Friday, August 29, 2025

The Importance of Our Community Health Centers


With National Health Center Week just wrapping up a couple of weeks ago (August 3-9, 2025), I think it is timely to highlight the work and obstacles that our community health centers across the country are facing, especially in light of increased regulation and decreased funding.

What Are Community Health Centers?

First off, for those of you who aren’t aware, Community Health Centers (CHCs) or Federally Qualified Health Centers (FQHCs) as they are also known are community-based health clinics that provide primary care and, in many cases, also provide other comprehensive services such as mental health, dental, pharmacy, and other key services designed to strengthen the health of the communities that they serve. These health centers are patient-governed with at least 51% of their board members being comprised of patients of the health center and the board composition matching the demographics of the community in which they operate. These FQHCs typically operate in underserved areas ensuring essential access to health care services for those who might have barriers to access elsewhere such as cost, no insurance, or language differences. FQHCs offer sliding fee schedules to accommodate those who don’t have insurance and might not be able to fully pay for their health care treatment. These health care centers provide a health care “safety net” for the populations that they serve ensuring that they always have access to essential health care services to improve the health of the communities they serve.

How Are FQHCs Funded?

Now that we all know what FQHCs are and the essential services that they provide, let’s talk a little bit about how they are funded. Like all health care providers, FQHCs have a mix of payors that fund or reimburse them for the services that they provide. These payors can include Medicaid programs, Medicare, federal grants, and to a lesser extent, commercial insurance payors. Additional sources of funding may also include private grants and donations. Federal grants for FQHCs are administered by the Health Resources and Services Administration (HRSA) which is part of the Department of Health and Human Services (HHS). These are competitive grants where potential grantees have to demonstrate need in their community and ability to serve that need. HRSA then looks at all grant applications and determines which communities have the most demonstrated need based on socioeconomic, demographic, and available health care resources to determine which areas qualify for the limited new grant funding available each year. Once a grant is awarded, a grantee has to continue to demonstrate performance through the annual submission of Uniform Data Systems (UDS) reports to HRSA which provide information on patient demographics, services, and outcomes which HRSA then uses to assess program performance and recommend quality improvement programs. Additionally, FQHCs are subject to intensive weeklong site visits either annually for newer or lesser performing FHQCs to every three years for more mature, higher performing grantees. 

To be clear, FQHCs probably have some of the most rigorous reporting and review requirements of any federal grantees and taxpayers can be assured that money spent on this program is not only put to the use that it was intended, but that those dollars are achieving measurable outcomes in the communities in which they are invested. The word "invested" in the last sentence is critical here as these programs aren’t entitlements as some politicians would like to frame them, but rather they are investments in the health of communities all around our country. Without healthy communities, we truly cannot have a healthy country, and these programs are quietly contributing to overall health and well-being of our country one community at a time.

Another service that many FQHCs provide is pharmacy services through a program administered by HRSA known as the 340B program. This program allows eligible entities such as FQHCs to access drugs from pharmaceutical manufacturers at deeply discounted rates. The FQHCs in turn use these savings to provide free or reduced-cost prescriptions to patients. In many cases, these pharmacies operated by FQHCs are the only pharmacy available in the community.

So, now that we have discussed what FQHCs are and their importance to the overall health and wellbeing of our communities, let’s talk about the challenges that FQHCs face. I am going to break these down into the following categories:

  1. Funding
  2. Workforce Shortages
  3. Administrative Burdens and Regulation

Funding

We have talked a little bit about the sources of funding that FQHCs face. Unfortunately, most of those sources are under continuous political attack. The recently passed “One Big Beautiful Bill” is anticipated to result in the loss of Medicaid coverage for over 10 million people according to the Congressional Budget Office (CBO). Many of these recipients are currently patients of FQHCs and will probably remain patients in some respect even after they lose their Medicaid coverage. This means that in these cases, instead of receiving reimbursement from Medicaid for the essential services provided to these patients, these FQHCs will be providing care on a greatly reduced sliding fee scale which doesn’t even come close to covering the cost of those services. When an FQHC receives full Medicaid payment for a patient visit, that payment may only cover about 82% of the cost of providing the service. If that service has to be provided for only a nominal fee or even free under a sliding fee scale, that problem is greatly amplified. At the same time, grant funding is stagnate and has not kept up with inflation. Grant funding is what FQHCs depend on to bridge the gap between what they receive on fee-for-service basis to provide services and what those services actually cost. So, with inflation raising the cost of those services, fewer patients being eligible for Medicaid, and stagnate or even decreasing HRSA grant funding available to bridge the cost gap of those services, you can see how our system of FQHCs is becoming increasingly vulnerable to funding challenges. Without changes to how we prioritize and fund this valuable work, many of these essential health care centers providing safety net services are going to be forced close their doors in the coming years.

Workforce Shortages

While staffing and workforce shortages are rampant across our entire health care system, especially after COVID, the impact on FQHCs is even more dramatic. With limited funding, FQHCs struggle to compete with larger, private sector health care entities that can offer higher benefits and salaries. On top of that, many FQHCs are in rural areas which just adds to the difficulty in recruiting and retaining talent. Add to that the ever-increasing demand for FQHC services resulting in heavy workloads and high patient volumes and you have a recipe for staff burnout and dramatic staff turnover.

Administrative Burdens and Regulation

The administrative burdens and associated costs of running an FQHC are great. We already discussed the fact that FQHCs are under strict oversight by HRSA requiring submission of detailed UDS reports every year and intensive site visits, not to mention whatever regulatory burden that is imposed by state or local agencies. But in addition to that, FQHCs are increasingly being required to adopt frameworks around and address the complex needs of Social Determinants of Health (SDOH) which requires the FQHC not only to consider the patient’s physical health needs, but also things like housing or food insecurity which many traditional reimbursement models do not adequately address. SDOH requires complex coordination of services across various needs and specialties with ever shrinking resources.

Additionally, FQHCs are responsible for ensuring access to care for the populations that they serve. This means providing non-traditional care mechanisms such as telehealth services. Telehealth services require increased technology capacity and capabilities and, in some cases, even providing technology devices to their patients to ensure their ability to access services.

All health care entities are highly regulated under HIPAA which requires strict controls to protect the privacy of patient data. Compliance with these regulations require extensive and expensive compliance and cybersecurity programs. With all of the breaches of health care organizations that are occurring, the requirements under HIPAA are going to become even more extensive over the next year. These additional controls will just add to the expense and complexity of managing cybersecurity operations for FQHCs. Unfortunately, while acute (inpatient) organizations have access to funds from large technology companies like Microsoft and the federal government for cybersecurity, these funds are not made available to FQHCs. While inpatient health care is a key component of our health care system in this country, we need to keep in mind that the whole point of a healthy primary care system is to help keep our patients out of inpatient settings as much as possible. Many hospital admissions can be prevented by providing access to adequate primary care services, a fact that seems lost on our technology communities and government.

Conclusion

In this article, we have discussed what an FQHC is, how they are funded, and some of the challenges that they face to their continued survival. Through this article, I hope I have explained the urgent necessity behind our FQHC system and why they are vital to the continued health and well-being of our communities. The threats that our FQHCs currently face really threaten our entire health care system. When FQHCs are not available to provide services in their communities, that need will eventually need to be met, usually by emergency departments and urgent care centers. This additional load on our emergency departments and urgent care centers means that those services are less available to everyone else. FQHCs providing preventive and primary care services to these patients prevent that escalation in the need of care that results in emergency department or urgent care visits and relieves overall pressure on our entire health care system.

In future articles, I will address some of the challenges faced by FQHCs from my perspective as an executive responsible for the technology portfolio of an FQHC and integrated health system.


Wednesday, August 27, 2025

Recruitment Is a Form of Marketing!

 


During my discussions with a number of executives, many of whom I am mentoring in one way or another, the topic of how they have been treated by various organizations during the recruitment process has come up a lot. One of the biggest gripes that I hear over and over again is the lack of respect that they receive when they interview for a position and don’t receive an offer. Typically, when you make it to the step of getting an actual interview for an executive level position, you are one of only  a handful of candidates being considered. As such, one would expect that when they are not chosen, they would receive some form of personal communication regarding the decision and maybe, if the company is really on the ball, some feedback on what they liked and what they felt the candidate could have improved on. What I am hearing is that many times, all the candidate receives is the same basic form email that every other candidate receives that wasn’t even selected for an interview. “We regret to inform that we will not be moving forward with your candidacy…blah, blah, blah.” Sometimes, it is just automatically generated through Indeed or whatever platform that they posted the job on, which makes it even worse. Keep in mind, that we are only talking about the candidates that were interviewed which is typically a very small number and to whom it shouldn’t be difficult to provide personalized messaging.

What you need to understand as someone who is responsible for recruitment for your organization, especially at the executive level, is that how you treat your candidates can strongly impact how that candidate views your organization, positively or negatively.

Recruitment as Marketing

As executives, many of us have to make decisions on vendor relationships. That could be whether we want to start doing or continue to do business with a particular company. Now, think about this. You are an executive of Company A who once went through the recruitment and interview process with Company B and felt that it was impersonal and disrespectful. Company B now is lobbying heavily to do business with Company A and you are a major influencer of whether that happens. How likely are you to let that negative experience impact your decision to do business with Company B? I would say the probability of that is very high. Some might say that allowing personal experiences to impact a business decision is slightly unethical. I would argue against that by saying that your experience gave you insight into how Company B operates. If Company B is disrespectful to high-level job candidates and fails to show empathy and personal interaction for something as simple as communicating that they didn’t get the position, what makes you think that the treatment that you would get as a customer would be any better? When you are exposed to the recruitment process of an organization, you get a sneak peek into their culture. In a lot of ways, Human Resources is one of the main gatekeepers and advocates of the company’s culture. So, if your experience with HR during an advanced stage of recruitment for a high-level position is cold and impersonal, it wouldn’t be a stretch to say that approach probably permeates a lot of the culture of the company. Thus, this is where HR unwittingly becomes part of the marketing process. That negative impression that you leave with a candidate may be what prevents your company from making a sale. In some cases, depending on the organizations involved, that sale could be substantial. What HR did during that interaction completely overrode anything that the Sales and Marketing departments did to get the sale.

Going Beyond Recruitment

Now, in this blog post, I kind of picked on HR and how many HR departments are handling their recruitment processes (this is not completely anecdotal as I have experienced it myself in past job searches), however, we all need to realize that no matter our role, we are ambassadors of our organizations and not just our current organization. Many of us remember names. If we had a bad interaction with someone, we tend to remember that. That memory tends to stay with us regardless of which organization that person is currently with. Our interactions with each other matter and can build or destroy credibility. I know that these days, it is common for many to have a short-term outlook on things. Many people aren’t planning on being tied to any one organization for the long-term and don’t think that the impressions that they make during their tenure with their current organizations can have long-term impacts on them. What this short-term thinking totally misses is that most of us have long-term memories and those memories tend to follow specific people as well as organizations. So, the impression or impact you make today can have long-term ramifications. Always be aware of the impressions and perceptions that you leave. When you interact with others, you are a brand ambassador for not only your current organization, but any organization that you work for in the future.

Conclusion

HR has a lot more brand and marketing influence than I think many HR professionals realize. How often does HR’s impact on the organization’s brand perception enter the thoughts of CHROs and recruiters? I would love to hear feedback from HR professionals on this and not just the negative. If you are doing something really forward thinking and progressive to represent your organization as an HR professional, I would love to have you share that here.

Additionally, we need to realize that all of us, in our interactions with others, can impact the brand perception of our organizations – past, present, and future!


Wednesday, August 20, 2025

What is IT Governance and Why is it Important?


 

In my almost three decades in IT, what has truly amazed me is how few organizations actually have IT governance programs. What is even more amazing is how few C-suite leaders and other leaders even understand what IT governance is and the value that it can bring to their organizations. This group of leaders includes those within IT as well, many of whom see IT governance as a threat to their leadership. Let’s take a dive into what IT governance really is, why it is valuable and why IT leaders should actually embrace and not fear it.

What is IT Governance?

Simply put, IT governance is a framework that helps organizations manage and align their IT operations with their business goals and objectives. At the end of the day, isn’t meeting the organization’s goals and objectives what we should all be about? IT doesn’t exist in a vacuum. In order to make sure that IT is properly aligned with and working towards the organization’s goals and objectives, stakeholders outside of IT need to be involved in determining what that looks like from a strategy and performance management perspective. The goal of IT governance is to bring those outside stakeholders to the table.

Why is IT Governance Important?

So, now that we know what IT governance is, why is it so important? Bringing outside stakeholders to the table to help IT leadership create an aligned strategy ensures that the projects that IT takes on are the right projects to help the business progress. Furthermore, these stakeholders work with IT to help prioritize these projects and provide support and funding to ensure that they get done. One of the most common reasons for projects failing is unclear business objectives or poorly defined project goals and milestones. Including stakeholders in this process can help ensure that the business objectives, project goals, and milestones are clearly defined before the project is even approved and started. This increases the likelihood of project success and that the project will provide the organization value. IT governance is really a “shared responsibility” model where IT works with its key stakeholders to share the responsibility for the success of the IT department and ensure that its efforts are optimized and delivering value to the organization.

Why Should IT Leadership Embrace IT Governance?

In the traditional IT model, IT owns the total responsibility for the success or failure of its initiatives and projects and whether or not it delivers value (real or perceived) to the organization. In this model, IT leadership really becomes the scapegoat for failures related to lack of engagement and support from other business leaders. I don’t know about you, but to me, that just seems like a recipe for failure. And a lot of times, it is.

With a true IT governance model, on the other hand, responsibility for the success or failure of IT to deliver value to the business is a shared responsibility with stakeholders having input into the strategy and execution of the IT department. If done right, there really is very little reason that there should be failure as we will see in the next section when we talk about the mechanics of how IT governance works and how it delivers value.

How Does IT Governance Work?

We stated earlier that, in its most simple terms, IT governance is a framework that brings together IT leadership and leaders or stakeholders from across the organization to share the responsibility for the governance of IT. Let’s talk a little bit, in a very generic way, about ways in which this is typically achieved. Keep in mind that these are broad, high-level applications and the approach and the details required to make this work for a particular organization really depends on that organization’s needs and resources.

1. The Chief Information Officer (CIO) should be a part of the business strategy development process and should be in attendance at board of directors’ meetings. In order to ensure IT alignment with business goals and objectives, the leader of the IT department needs to be in the room when those are developed and discussed.

2.  An IT Steering Committee should be formed made up of stakeholders from across the organization. This committee makes recommendations on the IT strategy and ensures that it aligns with the overall business strategy before being passed up to the board of directors for approval. 

a.      This committee acts as a governance body for IT where key metrics and KPIs for evaluating the operational performance of IT are developed, approved, and presented.

b.     Prioritization of projects and initiatives for that the IT department works on should also generally occur in this committee.

c.      The agreed upon KPIs, metrics, and project portfolio performance should be captured in a balanced scorecard which can then be used to measure the overall effectiveness of the IT department in achieving its strategic objectives. Plans for corrective action, if necessary, can be discussed and developed in this committee and then progress against those corrective action plans can be monitored along with the balanced scorecard. 

      3.  The IT scorecard, as approved and validated by the IT Steering Committee, should then be presented to the board of directors along with summaries of any actions discussed and taken in the IT Steering Committee and project portfolio status.

Conclusion

As you can see, this model sets up an organization for the most effective use and deployment of its IT resources by ensuring that said use and deployment is always in alignment with the needs of the business as directed by the business leaders. This avoids the IT department making key decisions in a vacuum and increases transparency in the effectiveness of the operation of the IT department. This transparency increases credibility and sets the IT department up to be trusted technology advisors and a strategic asset for helping the organization scale and achieve its objectives.



Tuesday, July 22, 2025

What CEOs Often Get Wrong About Innovation

Innovation at its core is really just defined as a new idea that solves a problem. Let’s focus in on the last three words of that sentence “solves a problem.” To be innovative, one needs a problem to solve. We need to help our CEOs understand that as CIOs, we are here to solve problems. We aren’t typically creating a product, we are supporting the business and helping it grow by providing technological solutions that help the organization achieve its goals. That often comes in the form of solving problems that are holding it back or that are pain points for the business’s operations.

Unfortunately, these days, many CEOs feel that their CIOs aren’t innovative enough unless they come up with flashy solutions and throw around buzzwords like AI or digital transformation not really knowing what they mean or how they even apply to their business. I have been shocked lately as I have talked with several CEOs and discussed projects with them about how many of them seem disinterested in solutions that merely solve the problem. When discussing projects with them, they all perked up when I talked about using AI agents, generative AI solutions or AI scribes for healthcare when they were disinterested in discussing projects around payroll solutions or other system implementations or improvements. This mindset is very dangerous in that a good CIO is there to help the business solve problems by proposing the best solution, not the flashiest or the sexiest solution. When we think about project management, three main tenets come to mind: the project is to be delivered on time, on budget, and be technically adequate (within scope). When we are delivering a project, we don’t add features to give the final product more wow factor as that would typically either mean increasing the budget throw additional manhours or duration or both. The goal is to deliver something that is technically adequate to meet the needs of the business. The same should go for the technological problems that we solve as CIOs. Being innovative means solving the problem in the manner that best suits the organization, nothing more, nothing less.

Unfortunately, our CEOs are inundated with marketing hype trying to sell them flashy solutions to problems that don’t exist or at least are not the most feasible solution to an existing problem. Additionally, they are also exposed to things that other organizations are doing that may or may not be applicable to their organization. As CIOs, this is where we need to put on our educator hat and educate our CEOs on how and why we choose the solutions we do. Sometimes the best solution to a problem is really the simplest solution.

Given this introduction, let’s talk about several questions about innovation in IT.

What is the CIOs role in innovation?

As a CIO, our role is the use of technology with business goals. The investments that we recommend in technology should directly support the goals and objectives of the business and be aligned to strategic objectives stated in the strategic plan or be solutions to problems that are preventing the business from achieving one or more of its goals or objectives. Innovation comes into play in providing those solutions. As stated earlier, innovation is just a new idea that solves a problem. As CIOs, it is our job to facilitate those new ideas.

Does innovation always require a novel idea?

Unfortunately, I think there is a misperception that innovation always requires a novel idea. While a lot of innovation really does start with a novel idea, especially those that we hear and read about, innovation can happen on a daily basis without creating something “novel”. Just coming up with a new idea or solution to a problem that your organization hasn’t tried before is being innovative. That doesn’t require that the idea or solution be so entirely new or original that no one has ever done it, just that the application of it is new to your organization or new to that problem.

With all of the focus and emphasis on innovation these days, isn’t there a cost to trying to drive innovation?

Absolutely. Organizations that want to strive to be innovation-first organizations where their goal is continuously come up with innovations invest in research and development or experimentation time. That may look like entire departments devoted solely to innovation or organizations over staffing their IT departments to give their staff time to experiment and play with new technologies in the hopes of them coming up with innovative solutions. There are very real costs to doing this. Taking your average overworked, understaffed IT department and coming in with a mandate that it needs to become more innovative just doesn’t work. Now, that doesn’t mean that they can’t come up with innovative solutions (many that I have observed do, by the way). It just means that they aren’t going to be actively looking for new ways to be innovative because the organization hasn’t staffed them for that ability.

What are the pitfalls that a CEO can get into when trying to hire an “innovative” CIO?

This really comes down to knowing your business, budget and what you need and can sustain. If you work for a nonprofit healthcare organization, as I do, you probably aren’t going to want or need to hire an executive from one of the big tech firms, even if you could afford them, thinking that they are going to bring innovation to your organization. If you do, the following will probably happen. They will recommend solutions that you can’t afford and the process of constantly being told no and not getting to work on cutting-edge technology will drive them away and you will be stuck recruiting for a CIO yet again, which can be a very costly endeavor. You are much better off hiring someone who understands and gets your industry and can bring their experience and expertise to your problems. Just because they have developed AI solutions or worked on the latest self-driving vehicle technology doesn’t mean they aren’t innovative or can’t provide an innovative approach to problem solving at your organization.

Does innovation by the CIO always involve technology?

To this question, I would answer with a resounding “NO”. At the end of the day, what you should be looking at is the best solution, not the most cutting-edge solution, not the most technical solution, not the most complicated solution, but the best solution. Sometimes, the best solution may involve a process change and may not require any technology at all or the best solution may require a process change followed by a technological solution. This is where you should listen to your candidate’s problem-solving skills and judge those rather than judging whether they fit your vision of being innovative or not.

This blog post has been written from my experience in technology both as a technologist and a leader and in dealing with numerous CEOs. Given that my experience may not be the same as yours and as always, I welcome your comments and perspectives and always look forward to hearing the perspectives of others as an opportunity to potentially learn and grow.


Thursday, March 20, 2025

 

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As the CIO for a nonprofit, community-based healthcare center, I interact with vendors a lot. Probably 25% or more of my week involves dealing with vendors on new project proposals, renewals, research, or getting support. With that experience, here are a couple of things that I would like you, all of the IT vendors out there who want a nonprofit’s business, to know about how to do business with a nonprofit and have more understanding of the people across the table from you.

1. Nonprofit organizations are way different from for-profit organizations. That should be obvious, but let me explain how this should play into how you interact with or understand a nonprofit organization:

a. Most nonprofit organizations, especially those of us relying on federal funding to serve vulnerable populations, have to fight for every dollar we get, therefore, it is imperative to make sure that we are good stewards of those dollars and get the most value for every dollar spent that we can.

b.  This means that we are going to ask more questions, move more slowly to make decisions, maybe consider more options, and certainly push on you for more information than maybe a for-profit customer might.

2. I am going to ask you for a nonprofit discount or special pricing every day, all day long. Your competitors offer this, and I will expect you to as well if you want to do business with me!

3. If you are a VAR representing multiple vendors, we are really going to lean on you to make sure that you are living up to the value-added component of our relationship. For the reasons stated above in item 1b, you might have to spend more time and effort to make a sale to us for a specific product or service. Please understand this before agreeing to enter into a relationship with us. We are going to bring you problems and look for you to help provide us with solutions.

a.  Just because we don’t buy today doesn't mean that we won’t in the future. You may present us with a great solution that we just can’t afford today, however, we will be continually working to find a way to swing that purchase in the future so your working on putting together solutions and proposals for us should be seen as an investment in future business even if you don’t immediately make a sale.

4. Due to lean staffing models, we are always in firefighting mode. Anything you can do to help us become more proactive is appreciated and will be reciprocated in the form of referrals to other colleagues. I personally speak to many of my colleagues in other nonprofit organizations and we frequently discuss our vendor experiences. I always highlight those vendors that I feel have gone above and beyond for us and make strong recommendations advocating for those vendors. Understand that the reverse is also true.

5. We generally want to establish a relationship and have trust in our vendors. We are going to be hesitant when we first start to do business with a new vendor, and it is incumbent on that vendor to build trust with us. While we are always price-sensitive, we also look to the value of the service offered. I don’t mind spending a little more money on a service if it helps me scale to the point where we can do more without adding more FTEs. I am always looking for that value beyond just the bottom-line cost. 
That being said, if you sell me on that value, you had better deliver or else any trust or goodwill will quickly evaporate and your opportunity to do business with us in the future will be greatly hampered.

In conclusion, the relationship between IT vendors and nonprofit organizations is built on understanding, trust, and mutual respect. Vendors who take the time to comprehend the unique challenges faced by nonprofits and offer tailored solutions, discounts, and unwavering support will find loyal and long-term partners. By recognizing the value in each interaction and seeing beyond immediate sales, IT vendors can foster strong, lasting relationships that benefit both parties and ultimately serve the greater good of the community.

Tuesday, March 11, 2025

No Project Management or Bad Project Management: Which is Worse?

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Over the last few years, I have gone back in forth on my opinion of whether it is worse to have no formal project management in place or to have some project management in place that is somewhat ineffective. Previously, I had always leaned toward having some project management in place being better as at least there was something to start from and it could hopefully get better. I have recently changed my opinion on that though after witnessing firsthand what ineffective or bad project management can do to an organization. Here is how I arrived at this change of opinion:

 Initial Belief: Bad project management is a starting point that could be improved upon.

Actual Observations: Bad project management rarely gets better. Individuals who are part of the “bad” process typically don’t want to change and don’t want to recognize what they are doing wrong.  This is basically like trying to get rid of a bad habit in your personal life, which we all know how that is to do. When bad project management habits become entrenched in an organization, they are very difficult to get rid of. Furthermore, leadership “thinks” that they have project management in place because they have individuals with the title of project manager in the organization so making change in this area becomes less of a priority.

Initial Belief: Bad project management probably at least enlists some elements of a project management discipline.

Actual Observations: This is really a myth. While there might be some aspects that are masquerading as project management discipline, in reality, it is usually just bits and pieces that someone has picked through and selectively implemented or tried to implement, but there is typically no discipline behind them and usually are misused.

Initial Belief: No project management just means chaos.

      Actual Observations: Typically, while not completely organized, there is usually some sort of project management happening at the user level so that they can at least manage their activity even if the overall project is being managed effectively. In my experience, it is easier to take these efforts and organize them into a project management discipline instead of fixing bad project management practice.

How Does This Usually Happen

  • I think we all agree that project management is critical for any organization that regularly has any type of work that involves multiple resources and/or multiple departments with multiple tasks that take place over a period of time. Many organizations make a half-hearted or uneducated stab at implementing a project management discipline. The problem that usually arises from this is that processes aren’t well thought out or established or applied consistently. This can be due to the following reasons:
  • Project management roles aren’t established as full-time, professional jobs within the organization which means that it just becomes another hat that someone who already has a full-time job ends up wearing.
  • Even if project manager roles are established in the organization, they are given to someone without any formal project management training, often someone in a clerical role, who really is just responsible for coordinating project activities. This role often doesn’t have the authority to manage the human resources assigned to particular projects.
  • Project management is distributed across the organization instead of centralized in a single PMO-type function. This leads to varying degrees of implementation and consistency.
  • Not only is project management a professional discipline that, to do well, requires a lot of education and judgement, but it also requires someone who is highly organized and is a master planner. Often, project management roles aren’t recruited for, they are bestowed or dumped on someone, which usually leads to poor results.

How Does This Typically Manifest

The results of poor project management usually are chiefly evident in lack of or poor planning. Poor or missing project planning usually starts right at the beginning of the project with inadequate requirements gathering and scoping. These two elements alone can doom a project. Without adequate requirements, how do you even build or manage a project plan let alone accomplish anything. This usually leads to massive scope creep as requirements get uncovered throughout the project and then are either reworked into the project with an unending timeline or are left out together delivering a failed mess of a project. Occasionally, requirements get missed, even on the best planned projects, but knowing how to deal with them makes all of the difference in the world. Being able to assess the impact on the project of addressing the new requirements as a scope change vs. adding them to a second phase of the project where initial requirements are delivered and the new requirements are then slotted into another phase takes training and professional judgement to do successfully, not to mention good communication skills to work with your stakeholders to determine the solution that is best for the project and the organization. Bad project management and managers don’t do this assessment and don’t work with their stakeholders to work out a recovery plan to keep the project on track.

Then there are so-called requirements that come in as change requests that aren’t really requirements but nice to have features that someone dreamed up. Strong project management is needed to sort these through and determine what is necessary to successfully deliver the project vs. what is not and can be negotiated for potential later prioritization or release. If your project management is really only just tracking and coordinating project activities, you lose this vital project management skill.

Requirements gathering and project planning are the foundation of a sound project. Without these, a project is doomed to fail before it even really gets started.

Another way that poor project management manifests itself is in lack of leadership, The inability to assess risks to the project and communicate those risks in a meaningful way so as to facilitate the creation of a mitigation strategy is key. This takes leadership and experience.

Lack of communication is also a hallmark of poor project management. Project managers are the glue that hold the project together. The only way to do this is by being a good communicator and facilitator. That means staying engaged with the project team and stakeholders, watching for signs of trouble or risk, communicating often and early when issues arise and making sure that everyone involved understands their role and responsibilities to the project and is held accountable.

Conclusion

While I would wholeheartedly agree that no project management in an organization is a bad thing, I have come to realize that bad project management is even worse as it can create confusion and lead to misunderstandings, lead to ineffective requirements gathering and planning and usually leads to unending scope creep and/or project failure.

As this blog was mainly an opinion piece, I would be curious to hear your opinions or experiences around lack of or bad project management and which you think is worse.

 


Friday, February 28, 2025

Teaching Leadership How to Interview and Hire Candidates

 

Image by storyset on Freepik

In my conversations and coaching as a thought leader with other leaders and, even in my experience as a job candidate over the years, I have noticed that many of us as leaders don’t really know how to effectively screen and interview candidates. This is a key skill, as not hiring the right individuals to build out your teams, taking too long to fill a position or failing to conduct a proper interview and turning down good candidates because you failed to interview them correctly are hugely costly mistakes. As a result, I thought that I would go through some of what I see as areas that many of us as leaders can improve on to make sure that we are filling our roles as efficiently and effectively as possible.

·         Not really understanding what you are looking for or need

o   I was made aware of a Midwest healthcare organization that has been looking for a Chief Information Officer for at least two years!

§  This is not a pipeline problem as my source that relayed this story to me stated that they had plenty of highly qualified candidates who have gone on to be very successful in CIO positions elsewhere after they were turned down by this organization.

§  Without being on the inside and knowing exactly what is going on, this seems to be a situation where the organization doesn’t really even know what they need or the hiring team can’t agree on what characteristics are a priority and, therefore, can’t come to agreement on a candidate. This is where the CEO as the leader needs to step up and be a leader and make a decision in the absence of complete agreement of their hiring team. This situation reflects poorly on the organization as a whole as it makes them really look incompetent.

·       Hiring managers/executives making interviews too much about themselves and not enough about the candidate

o   Interviews, by definition, are to find out about and get to know the candidate to assess their fit in the position and organization. Yes, there is an aspect of the interview where the candidate gets background information on the organization and the position, the interview should resist talking too much about themselves unless the candidate asks specific questions.

§  I actually heard of one leader who made the statement during an interview that he had forgotten more information about his industry than most people had ever known.

·       This can come off as arrogant and sets a very awkward tone and may cause you to lose a valuable candidate because they are put off by this.

·        Remember, the candidate is interviewing you as well

o   Be sure that you are listening to the candidate and what they are actually saying. If they are being too verbose or you would prefer the question to be answered in a certain way, be sure to let the candidate know that. Remember, the candidate has never met you before and doesn’t know exactly how you expect them to interact with them. This becomes even more complicated for the candidate if this is a phone or virtual interview as body language that would normally serve as cues is nonexistent.

§  Everyone is different, this includes interviewers, so set your expectations during the interview for how you expect the interview to go. Some leaders are more casual and want the interview to be more conversational. That is okay, just let the candidate know that upfront.              

§  Be open-minded. You never know when you are going to be pleasantly surprised!

·      Stay away from questions asking how the candidate would implement something or to assess issues with your organization.

o   The candidate only has the information about your organization that is publicly available. They don’t know what the needs or pain points of your organization are. Furthermore, it is unfair to expect them to solve those in the course of an interview even if you tell them what they are!

o   Instead, ask how they would come into your organization and assess needs. What is the process they would use to learn about deficiencies or opportunities, how they would go about prioritizing them, how would they confirm these with stakeholders, etc. The process and thinking behind that will tell you much more about the candidate than you could ever get from them solving a problem for you.

·        Be okay with “I don’t know” as an answer

o   Rarely is any candidate going to check all of the boxes. A candidate who is willing to be upfront and tell you that they know don’t something should be a positive sign rather than one who will try to bluff their way through the answer.

·       Make sure that your job description is updated for the current needs of the business and not just what the incumbent did. It is very likely that your business has changed since you hired the previous person in that role. This is the opportunity to incorporate those changes into the job description. Avoid falling into the trap of just trying to find the same person that you previously had.


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