Establishing a Project and Portfolio Management Framework Begin by laying out why it is essential for Mercy General to establish a formal project and portfolio management framework that goes beyond simply tracking milestones or tasks. Successful healthcare IT execution requires coordinated oversight, strategic alignment, and resource balancing across multiple simultaneous initiatives.

• Describe the leadership structures that should be put in place, including the roles of project managers, program directors, and portfolio managers, and explain how these positions work together to balance operational needs and strategic priorities.
• Recommend specific processes, such as portfolio reviews, status reporting, and risk assessments, that will help leadership maintain a clear, organization-wide view of healthcare IT progress.
• Provide examples of how a lack of coordinated portfolio management can lead to resource conflicts, missed deadlines, or misaligned outcomes, and explain how proactive leadership can address these risks.
• Emphasize that executive involvement must extend beyond simple approvals to include active prioritization, alignment, and accountability.

Approach this section not just as a technical planning exercise but as a leadership responsibility. Think about the behaviors, practices, and decision-making approaches that will help Mercy General's leaders foster a high-functioning, adaptive project management environment.