The Crucial Role of the Project Manager: Comparing Healthcare Experiences

Aricle

Dear Editor,

In the context where healthcare companies face increasingly complex challenges such as long waiting lists, a shortage of medical staff, overcrowded emergency rooms, and limited bed availability, the role of the project manager emerges as fundamental in determining priorities, organizing work, developing projects, and achieving set objectives. Optimizing time and efficiently managing resources is imperative and a thorough understanding of the medical-healthcare environment proves advantageous for conscious and balanced management of aspects such as budget, medical staff, and supplies [1].

The role of the project manager emerges as fundamental in determining priorities, organizing work, developing projects, and achieving set objectives in the context where healthcare companies face increasingly complex challenges such as long waiting lists, a shortage of medical staff, overcrowded emergency rooms, and limited bed availability [1].

Optimizing time and efficiently managing resources become imperative, and a thorough understanding of the medical-healthcare environment proves advantageous for conscious and balanced management concerning aspects such as budget, medical staff, and supplies. The project manager plays a key role in the internal organization of the healthcare company. The ideal profile for this role could be an external consultant bringing a different perspective or an internal appointee [2].

The project manager can be an internal collaborator acting as an operational arm alongside the medical director. This is the case in the South Tyrol Healthcare Company, where the decision was made to limit the use of external consultants, favoring the implementation of software to manage projects and, importantly, to see them through to completion. Starting from mid-2021 and within a year and a half, this role was reactivated in light of the many imminent challenges: from the migration to a new information system to managing waiting lists, constructing a new clinic, and developing prevention apps. The project manager’s role, in addition to demonstrating to healthcare colleagues how their contributions improve operational efficiency, involves understanding the company’s methodology and vision, deciding priorities, and building a complex network with external stakeholders.

The organizational culture within the staff and set standards to adhere to can be revitalized.

Concrete examples of success include the Coordination Health Agency of Friuli-Venezia Giulia, which established a centralized and outsourced hub active in the Pordenone inland port. It is an automated regional pharmaceutical warehouse supporting all healthcare companies, meeting patient needs by aggregating requirements and providing innovative drugs ahead of the European Medicines Agency (EMA) and the Italian Medicines Agency (AIFA) timelines. This has made Friuli the national best performer: it takes just 55 days to purchase innovative drugs after AIFA approval and publication in the Official Gazette, a record time compared to Sicily’s 81 days in second place [3]. The activities aimed at reaching this outcome began in 2018. The Friuli-Venezia Giulia Region, as part of regional planning in 2022, established the regional innovative drugs fund, which in 2023 reached an investment of 15 million euros – a unique experience for a special statute region that does not access national funds, aiming to support its healthcare companies in spending on innovative drugs classified in classes A and H within the LEA (Essential Levels of Assistance). Overall, almost 20 million euros are spent in this sector [4]. Despite the small population (1.198 million people) and special statute exemptions, management entrusted to an administrative director and a socio-health director has led to excellent results, demonstrating that the model could be replicated in other contexts.

The success of such initiatives, however, largely depends on involving all staff, initially resistant to change. The project manager’s task is also to make doctors, healthcare providers, and pharmacists understand how these processes allow them to reclaim their professionalism increasingly. This applies from drug management to emergency room management: emergency room problems are often not its responsibility but are attributed to both territorial health and social-health services and the hospital where the emergency room operates. This should be the guiding philosophy of healthcare management.

A discharge room was created in a nurse-led ward for patients awaiting at San Matteo Polyclinic in Pavia, Lombardy - Italy. Specifically, a platform was developed to measure handling times and the number of accesses, with results (and information) shared weekly. This reduced the average length of stay, encouraging timely and applicable patient discharge. Simultaneously, a platform was developed by the Territorial Health and Social Company (ASST) of Pavia finalize to monitoring in real-time the availability of healthcare beds in different setting, creating an automated dialogue between structures, including accredited private ones.

In another Italian Region, Marche, specifically at the Madonna del Soccorso Hospital in San Benedetto del Tronto, a similar solution was tested: due to high seasonal access to the emergency room, a “silver code” laboratory was activated for the benefit of the elderly population. This supported the emergency medicine department in managing a population segment that accounts for almost 38% of hospital access. The night shift was also rotated to a single department to free up other specialties to work more during the day. All with the aim of speeding up discharges. For the same reason, a home care nurse was activated directly in the emergency room, even on Saturdays and Sundays. To streamline territorial handling, municipal social workers were also involved.

Not only healthcare pathways need to be reviewed, but also pathways such as those involving analyses. In this case, the project manager can be the same laboratory director facing reorganization from the sample pathway perspective. This results in a single collection point from which a single latest-generation machine, controlled by a single technical figure, rationally redistributes samples throughout the hospital. Thus, the final result of that analysis reaches the unit’s medical-biologist manager who must use the test. This logic guided the modernization of the analysis laboratory at the Madonna del Soccorso Hospital in San Benedetto del Tronto, Marche Region Italy.

A recurring phenomenon in healthcare facilities is the difficulty in sharing spaces among physicians. At the IRCCS Maugeri in Pavia, a structural reorganization of the outpatient clinics, led to significant efficiency improvements in pathways and, consequently, greater attractiveness for patients. Despite initial resistance from medical staff, teamwork was gradually stimulated, allowing patients to find multiple services in the same place.

If the obstacle to implementing innovative projects in the public sector mainly lies in a cultural issue and difficulty partnering with private entities that can guarantee success, in the private sector, it is necessary to prove that the project generates profit or savings. In the public sector, it is more challenging to recruit a project manager because formal competition is needed. Conversely, the private sector lacks the public sector’s organization. A private structure optimizing procedures and costs for supply purchases is the Aurelia Hospital in Rome, where procurement is being outsourced: here, partners can negotiate on behalf of the structure as external entities, sharing objectives and results to obtain lower prices that would otherwise be impossible. Such an approach would currently be impossible in public healthcare companies, even though “the Italian model of public administration management is in a moment of great transformation, and the healthcare sector is certainly a precursor of innovative trends that can be experimented and implemented.

Many different experiences, compared during the Vision advanced training course organized by the Healthcare Management Academy of the University of Genoa, lead to one conclusion: each context needs to find its ‘ideal’ project manager, who today more than ever plays a crucial role in the healthcare field. In any situation, the project manager must be a guide capable of improving efficiency and care delivery through their skills, teamwork, and new technology assistance. Furthermore, they must always be characterized by the flexibility that allows them to change the project strategy in response to changes in the healthcare context: the project manager has great skill in managing time, resources, and budget, combined with the ability to communicate clearly with all project stakeholders.

Acknowledgments

None.

Conflict of interest statement

None.

Authors’ contribution

All authors equally contributed to the conception, design, execution, and manuscript preparation.

History

Received on December 16, 2024. Accepted on December 16, 2024.