Triage

An evening in the ER

You sometimes forget how fragile life can be, until you find yourself sitting in a hospital emergency room. A few days ago, our son celebrated his 5th birthday.  My wife threw him two parties; one was with his friends and the other was with family.  We believe our adventure began at the first party.  Though the party was private, it was in a public place around lots of other people.  Within 48 hours of the first party, our son was lethargic and complaining of a headache.  He complained of being cold but was running a fever.  Next thing ya know, he was tossing his little cookies.  That's when his experience ended and my wife's began.  My wife then complained of a headache and waves of hot and cold.  The headache got worse...and worse...and worse.  Since she has a history of migraines, she took medication with the hope it would stop it.  Then she got sick to her stomach, just like our son.  Unlike our son, she didn't get better.

Sunday night into Monday morning was rough.  She didn't sleep due to the "migraine".  I stayed home from the office so I could take care of our son.  Monday night turned into Tuesday and still the migraine got worse.  But this wasn't a normal migraine and the medication wasn't stopping it.  She called her doctor and waited.  After a few hours, and her doctor not returning her urgent call, she had enough.  It was time to go to the Emergency Room.  We called a family friend, who picked up our son, and we were on our way to the next phase of our adventure.

When I think of the ER, I have thoughts of sitting in a waiting room for 6 hours with people bleeding profusely from their heads or coughing like they have tuberculosis.  We made our way to Frederick Memorial Hospital (FMH).  I have to say, I was pleasantly surprised by the service we received.  I could include a few project management analogies in here but I'll try to stick to the story.  It took about 5 minutes to check in.  (symptoms, medications currently taking, age...)  We sat in the relatively empty waiting room for about about 20 minutes before they took us to triage.  Before being called, we saw them call the oldest and the youngest in the room and someone they flew in by helicopter.  It was interesting to see the prioritized patients moving in and out of the waiting room.  While in triage, they asked a few more questions and slapped and armband on her wrist.  A nurse appeared and told us we were being taken to "Fast Track".  She escorted us through a few doors to an area I would describe as a medical cube farm.

Within an hour, she had been seen by a nurse.  30 minutes later, a physician's assistant came.  30 minutes later, my Vicodin drugged wife and I were leaving the hospital.  So, what was causing my wife this excruciating pain?  The staff believe she was exposed to a virus that has been going around.  Instead of just making her sick, it infected a cranial nerve.  The nerve was swelling, causing the pain.

I'm still a little pissed that her doctor didn't call her back until today.  Thanks for nothing!  I would give the hospital a pretty good rating on a few things.  They definitely managed client expectations.  I literally expected a 6 hour wait.  We were in and out in less than 3 hours.  They had free WiFi.  What can I say, I like my WiFi.  It helped pass the time.  They kept us informed of what was going to happen next.  I think communications is key to keeping the costumer happy.  The last part was someone from FMH contacted me via Twitter to check up on us.  Now that is a savvy hospital!

Thank you to all those on Twitter and elsewhere who saw my initial Gowalla post.  It was very nice to receive your supportive tweets.

See you all online!

Derek

How To Prevent Your Project From Hemorrhaging

Triage Your ChangesThis post is in response to a post written by Jennifer Bedell on the PMStudent blog about goldplating. Goldplating is very common in application development and can be very expensive. If you're dealing with Waterfall, it's a little more obvious when it's happening.  Some may argue, but I've seen it happen in Agile as well.  I've sat across the table from a vendor and asked, are you prepared to roll back every one of these changes?  Their eyes get big because why wouldn't the client want these changes?  Well, too many times a developer is in the code and they think, while here, why not make this additional change we planned to do next month.  Or, now that I'm here, it makes a lot more sense if I do it like this versus what we originally thought.

In short, Jennifer wrote about goldplating caused by testers. She asked

why is it always the developers who get blamed for goldplating? When you consider the cost of change increases as the project timeline progresses, it becomes evident that, in addition to increasing scope, goldplating by a developer can also be costly. Goldplating by a tester can occur when a tester goes beyond the stated requirements in an effort to produce a “quality” product. A tester may feel that their suggestion would improve the customer experience so they log this in the defect log.  While their suggestion may do exactly what they envisioned, if it was not within the scope of the stated requirements, it becomes a form of goldplating or “feature creep”.   A tester’s job is to ensure that a quality product is delivered, but many testers rely on their own definition of quality rather than using the requirements to define quality...

I’ve seen team members at every stage of the Software Development Life Cycle (SDLC) attempt to goldplate, with the best of intentions. Regardless of where you are in your development process, any time there is a requested change to the baseline, there should be a control mechanism.  I call that mechanism a triage. Be it the customer or a customer representative (Project Manager, Product Owner, or BA), someone needs to vet anything and everything which could impact the baseline.  These changes need to be prioritized and reviewed.  I'm not saying changes should not be made.  I'm saying they need to be properly vetted.  Changes impact the schedule, the budget, and in the end...customer satisfaction.

Without this control point, I think you’re guaranteed to see creep somewhere in your project and you will see it begin to bleed time, money, or both.

Yes, we certainly want to deliver the greatest value to the customer. But, creep increases risk and that’s not value.

Am I just a control freak or do you agree with me?