Why conducting project ‘ward rounds’ works

Ali Mafi is a long-time project professional with an MBA who has spent decades in the construction world. In 2006, he set up training business Lean Thinking to provide training and facilitation for projects applying lean thinking, systems thinking and collaborative working.

Mafi has been involved with over 200 construction projects, including many large infrastructure projects in the highways, rail, and utilities sectors. Building projects he has worked on include prisons, NHS facilities, schools, city office blocks and commercial structures.

Over time, he has developed a data-driven approach to project improvement. He suggests running ‘ward rounds’ on projects, rather like doctors do in hospital, to keep a close eye on how things are going.

Project journal caught up with him to find out more.

Tell us about your idea of doing ‘ward rounds’ on projects

Ali Mafi: I have been looking at how projects can be improved since 1990. The thinking has always been to make project delivery more scientific with greater intellectual engagement and less stress. This has led to the development of the scientific and data-driven Timist project delivery system.

Timist has only one focus as a system, which is to deliver projects in a shorter time than any other system. Reducing the project cycle time has the widest and most significant impact on most of the other project performance criteria such as output/productivity, cost, cash flow, profitability, social value, carbon footprint etc. Time accounts for 70–80% of the project cost.

Delivering projects in the shortest time requires valuing and monitoring the project cycle time with the shortest feedback loop and having a system that functions like a sat nav, and measures time to completion daily. In order for the delivery system to function like a sat nav, daily collective knowledge of the entire supply chain is required.

This means supervisors need to walk the high-priority tasks, preferably with the designers and the client representative, and assess the production rate and batch size in a similar way to a hospital ward round, assessing the progress of a patient’s recovery. This approach can only be effective if the project tasks are prioritised in the order of impact on the end date using a program that schedules work based on work quantities, rather than task times, and is updated scientifically at least once a week using elapsed time.

The idea of ward rounds came from listening to my wife, a senior hospital consultant, and my son, a junior doctor, discussing their daily ward round experience. A ward round on a project requires a systemic approach (by being holistic and taking into account interdependencies); and systematic (with a structured, codified routine). There is a checklist that needs to be followed and there needs to be full psychological safety during the ward rounds to allow everyone to speak up.

What benefits would this bring?

AM: From our experience, this is the most effective project delivery routine that:

shortens the feedback loop
allows activities to be organised and worked on using quantities (i.e., length, area or volume) and not task times, eliminating optimism bias, etc., hence reducing the project cycle time by around 30%
highlights instantly the risks that matter the most
allows what can be controlled, which is the here and now
radically reduces the amount of email communication and the need for weekly meetings with individual sub-contractors
reduces the project cycle time and, in turn, improves everyone’s profitability
allows communication and collective problem-solving by the supply chain — normally, they are not allowed to talk to each other and don’t even know each other’s names
allows for assessing the problem visibly first-hand and quantifying the scale collectively.

Would you liken a project manager to a doctor who can make a diagnosis and suggest a medicine?

AM: During the project ward round, the reason for the problem (and the solution) typically comes from any of the participants, mainly the supervisors, or from the collective input. Decisions are then made, and the sequence of work is agreed upon on the spot. We rotate the lead of the ward rounds, and individuals at any time can request walking to specific areas that are causing issues.

Have you put your ward round idea into practice, and if so, what have the results been?

AM: We introduced the ward round into the Timist system and have been practising it on a weekly basis since the Proctor and Gamble high-tech lab project in Reading in 2019. On that project, the client also joined the ward round and tried to give answers to the questions on the spot.

The same ward-round approach applies regardless of the size of the project. Each ward round can reduce the project cycle time by several days and, in turn, substantially reduce the project cost or improve profitability. The industry-wide daily cost of delivering projects is over £70m daily. The standard practice of one-to-one meetings between the main contractor and sub-contractors in 90% of cases extends the project cycle time.