed by the third party, the developer of the appropriate systems. This stage will require a minimum of Husky Air’s resources because the specialists of third party will be the major resource for this stage.
  • The second stage will be completed by the third party contractor and will not involve resources of Husky Air, as well.
  • However, the personnel training stage will require all personnel, regardless of the level, be available for the appropriate training sessions.

It could be difficult because Husky Air will not shut down its operations therefore, the staff will continue work. It is the major resource constraint for the timely resource allocation for the appropriate project completion. In addition, some part of the personnel will be on the scheduled vacations, therefore, they will not be accessible, as well.

HARS will require the following resources for its successful completion: a system analyst with a team; programmers; database designers; interface designers; network administrator team; and training specialists. Husky Air personnel will be required as well as it has been already mentioned in the previous sections. These specialists will require special tools and software that will be provided by the third party (database development software, client-server software, etc.). The system analyst and the team will work on the initial stage of the project and will combine their efforts with programmers to create the appropriate design of HARS according to the requirements.

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Database designers will design and develop the necessary DBMS, using existing developments of third party as well as creating new modules for this system. Network administrator team will be necessary to create and manage network infrastructure of the future system. Interface designers will be used by all teams on the final stages of each module creation to develop the most appropriate and convenient interface for Husky Air stakeholders. Finally, training specialists will teach the Husky Air personnel to use HARS. All stages will involve the Husky Air personnel in different ways, discussed above.

Considering the above-mentioned resource constraints, the plan should be revised in order to include the buffer zones for the deadlines of each stage completion. Due to the moderate possibility of risks occurrence in the project of such scale, human resources might be reallocated to solve various upcoming issues (additional staff for testing procedures, for example). In addition, such non-project activities as assessment of the available documentation, calculation of medical records to be transferred to the electronic form, communication with current customers to notify regarding the situation, etc. can substantially influence the availability of Husky Air’s staff for project needs. Therefore, the time gaps should be added to each stage schedule to avoid deadlines failure and understand the real situation regarding the time needed for project completion. 

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