“Plan your work and work your plan.” So goes one of the truisms of successful organizations. Properly planning projects to successfully deliver them involves carefullybalancingconstraints such as size (scope), quality, schedule, budget, and risks. These elements are so closely linked that changing one will always have an impact on one or more of the others. Nowhere is this truer than in planning major information technology (IT) systems, which have become just as important to the working world astelephone, electricity, and plumbing systems.

As a result of public complaints, the 2014-2015 Ventura County Grand initiated an investigation into Ventura County’s methodology and practices for project management, using the county hospitals’ implementation of an electronic health record (EHR) system as a case study.

After extensive research and interviews, the Grand Jury found that:
• No countywide policyidentifies required project management standards.
• Project management countywide is inconsistent in its use of “best practices.”
• Based on its cost and its effect on other departments and agencies,the EHR system ranks as an “enterprise” project—a type that requiresa comprehensive, formal risk assessmentbefore the project’sstart-date. This was not done.
• Quantitative project status and “estimate at completion” (EAC) reports are not consistently
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required, which can cause the project-governing group to miss opportunities to identify problems and take corrective action.
• Important categories of expenses within the EHRproject’s total cost—such as labor hours and travel expenses—were not calculated and included when project authorization and funds were sought from thecounty’s Board of Supervisors. The project’s ultimate total costs will soar above the $71 million-plus originally authorized to an amount not yet known.
As a result of its investigation, the grand jury recommends that the Board of Supervisors standardize the use of project management “best practices” and formalize the approval of any deviation from those standards.
The grand jury also recommends that the board assign responsibility for IT project management to the county’s Information Technology Committee, giving the ITC authority to regularly monitor the achievement of stated IT project goals; ensure compliance with the approved project process; enforce the use of quantitative data to measure a project’s progress; identify problems; and assure that prompt corrective action is taken.