NR 631 Week 7 Project Schedule Example

Project Schedule: Fixed Dates First, Waiting Drawn as Work and Every Row Owned by One Role Up to the First Day of the Four-Room Pilot

Student Name

College of Nursing, Chamberlain University

NR 631: Nurse Executive Concluding Graduate Experience I

Instructor Name

Month Day, Year

Project Schedule: Fixed Dates First, Waiting Drawn as Work and Every Row Owned by One Role Up to the First Day of the Four-Room Pilot

Fixed Points, Entered First

Preparation, Placed in the Gaps

Waiting Is a Task

Three rows are mostly waiting. The report sits in a queue that typically takes four to six weeks, and the freeze adds two more weeks; it is drawn from 28 September to 30 October so the wait is visible. The determination takes about two weeks. The surgeons' offices are small practices whose managers return calls slowly; their row is given twelve days for five phone conversations.

What Everything Waits On

Two rows hold up the rest. The director's decision on 14 October releases the nurse hours; without it, nothing from 19 October on can begin. The office managers' agreement comes before the committee's 10 November approval; if that slips, the committee could not approve the pilot until 8 December, which would leave only two pilot weeks before the holidays.

If Something Slips

If the report is not ready by 13 November, the pilot starts anyway with the hand-count fallback from the OR board log, as agreed in the aim brief. If the director's decision moves past 21 October, training cannot fit before the freeze ends and the start moves to 30 November, with three pilot weeks instead of four. If the committee withholds approval on 10 November, the pilot runs as a nursing-department change in two rooms whose surgeons' offices agreed, under the fallback aim.

Slack

One week of slack sits between the end of training and the dry run, and the dry run itself can be repeated on 13 November. No other slack exists, and the schedule says so.

Consistency With Earlier Weeks

The aim, the four rooms and the 58% baseline are unchanged from the aim brief, and the pilot still opens on the Monday after the freeze and closes before the holiday schedule. The approvals and waits match the approval map.

Where the Schedule Stops

At pilot day 1, which is also the row the director owns. The pilot itself, its weekly reviews and the January report belong to the next course and will be scheduled there. Writing the pilot weeks in detail now would assume the approvals on which they depend.

What the Hospital Is Already Committed To This Quarter

The schedule has to fit around commitments the department made before this project. The OR system upgrade takes most of the analysts' attention in late October and early November. The perioperative department is preparing for its annual competency week in the first week of December, which takes the OR educator's time. Orthopedic block time in room 5 shifts on 1 December under a scheduling change already approved. None of these moves for the pilot, so the pilot moves around them: training is placed before the competency week, and the dry run uses the room 5 schedule that will apply after 1 December.

Risks to the Dates

Three risks are most likely to move the schedule. A surge in emergency surgery could pull pre-admission testing nurses into preoperative holding, which happened twice last winter. Staff sickness in November could empty the afternoon call slot. And the OR system upgrade could run over its freeze, which would delay the report. For each, the response is already written in the slip paragraph above, so a delay becomes a known choice rather than an emergency.

Communication Along the Way

After each row with an approval, the student sends the director a two-line update the same day: what was granted, in what form and what it releases. If a row slips by more than three working days, the director hears that day, with the effect on the start date. The CNO hears through the director at the 21 October meeting and again at the committee meeting on 10 November.

Why the Schedule Is Built This Way

Improvement work runs in cycles that start only when the conditions for testing are in place (Langley et al., 2009). A schedule that priced approvals at zero would show the pilot starting in October, which this hospital's calendar does not allow. The redesign at one public hospital took 35 days to implement in holding (Coffey et al., 2018); this plan allows less than that for implementation, but more for approval, because the change also reaches outside the hospital's own staff. Hospitals that held their gains kept a committee and visible data in place (Phieffer et al., 2017), so the committee dates appear in the schedule even where nothing is asked of them.

References

Coffey, C., Jr., Cho, E. S., Wei, E., Luu, A., Ho, M., Amaya, R., Pecson, M., Dalton, F. V., Kahaku, D., Spellberg, B., & Sener, S. F. (2018). Lean methods to improve operating room elective first case on-time starts in a large, urban, safety net medical center. The American Journal of Surgery, 216(2), 194-201. https://doi.org/10.1016/j.amjsurg.2018.05.002

Langley, G. J., Moen, R. D., Nolan, K. M., Nolan, T. W., Norman, C. L., & Provost, L. P. (2009). The improvement guide: A practical approach to enhancing organizational performance (2nd ed.). Jossey-Bass.

Phieffer, L., Hefner, J. L., Rahmanian, A., Swartz, J., Ellison, C. E., Harter, R., Lumbley, J., & Moffatt-Bruce, S. D. (2017). Improving operating room efficiency: First case on-time start project. Journal for Healthcare Quality, 39(5), e70-e78. https://doi.org/10.1097/JHQ.0000000000000018