Stakeholder Involvement at Nemours Children's Hospital

Unfortunately, the burden of having a child that requires hospitalization is often compounded by excessive paperwork and the need for the patients and families to physically navigate a maze of administrative, testing, and treatment areas. In an effort to remedy this, the scope for a $397 million project to create the new Nemours Children's Hospital in Orlando, Florida, was to deliver a user-friendly experience by developing a more integrated approach for providing care for its patients. In particular, the vision was to have most, if not all, of the support and treatment activities available on the patient's floor. The project team also understood that without stakeholder buy-in this vision could not be achieved.

One key stakeholder group was the patients and their families. To get input from this user-group, an advisory council of patients and families was created and their input solicited for alternative designs that were mocked up at an off-site preview center. For example, parents could step into inpatient and outpatient rooms, while children could try out alternative mattresses. The advisory council provided valuable input such as the child who noticed a scary shadow on the ceiling when lying on the bed. In reflecting on the project, the team felt that allowing the advisory council to provide input on specific options as opposed to asking them to help redesign the rooms helped ensure the project did not fall behind its schedule. Constructing the center also served another stakeholder group, the general public, where almost 4,000 people toured the preview center prior to the hospital's opening.

Staffing a new hospital was another major project challenge. For example, in the year before the hospital was to open, 700 physicians and nurses were screened. But an important difference between healthcare employees and employees in other professions is that healthcare workers have to be licensed. Thus, another important stakeholder group was the Florida licensing board. In particular, it was important that the board not be overwhelmed with hundreds of healthcare workers all seeking their licenses at once. To address this, three Nemours employees were dedicated to helping with licensing issues. One of these employees worked fulltime on building relationships with the state agencies.

One complication that plagues most projects related to constructing a brand new facility is that input from the employees, another critical stakeholder group, is not available because most of them have not been hired yet. This was the case at Nemours where staff would not be hired until a few months before the hospital was to open. Not having employee input early in the project creates an almost certain guarantee that changes will need to be made later in the project, which in turn can have important implications for the project's scope. To address this, Nemours created an oversight committee with expertise on healthcare regulations to review the change requests originating from the newly hired employees. Suggested changes that were needed to meet regulations were approved. Approvals of other change requests were evaluated on the basis of their impact on patient care and cost-effectiveness.

In the end, the project was an overwhelming success. With 137 beds and 630,000 square feet, the hospital opened on time and was completed on budget. The project was also a finalist for the 2013 PMI Project of the Year Award.

Questions

1. How did stakeholder involvement contribute to the success of the project?
2. Were there any risks to involving stakeholders in the construction of the new children's hospital? What steps did the project team take, or what could they have taken to mitigate these risks?