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#SROA2020 Highlights: Managing Projects in Radiation Oncology

By Tammy McCausland

On Thursday, October 29, Donna Royster, radiation oncology administrator with Atrium Health, presented practical tips on how to incorporate project management (PM) principles in radiation oncology. She also discussed why health care needs a more formal approach to project management.

Royster said project management has become a prominent business skill because it can help control costs, reduce risk and improve outcomes. PM can provide better control of financial, physical and human resources, improve customer relations, shorten development times, reduce costs, increase profit margins, improve productivity, reduce stress and more. Royster identified four key project roles:

  • Project manager: the person who plans, manages and executes the project by engaging team members
  • Project sponsor: a senior leader who provides guidance and makes key decisions (administration)
  • Project team: all individuals who contribute to the execution of the project (teammates, vendors, consultants)
  • Project stakeholder: anyone impacted by the project’s outcomes or provides resources (patients, staff, community)

Projects have five stages, and each stage has key accomplishments and deliverables. Royster talked about what’s involved in each stage and identified key activities, considerations and deliverables for each.

Stage 1: Initiate the Project

  • Review background information, market research and other pertinent data.
  • Select the project manager.
  • Determine project goals and ensure they align with organizational goals.

Key activities: Conduct background research. Talk to colleagues who have undertaken similar projects. Learn about the financial and HR costs and the amount of time and effort required.

Key considerations: Consider what need is driving the project and how a successful outcome will improve your work and organization. Reflect on whether the project’s end result is worth the resources and time required.

Key deliverables: Develop a concise overview of the project’s expected costs, outcomes and benefits, including a project description and justification. Present your overview to an organizational leader who can approve the project.


Stage 2: Plan the Project

  • Create a step-by-step plan of how to execute the project.
  • Develop a schedule that includes all project-related activities, a budget, a list of contributors and their roles and responsibilities, and a description of how you will measure progress and results.

Key activities: Create the project plan that includes a budget, schedule, list of team members and progress indicators.

Key considerations: Think about project contributors—project team, stakeholders, colleagues and leaders—who may want to provide input about the project plan. It’s easiest to make changes at the planning stage.

Key deliverables: Finalize and present the project plan. If the project gets approved, hold a kickoff meeting with the project team to review all components.


Stage 3: Execute the Project

  • Carry out the plan.
  • Measure progress and monitor any changes from the plan.

Key activities: Share key deadlines and activities with the project team. Monitor the schedule and budget closely. Track your progress and results and share them with the project team and project sponsor.

Key considerations: One or more tasks or results will diverge from the project plan—this is normal. Adjust future steps to minimize any negative effects. The project sponsor can provide guidance about how to reallocate resources to get the project back on track.

Key deliverables: Keep a detailed list of any delays, failed steps, additional costs or other unforeseen changes. Adjust future steps as necessary to ensure the project stays on time and on budget. Share all changes with your project team. Update the schedule and budget as steps are completed.


Stage 4: Monitor and Control

  • PM monitoring and controlling starts as soon as a project begins.
  • Monitoring and controlling project work is the process of tracking, reviewing and regulating the progress in order to meet the performance objective.
  • Project activity monitoring occurs throughout the project.
  • Controlling is the corrective and preventive actions taken.


Key activities: The goal of project monitoring and controlling is to provide an understanding of the project’s progress and effectively communicate the project status.

Key considerations: Identify when the project’s performance deviates significantly from the plan, so that the project team can take appropriate corrective and preventive actions. Project activity monitoring occurs throughout the project. Controlling is about taking corrective and preventive actions.

Key deliverables: The process required to track, review and orchestrate the project’s progress and performance—identify any areas in which changes to the plan are needed and initiate them.


Stage 5: Close the Project

Key deliverables: The key deliverables include documentation from each step, any products or deliverables the project yielded, reviews for each team member and lessons learned. An updated budget and timeline should reflect the total cost and number of hours spent compared to the budgeted amount.

It’s important to establish a “Culture of High Expectations,” which means taking actions in the implementation stage and during your project in the monitor and control stage. Focus on accountability and issue resolution. “A culture of low expectation is a catastrophe waiting to happen,” said Royster. “Individual workers, because they feel that they are a minor cog in a huge wheel, repeatedly fail to act with accountability at critical moments. . . Use your power to manage work issues and work culture to avoid having your project end up on the operating table.”


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Do you have a formal approach to project management in your department? 


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