Financial planning in MBA Capstone Project - Term Paper Example

Latoya Tulloch MBA CAPSTONE PROJECT April 21, Contents Contents 2 MBA CAPSTONE PROJECT 4 3.0 Functional areas 5 4.0 BusinessCase 6 5.0Business objective 11 6.0 Key assumptions and hypothesis 11 7.0 Project description 14 8.0 Project Alternatives 16 8.1 Film x-ray mammography 16 9.0 Lease vs. purchase 17 10.0 Potential solutions 17 11.0 Engineering information 19 12.0 Technology basis 20 13.0 Project schedule 21 14.0 Project cost estimate 21 15.0 Variance and the reasons of variances 22 16.0 Project execution plan 22 17.0 Risk management plan 25 18.0 Organizational Plan 25 19.0 Procurement plan 26 20.0 Training Plan 26 21.0 Public impacts 27 22.0 Long-term impacts 27 B. A log of time spent with the client 28 References 30 MBA CAPSTONE PROJECT 3.0 Functional areas The three functional areas upon which the problem is based include financial planning, research and development, and leadership. These are discussed as follows: 3.1 Financial planning This project will require substantial funds to be spent on purchase of sophisticated equipment that is used in implementation of image segmentation technique. Before the project is approved, an appropriate budget estimate has to be approved, but that will require adequate justification of all the important expenditure – the project cannot be approved without proper justification of budget estimate. This will be a tasking process keeping in mind that budgeting requires specialized accounting knowledge, but I will make efforts to put up a team with diverse knowledge and skills to help in areas that require specialized attention. 3.2 Research and development This project entails extensive investigation in order to arrive at the most effective scientific method of screening, which will potentially phase out the old techniques that have somewhat hampered treatments and screening of breast cancer in Mt Sinai Hospital. Investment in R&D of this magnitude will require hefty budgetary allocation, and the project committee in charge of approving the project must be convinced the expenditure that will be channeled towards R&D will be recovered in the long-term, otherwise the project will be considered ineffective. 3.4 Leadership Successful implementation of this project will require the project manager together with his/her team to work productively and as a united team in order to ensure effective and smooth implementation process. Despite financial and time constraints, the expectations of the project are quite high and hence very high leadership qualities are required to ensure all aspects of the projects are balanced. Most importantly, effective implementation requires a cohesive team, which is not possible without the right leadership. 4.0 Business Case Breast cancer is caused by genetic mutation of cells that are produced within the milk-producing lobules, which results to their abnormally quick growth. This project has been hatched with the realization that breast cancer can be treated easily if the hospital is in possession of modern and more sophisticated equipment - which aids in highly accurate screening tests 4.1Primary justification Breast cancer is a leading cause of deaths in Mount Sinai Hospital. Additionally, it is a matter of fact that breast cancer is the leading form of cancer that is killing many women in Mount Sinai Hospital as well as all other hospitals in the world. It is, therefore, very important for the hospital management to consider introduction of an image segmentation facility to help with early warning of breast cancer, because this is literary the key to improving breast cancer diagnosis in the hospital. Image segmentation use contours on the region they are positioned on to find the features of an image. As illustrated in figure 1, introduction of screening in US has increased breast cancer incidence, and this will be a primary benefit of this program. Fig 2 Incidence of invasive breast cancer per 100 000 women in the US 4.2 Performance gap and the expected benefits One of the most common screening methods used by radiologists in analysis of the mammograms is X-ray mammography. This technique is very important in detection of the presence or absence of lesions from the mammograms (Stems, 1996). It, however, becomes extremely difficult to detect breast cancer during its early stages because its presence is especially restrained and unsteady. As such, if only experiences are diagnosed, radiologists and doctors can easily fail to detect the presence of abnormality. Having said that, the doctors and radiologists can rely on computer aided screening technology to get a more effective and reliable diagnosis (Sheng, Hong and Enmin, 2011). The aim of having such a computer aided imaging technique is to ensure an accurate segmentation of medical images. This process involves use of different criteria to segment different areas of an image (Chang and Teng, 2007). Use of mammography images in breast cancer image segmentation is a tasking procedure though its accuracy is essential for screening of tumors as well as classification of tissue for early discovery of breast abnormalities. Although it is not perfect, digital mammography imaging is recommended for this project because it is essentially the most efficient imaging method (Guido and Nico, 1999). For women without symptoms, digital mammography imaging is believed to detect between 80% and 90% of the breast cancer. A precise image segmentation of the mammography images is very crucial for a computer aided equipment to perform accurate diagnosis. 4.3 Early detection benefits The type of equipment used is one of the factors that influence early detection through mammography. Knowledge of breast radiology and advances in technology has eased detection of breast lesions. The probability of detecting tumors before they are revealed clinically, with a short preclinical phase, is very low. However, screening Morrison can be used to detect tumors with preclinical phases that have existed for a long time. Investigations have revealed that the cases in their preclinical phase, which have been diagnosed through mammography screening, have a mean duration that is longer than that of the cases that are usually detected through manifestation of symptoms (Warren-Burhenne and Burhenne, 1992). It is also evident that tumors develop slowly during the preclinical phase and have the same character when their symptoms start manifesting themselves. However, through accurate detection of tumors that may remain unnoticed for a while or those with progressive growth, mammography screening improves the prevalence rate. 4.4 Reduction of breast cancer due to mammographic screening Scientific studies have revealed that regular mammographic screening reduces the chances of dying from malignancy, especially for women aged between 50 and 70 years. This comes amidst strong opposition of screening breast cancer by critics who have questioned its value. A research carried out by the International Agency for Research on Cancer (IARC) found that a 35% reduction in mortality of women who are screened regularly is as a result of the 25% reduction in mortality that occurs in the trials of mammographic screening. Introduction of mammography screening is expected to save about 34 lives each year in Mount Sinai Hospital. 4.5 Radiation Risks in Mammography The United States Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), in its 2000 report, pointed out uncertainty in risks for solid cancer and a risk in low or chronic doses. The approximation of cancer identification rates are extremely high for women aged 50-64 years (NHSBSP data). According to During Young and Burch (2000), during the mammography screening, the radiation doses that are received are expressed as mean glandular dose (MGD) (United States Scientific Committee on the Effects of Atomic Radiation, 2000). The data for different does is presented in Tables 1, 2 and 3. The mean dose for a woman whose each breast is being performed - a two-view mammography is represented by 3.65 mGy, while the doses that are above the top 2% and 0.1% of the population are represented by 11 mGy and 20 mHy. This group receives higher doses mainly because they have large breast size. Cancers discovered/ induced Age (years) 3.65 mGy (mean MGD) 11 mGy (MGD above by 2% of screened women) 20 mGy (MGD above by 0.1% of screened women) 50-63 105 33 20 55-58 121 40 21 60-63 179 61 34 Table 1. Ratio of cancers discovered to cancers induced, with 3-yearly two-view screening. Cancers discovered/induced Age (years) 3.66 mGy (mean MGD) 12 mGy (MGD above by 2% of screened women) 20 mGy (MGD above by 0.1% of screened women) 30-35 2.5 0.86 0.49 36-40 6.3 2.1 1.3 41-45 10.9 3.9 2.4 46-49 19.5 6.8 3.9 Table 2. Cancers discovered/cancers induced in younger women, with annual two-view screening, without family history. Cancers discovered/induced Age (years) Index patient age at diagnosis (the age at which the first-level relatives got their breast cancer) 3.66 mGy (mean MGD) 11 mGy (MGD above by 2% of screened women) 20 mGy (MGD level exceeded by 0.1% of screened women) 25-30 31-40 6.0 2.0 1.2 31-35 20.0 5.7 3.8 36-40 42.0 15.0 7.8 41-45 54.0 19.0 10.1 46-50 60.0 21.0 11.2 30-35 41-50 12.0 5.0 2.4 36-40 20.0 7.8 3.8 41-45 33.0 12.0 6.1 46-50 36.0 13.0 6.9 Table 3. Cancers discovered /cancers induced in younger women, with annual two-view screening and family history, 5.0 Business objective 5.1 Critical success factors It will be very important if Mount Sinai Hospital could seek more efficient ways of implementing new technology such as the in one in the form of digital mammography - with the aim of boosting patient volume capabilities. This is especially with consideration of the current situation of an aging mammography technologist environment and an acute shortage of breast radiologists. Furthermore, the national screening rates have reduced for the past couple of years; hence, Mount Sinai Hospital will find it important to embark on an extensive awareness on the importance of undergoing breast cancer screening. In order to demystify the issues of screening, the hospital will need to increase its commitments towards educating women in matters of cancer. Essentially, as the hospital embarks on reversing the declining rate of screening, the revenue capacity will be expected to increase up to the rate of 20%. This will, however, take place only if the hospital maintains high standards in all its services in order win the royalty of the clients. This will also include engagement in perception centered performance improvements such that the hospital upholds a good image to its clients as well as other stakeholders. 6.0 Key assumptions and hypothesis Implementation of the screening project in the hospital is expected to substantially reduce mortality rate from breast cancer by 2015. Despite the great expectation that the project will achieve excellent results, it is also expected that the project will introduce workload demands on the staff and this will present a major challenge to the organization. If the Hospital will find it extremely hard to recruit staff with the necessary knowledge to handle the equipment, the board members must convene a meeting to develop new ways of introducing new types of staff in order to move with the pace of the project. One of the possible ways of developing skills of the existing staff so they could be able to operate the new screening equipment include sending some selected staff to training centers that specialize with screening programs. In addition, that staffs who are already working in similar screening programs will be trained in the centers in order to develop and update their skills. 6.1 Cost Assumptions For the women aged 50-70, breast screening using mammography costs about $70 million per year. It is expected that the program will save about 34 lives per year. Generally, the program is expected to increase the live expectancy of every woman who is screened by the equipment by 15 years. Therefore, the program is estimated to cost about $2500 annually for every life saved. This cost is similar to the cost of screening of cervical cancer in United Kingdom (Peto et al., 2004). 6.2 Operating and maintenance manpower requirements/costs The program will require 2 months to be set aside for the training of the manpower. The primary objective will be to increase the number of Surgeons, Gynecologists, Oncologists, Physicists, and Pathologists with concentration in Oncology. The following is a suggested balance of the manpower: Five radiation oncologist, 2 medical Oncologist and one Clinical Hematologist. One specialist to be trained in surgical oncology, Clinical Oncology, Surgical Pathology and Clinical Hematology. Every year, one Therapy Radiographers should be trained Two medical physicists to be trained. The digital screening mammography will last for about 10-years, after which it can be sold at a marginal scrap value, and replaced with a new one. The cost of purchasing and operating equipment is as shown in Table 4, which also shows comparison with a screen-film. All other costs essential in its maintenance are listed in the table. Unit Costs Screening Mammogram CPT Code(s) Cost Screen-Film 76092 $151 Digital HCPCS $180.29 Additional Imaging (Diagnostic) Diagnostic Mammogram  Digital (unilateral) G0206 $169.21  Screen-Film (unilateral) 76090 $146.45  Digital (bilateral) G0204 $185.50  Screen-Film (bilateral) 76091 $197.40 Ultrasound (unilateral or bilateral)† 76645 $300.00 MRI  unilateral 76093 $283.23  bilateral 76094 $373.23 Procedures  Ultrasound-guided 76942 $433.85  Mammography 76096 $576.61 Visit Costs Office visit with physician $155.00 Radiology (imaging) visit personal time $185.00 Procedure (biopsy) visit personal time $200.00 Table 4: Unit costs used to estimate operating costs 6.3 Utilities and service requirements Running screening mammogram will consume relatively small amount of power, and therefore, some electricity expenses will be incurred every month. Other utilities required to maintain the mammogram include water and air, which will also consume a very small portion of the budget. The budgeting committee will estimate the cost of utilities per year, which will be increased every year depending on the scale and the stage of the program. 6.4 Lifecycle cost considerations A reserve will be set aside to cater for the replacement of the equipment after its useful life lapses in 10-years. This will be in consideration of the fact that the capital for the replacement is massive and if there are no reserves, the hospital might experience unprecedented cash flow problems in future when replacing the equipment, or else interrupt continuation of the program if the equipment will not be replaced immediately. 7.0 Project description 7.1 Project description The preferred equipment that will be installed in the hospital for breast cancer screening is called digital screening mammography. This x-ray equipment is supplied by different manufacturers. It functions by displaying the mammography image in digital format. The equipment will be purchased on a cash basis and then implemented in different phases. The first phase, which will take about a month, will involve the whole process of procurements and installation. After the equipment is fully installed and confirmed to be fully functional, subsequent phases will be embarked on. The second phase, which is the demo-phase, will entail subjecting a number of women to breast cancer screening with the primary aim of testing the equipment for functionality and incase any problem is detected it will be fixed accordingly. Other important stages will include undertaking of the real screening after the equipment has been confirm to be almost free of any issue and when all the staff will have been fully trained and inducted into their roles. During the final stage, the program will have been considered to have officially kicked off, and everything will be run as per the short-term as well as the long-term plans. 7.2 Facility Capability The introduction of a digital mammography in the hospital will be considered successful only if it will bring improvements to the existing system. In this sense, the screening program is expected to have a number of capabilities, including: decline in the necessity for recurrent images; the equipment should make a more effective use of x-rays by delivering fewer dose; the clinicians should be able to access images at any destination; the storage spaced should be reduced; manual handling by radiographers should be reduced; enhanced image manipulation; ease of consultation among clinicians; improve the clinical environment by exempting the need for chemicals; and enable instantaneous exchange of information among different departments. 7.3 Changes from the current design Currently, Mount Sinai Hospital is relying on traditional methods of screening breast cancer, which are somewhat ineffective as they are highly inaccurate. As such, the president of the hospital has proposed for the adoption of a digital screening mammogram, which will introduce an overhaul to the whole process of screening of cancer in the hospital. The new technique will hopefully increase the cancer detection accuracy rate by more than 50%. The new program will require changes to be introduced in the entire system of the hospital including staffing and leadership. A variety of new staff will be hired to take up new roles in the program while different existing staff will be taken through an extensive training to be able to handle new roles appropriately. The project manager, who will be charged with the responsibility of ensuring smooth implementation of the new screening program, will be required to be a person of high integrity, and strong coordination and planning capability because he will be entrusted to ensure that the whole program is run successfully 7.4 Location of the equipment The screening mammography will be situated in the hospitals headquarters branch at New York City. Part of the strategic plans will propose introduction of similar equipments in the hospitals branches, but this will only come after the initial program is successfully implemented and tested within the headquarters. 8.0 Project Alternatives Following a review of the screening equipment that are available in the market, it was found that besides digital mammography, there exists other alternatives such as computerized radiography, computer aided detection, Ultrasound, Film x-ray mammography, and Magnetic resonance imaging among other imaging techniques. 8.1 Film x-ray mammography Film x-ray mammography is a screening intervention that is very effective in reducing breast cancer mortality. This technique is expressed in randomized controlled trials. 8.2 Computerized radiography Like digital mammography, computerized radiography has many advantages including low cost of operation, but it comes in variety of performance and quality. 8.3 Computer Aided Detection (CAD) Computer aided detection is applicable in digital mammographic images. This technique is mostly preferred for its reduction in the number of human readers required per film and improved sensitivity. Currently, no clear benefits have been identified from this technology. 8.4 Ultrasound Ultrasound is a very effective method if used for breast guided biopsy and further evaluation of mammographic anomalies. Studies have revealed that Ultrasound can be used as a secondary addition to screening of the mammographically dense breast, and can also be used in the primary screening of younger women experiencing higher risk. Breast ultrasound is cheaper and easily available compared to other imaging techniques such as magnetic imaging resonance and nuclear medicine. However, the numbers of radiologists who can perform ultrasound screening are not easily available and the procedure is time consuming. 8.5 Magnetic resonance imaging Magnetic resonance imaging has the most sensitive capability of all other methods that are available for screening breast cancer. However, the technique has a higher false rate compared to x-ray mammography and its equipment is very expensive. 9.0 Lease vs. purchase Although purchase of mammography equipment has been found to be very expensive, the hospital will opt to purchase rather than lease because doing so will be cheaper in the long-term. An investigation into the cost of leasing mammography equipment revealed that the rental expenses will equate the purchase price after the fifth year, which is far much expensive considering that the equipment, if purchased, will be resold after the tenth year at a marginal scrap value. However, if the organization was experiencing cash flow problems currently, it could have made a lot of sense to lease the equipment and use the much needed cash in other operating activities - and only opt to purchase it in future when the cash problem will have been surmounted. 10.0 Potential solutions Mount Sinai is expected to leap a lot of benefits following commencement of the project. Some of the problems that are expected to be addressed by the equipment in the short-run include prevention of loss of clients to other Hospitals with sophisticated screening machines, and an increase the cancer detection accuracy rate by more than 50%, hence leading to a reduction of mortality rate as a result of breast cancer by up to 25%. Making the hospital more reliable in terms of breast cancer screening is also expected to increase the much needed revenue by the hospital, which will be used not only for the furtherance of the project its self but also other projects that will see Mount Sinai Hospital expanding in terms of clients capacity by up to 50% in two-years. The growth in revenue as a result of the new venture is hoped to reach up to 25% by the end of the first year since the commencement of the project. A variety of new staff will be hired to take up new roles in the program while different existing staff will be taken through an extensive training to be able to handle new roles appropriately. The following are the ways the functional areas will be used to address the problems. 10.1 Financial planning Implementation of this project will generate both short-term and long-terms benefits, by particularly helping the hospital increase its revenue. Having achieved this, the essence of setting funds aside for the project during budgeting will have born fruits. Indeed, successful implementation of the project such that it becomes a sustainable source of revenue in the future will be possible because of due financial planning - this is essentially the core of the criteria that will determine the approval of the project. 10.2 Research and development The successful implementation of the mammography screening technique will be the fruits of an extensive investment in R&D. Even after the project is implemented, the hospital will be required to continue setting funds for R&D in order to carry out survey and investigations into the best manner of implementing and running the project. Besides, there other additional programs that will be run hand in hand with the mammography project such as creation of awareness of the importance of breast cancer screening – all of which will require continuous investment in R&D in order to find out the best and the most effective way of doing it, as well as evaluating the results of the projects. Generation of additional income will justify the extra budget that will be set aside for R&D. 10.3 Leadership As discussed, successful implementation of the project will call for good leadership, especially in terms of bringing the team that will be involved together. The qualities of leadership, therefore, will include diligence, understanding, team player, patience and passion among many other qualities that leads to effective working in a challenging project of this magnitude. 11.0 Engineering information Table 5: Screen-Film Mammography Equipment - Digital Manufacturer The following is a list of full-field-of-view digital screening mammography available in the U.S. Indirect–conversion detectors • GE Scintillator Pixel size Field of view CsI(Tl) TFT 100 microns 18*23 cm • Fischer Imaging Scintillator CsI(Tl) Pixel size CCD 24/48 microns Field of view CsI(Tl) CsI(TI) CCD 24/48 microns 22 * 30 cm (scanning) Direct–conversion detectors • Hologic/Lorad Photoconductor Pixel size Field of view amorphous selenium TFT 70 microns 24 x 29 cm 12.0 Technology basis Digital mammography is one of the most technologically sophisticated machines used for screening of early anomalies in the breast. The best opportunity to treat breast cancer is when screening is done early to detect possible anomalies, which should be followed by immediate treatment. Therefore, digital mammography is recommended in this program to help in saving lives of many women who succumb to breast cancer every year. With this kind of technology, screening mammograms can be conducted in 10 to 12 minutes. The risk of lost films is gotten rid of because images are obtained and stored by electronic means. Pressure or compression is used to take an average of two images from each breast, a procedure that can sometimes cause discomfort. Despite this discomfort, the procedures remain very crucial because it offers quality images - the women can abstain from scheduling for mammograms one week prior to menstrual cycle because during this time the breasts are usually very sensitive, so they can avoid discomfort. In addition, patients should desist from wearing deodorant talcum powder during screening to ensure the quality of the image is enhanced. 13.0 Project schedule                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             14.0 Project cost estimate Task Procurement and installation of mammography equipment and accessories $3,500 Training of staff to take up new roles $1,500 Kinking off the demo program in Mount Sinai hospital $500 Implementation of the mainstream program $2,500 Delivery of 2013-14 Annual Performance Report - confirmation of proper installation digital mammography $15 14.1 Estimate basis To estimate the cost of the equipment and the screening procedure, the finance department will be required to invite bidders to suggest their prices. The estimate costs will be an average of the bidders’ prices. The cost information that will not be available from the bidders will be derived from the past experience of purchasing similar items. If a past item is used as a basis for cost estimation, the figure must be adjusted for the present value if it was purchased more than a year ago. 15.0 Variance and the reasons of variances For the first one year, variance from the budgetary allocation is not likely to occur. However, from the second year and the subsequent years, there is a possibility that variances will occur due to substantial changes in the cost of maintaining the equipment and perhaps the cost of meeting the salaries. Sometimes, a shortage of experts in different fields could result to substantial increase in salary expenditure. Also, the cost of different items and accessories required to run the mammography screening equipment could unexpectedly increase beyond the budgetary allocation. The budgetary committee will be required to put into account possible variances when preparing the budgets. 16.0 Project execution plan 16.1 Funding plan The budgetary committee will be required to submit the budget estimates for all the phases, from June 2013. This budget presentation, if approved, will be for the 2014 financial year, which will start from January 2014 up to December 2014. As such, the budget will be a forecast of 2014; and the depreciation, as discussed, will be provided on a straight line-basis for a period of 10-years. 16.2 Contracting Strategy 16.21 Procure and installation phase The quality assurance, technical and the finance departments will be actively involved in the procurement and installation of the equipment. The finance department will be charged with the responsibility of ensuring that the qualifying bidders have successfully complied with all the requirements of bidding and have met all the financial thresholds. The Quality Assurance (QA) will monitor each and every item that is purchased by ensuring that all the mammography quality thresholds are complied with. This includes providing guidelines on the development and educational needs to enable the mammographers to exploit their potential performance. The QA will also ensure that all the staff is actively involved in the process of installation so they can have an opportunity to develop a complete understanding of their responsibility within the team. The QA will be led by a radiography manager, who should possess substantial experience in operation and maintenance of mammography equipment. The technical department will comprise of 2 engineers with sufficient qualifications in mammography installations, and a team of three technicians to offer them assistance. The technical team must ensure that all the installation work adheres with the Medical Electrical Installation Guidance Notes - a document that will offer guidance into the specifications of reinstalled imaging and x-ray equipment (MEIGaN, 2005). Other areas that will be subject to this document include the breast screening trailers. 16.22 Demo-phase The technical and quality assurance teams will play a very critical role during the demo-phase. The technical team will ensure that, in case a problem is detected during the troubleshooting or testing of the equipment, qualified experts are contacted to offer assistance. During fixing of any problem during this phase, the quality assurance must continue monitoring the process closely to ensure that the above discussed quality requirements are not circumvented; and that only the contractors who have met quality requirement thresholds are involved during the phase. 16.23 Final-phase During the final phase, the real program will be implemented. All the team that have been mentioned above will continue to play active roles in ensuring the work they commenced during the procurement and installation phases is brought to a successful completion. They shall continue to play similar roles as allocated to them from the beginning, but they must ensure no stone is left unturned since this phase will be final. 16.3 Regulatory compliance plan With the help of the Medical Electrical Installation Guidance Notes, the program team will ensure that all the regulatory rules regarding the mammography program are complied with. Also, any other documents that will be available for testing and specification of the mammography equipment will be consulted accordingly (NHSBSP, 1995).Some of the requirements that the team will seek to comply with include the following: Ensuring that important maintenance, servicing and repairs is done adequately. Ensuring that, in case of nay problem, corrective measures are taken accordingly and that they are recorded and evaluated. Ensuring that essential equipment tests are done and that quality control procedures are carried out in the right manner. Notifying National Coordinating Centre for the Physics of Mammography (NCCPM) in case of any equipment error using a suitable form, copies of which should be sent to Quality Assurance in compliance with the internal procedures 17.0 Risk management plan The program team will continuously carry out risk assessment in order to improve the safety of the patients and prevent or reduce occurrence of errors and breakdown of systems, which can lead to injuries among other harmful effects. This process will involve development of systems that can administer the reporting of undesirable occurrences, potentially unsafe situations and near mistakes. The risk management team will also collect and analyze data that will be used to assess the performance of risky processes such as diagnostic testing, and preventive screening. 18.0 Organizational Plan The project manager will oversee the process of implementation of the program, from procurement and installation till completion of the reporting of the first annual report. He will do his work with the help of different team leaders from different departments including the technical manger, finance manager, and the procurement officer. These positions will be held by the following individuals: Project Manager – Janet Riveria Technical/engineering manager - Mrs Willis Finance manager – Dickson Patel Procurement Officer – Michael White 19.0 Procurement plan The project manager will assist the procurement officer in procuring all the necessary items. The whole process of procurement must be done in compliance with the stipulated procurement rules including the bidding procedures. The procurement officer must also work closely with other crucial departments, such as the quality assurance who must approve the qualified bidders in accordance with quality assurance rules and procedures. 20.0 Training Plan In order to ensure that the quality of the services is up to standard, it will be necessary to maintain the appropriate staffing levels, through continuous training. Training of mammographers should be done in accordance with the requirements of National Health Service Breast Screening Program (NHSBSP). This training will be meant to equip mammographers with technical expertise and information that will help them meet the individual needs of the patients and attain acceptable service outcome. The staff will be required to attend the various national training centers that are available, and particularly undertake postgraduate courses that will award them, certificates in different areas of expertise. Besides these programs, the team that will participate in the current project will be required to undergo a 2-months local training before its commencement. The primary objective of the local training will be to increase the number of Surgeons, Gynecologists, Oncologists, Physicists, and Pathologists with concentration in Oncology. 21.0 Public impacts The public and particularly the women are going to draw many benefits from the current program. Digital mammography cancer screening will save many lives. As previous studies have shown, similar programs have shown a 30% to 40% reduction in breast cancer related deaths, for those women who have been screened using mammography technology. The program will, therefore, help increase the survival rate of breast cancer patients. The women who will regularly use this program will have taken good defensive actions since regular breast cancer screening can help to detect cancer when it is still in its early stages. Consequently, this will help the public by curbing possible spread, availing a better opportunity of successful cancer treatment and by finding more treatment options. 22.0 Long-term impacts In the long-term, the mammography screening program is expected to lead to reduction in mortality from breast cancer as well as significant improvements in treatment of screening in Mount Sinai Hospital. The treatment will have become more effective because it will be possible to detect cancer at an earlier stage. Making the hospital more reliable in terms of breast cancer screening is also expected to increase the much needed revenue by the hospital, which will be used not only for the furtherance of the project its self but also other projects that will see Mount Sinai Hospital expanding in terms of clients capacity by up to 50% in two-years. B. A log of time spent with the client Digital screening mammography project Date Duration Mode Attendees Topics Discussed Follow-Up Action(S) Mar 17 2013 80 minutes On-site meeting Carolyn Robinson Assistant Director/Administrator Preliminary discussions regarding project viability and potential impacts R&D to carry out a market survey to establish project viability and impacts Mar 23-2013 120 minutes On-site meeting Dickson Patel -manager Presentation of problem statements. Discussion of financial viability and implications Dickson Patel to prepare plans for the program in preparation for approval Mar 30 2013 120 minutes On-site meeting Janet Riveria Jerry Willis -Project representatives Discussion of budgetary considerations and procurement considerations Representatives from different departments to give their views regarding the budget and the project in general April 3 2013 60 minutes On-site meeting Dickson Patel -managers Discussions of bidding procedures and potential vendors and their qualifications An advert to be placed to invite interested vendors to apply for bidding April 10 2013 60 minutes On-site meeting Carolyn Robinson Assistant Director/Administrator Presentation of the project document containing timeline, budgetary estimates and approval requirements The project schedule to be prepared with all the concerned parties being involved References Chang, P. L., & Teng, W. (2007). Exploiting the self organizing map for medical image segmentation. In, twentieth IEEE international symposium on computer based medical systems, 281-288 Guido, M., & Nico, K. (1999). Single and multiscale detection of masses in digital mammograms. IEEE Transations on Medical imaging, 18(7), 628-638. June 2005. MEIGaN. (2005). Medical Electrical Installation Guidance Notes (MEIGaN). MHRA Version 1, NHSBSP. (1995). Guidance Notes on Mammographic X-ray Equipment: Selection, Maintenance, Suspension from Use, Replacement. NHS Breast Screening Programme, 1995 (Publication 32). Peto, J., Gilham, C., Fletcher, O., & Matthews, F.E. (2004). The cervical cancer epidemic that screening has prevented in the UK. Lancet, 364, 249–256. Sheng, Z.X., Hong, L. ,& Enmin, G.(2011). Marker-controlled watershed for lesion segmentation in mammograms. J digital imaging, 24(754), 763 -2011 Stems, E.E. (1996). Can j. sung. 33, 128-132 United Nations Scientific Committee on the Effects of Atomic Radiation (2000). Sources and Effects of Ionising Radiation. London: UNSCEAR Warren-Burhenne, L. H. T., & Burhenne, H. (1992). The British Columbia mammography screening program: evaluation of the first 15 monrhs. Am J Roentgenol, 1(158), 45– 49. Young, K.C., & Burch, A.(2000). Radiation doses received in the UK breast screening programme in 1997 and 1998. B J Radiol 73, 278-287 Read More