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Module Topic Highlights Learning Resources Estimated Minimum Time Requirements 1.5 hours


Introduction to Project Management

A. B. C. D. E.

Key learning principles Introductions and logistics What is a project? Elements of a project Project management toolkit and case study F. Personal experience with projects G. Individual commitment to learning


Project Proposals Project Design and Plan

A. Project proposals

Evaluating alternatives

Trainers Guide and Trainee Guide are resources available to support the entire training program Project Proposal Tool Project Charter Tool Case Study Project Charter Tool Team Tools Project Charter Tool Detailed Project Planning Tool Cash Budget Template Budget Detail Worksheet Template Risk Matrix Tool Project Charter Tool Detailed Project Planning Tool

1.5 – 2 hours

C. Getting approvals
3 A. Project Charter Plan first, then do! What is a project charter? Key elements of a project charter B. Team Creation Establishing Project Team values Roles and Responsibilities Conducting Project Team meetings C. The Project Plan Introduction to the Detailed Project Plan Using the Milestones Setting Tasks Completing the Project Plan D. Budgeting Introduction to cash budgets Creating a budget 30 hours

1.5-2 hours

1-2 hours

2 hours

E. Risk Management Anticipating and Mitigating Risks 4. Project Implementation A. Implementing the Project Tasking and Tracking Scope management Risk Monitoring

1 hour

1.5 hours

B. Change Management

2 hours

The Human Dynamics of Change and Transition Leading change Building change into your project plan A. Evaluating projects B. Lessons learned C. Project Management training evaluation


Post Implementation Review

Post Implementat ion Review Tool

1.5 hours

Menu of Icons: Discussion question. Can be facilitated by the trainer in a large group, or by facilitators in smaller groups. Use the group discussion questions as an opportunity to reinforce that we learn from our positive and negative experiences…and that we can learn from others’ experiences (shared-learning).

Toolkit. Refer to a specific tool in the Project Management Toolkit.

Key Learning. Focus on ensuring this key learning is understood.

Individual Exercise: A reflective, individual exercise facilitated by the trainer. Allow trainees to consider personal experiences and individual leadership objectives.

Activity: An activity to be facilitated by the trainer, including for example, a review of a project management tool with a case study question, a cash budget activity etc.

Additional Resources: Refer the trainee to additional information (e.g. books, articles, materials on website or on other websites, videos).


A. Project Charter Plan first, then do! What is a project charter? Key elements of a project charter B. Team Creation Establishing Project Team values Roles and Responsibilities Conducting Team Meetings Project Charter Tool Case Study Project Charter Tool Team Tools 40 hours

1.5-2 hours

C. The Project Plan Introduction to the Detailed Project Plan Using the Milestones Setting Tasks Completing the Project Plan

Project Charter Tool Detailed Project Planning Tool

1-2 hours

D. Budgeting Introduction to Cash Budgets Creating a budget

Cash Budget Template Budget Detail Worksheet Template Risk Matrix Tool

2 hours

E. Risk Management Anticipating and Mitigating Risks

1 hour

A. Project Charter Plan first, then do! What is a project charter? Key elements of a project charter Project Charter Tool Case Study 30 hours

Pre-Project Stage

1. Project Design and Planning

2. Plan Implementati on

3. Post Implementati on

5 Why? What? How? Do! Monitor Revise MODULE 3A PROJECT CHARTER: PLAN FIRST, THEN DO! Review Celebrate

Discuss how a project is started – how ideas move from abstract to tangible. Review the stages of a project from design of the business case for the project...alternatives need to be explored and choices made on the best options. This was discussed in Module 2. Reinforce that the focus of training on project management is to plan first, then act. Taking the time (and resources) to plan is critical. The Project Charter requires a lot of work before you can move to project implementation.

Brainstorming Discussion: Following on the discussion in Module 1F about personal experiences with projects, BRAINSTORM examples of projects (healthcare and non-healthcare) that have not been successful. What do you believe made the porjects unsuccessful? E.g. budget deficits, lack of resources, lack of clear goals, lack of leadership? Record answers on flip chart.

Introduce and explain the brainstorming technique from the toolkit



Powerpoint presentation: What is a Project Charter? Use the powerpoint to guide your teaching. The Training Guide encourages you to use lots of activities, questions, discussions and to record key ideas on flipcharts. The powerpoint is only a guide to training. What is a Project Charter?

6 ➢ Formal agreement between the project manager and the key stakeholders ➢ Tool for managing the expectations of the project sponsor and stakeholders

Why should I write a Project Charter? ➢ All future decisions in the project should be evaluated for alignment to the Project Charter ➢ More likely to get approvals and resources with a formal written Project Charter Discussion: What are the differences between a Project Proposal and Project Charter?

Project Proposal Purpose: Suggests that a project should be initiated Often led by sponsor or manager Contains a high level estimate of costs Suggests resources and what/who may be required Requires review and approval for proposal by Project Sponsor Approval to proceed to detailed planning

Project Charter Purpose: Defines how a project will be completed Led by Project Manager Contains a detailed budget Names resources and gives detailed time requirements Requires signoff by Project Sponsor (and sometimes key stakeholders) Approval to proceed with project and budget


Toolkit: Go to the Project Management Toolkit and pull out the Project Charter Tool. Looking at the tool, review its key elements.

Project Purpose: ➢ Describe the opportunity or problem the project will address ➢ Provide background on why the project has been considered ➢ Identify the key needs the project will meet


ACTIVITY #1: Creating a Project Purpose: Create a project purpose for the Triage Centre using the Case Study


The Mulkulla Mother-Child Hospital (MCH) is located in Mulkulla, a coastal city located in the Hadhramout region of Yemen. The Mulkulla MCH is being established as a teaching hospital associated with the adjacent University of Mulkulla’s medical school. At present, there is an out-patientclinic at the Mulkulla MCH that currently operates 12 hours/day. The leadership team at the hospital wants to expand the operating hours of the out-patient clinic to 24/hours per day. The public is really putting pressure on the hospital to open 24/hours/day. In addition to out-patient services, the Mulkulla MCH has plans in place to establish a 10-bed pediatric emergency ward. To achieve these objectives, the leadership team at the Mulkulla MCH has decided to set up a triage station(sorting station) to help the MCH staff respond to the patients needs. If a triage station is set up in the hospital, the MCH staff can assess patients arriving at the hospital and ensure that the right patients get the right treatment at the right time. Initially, doctors at the Mulkulla MCH can do the assessing of patients. But, the leadership team ultimately can train nurses to do this triaging with focused training (5 days) and support. Nurses won’t need to know how to diagnosis – the y will need to decide “how sick, how quick?” Resident pediatric doctors can teach these nurses. The idea to set up a triage centre has been discussed with the MCH leadership team and there is enthusiasm for this project. Yet funding parameters are not clear and a Project Sponsor has not been clearly identified. The leadership team is uncertain about how to proceed. Mulkulla MCH leadership team and front-line workers have met to discuss the potential project. There is some confusion and lots of questions: How will the triage centre work? Will patients being admitted for maternal care be assessed at the triage centre? Who should conduct the assessments of in-patients? And, there is concern: existing systems will need to be enhanced: systems for admission, transfer, referral and discharge and filing systems must be in place to make a triage centre work smoothly.

Key Elements of the Project Charter: Roles

8 ➢ The Project Sponsor – He or she is responsible for approving whether the project can proceed and approve when a deliverable has been met

➢ The Project Manager – – The primary point of contact for stakeholders Responsible for ensuring that the project is completed on time and on budget

Key Elements of the Project Charter: Budget ➢ A budget includes all costs that will be incurred as a result of the project ➢ Costs that are incurred as a result of operations start- up are also included

ACTIVITY #2: Would these Items be Included in your Project Budget in the Triage Centre Case Study? 1. Project Manager’s Salary 2. Medical Supplies 3. Computer for reception 4. Project Sponsors Salary 5. Travel expenses 6. Computer software 7. Administrative Expenses 8. Ambulances

Key Elements of the Project Charter: Success Criteria ➢ Define the elements that are critical to the addressing the issues that started the project and creating value E.g.: • • Decrease patient wait times Decrease cost of operations

➢ Refer back to these success criteria to assist in resolving issues and conflict over scope, budget etc in the future

9 Key Elements of the Project Charter: Scope ➢ This is one of the most important parts of the Project Charter • Adding or eliminating too many items will make it impossible for you to succeed

➢ Consider which things really need to be part of the project and which are just “nice to have” ➢ Limiting your scope to those actions that are absolutely necessary to achieving your goal will make it much easier to succeed ➢ Ask yourself “If we don’t do this will we still get the results we need?”

Key Elements of the Project Charter: Assumptions ➢ Typically assumptions, if true would be favourable to the project (e.g. if this proves to be true, the project benefits) ➢ These include things like: • • • Staff resources will be available in a timely fashion Building approvals are not required Existing computers could be used for the project

➢ Use these assumptions to consider contingencies or options in case your assumptions do not prove true

Key Elements of a Project Charter: Dependencies ➢ Those activities or events upon which your project depends on to be successful ➢ Dependencies may include things such as: • • • The completion of a related project The completion of earlier projects as part of a larger program The availability of technology

Key Elements of a Project Charter: Constraints

10 ➢ Constraints are typically not favourable to the project – if this “thing” proves to be true, the project suffers ➢ Constraints may make your project harder to manage or impact your ability to deliver ➢ Constraints on a project would include such things as: • • • Equipment order lead times are unpredictable Computer resources can only be accessed weekdays No overtime payment is permitted

➢ Your project plan should incorporate these restrictions and address ways to manage or mitigate them

Key Elements of a Project Charter: Milestones ➢ Accomplishments, results, deliverables and events used to measure overall project progress ➢ Milestones should be specific and measurable – We can say definitively if they have been achieved ➢ Milestones typically mark the end of a phase such as design, development or construction

ACTIVITY #3: How would you classify the items in the list below: Milestone or Task in the Triage Centre Case Study? 1. Project Plan Completed 2. Design approval received 3. Fence built around construction zone 4. Communication session for nurses 5. Construction completed 6. Electrical Installed 7. Training Delivered

11 Key Elements of a Project Charter: Resources ➢ Who do you need to be able to complete your project? ➢ Consider subject matter experts (such as computer, construction etc) and other team mates you might require. Will there be any new hires or consultants required? Name Position Project Responsibilities Current or New % of Time

Key Elements of a Project Charter: Risks ➢ Every project has risks. By identifying risks early, you can ensure you minimize them. ➢ Risks should span the entire project and include everything from resourcing issues, to government and regulatory changes, to budget risks, to construction delays and more ➢ Risks are usually measured according to their likelihood and their severity. ➢ Risks are discussed in detail later in this module.

Ensure that all questions are asked, and answered. It is critical that trainees understand the Project Charter.

B. Team Creation Establishing Project Team values Roles and Responsibilities Conducting Project Team meetings Project Charter Tool Team Tools 1.5-2 hours


SMALL GROUP ACTIVITY #1: Talk about the characteristics and values of a highly-effective team using brainstorming and consensus techniques from the team toolkit. Objectives: • • Discuss individual experiences from your best teams Using the consensus technique, develop a list of the characteristics of effective teams Introduce the team tools from the consensus techniques toolkit and practice brainstorming and

Suggested Process for small groups: 1. 2. 2. 3. 4. Read over the exercise to ensure everyone understands. Facilitator to introduce the team tools in the toolkit. Select a recorder to collect information generated by your team. Individually, take one minute and think about the best team of which you have ever been a member. Individually, take four minutes and jot down whatever comes to mind that makes you think of this as your best team. 5. What did your team do? How did it work together? What did you feel? What characteristics of this team stand out? and list individual responses (use

Use brainstorming technique Flipchart in each small group).



Use consensus technique and list what you think are the five most important characteristics of effective teamsas experienced by your team members. Share your five most important characteristics and any questions about consensus with the larger group.


LARGE GROUP ACTIVITY #2: Highlight the Characteristics of an Effective Team: point to each of the values on the circular chart and explain in a little more detail. Refer to the materials in the trainee’s guide.

Clear Purpose Informality relaxed. Participation Listening ideas. Civilized Disagreement and conflict. Consensus Decision not necessarily everyone’s

The vision, mission, goal, or task of the team has been defined and is now accepted by everyone. The environment tends to be informal, comfortable, and There are no obvious tensions or signs of boredom. There is much discussion and everyone is encouraged to participate. The team uses effective listening techniques such as questioning, paraphrasing, and summarizing to get out There is a disagreement, but the team is comfortable with this shows no signs of avoiding, smoothing over, or suppressing For important decisions, the goal is substantial but unanimous agreement through open discussion of ideas, avoidance of formal voting, or easy

compromises. Open the tasks Communication hidden Team members feel free to express their feelings on as well as on the group’s operation. There are few

14 agendas. Communication takes place inside of meetings. Clear Roles and There are clear expectations about the roles played by each Work Assignments team member. When action is taken, clear assignments are made accepted, and carried out. Work is fairly distributed. Shared Leadership While the team has a formal leader, leadership functions shift from time to time depending upon the circumstances, the needs of the group, and the skills of the members. The formal leader models the appropriate behavior and helps establish positive norms. The team spends time developing key outside relationships, mobilizing resources, and building credibility with important players in other parts of the organization. The team has a broad spectrum of team player types. Periodically, the team stops to examine how well it is functioning and what may be interfering with its effectiveness.

External Relations

Style Diversity Self-Assessment

LARGE GROUP ACTIVITY #3: After the review of the characteristics of an effective team, discuss the use of the brainstorming and consensus techniques. Did your team follow the rules set out in the Toolkit? MODULE 3B TEAM CREATION: TEAM ROLES AND RESPONSIBILITIES KEY LEARNINGS: Share the chart below to identify some of the most likely causes of team dysfunction. Assure trainees that using the tools, and being proactive in designing and managing project teams, can avoid or minimize these risks. Emphasize the importance of defining the roles and responsibilities for each member of the team.

Identify the Team Selection Worksheet in the Toolkit as a tool that can help in identifying members of the Project Team.


Individual Exercise: Think of a project team that you worked on in the last two years. Answer the following questions: 1. What was your role on the project team? What duties and activities were you responsible for? How did you contribute to the accomplishment of the team’s objectives? What did you need from others in order to do your job the way you liked to? Be specific, e.g. information, mutual support, communication, career development, organization training, workload priorities:What: 3. From Whom:


What did you need to know about other team member’s jobs and expertise to help you do your own work? What: From Whom:

Alternative Small Group Exercise: If the group would prefer more activity, divide the trainees into small groups of 5-7 per team. Give each team some building materials (e.g. children’s blocks, LEGO blocks, or ask them to use natural items like branches and rocks, and ask each team to create a boat or another specific structure in 20 minutes. After the building session, ask them to answer the questions above. KEY LEARNINGS: Make the connection from the past to the present to enable team members to see how they can be successful in their new project team roles. Clarify the objectives as:


SMALL GROUP ACTIVITY #4: Establishing Team Meeting Norms using Brainstorming and Consensus Techniques from the Toolkit

Suggested Process: 1. Read over the exercise to ensure that everyone understands.

16 2. Select a recorder to collect the information generated by your team.


Use Brainstorming and develop a set of five norms by Consensus that your team will use to govern how team members will perform during your team meetings (use Flipchart).


Review your Team Meeting Norms. Are they clear and specific? (If not, change them.)


Bring your norms to the facilitator for discussion.

C. The Project Plan Introduction to the Detailed Project Plan Using the Milestones Setting Tasks Completing the Project Plan Project Charter Tool Detailed Project Planning Tool 1-2 hours


The Detailed Project Plan should be developed after the Project Charter has been completed, and the Project Team has been identified.

17 Review the tool and explain its purpose: • The purpose of the Detailed Project Plan is to identify specific milestones and tasks, and assign timing and accountability to each task. – • The Detailed Project Plan tells us who is going to do what by when.

The Detailed Project Plan is used throughout the life of the Project as a tool to track progress on each task. Pre-Project Stage 1. Project Design and Planning Why? What? How? 2. Plan Implementati on Do! Monitor Revise 3. Post Implementati on Review Celebrate


KEY LEARNINGS: Use this chart to discuss the detailed Project Plan Phases Project Plan Phases PLAN Description • • During the Planning Phase, the Project is described in detail. In this phase, the Project Manager will create: ○ ○ ○ ○ ○ ○ DO • • The Project Proposal The Project Charter The Project Team The Project Budget The Detailed Project Plan The Risk Assessment

This phase of the project is about putting the Project Plan into action. The Tasks that were identified in the Project Plan are assigned to individuals on the Project Team, to be completed by a certain date. The Project Manager monitors the Project Team’s progress, and adjusts resourcing or tasks as required in order to meet specific milestones. This phase of the project occurs after the project activities are complete. In this phase, the Project Monitor will complete the PostImplementation Review.


• •

19 MODULE 3C THE PROJECT PLAN: USING THE MILESTONES Discussion Question: The Project Manager will use the timing and high-level milestones described in the Project Charter to identify key milestones in the project. What is a milestone? What are some examples of milestones in the PLAN phase...and in the DO phase? Why is it critical to track milestones?

Use a flipchart to record answers: Definition: Milestone • A Milestone indicates the end of a group of tasks or the completion of a key deliverable in the Project. A Milestone is used to determine if the Project is on track, according to the Detailed Project Plan

Milestones in the PLAN Phase might, for example, include: ✔ Project Charter Complete ✔ Project Budget Complete ✔ Project Team in Place Milestones in the DO Phase might, for example, include: ✔ Requirements Identified ✔ Process Design Complete ✔ Physical Space Secured ✔ Physical Space Upgrades Complete ✔ Health Care Staff Training Complete ✔ Facility is Ready to Treat Patients (Go Live)

CASE STUDY ACTIVITY #1: Review the Milestones identified in the Project Charter for the Mulkulla Mother-Child Hospital Triage Centre (Module 3A). Ensure that the Milestones address: ○ ○ ○ • Physical changes (building, equipment, computers, etc.) that must occur Regulatory or government approvals that are required Hiring, training or other human resources activities that must occur

Are there any Milestones that have been missed? Insert all Milestones into the Detailed Project Plan

20 • • • • Once the Milestones are identified for a given Project, they should be placed in the order in which they will occur In the Detailed Project Plan, the Project Manager will assign dates to the Milestones These dates establish the timing for the entire project, and set the dates for the beginning, and end, of the Project Some dates associated with Milestones may be mentioned in the Project Charter; all dates for completion of milestones should be consistent in all Project documents


There are a number of tasks that will need to be accomplished to meet each Milestone. Use a flipchart to explain tasks and their importance. Definition: Task • • A Task is an activity that needs to be accomplished within a defined period of time Tasks can be described at a very detailed level, and any task might have several more detailed tasks, or sub-tasks associated with it

Tasks should be included that address the Risks identified in the Risk Matrix Tool: refer to that document when identifying tasks E.g.: Task: Determine training requirements for nursing staff » » Subtask 1: Survey nurses to determine current practices Subtask 2: Speak to doctors and ask for their input on nurses’ training requirements (i.e. what training do the nurses need to be successful?) Subtask 3: Review new processes, and compare to current processes to identify gaps in knowledge Subtask 4: Based on gaps, identify training requirements for nurses

» »


Discussion Question: Once Tasks have been identified and are in the appropriate order in the Detailed Project Plan, why is important that each Task be assigned to an individual? ○ ○ The responsibility for completing each Task should be assigned to a single individual, rather than a group, wherever possible. Other people may need to be involved or consulted in order to complete the Task, but only one person should be named as responsible. Project Managers may choose to involve the Project Team in this exercise in order to encourage buy-in and ownership over individual tasks.

Discussion Question: Now, timing should be assigned to each Task. To determine timing, what should you think about? What can we do if we find that the Tasks cannot be accomplished by the date assigned to the Milestone? Why would a Project Manager involve the Project Team when assigning timing to each Task? • When we think about timing, we need to consider: ○ ○ ○ • Dependencies: Which tasks must be complete before another can start? Resources: Can the same people accomplish all of the tasks they’re assigned to within a particular period of time? Duration: How long will it take to complete each task?

Project Managers may find that the Tasks they have identified cannot be accomplished by the date assigned to the Milestone. In this case, the Project Manager can: ○ ○ ○ Add resources to the Project Team to accomplish the Tasks faster Move the Milestone date Remove Tasks that are not critical

Project Managers may wish to involve the Project Team in assigning timing to each Task ○ This will ensure that those who are responsible for completing the Tasks agree that they can be completed within the given time frame



Once the Detailed Project Plan is completed, it should be shared with: ○ ○ The Project Team The Project Sponsor

Copies of this document have been issued to: Versio n Name Title Date Issued Initials

• •

Note that the Detailed Project Plan may change as the Project progresses, and dates and resources change Each version of the Detailed Project Plan should be saved; when changes are made, it is important to be able to refer back to the original Project Plan to determine how timing has changed The Detailed Project Plan is now ready to be used to monitor progress against tasks!

D. Budgeting Introduction to Cash Budgets Creating a Budget Cash Budget Template Budget Detail Worksheet Template 2 hours


Key Learning: Introduce the concept of cash budgets Discussion Question: Start a discussion to see if people know what a budget is. Discuss the importance of budgeting to ensure that a project is well planned and sufficient funding is in place.

Powerpoint presentation: Introduction to Cash Budgets Use the powerpoint to guide your teaching. The Training Guide encourages you to use lots of activities, questions, discussions and to record key ideas on flipcharts. The powerpoint is only a guide to training.


ACTIVITY: Review the Introduction to Cash Budgets with Examples in the Trainee Workbook. Go though the examples with the students and have them independently complete Example 2 to ensure they understand.


Introduction to Cash Budgets With Examples A Cash Budget is an estimation of the cash inflows and outflows for a business or organization or individual for a specific period of time. Cash budgets are often used to assess whether the entity has sufficient cash to fulfill regular operations and/or whether too much cash is being left in unproductive capacities. It also helps to plan for special projects and equipment expenditures. A cash budget is extremely important, especially for small businesses, because it allows a company to determine how much credit it can extend to customers before it begins to have liquidity problems. For individuals, creating a cash budget is a good method for determining where their cash is regularly being spent. This awareness can be beneficial because knowing the value of certain expenditures can yield opportunities for additional savings by cutting unnecessary costs. For example, without setting a cash budget, spending US $1 a day on a small item seems fairly unimpressive. However, upon setting a cash budget to account for regular annual cash expenditures, this seemingly small daily expenditure comes out to an annual total of US $365, which may be better spent on other things. A surplus budget means there is extra cash at the end of a period, while a balanced budget means that the cash inflows equal the cash outflows. A deficit budgetmeans cash outflows will exceed the cash inflows. Cash Budgets are usually compiled and re-evaluated on a periodic basis. Adjustments are made to budgets based on the goals of the budgeting organization. In some cases, budget makers are happy to operate at a deficit, while in other cases, operating at a deficit is seen as financially irresponsible.

EXAMPLE #1: GROUP ACTIVITY Let’s use a simple example to show the basics of preparing a cash budget.

a) b) c)

Your hospital has US $2,750 in its bank account. Your hospital receives US $4,125 per month. You want to buy a vehicle for the hospital which will cost US $13,750 You can arrange to pay US $6,875 this month (after some government funding comes in) and US $6,875 next month.

What will be the balance of the hospital’s bank account after you have paid for the vehicle? How will you fund this cash deficit?

26 EXAMPLE #1 This Month Beginning Balance Cash Inflow Total Cash Inflow Cash Outflow Ending Balance 2,750 4,125 6,875 6,875 0 Next Month 0 4,125 4,125 6,875 (2,750)

EXAMPLE #2: INDIVIDUAL ACTIVITY a) You are running an out-patient clinic and you need to install a new telephone system. This will cost US $15,000. The telephone company will provide this new system and you will need to pay for it over the next several months. b) Currently you have US $7,000 in your clinic bank account. c) Your clinic receives US $5,000 each month in user fees. d) You have agreed to pay US $3,000 per month for the new telephone system, starting now (Month 1). In addition, you will be able to sell your old telephone equipment and you will receive US $6,000 in 2 month’s time (Month 3). At that time, you will pay all the money you get from the sale of the old telephone equipment towards the new telephone equipment, in addition to your normal US $3,000 monthly payment. What will your End Balance be at the end of Month 4?

Beginning Balance Cash Inflows Monthly User Fees Sale of Old Equipment Sub Total Cash Outflows

Month 1 7,000 5,000 12,000 3,000

Month 2 9,000 5,000 14,000 3,000

Month 3 11,000 5,000 6,000 22,000 9,000

Month 4

27 Ending Balance 9,000 11,000 13,000

Individual Exercise #1: Student Cash Budget Introduce the Exercise #1 Scenario (Student Cash Budget) for students to complete an individual exercise in creating a cash budget. Use a handout or work on EXCEL to complete the template on the Student Budget Exercise. After students have finished, share the answer in a handout (or show from your computer and project onto a screen). Then handout the answer (or show on the screen).

Let’s complete a Cash Budget for the next 6 days. Today’s Date is Saturday 23rd October. The template has already been set up for you with the days of the week, starting with Saturday. The following information will help you to complete the budget accurately. ➢ The amount of cash in your wallet is US $50 ➢ On Monday your father will give you US $1,650 as your weekly allowance ➢ Your friend, Assim, owes you us $100. He has promised to pay you half of this money on Tuesday. He will repay the rest of the money next week.

28 ➢ You spend US $5 every day in the cafeteria at your college. You attend college from Saturday to Wednesday ➢ Your car needs to be filled with petrol today. This costs US $35 ➢ On Monday you will need to pay your mobile phone bill which is US $25 ➢ On Thursday night you will go out with your friends. You will spend the following amounts under “entertainment”.

➢ ➢ ➢ ➢

Dinner Coffee at Café Sweets Music CD

US $10 US $ 1 US $ 3 US $ 7

Required: 1. Complete a Cash Budget using this information.

2. Identify the day you have the least cash
3. How much money will you have when you wake up on Friday morning?

Exercise #1 Template: Student Cash Budget
Satur day S und ay Mond ay Tuesd ay Wednesda y Thurs day Frid ay

Beginning Balance CASH INFLOWS Weekly Allowance Assim Pays you Total Cash Inflow CASH OUTFLOWS


Cafeteria Petrol Mobile Phone Entertainment Total Cash Outflow ENDING BALANCE Notes:
1. Your beginning balance on Saturday is what you have when you start or the balance at the end of the Friday before. 2. Your Beginning Balance each day is the Ending Balance from the day before.

Exercise #1 Answer



Sund ay

M ond ay

Tuesd ay

Wedn esday






5 1 ,65 0

1 ,62 5

1,67 0


1,64 4


50 50 10 1 ,65 1 ,67 1,67 0 1,665 1,64 4




5 35


5 25



21 40 10 5 5 30 1 ,62 5 5 1 ,67 0 5 1,66 5 21 1,644 1,64 4


Notes: 1. Your beginning balance on Saturday is what you have when you start or the balance at the end of the Friday before. 2. Your Beginning Balance each day is the Ending Balance from the day before.

Additional Resources: Answers to these exercises on cash budgets can be found on the Bridges’ website in EXCEL formatting, complete with formulas and comments.


Small Group Activity: Now you will want to create a Cash Budget for the MCH Case Study. Refer back to the Case Study in the training materials. Review the requirements of this exercise. The trainees will use information from the case to build the budget for this triage centre project. Allow the trainees to work in small groups.


Budget Tools in the Project Management Toolkit are introduced – refer to the Budget Detail Worksheet Template and the Cash Budget Template in the toolkit.

The Mulkulla Mother-Child Hospital (MCH): Case Study Scenario Using your Case Study details and the Excel Template that has been prepared for you, create a budget for the year for the MCH for this project. The template has already been set up for you with the months of the year, starting with January. If you wish to start in another month, other than January, just change the column headings to reflect any full 12 month period. Also, you are free to change the row headings where you feel it is appropriate and some blank rows have been left for you to add other cash inflows and outflows that you determine may be necessary. For many of the cash outflows, you may need to do another schedule before you get your final numbers for each month. For instance, for the cost of “Nurses”, you may need to create a separate spreadsheet showing how many you need for each month, and their hours and their salaries. The total of this “sub schedule” will be carried forward into your final yearly budget. Required:

1. Complete

the Budget Detail Worksheet to determine your overall costs and funding for the project.

2. Complete the MULKULLA MOTHER-CHILD HOSPITAL Cash Budget using the
worksheet from #1 above. Determine when you will need to plan for cash inflows and outflows. 3. Do you identify any problems and if so, can you adjust your budget to try to correct them? __________________________________________________________________________________ _________________________________________________________________________________ 4. Does the budget help you in your overall planning of for the MCH Triage Project?

32 __________________________________________________________________________________

Budget Detail Worksheet

Trainees should work in small groups to BRAINSTORM about the costs of the project. How much will this project cost? Are we on budget? How much have we spent on the various expense items? These are all questions you must be able to answer when planning a project. The Budget Detail Worksheet may be used as a guide to assist you in the preparation of the budget and the budget narrative (which explains the how and why). Once you have your total budget numbers, you can put them into your Cash Flow Budget to plan, month by month (or week by week if you wish) when you will be receiving your Cash Inflows and when you will be incurring your Cash Outflows. Refer to the attached Budgeting Excel spreadsheet in your training materials. List each position by title and name of employee, if available. Show the annual, or hourly or monthly rate and the percentage of time to be devoted to the project. 1. Professional Staff Name/Position Estimated Cost Dr. ? - Paediatrician Dr. ? - GP # Full-time nurses # Lab Technicians Pharmacist TOTAL $_________ 2. Administrative Staff Name/Position Estimated Cost Computation ($ ($ ($ x ($ x Computation ($ x 100%) $ $ $ $ $

x 100%) x 100% x #) % x #) %)

33 Receptionist Secretary Security Cleaners Porter Transport/other Laundry Services Maintenance Staff Food Services Staff ($ ($ ($ ($ ($ ($ ($ ($ ($ x x x x x x x x % x 1) % x 1) x % x #) $ $ $ $ $ $ $ $ $

% x #) % x 1) % x 1) % x 1) % x 1) % x 1)

TOTAL Budget Narrative:


Discuss here your rationale for the professional and administrative staff costs you are budgeting and why they are required.

3. Set Up Costs for Triage Unit Item Cost Medical Equipment • Itemize if necessary Beds Sheets Blankets Medical Supplies Computation ( ( ( ( ( ( ) ) ) ) $ $ ) ) $ $ $ $ Estimated

34 • • Itemize if necessary ( ( ( ( ) ( ( ) ( ( ( ) ) ) ) ) $ $ $ $ $_________ ( ) ) ) ) $ $ $ ) $ $ $ $ $

Laboratory Supplies • Itemize if necessary • ( Additional Furniture • Itemize if necessary • ( Development & Printing of forms Patient Records System Initial Training Costs Total

Budget Narrative: Discuss here your rationale for the setup costs for the triage unit.

35 4. General Operating Costs Item Cost Computation Estimated

Rent or Lease Cost Electricity Water Cleaning & Laundry Supplies Fees/taxes of any sort Other Miscellaneous Costs Opening Celebration Costs

( ( ( ( ( ( ( (

) ) ) ) ) ) ) )

$ $ $ $ $ $ $ $

Community Communication Plan

Total Budget Narrative: Discuss here your rationale for the General Operating Costs.


BUDGET SUMMARY When you have completed the budget worksheet, transfer the totals for each category to the spaces below.

36 1. Professional Staff 2. Administrative Staff 3. Set Up Costs for Triage Unit 4. General Operating Costs TOTAL PROJECT COSTS $_________ $_________ $_________ $_________ $_________

PROJECT FUNDING You will now have to look at what your sources of Cash Inflows will be.

1. Government Funding / Grants 2. Municipal or Local Funding / Grants 3. Donations 4. User Fees 5. Fundraising Activities TOTAL PROJECT FUNDING

$_________ $_________ $_________ $_________ $_________ $_________

37 MCH Case Study Exercise Template

Note to Trainers: Ensure the Cash Budget Template is printed off on legal or long paper to ensure enough width. You may wish to provide copies of this template for students. Alternatively, have students work on the budget on EXCEL and complete it on their computer. All amounts are in US $ Beginning Balance CASH INFLOWS Government Funding / Grants Municipal or local Funding / Grants Donations User Fees Local Fundraising Activities TOTAL CASH INFLOWS CASH OUTFLOWS ADMINISTRATIVE STAFF: Receptionist Secretary Security Cleaners Porter Transport/Driver Laundry Services Maintenance Staff Food Services Staff PROFESSIONAL STAFF: Physicians - GPs Physicians - Pediatric Nurses Lab Technicians Pharmacist Other SET UP COSTS FOR TRIAGE UNIT: Medical Equipment Beds, sheets, blankets
Ja n. Fe b. M ar. Ap r. Ma y Ju n Jul Au g. Se p. Oc t. No v. De c.

38 Medical Supplies Laboratory Additional Furniture, desks, chairs Development & Printing of forms Patient Records System Initial Training Costs Other GENERAL OPERATING COSTS: Rent or Lease Costs Electricity Water Cleaning & Laundry Supplies Fees/taxes of any sort Other OTHR MISCELLANEOUS COSTS: Opening Celebration Costs Community Communication Plan Other



E. Risk Management Anticipating and Mitigating Risks Risk Matrix Tool 1 hour


Key Learning: Introduce the Risk Matrix Tool and means to assess and mitigate risks associated with projects.

Powerpoint presentation: The Impact of Risk Management Use the powerpoint to guide your teaching. The Training Guide encourages you to use lots of activities, questions, discussions and to record key ideas on flipcharts. The powerpoint is only a guide to training.


Toolbox: Introduce the Risk Matrix Tool.

Risk Matrix Tool Exercise: Refer to the Risk Matrix Tool Exercise in the trainer’s workbooks. The Exercise has 3 parts: A, B & C. LET’S ASSESS THE RISK OF THE PROJECT When you assess risk, you have to think about all the possible things that could go right or go wrong. This process gives you an opportunity to grasp and determine the

41 impact of the “worst case scenario” and then plan ahead to try to mitigate (reduce) the risks.

The next exercise is one in which you are to BRAINSTORM

all the possible

things that could go wrong in your project. You may want to use the template from your MCH Cash Budget exercise (Module 3D) as a tool in identifying some of the line items that could cause / be affected by a risk. Part A:

Using the Risk Matrix Tool

record the risks, the impact on the project, the

probability (how likely it is that the risk would occur), describe the specific risk you foresee and then record how you could mitigate the identified risk. In order to get you started on the Risk Matrix which follows, here are some examples of potential risks: • • • • • • • • • Delay in training of people responsible to manage the triage desk Construction delay in installation of the triage desk Budget shortfall during the project operations Medical personnel don’t have time to commit to the project Medical supplies and equipment – Supply sources? Costs? Delivery Problems? Establishing trust with patients/families and does the facility reflect a perceived real need? Cultural issues – will people go to a hospital for these issues – will it be easily acceptable in the community? Cannot get qualified staff Cannot get supplies/equipment RISK MATRIX TOOL What are the Risks? What is the impact? High/Medium/L ow What is the probability of this risk? High/Medium/L ow Describe the risk How can you mitigate it?


43 Part B:

Key Learning Part B: Teach trainees how to use the matrix to determine where the Impact and the Probability intersect to determine if the risk is High, Medium or Low for each identified item. You will note that you entered the risk as High, Medium or Low. You also entered the probability of the risk occurring as High, Medium or Low. Using the table below, for each risk identified, determine each one’s overall risk to the project.

What is the Probability? High Medium Low High High High Medium

What is the Impact? Medium High Medium Medium Low Medium Medium Low

Key Learning: After the students have completed the Risk Matrix Tool, and assessed whether the impact and probability is High, Medium or Low, you will have them use the matrix shown in Part B to determine the overall risk of each item. Show the students how to use a matrix and to see where the boxes intersect.

Part C: What would be the impact &/or cost if you did not proceed with this project?


44 _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ ___________________________________________________________________________________

___________________________________________________________________ ___________________________________________________________________

Key Learning: It is important to explain to students that not all projects should necessarily proceed. Often there is a momentum when management decides to move forward on a project, and they have blinders on in terms of risks. One of the hardest things to do is to get the parties involved to answer the question posed in Part C of this exercise. Sometimes it is best to walk away from a project if the risks are too great.