Jaakko Kujala

Project business as a research field

Purpose – The purpose of this paper is to introduce project business as a research field. The project business view in this paper puts focus on the management of firms and their businesses, and this way the paper complements the existing project‐centric view of the role of projects and their management in various business contexts.Design/methodology/approach – The paper proposes a conceptual framework for project business and identify relevant research areas and themes. These research areas and themes are derived by using the knowledge and experience obtained from scientific project business research conducted in Finland since the early 1990s.Findings – This paper describes project business as a research field by introducing a project business framework and the four major research areas inherent in the framework: management of a project, management of a project‐based firm, management of a project network, and management of a business network. It also suggests specific research areas and themes within the ...

Time‐based management of patient processes

PURPOSE The purpose of this paper is to present a conceptual framework that would enable the effective application of time based competition (TBC) and work in process (WIP) concepts in the design and management of effective and efficient patient processes. DESIGN/METHODOLOGY/APPROACH This paper discusses the applicability of time-based competition and work-in-progress concepts to the design and management of healthcare service production processes. A conceptual framework is derived from the analysis of both existing research and empirical case studies. FINDINGS The paper finds that a patient episode is analogous to a customer order-to-delivery chain in industry. The effective application of TBC and WIP can be achieved by focusing on through put time of a patient episode by reducing the non-value adding time components and by minimizing time categories that are main cost drivers for all stakeholders involved in the patient episode. RESEARCH LIMITATIONS/IMPLICATIONS The paper shows that an application of TBC in managing patient processes can be limited if there is no consensus about optimal care episode in the medical community. PRACTICAL IMPLICATIONS In the paper it is shown that managing patient processes based on time and cost analysis enables one to allocate the optimal amount of resources, which would allow a healthcare system to minimize the total cost of specific episodes of illness. Analysing the total cost of patient episodes can provide useful information in the allocation of limited resources among multiple patient processes. ORIGINALITY/VALUE This paper introduces a framework for health care managers and researchers to analyze the effect of reducing through put time to the total cost of patient episodes.

Project strategy: strategy types and their contents in innovation projects

Purpose – Previous literature on project strategy has adopted the narrow view that a project is to be conducted under the governance of a single strong sponsor or parent organization. The purpose of this study is to provide a critical analysis on prior project management (PM) literature addressing different context‐specific strategies of single projects.Design/methodology/approach – Literature analysis.Findings – There are two important determinants in the projects context that affect the strategy of a single project: a projects autonomy in its environment and the complexity of projects stakeholder environment. Based on these two determinants, we characterize four types of alternative positions that projects can have in their context: parents subordinate and autonomous projects that occur in a stakeholder environment that is not complex, and projects with weak and autonomous positions in a complex stakeholder environment. The developed project strategy framework is applied in the context of innovation...

The impact of patient-physician web messaging on healthcare service provision

BACKGROUND Information technology can support the delivery of healthcare. Patients are eager to make use of such tools as web messaging, yet its deployment has been limited to date. A fear still pervades that the cost associated with a possible increase to physician workloads may outweigh any suggested benefits. GOAL This paper aims to review the body of research completed in the area of patient-physician web messaging. The findings of this review will then be assessed and synthesised, with the intention of creating an overview of both the benefits and costs of patient-physician online messaging. Areas of particular importance to future research may then be identified. RESULTS Demand and support for online communication tools amongst patients is strong, and can increase quality of care due to increased patient-physician communication. Although there would seem to be great potential to increase process efficiency, there would not seem to be sufficient evidence as of yet to suggest that this is the case. CONCLUSION Further quantitative research in particular is required to assess the impact of online communication, with special regard to the effect on overall patient demand and on healthcare process efficiency.

Project-based management as an organizational innovation: drivers, changes and benefits of adopting project-based management

This paper examines project-based management as an organizational innovation. Institutional theory and innovation diffusion literature suggest that the drivers for adopting an organizational innovation may differ across organizations, and that the drivers may be linked with the timing of the innovation. A survey questionnaire was used for data collection, and the sample consisted of 111 companies representing a variety of industries. The results of this study identified external pressure and internal complexity as drivers for introducing project-based management. The degree of process change, depth of project-based management adoption, and local success of project-based management introduction as changes caused by adopting project-based management are examined. The study also reveals benefits from introducing project-based management in the form of improvement in project culture, and efficiency improvement.

A stakeholder network perspective on unexpected events and their management in international projects

Purpose – While earlier literature has focused on the management tactics of unexpected events, this paper employs an inter‐organizational network perspective to the study of unexpected events in international projects. The paper aims to illustrate how a focal projects local stakeholder relationships are associated with the emergence and management of unexpected events in the context of international projects.Design/methodology/approach – A qualitative, multiple case study of three international projects conducted in challenging institutional environments.Findings – The findings of this paper reveal the different mechanisms through which the local stakeholder relationships affect the emergence and management of unexpected events in international projects. Owing to differences in the amount and quality of local stakeholder relationships, the management, nature and number of unexpected events that are encountered differ from project to project. The findings of this paper reveal a paradox – both the existenc...

A Negotiation Approach to Project Sales and Implementation

We conceive the project sales and implementation process as a continuous joint decision-making process between the customer and supplier. We draw a parallel between the stage model of negotiations and phases of the project sales and implementation process, and apply the framework of negotiation analysis to the context of project management. A sample of negotiation strategies for both counterparts is presented to illustrate how the negotiation analytic framework can be used to describe and analyze different strategies the supplier and customer can employ in different phases of the project sales and implementation process. We find that a qualitative application of the approach facilitates the description of generic negotiation maneuvers in projects, supports the analysis of project negotiations, and provides several practical suggestions to improve negotiation outcomes.

Cardiac surgery productivity and throughput improvements

PURPOSE The high variability in cardiac surgery length--is one of the main challenges for staff managing productivity. This study aims to evaluate the impact of six interventions on open-heart surgery operating theatre productivity. DESIGN/METHODOLOGY/APPROACH A discrete operating theatre event simulation model with empirical operation time input data from 2603 patients is used to evaluate the effect that these process interventions have on the surgery output and overtime work. A linear regression model was used to get operation time forecasts for surgery scheduling while it also could be used to explain operation time. FINDINGS A forecasting model based on the linear regression of variables available before the surgery explains 46 per cent operating time variance. The main factors influencing operation length were type of operation, redoing the operation and the head surgeon. Reduction of changeover time between surgeries by inducing anaesthesia outside an operating theatre and by reducing slack time at the end of day after a second surgery have the strongest effects on surgery output and productivity. A more accurate operation time forecast did not have any effect on output, although improved operation time forecast did decrease overtime work. RESEARCH LIMITATIONS/IMPLICATIONS A reduction in the operation time itself is not studied in this article. However, the forecasting model can also be applied to discover which factors are most significant in explaining variation in the length of open-heart surgery. PRACTICAL IMPLICATIONS The challenge in scheduling two open-heart surgeries in one day can be partly resolved by increasing the length of the day, decreasing the time between two surgeries or by improving patient scheduling procedures so that two short surgeries can be paired. ORIGINALITY/VALUE A linear regression model is created in the paper to increase the accuracy of operation time forecasting and to identify factors that have the most influence on operation time. A simulation model is used to analyse the impact of improved surgical length forecasting and five selected process interventions on productivity in cardiac surgery.

Time-based analysis of total cost of patient episodes: a case study of hip replacement.

PURPOSE Healthcare in the public and private sectors is facing increasing pressure to become more cost-effective. Time-based competition and work-in-progress have been used successfully to measure and improve the efficiency of industrial manufacturing. Seeks to address this issue. DESIGN/METHODOLOGY/APPROACH Presents a framework for time based management of the total cost of a patient episode and apply it to the six sigma DMAIC-process development approach. The framework is used to analyse hip replacement patient episodes in Päijät-Häme Hospital District in Finland, which has a catchment area of 210,000 inhabitants and performs an average of 230 hip replacements per year. FINDINGS The work-in-progress concept is applicable to healthcare--notably that the DMAIC-process development approach can be used to analyse the total cost of patient episodes. Concludes that a framework, which combines the patient-in-process and the DMAIC development approach, can be used not only to analyse the total cost of patient episode but also to improve patient process efficiency. ORIGINALITY/VALUE Presents a framework that combines patient-in-process and DMAIC-process development approaches, which can be used to analyse the total cost of a patient episode in order to improve patient process efficiency.

Stakeholder Dynamics During the Project Front‐End: The Case of Nuclear Waste Repository Projects

Understanding stakeholder dynamics and their impact on project management is crucial, especially for large and complex projects such as nuclear waste repositories. This study examines the stakeholder dynamics during the project front-end stage of two pioneering nuclear waste repository projects. To analyze changes in stakeholders’ importance and position on a project, we propose and apply a new conceptual framework: a stakeholder salience-position matrix. The study explicates how stakeholder dynamics are influenced by the interaction of stakeholders’ influence behavior, stakeholder management activities, and the projects contextual conditions. Prior stakeholder literature has rarely conceptualized the elements of stakeholder dynamics in a systematic manner.