There are parallels between what goes on in the emergency room, with its host of accident and gunshot wound victims, and what goes on in successful project management

Little, Terry

NASA Technical Reports Server

by Terry Little 
Contrary to what my wife would say, I don't watch 
much television. I do. however, regularly watch one 
show on the Learning Channel-the reality series 
called Trauma: Life in the E.R. 
WHILE WAT HING T I lE LAST EPISODE, I RECOGNIZED 
parallels between what was going on in the emergency 
room, with its host of accident and gunshot wound victims, 
and what goes on in successful project management. 
Inside a Metaphor 
First, there was a sense of urgency, but not haste. 
As an ambulance or helicopter brought in patients, the 
physicians, nurses and technicians did some quick 
planning, anticipating the li kely condition and needs of 
the patient. They moved to get the necessary tools and 
equipment in place before the patient arrived. 
20 APPL THE NASA AC ADEMY OF PROGR AM AND PROJECT LEADERSHIP 
Once the victim appeared, there was no wasted 
motion. With time as the chief resource, no one did 
anythin g that didn't directly address the ultimate 
objective-saving the victim. The medica l tea m shared 
a clea r set of prio rities ; dea l with life threa tening issues 
firs t, possibl e long- term consequences second and 
ignore everything else. 
Each person in the room had an active role. 0 one 
was in the emergency room as an observer or overseer. 
Someone was clearly in charge, but typica lly no one 
wa ited to be told what to do. Interes tingly enough, no 
one ever seemed pa ralyzed by fea r of doing th e wrong 
https://ntrs.nasa.gov/search.jsp?R=20120000517 2019-08-30T18:32:15+00:00Z
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thing. Through training and experi ence, th e entire 
tea m operated in harm o ny. Wh en there wasn ' t enough 
info rmatio n to make a decision abo ut a course of 
trea tment, the staff moved quickly to get mo re info rma-
ti o n us ing x-rays, magnetic 
analyses and lots of di scuss ion-all aimed at dec iding 
o n the "right" thing to do. We accept that as a matter of 
course, but should we? 
What's wrong with making a rapid decisio n based 
upon the data at hand, 
intuition and experience; and resonance imaging and similar 
diagnosti cs. People spent little 
time debating or pondering 
what to do next. TIley decided on 
what to do and got on with it. 
Sometimes the unexpected 
happened and a situation that 
seemed to be in control 
suddenly went out-of- contro l. 
In those cases, there was 
Let's face it, 
for any project 
emergency there 
is no perfect 
th en , hav ing made th e 
decision, foc using our energy 
on execution? Let's face it, a 
perfect answer for any project 
emergency doesn't exit. Yes, 
there are some fundamentals 
to consider, but never a back-
of- th e-book answer that 
no hand wringing or fault 
findin g-just a measurcd, 
adapted response to the new 
situati on. Sometimes there 
answer. 
prescribes the solutio n. 
And fin ally, how do we 
were mistakes; mostly they were 
acts of omission rather than commission. There was 
concern and open discussion about the mistakes, but 
lea rning was the chief consequence. 
I also noted that there was a genera l acceptance that 
not everything affecting the pati ent was totally within th e 
contro l of those in the emerge ncy room. The staff 
spent their time dea ling with what was in their control 
and not complaining abo ut what was n't. 
Rerun 
[ kn ow some of yo u are th inking that I have carried 
this metaphor too fa r. Perh aps so-perh aps not. 
Consider planning and preparin g for the project. 
It 's impo rtant to do it, but a team sho uldn 't spend too 
much time trying to achieve pelf ecti on. The plan will 
never perfectly refl ect reali ty. And what about prioriti es? 
Certainly a project 's pri oriti es arc likely to be less 
clea r- cut than those in an emergency room, but having 
them and working to them is no less important. 
Think abo ut economy of resources. It 's impo rtant to 
have the right number o f people working the project, but 
each must have an ac ti ve role. Like the emergency room, 
a project has no place for bystanders. 
Expending effo rt o n th e ni ceti es when the 
fundamental o bjective is in q uestio n doesn 't work. Fro m 
what [ know of project management, the expressio n 
"Nero is fiddlin g while Rome burns" is alive and well. 
Reca ll from yo ur own ex peri cncc what happens when 
a project begins to go awry. Lots of meetings, lots of 
dca l with mistakes in project 
man-age ment? Th ey are 
inev itab le, you kn ow. Any 
project manager who cla ims 
to have never made a mistake is either a neophyte or a 
li ar. Sometimes our mistakes result from things we do 
or don 't do when we sho uld have known better. O ther 
times o ur mistakes are only retrospecti ve mistakes-
mistakes because of fac tors we coul d not have known o r 
anticipated . 
I n either event, we should dea l with o ur mistakes 
and those the folks working fo r us make in the same way 
as the emergency room does. Admit the mistake. Distill all 
th e lea rning from it we can. Move on. Like the emergency 
room staff, the alternati ve of avoiding mistakes by do ing 
nothing simply isn 't in our playbook. 
"In order to provoke unconventional 
thinking, you nccd to create a situation 
wh ere the status quo won 't get you 
there," says TERRY LITTLE of his man-
agement style. "Until you're able to turn that light on in 
people's heads that just doing things the same old way 
isn't going to get you to where you need to be, you 're not 
going to stimulate innova tive, creative thinking." 
Link is currenrly the Director of thc Kinetic Energy 
Boost Office of the Miss ile Defense Agency. Before 
that, he was the head of the Air Force's Center for 
Acquisition Excellence. He is one of the Air Force's 
most seasoned program managers, and was promoted 
to Senior Executive Service in 1997. 
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ASK 12 FOR PRACTITIONERS BY PRACTITIONER S 21 
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Project Management: The Television Show

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