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Allison is a registered nurse and senior health policy adviser with some 25 years experience. Prior to launching CPD Nurse Escapes, Allison worked as a private consultant for a diverse range of clients in the government and non-government, health, community and education sectors. Allison has an extensive background in regulation, governance and professional practice and applies this in education, policy development and project management. Allison was the Principal Advisor, Professional Practice at the Nursing & Midwifery Board of South Australia, for 10 years where she was responsible for developing nursing and midwifery policy and standards and advising and educating nurses and midwives on professional practice issues.

Tuesday, 4 September 2012

Managing a Nurse Led Project

The Oxford English Dictionary describes a project as;

An individual or collaborative enterprise planned and designed to achieve an aim.
 A project is typically defined as a collaborative enterprise, frequently involving research or design, that is carefully planned to achieve a particular aim.

Projects can be further defined as temporary rather than permanent systems that are constituted by teams within or across organisations to accomplish particular tasks under time constraints. Stephan Manning

A project is a temporary (or discreet) assignment with a fixed timeline designed to create or result in a unique product or outcome. It is different to an operational process although though it may result in implementation of new operational processes. An operational process is the core business/s of the organisation. A project may be aimed at implementing new or changed operational processes to improve services.

Implementing a new may require the project manager to seek/gain funding before commencement or this may already have been achieved before the project manager is appointed. A sound project requires some sort of management framework – usually referred to as a Project Plan – which outlines the actions, timelines, reporting process, cost and outcomes of the project at each and every stage.

A successful project requires a designated Project Manager to ensure the plan is implemented effectively and in a timely manner and to oversee and action the plan and ongoing decisions.  It also requires an advisory/decision making process (usually a project committee) to whom the project manager reports and as a sounding board and formal/transparent decision-making body

So why are nurses excellent project leaders?

Nurse led projects are essential in the continuing development of the nursing profession and nursing services. As nurses have direct contact and communication with clients, client populations and their families and support networks, they are very effective at leading and managing projects related to client care and services. They have direct and comprehensive knowledge of client’s and client population needs, issues and their expectations of health care services.

As nursing is an applied science, nurses are practical and outcomes focused and therefore able to recognise where changes in practice result in improved client care or outcomes.  Nurses are experienced at working within tight resource constraints and meeting measurable outcomes. They are effective time managers. They are highly skilled at working and collaborating with multi disciplinary teams and are expert case managers.

All of these skills transfer effectively to project management and to nurses as project managers.  However nurses do not often get the opportunity to, or are experienced at project management and although their multitude of skills are readily transferable to managing project, there are many pitfalls and challenges faced by the uninitiated.

A nurse led project requires the nurse project manager to

·      Develop a Project Plan
·      Develop a budget for the project
·      Convene an advisory committee
·      Coordinate and negotiate with Stakeholders
·      Understand the politics and policies and
·      Deliver agreed outcomes

A project is in essence managed within a complex infrastructure of stakeholder individuals and groups, internal and external policies, politics and agendas and expected outcomes, which are often predetermined by the different stakeholders. These expectations are often unconscious and often conflicting!

A nurse with clinical expertise relevant to the project focus, may not however, have ever developed a project brief, project plan, or project budget and may never have had experience with submitting or working within a funding grant or reporting to an advisory committee.  All of this can be extremely daunting and result in a great deal of angst and delays to getting the project off the ground.

So where does one start?

All projects, however big or small are based and depend on four primary constraints or limitations.  They require a formalised and structured method of managing an agreed change process in a rigorous manner so that planned outcomes are achieved and focuses on producing:

1.    within a given level of resources (COST)
2.    achieved by a certain time (TIME)
3.    specifically defined outcomes (SCOPE)
4.    to a defined quality (QUALITY)


To determine the cost of a project we must ask and answer a range of questions relating to the resources available. It may be that resources have already been isolated to manage the project or it may be that the first stage of the project is to identify, seek and gain funding before the project can commence. All other components of the project are determined on the cost. The level of quality, scope of the project and the outcomes that can be achieved and the timeline are dependent on the money and resources. The project team must therefore determine

·      What is the total cost of the project?
·      What is the source of the funding?
·      Is there more than one contributor?
·      Often already determined or project manager may be required to submit funding grant
·      Project may have fixed costs – project scope needs to fit into costs
·      What about external costs – outside of your control
·      Is cost negotiable?
·      Are some costs for unique purposes only?
·      Are there ‘strings’ attached – provisos?


The timeframe of the project is usually outside of the project managers control. It may have been predertermined as part of the organisations strategic directions, as part of budget timeframes such as the financial year, timing of funding or grants etc.

The project team must therefore determine;

·      What is the timeframe/deadline for the project?
·      Each action/milestone requires a clear time frame
·      May be tied to funding
·      Is timeframe negotiable? Who determines this?
·      Is timeframe flexible?


Although each of these components are interdependent it is important that the project scope of clear and definable. This will determine the funding that is sought and the success of gaining grants, the time it will need to achieve the scope. Many projects fail because they have a poorly defined scope and try to achieve too much within the other constraints. Their outcomes become vague, unmeasureable and unrealistic. Many projects fall into oblivion or end up not being completed because of this.

The project team must therefore determine;

·      What is the scope of the project?
·      Clearly document a precise scope (the full range of issues to be covered within the project)
·      Cleary document objectives
·      Should be aligned with strategic directions of organisation
·      Should identify an end point (specific breadth and limits of the project)
·      Should identify clear (measurable) milestones


The quality of the project determines the accuracy, validity and credibility of the outcomes achieved. Quality refers to the inherent features of the project and their capacity to achieve the identified outcomes. Defining the quality determines all other constraints. The quality of the project outcome determines the scope of the project – the breadth of the project. The higher the quality required the more time and resources needed therefore quality is retrained by resources

In Part 2 I will talk about the Project Manager, their role and skills required.


Stephan Manning Embedding Projects in Multiple Contexts: A Structuration Perspective http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1582680

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