Literature Review of Pain Management in Dementia. Essay Example

Literature Review of Pain Management in Dementia. Paper LITERATURE REVIEW. Abstract Within the dementia care environment, it is my experience that it is often unclear to nursing staff as to appropriate assessment and management of pain for clients in the palliative stage of their illness. Although nurses have their experience to guide their practice, as the health professional most involved with the client at the end of life, there is a need for review of current assessment tools and management strategies to ensure the care given is evidence based and best practice. Aim The aim of this review is to examine what is the most appropriate method of pain assessment and management when working with clients with cognitive impairment. Methods Searches were made of several databases Cinahl Embase Medline BNI Psych For articles published between 1990 and 2006 using the keywords, pain assessment, pain management, elderly, dementia and palliative care. Findings Most evidence in relation to this area of practice is anecdotal demonstrating a need for further research. Evidence presented in this review shows encouraging results in regard to the development of assessment tools and that there are clear standards of process for management of pain at the end of life. The results also show that nurses are concerned and are making attempts to be proactive in this area of care despite many barriers. Conclusion Good pain control requires both sensitivity to the clients needs on every level and the competence to meet them. Assessment and management of pain for individuals with a dementia is still very hit and miss, with evidence of both very good and very poor practice being demonstrated. We will write a custom essay sample on Literature Review of Pain Management in Dementia. specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Literature Review of Pain Management in Dementia. specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Literature Review of Pain Management in Dementia. specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Nurse education is still an unmet need within this area of practice. And that overall clients are experiencing unnecessary pain on a regular basis which could have been prevented. Introduction Pain Pain can be a common experience for many older adults and has negative effects on their health, functioning and general well being Pain presents an enormous challenge for most nurses within their daily working lives. This is due to the individual nature of pain; a client’s experience of pain is affected by their life experience compounded with the procedure or illness. Macaffrey identified the individual nature of pain when he said, â€Å"Pain is what the experiencing person says it is and exists whenever he says it does†(1979, Cited in Epps 2001). Pain can be present in the older adult for many reasons. Chronic pain conditions may include arthritis, gout and peripheral vascular disease, acute conditions such as cancer; cardio vascular disease and surgery are also prevalent causes of pain. An elderly client may present with more than one type of pain in different locations with varying causes making the nurses job all the more challenging. Dementia. The word dementia comes from Latin and translates as â€Å"out of ones mind†(Epps 2001). Although this gives a broad definition of the symptoms, dementia is actually a disease caused by permanent brain changes and loss of neurons. These changes affect the client in several ways. The impairment of cortical functions affects â€Å"memory, orientation, comprehension, calculation, learning capacity, language and judgement†(WHO 1993). Various dementias exist the most common being Alzheimer’s, which accounts for 65% of UK diagnosis’s (Stevens et al 2001). There are other dementias such as vascular, lewy body and picks. All of the dementias impair basic functioning and the ability to communicate also the client’s ability to interpret the feelings of pain and recall them to communicate to the nurse. This impairment potentially results with individuals unable to express pain and report it appropriately. This in turn may result in inadequate assessment and management as has been shown in studies (Bernabei Et al; 1998. Horgas Tsai; 1998). One study reported that 60% of nursing home residents with a physical diagnosis known to cause pain had not received any pain relief in the previous month (Feldt et al 1998). The American geriatric society (1998) believe that clients with dementia are at high risk for unidentified and under treated pain. As with all older adults, clients with dementia present with chronic conditions such as arthritis and acute pain experienced in the aging and the end of life process. Moss (2002) gives evidence that most elderly clients who move into long-term care will die in an institution either a nursing home or a hospital many of whom will have dementia. She states that 91% have a strong co morbid condition likely to cause pain. â€Å"The control of pain is the key to all other care†(Raiman 1998). This is especially true within old age psychiatry as if a client is in pain it may be impossible to recognise a pure diagnosis of agitation or depression and intervene accordingly when there is the possibility that these symptoms may be reactive due to inadequate pain relief. The key to therapeutic success is how well are the symptoms being relieved. Untreated pain in the client with dementia can delay healing, disturb sleep and daily activity, reduce quality of life and prolong hospitalisation (Horgas 2003). Appropriate assessment and management of pain should be paramount to nurses working in the elderly care sector. Search methods A search of the Cinahl, Medline, Embase, BNI, psycINFO databases were made using the following key words, pain assessment, pain management, elderly, dementia and palliative care. The reference lists of identified papers were also searched for relevant articles. The use of many databases was deemed necessary due to the specialism the enquiry relates to as research in dementia is still relatively new. Inclusion criteria are as follows: Articles must relate to palliative care and/or pain relief in the elderly that have reference to impaired cognition within the main body of the text and not just articles solely referencing dementia in order to gain a wider breath of material. Articles must not be specific to a particular medical condition such as breast cancer as the recommendations will be specific to condition and not transferable to an elderly psychiatric unit. Articles must have been published between 1990 and 2006. The review was not limited to a study design type as most papers identified are qualitative and give anecdotal evidence. Anecdotal evidence may not be seen as the most reliable (Parahoo 1997) but there are reasons why within this area of research most results fit into this category. Atkinson et al (1999) suggest that palliative care and adequate pain relief does not attract much funding from the pharmaceutical companies therefore unattractive to researchers, also as suggested by Ray et al (1998) ethical committee accreditation may be difficult to obtain particularly with issues as consent and suitability to participate in controlled trials as they may last longer than the client remains alive giving inaccurate results. Another reason maybe that the cognitively impaired are often excluded from research studies, as they are unable to give adequate feedback to fulfil the researchers needs for the inclusion of data. The search returned nine articles that fully met the inclusion criteria these have been included in the review. Findings The findings will be divided into two sections pain assessment and pain management. All papers bar one fell in to the naturalistic paradigm of research in that the researchers explored the nurse’s feelings and thoughts during semi- structured interviews about assessment and management of pain and recorded their findings in a descriptive manner. The paper set in the positivist paradigm was a correlation design that examined the relationship between two variables in this instance pain and agitation and generated results of a quantative nature. In all papers the sample was purposive in that clients were selected because they experience the phenomena under investigation in this instance, elderly institutionalised clients. All studies identified within the papers had been ethically approved. Pain assessment. A barrier to effective pain management is a failure to assess pain. Pain assessment is invaluable; it sets a base line against which the intervention can be compared. There are several methods of pain assessment identified within the literature. This review explores the findings drawn from the research. This article will draw reference to self-report scales as they still hold their place within pain assessment as well as those methods that concentrate on adults that are unable to communicate their pain. Pain can be assessed by means of self reporting and research by Davie et al (2004), Kovach et al (2000), Panke (2003) and Zwackhalen et al (2006) identify this as the â€Å"gold standard† in pain assessment. There are several self-report scales available to assess pain in the elderly. Most self report tools focus on pain intensity these include The visual analogue scale (VAS) which asks a client to select a number between 1 and 10 and the verbal rating scale (VRS) where you ask the client to verbalise their pain on a scale between no pain and worst pain possible. Molony (2005) found the VRS the most popular scale to use when questioning nursing staff; the main drawback of the tool that she identified was that clients learnt to anticipate the nurse’s questions. nd therefore the test may lose objectivity. There is some conflict within the literature in that Zwackhalen believes that these scales hold little benefit within dementia following her research as she identifies that these scales requires the capacity to understand the task and also the ability to communicate pain therefore generating inaccurate generated scores this view is supported by Hayes (1995) and Ferrell (1995) where as Davies generates evidence that 80% of clients in midstage dementia were able to use these scales effectively. It is because of these contrasts that it would be beneficial to explore behavioural tools and other methods as a means of supporting self-report tools in order to gain comprehensive assessment. Panke (2003) believes that non-verbal cues are their own means of self-report and should be regarded as such by patients that can’t communicate. The most commonly referenced tool within the literature is The Checklist of Nonverbal Pain Indicators (CNPI) by Feldt (2000), research on this tool by Horgas (2003) and Davie (2004) have deemed this to be an effective tool to use within dementia care. There are other tools identified within the literature but due to the frequency that it was referenced and studies that included it within their framework the critique of literature in regard to this tool seemed most relevant. The tool is designed as an observational tool for use by nursing staff. It was designed to assess postoperative clients. It asks nurses to observe for certain behaviours and score a point of one if they are present. There is no clear definition attached to this tool as to how the score correlates to pain intensity, the papers that reviewed this tool recommended that it be used in conjunction with a self reporting tool but also if there were any behavioural indicators of pain scored present further investigation and treatment should be actioned. Both of these researchers conducted their studies in community settings which could have biased the results as the tool is designed for acute pain not chronic pain and you can make the assumption that clients were not postoperative also the samples used were small there by not possibly encompassing the full range of cognition and varying physical illness. Also this tool is subjective to the nurse’s viewpoint hence the researchers results are biased towards the nurse’s viewpoint and not the client’s experience. Epps (2001) believe that nurses often under report pain of clients with dementia. It is assumed as the researchers indicated the use of another tool that this a limitation of this tool that it cannot be used as a stand-alone assessment. It may be worthwhile to repeat these studies in an impatient dementia environment to test the validity of the results. Behavioural indicators of pain as outlined by Evans (2002) in addition to those in Feldts tool are aggression, loss of appetite and withdrawal Kovach (2003) further expands on this by advising staff to look for changes in mobility and respiration. Evans and Kovachs work highlights that Feldt tool is not comprehensive, as it does not highlight what people are trying to communicate with their ongoing behaviours and that it can only be used at that snapshot in time, this factor is something that was not identified by the authors. Also how often this tool should be utilised is not explored would it be beneficial to use it daily or just when the nursing staff notice change. Panke (2003) believes you should consider all cue verbal and non-verbal and that continual reassessment of these cues is vital. Molony (2005) asked nursing staff to document the frequency of assessment. The highest frequency was found to be on admission, as determined by medical condition and those patients receiving â€Å"narcotics†. This concurred with 95% of participants. This study was comprehensive as it had 160 participants covering a cross section of job roles within the nursing sphere. Panke (2003) points out that behavioural cures are not always reliable, as moaning and grimacing are symptoms that occur with delirium as a common factor in the client in the end stage of life and that this may require assessment for both causes. This is supported by Ferrell (1995). Cohen Mansfield et al also concluded through their study that assessment is made further difficult as the client group expressed discomfit Constipation, emotional distress, cold and hunger in the same ways such as calling out and increased agitation. Cohen Mansfield study was extremely limited as it was restricted to one nursing home with a very small sample all of which had a moderate dementia and had been placed there for over two years. Most literature reviewed did not account for other possible causes of pain like symptoms. This is both positive and negative as the papers remain focused on the topic of pain assessment but the detraction is that it does not encourage the reader to view the client’s situation holistically. Only Kovach (1999) within my included literature highlighted the importance of the nurse client relationship in interpreting none verbal cues and that familiarity with the client develops the nurse’s intuition of changes in behaviour. Kovach cited another study by Parke (1998) within her research that advocated that assessment methods require nurses to know their patient intimately in order to recognise behaviours which signal presence of pain. The ability to communicate and relate to your clients is important as often the nurse is the main caregiver and clients need to feel that we will respond to them and make them feel safe at a time when the situation is alien and fearful. It would be beneficial to further explore the importance of the skills needed by the nurse in this area of care. All papers identified a lack of nurse knowledge and competence as a barrier in the assessment of pain and many suggested the need for action to improve this also nurse attitude was cited. This was mainly centred on nurse’s unfamiliarity with the assessment tools. This is identified by Davie (2004). ) Who when gaining feedback on the research conducted, the nursing staff felt that tools could be too time consuming and difficult to interpret. 99% of respondents who participated in Molony’s study (2003) felt that education was something that should be ongoing and be presented in the form of workshops, seminars and peer teaching by the bedside in order to update practice. The main barrier identified of staff not receiving appropriate training was the need for more nurses to staff units so others could attend training. This is in conflict with the NMC code of conduct that states it is the nurses own responsibility to update her practice and therefore ward staffing should not be an issue although many trusts have policies to support learning and development. Evans (2002) reviewed the literature and other research within her study, she found that educational initiatives that address clinical skills in pain and symptom management were required. Moss (2002) in a study of four hundred nursing homes in the united states that 29% of staff did not feel confident to adequately assess pain although 55% agreed pain was a problem for clients with dementia. This would leave 45% to believe that there is no problems with this issue hence highlighting further the need for nurse education, as almost half the staff in four hundred nursing homes did not recognise the problem. This figure is astounding. Kovach (1999) as part of her study evaluated the education programme currently being piloted to address the discomfit needs of clients with moderate to severe dementia. She found that staff using the protocol for assessment for which they had been trained resulted in increased awareness of resident’s discomfit and improved assessments. The findings of this study could have been strengthened by the use of a control group of nurses already competent in the assessments to provide a conclusive baseline that nurses should attain and a larger sample size. Also the recognition of variables such as physical diagnosis would have been beneficial to assess if they impacted on the findings. Glaring omissions in all research critiqued was that of involving family in the decision making process and also the gaining of information from families in order to ascertain normal behaviours and responses to pain, this could be for many reasons. Is this due to the nurse being perceived as the expert or are families at this distressing time not considered to be able to give eliable information. This requires further exploration as to the benefit of relatives input in a clients care. Also omitted was the use of do not escalate or do not resuscitate order and what they men to the client receiving palliative care and in the age of the expert patient many making advance directives and how this dictates the care we can give as nurses, do we have the right to override these statements if we deem it to be in the clients clinical best interests and where does this feature in the assessment process. This requires further research. The use of documentation and the value of the nurse-to-nurse handover is not explored within the literature as a means to aid assessment both of which are commonplace in a nurses daily routine, which leads me to believe that both these activities happened but were not documented by the researchers. Pain management Horgas and Tsai (1998) investigated prescription administration of analgesic medication of clients with cognitive impairment. The research question they posed was that cognitively impaired nursing home residents might not be prescribed adequate analgesia. The researchers concluded that clients with dementia were being prescribed and administered significantly less analgesic medication both in number and in dosage than clients without cognitive impairment it was also reported that clients who were more disorientated or withdrawn were prescribed significantly less analgesia. This correlation study drew from a large sample of 339 residents from four homes showing the study to be both reliable and valid. Moss’s study provides anecdotal evidence to support that nursing staff felt that pain in client with dementia is as aggressively treated as pain in other clients whilst Panke (2003) identified that physician were loathe to prescribe for any thing that wasn’t cancer. These conflicts may be explained as the United States and the United Kingdom have different protocols for appropriate treatment disseminated from government and allied agencies and moss’s study was in the UK and the others in the U. S. Kovach (2000) reports that the treatment strategies used by nurses are poorly understood. The outcome of her interviews with nursing staff was that nurses often felt that psychotropic drugs were being inappropriately used to treat the behavioural symptoms of pain and that analgesics commonly underused. Both the observers and the workers have identified this as a problem yet it still continues to happen as Swakhalen’s 2006 study shows. It is because of this that the need to review best management is vital. Recent research by the Joseph Rowntree foundation indicates that these problems could be overcome by the use of the NICE guidelines for analgesia (2004) these recommend regular administration and treatment adjusted from one step to the next according to increasing or decreasing pain severity, history of analgesic response and any side effects. This approach also calls into question the use of as required medication and its prevalence. The literature concurs that regular scheduled pain relief is most effective in managing symptoms. The foundation also advocates the use of non-pharmacological intervention for Pain management. The literature mainly identifies methods of drug administration and drug type most appropriate to the client group. Management of pain is one of the most important goals when caring for clients at the end of life. Horgas (2003) identified the goal of pain management is to maximise function and improve quality of life. Kovach (2000) found that nursing staff prioritised comfort over issues such as side effects or toxicity. Although some staff expressed concerns about sedation and falling in mobile clients but this becomes less of an issue with clients in the end stage of life, as they are normally bed bound. The issue of constipation was also raised by Panke (2003) as a common side effect of analgesics that was likely to cause pain and recommended that clients should be prescribed laxatives as a matter of course. Horgas (2003) identified the considerations for administering analgesics in the elderly. It is noted that aging has an affect on the effect of the drug on the client and also the concentration of the active drug is affected. Elderly clients are at higher risk of side effects due to decline in metabolism and elimination. Gradual titration is recommended to over come this. A Diamorphine as opposed to morphine is commonly the drug of choice for subcutaneous administration due to greater solubility. Kovach (2000) found that nurses felt that narcotics were underused but appreciated the value of them to maintain comfort and dignity. She supports this with several anecdotal accounts from staff. Nurses only commonly used morphine for severe pain and to promote comfort during dying. The literature concurs that longer acting opioid medication such as Fentanyl should not be rescribed for the dying client because of the slow onset of pain control and it being difficult to titrate quickly. Kovach (2000) identified that fentanyl was more commonly used than morphine in the relief of clients pain. It is recommended that fentanyl is administered via a transdermal patch as this can overcome many reasons for non-compliance in the demented client such as resistiveness; lack of understanding or forgetting to take medica tion also it is considered helpful for those clients that are unable to swallow oral preparations. If fentanyl has previously been administered and deemed not effective this will need to be supplemented with diamorphine via a syringe driver as recommended by many researchers within the review. Only half of the participants in Kovach’s study were able to identify appropriate dose escalation, most identified that there was a need to increase dosage but unable to identify a systematic process within which to work. Does this mean that clients are only getting the appropriate treatment 50% of the time due to a lack of staff education? Not all pain is opiate sensitive such as pain on movement that’s breakthrough. This is more likely to be effectively managed by the use of a non-steroidal anti-inflammatory drug (NSAID). This group can cause gastric irritation and the use of a gastric protective drug is advised. Panke (2003) identified that nurse were proactive in advocating supplementary pain relief of this nature. The literature cited the transcutaneous electric nerve stimulation (TENS) as an appropriate method of pain relief, but no evidence is available to state how effective this method actually is. All literature that cites the TENS also states it should not be used for first line pain relief. Conventional medication may not always be affective and nurses should have an awareness of complementary therapies and relaxation. Nurses in Kovachs study were not questioned about non-pharmacological measure but common themes drawn from the interviews were that massage, one to one intervention, repositioning and music therapy were thought to be effective. None of the literature mentions the involvement of other agencies in promoting comfort such as the tissue viability team or the music therapists, the onus is put on the nurse to provide these things which may be outside her sphere of competence also lacking within the research is the use of equipment such as airflow mattresses and relaxing fragrance atomisers or fans to assist with those that can’t maintain body temperature. Although the literature is comprehensive on chemical pain relief, it is often not holistic as to assess the client’s environment. There are articles on alternatives to medication that were generated during the literature search such as one by Pearce (2004) advocating that the approach be high touch and include things such as hand activity and soothing touch, but sadly articles such as this that make complete sense to the reader are not evidence based and therefore inadmissible to be critiqued in this review. Actual research in this area is desperately needed to guide nurse’s practice to create a holistic approach. It should be noted that techniques such as relaxation require higher levels of functioning and may only be successful if the client can participate. Restlessness and delirium are common close to death. This may be due to opioid toxicity, a recommendation of haloperidol is recommended for drug toxicity. Panke (2003) is the only author to identify this. I have commonly seen it myself in practice that a low dose antipsycotic is very effective. Haloperidol also can assist with nausea and vomiting. The ethical issue as to whether analgesia will hasten death is identified within the literature as a concern for nurses and relatives. With nurses interviewed by moss (2002) asking what is permissible? The American nursing association in 1991 stated â€Å"nurses should not hesitate to use full and effective doses of pain medication for the proper management of pain in the dying patient. The increasing titration of pain medication to achieve adequate symptom control, even at the expense of life is ethically justified†. None of the literature asks what is the patient’s quality of life and if we are, why are we attempting to extend this, also could unrelieved pain hasten death due to the stress level it places on the client. These are all area that needs further research. No mention is made in the research as to the impact of hospital policy on the treatment of these clients and whether there are set standards dictated from trust level. Conclusion There is a clear need to address this issue as the proportion of people with dementia is likely to increase along with the increasing proportion of elderly persons in the population as due to more effective health care people are living longer. Although pain assessment and treatment is complicated with the client with dementia. Many clients pain can be relieved by the nurse’s efforts to understand each individual and their unique way of communicating pain. Effective assessment and management requires â€Å" listening to and believing in reports of pain as well as the knowledge and skill in detecting pain among those unable to convey its presence verbally† (Horgas Tsai 1998). All management should be individualised and tailored to the client. The most important step in improving pain control in clients with dementia as identified by this review is for nurses to be proactive in the assessment of pain. Pain assessment is the important first step in effective pain management. This review has identified that individuals with dementia can answer simple questions about the presence of pain and pain assessment in older adults should always start with self-reported pain. Nurses need to be aware of all possible sources of information when assessing clients with dementia and other conditions that impair communication and take into account non verbal behavioural cues such aggressiveness and increased vocalisation. This review also identified the need for increased frequency of assessment and that it is performed at a relevant time as clients may not be able to recall past experience of pain due to their impairment. Pain is a significant problem for older adults and has the potential to negatively impact on all areas of their lives. Pain management that includes both pharmacological and non-pharmacological measures was considered to be effective. The need for appropriate nurse education has been highlighted throughout the review and that most nurses felt that they did not have sufficient knowledge to care for these clients, this is something that needs urgent address in order to provide a good quality of service. With the advancement of technology and medication, pain is not an experience that should be commonplace for any individual receiving medical care whether it is in hospital or in the community and with the effective use of strategies we as nurses can really improve the quality of our client’s lives. Areas highlighted for further research from this review are nurse education and ethical issues regarding pain relief and non-pharmacological treatments. This review found many omissions in the research but this could be due to the fact that certain activities are commonplace and the expectation is on the reader to assume these activities happen.

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Avoiding Project Failure Dissertation ABSTRACT Project management have become increasingly important in the development of any nation. Various organisations have used project management techniques as a means of bridging the gap between failure and success in implementation of projects. Despite this increasing awareness of project management by organisations, projects still fail. The purpose of this dissertation is to systematically investigate the causes of project failure and how these can be prevented, managed, or controlled. Research studies investigating the reasons why projects fail, has been ongoing for years, with various researchers, organisations and project management institutions, providing lists of reasons, which they believe, are the cause of project failure. However, despite these lists projects continue to fail, Atkinson (1999). This research is done with the anticipation of not only adding information to the body of knowledge already in existence, but also examining the major issues currently causing project failure; this will help organisations effectively manage projects. To determine how to avoid project failure the criteria for measuring project success has to be properly determined and agreed upon; the major criteria commonly used are; cost, time and quality. Then the causes of project failure need to be determined. This study also examined generalisations made from existing literature about causes of project failure and methods of avoiding project failure using three construction case studies in United Kingdom. This is a secondary or desk research, which involves the collecting and analysis of secondary data, or data that already exists, from which inferences have been made, and conclusions drawn. CHAPTER 1: INTRODUCTION 1.1Research background Projects make a vital contribution to industrialisation and hence the growth of a nations economy. The importance of projects in the development of any nation cannot be overemphasized. This is demonstrated in various literatures explaining the success and failure of projects. Although projects are said to be important, its implementation can be an uphill task. Various researchers have discussed project management as a technique to help prevent against failure in projects. Others have established checklists to help prevent failure. Despite the increased project management awareness and these checklists, some projects still fail, Atkinson (1999). All projects are constrained by inherent risks; knowledge of these risks will play an important role in achieving success and avoiding failure. Usually projects consist of three stages consisting of the approval, execution and evaluation stages. If any of these stages is not managed properly it may result to the failure of the entire project. Failure or Success in projects is a multi-dimensional issue and may be influenced by so many factors. Some projects may have failed in project management practices including cost overrun, scope creep, delay in schedule etc, and other projects may fail in procurement practices. Despite these failures in the following areas the project may still be perceived as successful by the end users. An example is Wembley Stadium; despite all the issues associated with the project in terms of project management and procurement practices, it is still perceived to be successful and a state of the art stadium by the end users. This may result from the fact that it has hosted world class sporting events. Usually, projects are designed to meet stakeholders objective. These objectives define the criteria for success of that project, and projects not satisfying these objectives are deem to fail. Effective communication and clarity in the stakeholders objective is vital to the project manager. This thesis examines the causes of project failure and how these can be prevented, managed or controlled. It discusses project failure and success with the help of case studies in order to identify the critical success factors and reduce failure in the implementation of projects. This research is done with the anticipation of not only adding information to the body of knowledge already in existence, but also in defining the criteria for project success and identifying the variables involved. This will help organisations effectively manage projects. 1.2 Aim The aim of this research is to carry out appraisal on the causes of project failure and the appropriate methods of avoiding project failure. This aim is intended to be achieved with the following objectives. 1.3 Objectives To provide a review of project management To analyze success criteria for projects To explore factors that causes project failure or success To examine methods of avoiding project failure 1.4 Scope This research is based on construction projects executed in the United Kingdom over the last two decades. 1.5 Research Structure Chapter One, Introduction this introduces the research; topic highlighting the aim, objectives and scope of the research. Chapter Two, Literature review critically reviews the existing Literature regarding the subject. It establishes the definition of project success and the success and failure criteria / factors. Chapter Three, Methodology describes the methodology used to undertake this research. It demonstrates the fact that secondary data was mostly used in undertaking this research. Chapter Four, Case Studies Case studies on projects from the UK construction Industry were discussed in this Chapter. These case studies were analysed and linked to the literature review chapter. Chapter Five consists of the analysis of the discussion and findings. This is derived from critically analysing the Wembley, Heathrow terminal five (T5) and Holyrood case studies. Chapter Six, Conclusion and Recommendation: This chapter concludes the research and suggests directions for further research. CHAPTER 2: LITERATURE REVIEW 2.1 Introduction The importance of avoiding project failure in a rapidly evolving project-driven 21st century cannot be over-emphasized. Attempts to understand the causes of project failure and/ or success have proven problematic, despite attempt by many practitioners and academics over the years. Project demands have constantly increased over the last decade and have driven our society into a constantly changing environment. Despite attempts to make project appraisal and delivery more rigorous, a considerable proportion of delivery effort results in project that does not meet user expectations and are consequently rejected. In our view this can be attributed to the fact that few organisations have the facilities, training and management discipline to bring project to successful completion. Project success does not come easily; much has been contributed over the last decade to our understanding of the nature of and reason for successful and unsuccessful project completion. In addition many projects fail to complete at all. Sometime failure to satisfy all the original goals of a project can still be regarded favourably if the main sponsor is not satisfied with the outcome and the key stakeholders have gained in some way. Generally, the key development considerations are to have the goal clearly defined, to plan how to realize the goal and implement the plan. Developing an alternative methodology for project management founded on stakeholders, senior management support and proper planning should lead to a better understanding of the management issues that may contribute to the successful delivery of projects. This literature review is aimed at carrying out appraisal on the causes of project failure and the appropriate methods of avoiding it. It begins with key definitions, then analysis of causes of project failure and project success. Then it looks at success factors and criteria; also examine ways of avoiding project failure. The chapter ends with summary of the discussion. 2.2 What is a Project? Gary and Larson (2008:5) defined project as â€Å"a complex, non routine, one-time effort limited by time, budget and resource, and performance specifications designed to meet customer needs. This is in contrast to how an organisation generally works on a permanent basis to produce their goods and services. For example the work of an organisation may be to manufacture a vehicle on a continual basis, therefore the work is considered functional as the organisation creates the same products or services over-and -over again and people hold their roles on a semi permanent basis. A project can be defined as having constraints (usually centred around time and resources, but also including all aspect of the process and the outcome); projects are processes that in many circumstances are core business for organisation. The diagram below show different levels in project management. 2.3 What is Project Management? According to Gray and Larson (2006) Project management is a task derived from an organisation that enables professional project managers to use their skills, tools and knowledge to plan, execute and control a unique project within a limited lifespan by meeting the specification requirements of the organisation. Since the outcomes of the capital projects have strategic implications on the success and profitability of the business, the ability to deliver based on pre-determined objectives should be critical to the companys success. And yet one-third of all the oil and gas projects exceed budget and time projections by more than 10 percent. Failure to deliver big projects on budget and on schedule is highly publicized and damage the companies profile with capital markets that predictability and strong returns. Continual use of traditional project management techniques will not alter this trend. Companies that want to change and improve on their performance with critical capital projects will need to adopt new techniques. Munns and Bjeirmi (1996) also defined project management as a process used as a control to achieve the project objectives by utilizing the organisational structure and resources to manage a project with the application of tools and techniques, without disrupting the routine operation of the company. ‘Project management is the discipline of managing all the different resources and aspects of the project in such a way that the resources will deliver all the output that is required to complete the project within the defined scope, time, and cost constraints. These are agreed upon the project initiation stage and by the time the project begins all stakeholders and team members will have a clear understanding and acceptance of the process, methodology and expected outcome.(http://www.projectsmart.co.uk/introduction-project-management.html accessed on 30/06/09) Project management has been defined as â€Å"the process by which projects (unique, complex, non- routine, one-time effort limited by time, budget, and resources) are defined, planned, monitored, controlled and delivered such that the agreed benefits are realised† (APM, 2006:3) Other definitions have been offered, Reiss suggests that a project is a human activity that achieves a clear objective against a time scale, and to achieve this while pointing out that a simple description is not possible, he suggested that project management is a combination of management and planning and management of change. Despite all the suggestions about what is project management, the criteria for success, namely, cost, time, and quality remain and are included in the actual description. Meaning that Oisens definition of project management was either correct, or as a discipline, project management has not really changed or developed the success criteria over 50 years. Therefore project management is a learning profession. The significant point from all the definitions and suggestions of project management is that while the factors have developed and adopted, changes to the success criteria have been suggested but remain unchanged. In 2008, a survey undertaken by Booz Allen Hamilton (project management consultant) which comprises of 20 companies in engineering, procurement and construction; shows that 40 percent of all projects executed where faced with cost overruns and behind schedule. These overrun in cost and schedule has led to clients dissatisfaction on project performance; this view also agree with the research of M J Lang (1990). Therefore effective project management is very vital in such a volatile business environment. 2.4 Project Management Methodology Generally, projects are split into three phases Initiation, implementation and closure. Every stage of a project has multiple checkpoints which must be met before the starting of the next stage. The degree to which a project will be managed depends on the size of the project. For a complex project in a large organisation that involves a number of people, resources, time and money, a more structural approach is needed, and there will be more steps built into each stage of the project to ensure that the project delivers the anticipated end result. For a simple project in a small organisation, agreed milestones, a few checklists and someone to co-ordinate the project may be all that is required. 2.5 Defining Project Failure From Penguin English Dictionary (1992), failure is define as unsuccessful project that fails to perform a duty or an expected action, non-occurrence or non-performance. Whereas success can be defined as the achievement of something desired, planned or attempted (Cambridge Dictionary, 2007). It is also said that success is an event that accomplishes its intended purpose (dictionary.com, 2007). Anything short of that is failure. Project failure is an unpleasant event that cost large amount of money to the organisation. 2.6 Causes of Project Failure Pinto and Mantel (1990) carried out a research on the causes of project failure and revealed a good explanation that encompasses both internal efficiency and external effectiveness. They state that project failure is a vague concept, which has evoked much as to its definition, as the case with the definition of project success. A project is considered a failure â€Å"whenever a project does not meet the expectations of the stakeholders†. This has lots of impact to both the organisation and all stakeholders to the project. They include: cost and time overruns, quality degradation, frustration and stress, sometimes resulting to people quitting, low corporate market value, low public opinion and negative media campaigns. The total effect can be very costly to the organisation; at times even force the company into closure. Bienkoski (1989) identified ten factors that can lead to project failure and they are: * Lack of change management- happens when there is no method to handle or recognise changes. * Communication- causes delay or even failure since team members do not have the information they needed, issues or changes do not get escalated, project reporting is sluggish * Inadequate resources- Task take longer than expected to complete, deadlines and milestones get missed, and project completion date comes into jeopardy, one end of working more than necessary (double shift) to get the work done * No one is in control, not even the project manager, who is assigned to the project but not given the free hand to manage the project. This is most problem encounters in matrix organisation * Project lacks structure caused by things such as critical tasks being under rated * Inaccurate estimates. A top- down plan causes constraints on the prediction of the cost of the project * Poor risk management. The project initiation stage is not properly planned * Insufficient non-resources are not allocated to the project; for instance, it is not possible for a project to succeed if the right resources are made available for that project * Incompetent project management skill * Project changes from its original objective and goals. This can occur due to additional requirement from the client Pinto and mantel (1990) argue that the major causes of project failure are changes in the project environment, as it goes out of hands of the management. 2.7 Defining Project Success Lewis (2005) states that project success can be defined as meeting the required expectation of the stakeholders and achieving its intended purpose. This can be attained by understanding what the end result would be, and then stating the deliverables of the project. Shenhar et al. (2001) state the opposite: that project success is commonly judged by time and budget goals criteria, whereas in some cases this does not apply to some projects. Thiry (2006) argues that project success can only be defined if executives are able to consider the contribution of benefits and if the project is able to achieve these measures in relation to resources, competencies and complexity within the project parameters. 2.8 Key Performance Indicators (KPIs) as a Measurement for Project Success The purpose of the KPIs is to enable measurement of project and organisational performance throughout the construction industry (The KPI Working Group 2000). Collins (2000) advocates that the process of developing KPIs involves the consideration of the following factors: * KPIs are general indicators of performance that focus on critical aspects of output or outcomes * Only a limited, management number of KPIs is maintainable for regular use. Having too many (complex) KPIs can be time-and resource-consuming * The systematic use of KPIs is essential as the value of KPIs is almost completely derived from their consistent use over a number of projects * Data collection must be made as simple as possible. * A large sample size is required to reduce the impact of project specific variables. Therefore, KPis should be designed to use on every building project. * For performance measurement to be effective, the measures must be acceptable, understood and owned across the organisation * KPIs will need to evolve and it is likely that a set of KPIs will be subject to change and refinement * Graphic delays of KPIs need to be simple in design, easy to update and accessible. Key Performance indicators for measuring project success can be illustrated with the help of the diagram below (Albert Ada, 2004). They identified the following as the measurement of project success: Cost, time, quality, commercial profitable/value, environmental performance, user expectation/ satisfaction, health and safety and participants satisfaction. This will help in explaining what the project success might mean to different stakeholders. Key Performance Indicators Dvir et al. (2003) state that the ranking of success is a one-sided judgement, as the definition of success is difficult to define, because it has different meanings for different people; thus, the criteria of success should reflect the diverse interest and view that lead to a multi-dimensional and multi-criteria approach. Baccarini (1999) states: that success entails â€Å"hard† criteria which often linked with cost, time and quality. He also states that hard criteria which can be easily measured can lead to some form of substantial agreement. In contrast, soft criteria are known to be one sided, restrained and not easily assessed. This implies that project success is a fantasy of the mind and only an individual can turn such vision into reality. A contrasting view from Westerveld (2000) defined project success as â€Å"the satisfaction of all the stakeholders, meaning that as long as the stakeholders are pleased with the outcome and gain profits or revenue from the project, then it is classed as a success. One of the Squares root corners, organisational benefits, drew much attention because of its significance and it was further analysed. Kerzner (2001, p6) suggests three criteria from the organization perspective in order for a project to be successful. The first is that it must be completed with minimum or mutually agreed upon scope changes, even though stakeholders constantly have different views about projects results (Maylor, 2005, p288). Secondly â€Å"without disturbing the main work flow of the organization because a project has to assist organisations everyday operations and try to make them more efficient and effective. Finally, it should be completed without changing the corporate culture even though projects are almost exclusively concerned with change with knocking down the old and building up the new (Baguley, 1995, p8). A project managers main responsibility is to make sure that he delivers change only where is necessary, otherwise he is doomed to find strong resistance from almost all organisational departments (Kerzner, 2001, p158) which ultimately could lead to project failure. A more structured approach to project success is grouping the criteria into categories. Wideman (1996, p3-4) describes four groups, all of them time dependent: internal project objectives (efficiency during the project), benefit to customer (effectiveness in the short term), direct contribution (in the medium term) and future opportunity (in the long term). The characterization of ‘time dependent is based on the fact that success varies with time. Looking at the future benefits of the organisation can be really difficult, because in some cases they dont even know what they want, yet it is vital to know what the project is trying to achieve after completion time so that success criteria are clearly defined in the early stages. This is quite a different approach, because the focus moves from the present success criteria to the future, in a way that a project can be unsuccessful during execution if it is judged by criteria like cost and quality, but in the long term it can turn to be a thriving story. A good example of this hypothesis is hosting the Olympic Games in Athens, Greece, which received mass criticism both during the planning period, due to delays in construction time, and when it was finished, due to huge cost. But the benefits that Greece will gain from the Olympic Games can be fully understood after 5 or maybe 10 years from the hosting year (Athens2004.com). All the above success criteria should be simple and attainable and, once defined, they should also be ranked according to priority (Right Track Associates, 2003). Straightforward criteria are easy to understand by everyone involved in the project and therefore commitment is guaranteed. Unrealistic criteria can put a ‘failure label on many projects because of the unreachable standards, can generate low team esteem and team performance in future projects and finally generate unfair disappointment among stakeholders. As for priority issues, it is inevitable that things will go wrong and the project manager will be in a tough situation where he must make the right decision having in mind that he has to sacrifice the least important success criterion. Also Shenhar et ‘al (1997) are of view that project success can be seen from the four area: Project efficiency, impact of the project to the customer, business success and finally what the project holds for the future. This was further explain in the diagram in 3. 2.9 Defining Project Success Factors and Project Success Criteria Muller and Turner (2007) defined the two components of project success in relation to the use of project management as follows: Project success factors are the elements of a project that can be influenced to increase the like hood of success; these are independent variable that makes success more likely. Project success criteria are the measures by which judge the successful outcome of a project; these are dependent variable which measure project success. We often hear or read about various success stories. But what is success and what criteria should organizations use to identify success? What factors lead to a successful project? The purpose of this study is to define project success criteria, clarify their difference with success factors and analyse their importance in project management methodology. One of the vaguest concepts of project management is project success. Since each individual or group of people who are involved in a project have different needs and expectations, it is very unsurprising that they interpret project success in their own way of understanding (Cleland Ireland, 2004, p2). For those involved with a project, project success is normally thought of as the achievement of some pre-determined project goals (Lim Mohamed, 1999, p244) while the general public has different views, commonly based on user satisfaction. A classic example of different perspective of successful project is the Sydney Opera House project (Thomsett, 2002), which went 16 times over budget and took 4 times more to finish than originally planned. But the final impact that the Opera House created was so big that no one remembers the original missed goals. The project was a big success for the people and at the same time a big failure from the project management perspective. On the other hand, the Millennium Dome in London was a project on time and on budget but in the eyes of the British people was considered a failure because it didnt deliver the awe and glamour that it was supposed to generate (Cammack, 2005). In the same way that quality requires both conformance to the specifications and fitness for use, project success requires a combination of product success (service, result, or outcome) and project management success (Duncan, 2004). The difference between criteria and factors is fuzzy for many people. The Cambridge Advanced Learners Dictionary describes a criterion as a standard by which you judge, decide about or deal with something while a factor is explained as a fact or situation which influences the result of something. Lim Mohamed applied those definitions to project success and illustrated the difference. It is clear now that critical factors can lead to a series of events which ultimately meet the overall success criteria of the project, so they should not be used as synonymous terms. Project success can be seen from two different perceptive, the micro and macro viewpoint (Lim Mohamed, 1999). This can help in better understanding of what project success means to different people. 2.9.1 Success Criteria Many lists of success criteria have been introduced in the previous decades by various researchers. Primal success criteria have been an integrated part of project management theory given that early definitions of project management included the so called ‘Iron Triangle success criteria cost, time and quality. (Atkinson, 1999, p338) Atkinson continues that as a discipline, project management has not really changed or developed the success measurement criteria in almost 50 years. To meet the urgent need of modernizing the out of date success criteria, he suggest the ‘Square Route ( 3) success criteria instead of the ‘Iron Triangle, where he groups the criteria that other academics have proposed. The main change is the addition of qualitative objectives rather than quantitative, namely the benefits that different group of people can receive from the project. These benefits are seen from two perspectives, one from the organisational view and one from the stakeholders view. It is obvious that each part will have benefit differently from projects. For example one organisation can gain profit through achieving strategic goals when a project is completed and at the same time these goals have a serious environmental impact in the stakeholders community. This means that a successful project must bargain between the benefits of the organisation and the satisfaction of end users. The fourth corner of the ‘Square Root is the Information System which includes the subjects of maintainability, reliability and validity of project outcomes. Belassi and Tukel (2001) are of the opinion that criteria for measuring project success/failure can grouped into two groups: the factor and system response groups. The identified factor groups are: factor related to project manager, factor related to project team members, factor related to the project itself, the organisation handling the project and the factor related to the external environment in which the project takes place. The diagram below shows this in more detail. 2.9.2 Success Factors As mentioned earlier; success factors are those inputs to the management system that lead directly or indirectly to the success of the project or business (Cooke-Davies, 2002, p185). Some project managers intuitively and informally determine their own success factors. However, if these factors are not explicitly identified and recorded, they will not become part of formal project management reporting process nor they become part of the historical project data (Rad Levin, 2002, p18). Belassi Tukel (1996, p144) classified these factors into 5 distinct groups according to which element they relate to. 2.9.2.1 The Organization Top management support is the principal success factor for many independent research groups (Tukel Rom, 1998, p48) (CHAOS Report, 2001, p4) (Cleland Ireland, 2002, p210) (Tinnirello, 2002, p14), which means that no project can finish successfully unless the project manager secures true support from the senior or operational management. It is extremely difficult to work in a hostile environment where nobody understands the benefits that the project will deliver to the organisation. Stakeholder management and contract strategies (number of and size of the contracts, interface between the different contracts and the management of contracts) are separate success factors which are also considered part of organization issues (Torp, Austeng Mengesha, 2004, p4). 2.9.2.2 The Project Manager Having a project manager is not going to guarantee the success of a project. He must have a number of skills to use during the project to guide the rest of the team to successfully complete all the objectives. In the 2001 CHAOS report (The Standish Group International, 2001, p6), business, communication, responsiveness, process, results, operational, realism and technological skills are mentioned as some of the most important skills a project manager should have to deliver success. However, more resent research by Turner and Muller (2005, p59) has concluded that the leadership style and competence of the project manager have no impact on project success. It is very interesting to investigate why a highly respectable professional body for project managers published such a contradictive position. A possible answer could be found in the fact that project managers results are difficult to prove and even more difficult to measure. If the project is successful, senior management will probably claim that all external factors were favourable. On the contrary, if it turns to be a failure, project manager easily becomes the scapegoat. 2.9.2.3 The Project Team Project managers are very lucky if they have the option to choose their project team. More often, their team is inherited to the project from various sectors of the organisation. It is vital to have a good project team to work with, with core skills that can be evolved to core competences and capabilities for the whole organisation. All m Avoiding Project Failure Dissertation Avoiding Project Failure Dissertation ABSTRACT Project management have become increasingly important in the development of any nation. Various organisations have used project management techniques as a means of bridging the gap between failure and success in implementation of projects. Despite this increasing awareness of project management by organisations, projects still fail. The purpose of this dissertation is to systematically investigate the causes of project failure and how these can be prevented, managed, or controlled. Research studies investigating the reasons why projects fail, has been ongoing for years, with various researchers, organisations and project management institutions, providing lists of reasons, which they believe, are the cause of project failure. However, despite these lists projects continue to fail, Atkinson (1999). This research is done with the anticipation of not only adding information to the body of knowledge already in existence, but also examining the major issues currently causing project failure; this will help organisations effectively manage projects. To determine how to avoid project failure the criteria for measuring project success has to be properly determined and agreed upon; the major criteria commonly used are; cost, time and quality. Then the causes of project failure need to be determined. This study also examined generalisations made from existing literature about causes of project failure and methods of avoiding project failure using three construction case studies in United Kingdom. This is a secondary or desk research, which involves the collecting and analysis of secondary data, or data that already exists, from which inferences have been made, and conclusions drawn. CHAPTER 1: INTRODUCTION 1.1Research background Projects make a vital contribution to industrialisation and hence the growth of a nations economy. The importance of projects in the development of any nation cannot be overemphasized. This is demonstrated in various literatures explaining the success and failure of projects. Although projects are said to be important, its implementation can be an uphill task. Various researchers have discussed project management as a technique to help prevent against failure in projects. Others have established checklists to help prevent failure. Despite the increased project management awareness and these checklists, some projects still fail, Atkinson (1999). All projects are constrained by inherent risks; knowledge of these risks will play an important role in achieving success and avoiding failure. Usually projects consist of three stages consisting of the approval, execution and evaluation stages. If any of these stages is not managed properly it may result to the failure of the entire project. Failure or Success in projects is a multi-dimensional issue and may be influenced by so many factors. Some projects may have failed in project management practices including cost overrun, scope creep, delay in schedule etc, and other projects may fail in procurement practices. Despite these failures in the following areas the project may still be perceived as successful by the end users. An example is Wembley Stadium; despite all the issues associated with the project in terms of project management and procurement practices, it is still perceived to be successful and a state of the art stadium by the end users. This may result from the fact that it has hosted world class sporting events. Usually, projects are designed to meet stakeholders objective. These objectives define the criteria for success of that project, and projects not satisfying these objectives are deem to fail. Effective communication and clarity in the stakeholders objective is vital to the project manager. This thesis examines the causes of project failure and how these can be prevented, managed or controlled. It discusses project failure and success with the help of case studies in order to identify the critical success factors and reduce failure in the implementation of projects. This research is done with the anticipation of not only adding information to the body of knowledge already in existence, but also in defining the criteria for project success and identifying the variables involved. This will help organisations effectively manage projects. 1.2 Aim The aim of this research is to carry out appraisal on the causes of project failure and the appropriate methods of avoiding project failure. This aim is intended to be achieved with the following objectives. 1.3 Objectives To provide a review of project management To analyze success criteria for projects To explore factors that causes project failure or success To examine methods of avoiding project failure 1.4 Scope This research is based on construction projects executed in the United Kingdom over the last two decades. 1.5 Research Structure Chapter One, Introduction this introduces the research; topic highlighting the aim, objectives and scope of the research. Chapter Two, Literature review critically reviews the existing Literature regarding the subject. It establishes the definition of project success and the success and failure criteria / factors. Chapter Three, Methodology describes the methodology used to undertake this research. It demonstrates the fact that secondary data was mostly used in undertaking this research. Chapter Four, Case Studies Case studies on projects from the UK construction Industry were discussed in this Chapter. These case studies were analysed and linked to the literature review chapter. Chapter Five consists of the analysis of the discussion and findings. This is derived from critically analysing the Wembley, Heathrow terminal five (T5) and Holyrood case studies. Chapter Six, Conclusion and Recommendation: This chapter concludes the research and suggests directions for further research. CHAPTER 2: LITERATURE REVIEW 2.1 Introduction The importance of avoiding project failure in a rapidly evolving project-driven 21st century cannot be over-emphasized. Attempts to understand the causes of project failure and/ or success have proven problematic, despite attempt by many practitioners and academics over the years. Project demands have constantly increased over the last decade and have driven our society into a constantly changing environment. Despite attempts to make project appraisal and delivery more rigorous, a considerable proportion of delivery effort results in project that does not meet user expectations and are consequently rejected. In our view this can be attributed to the fact that few organisations have the facilities, training and management discipline to bring project to successful completion. Project success does not come easily; much has been contributed over the last decade to our understanding of the nature of and reason for successful and unsuccessful project completion. In addition many projects fail to complete at all. Sometime failure to satisfy all the original goals of a project can still be regarded favourably if the main sponsor is not satisfied with the outcome and the key stakeholders have gained in some way. Generally, the key development considerations are to have the goal clearly defined, to plan how to realize the goal and implement the plan. Developing an alternative methodology for project management founded on stakeholders, senior management support and proper planning should lead to a better understanding of the management issues that may contribute to the successful delivery of projects. This literature review is aimed at carrying out appraisal on the causes of project failure and the appropriate methods of avoiding it. It begins with key definitions, then analysis of causes of project failure and project success. Then it looks at success factors and criteria; also examine ways of avoiding project failure. The chapter ends with summary of the discussion. 2.2 What is a Project? Gary and Larson (2008:5) defined project as â€Å"a complex, non routine, one-time effort limited by time, budget and resource, and performance specifications designed to meet customer needs. This is in contrast to how an organisation generally works on a permanent basis to produce their goods and services. For example the work of an organisation may be to manufacture a vehicle on a continual basis, therefore the work is considered functional as the organisation creates the same products or services over-and -over again and people hold their roles on a semi permanent basis. A project can be defined as having constraints (usually centred around time and resources, but also including all aspect of the process and the outcome); projects are processes that in many circumstances are core business for organisation. The diagram below show different levels in project management. 2.3 What is Project Management? According to Gray and Larson (2006) Project management is a task derived from an organisation that enables professional project managers to use their skills, tools and knowledge to plan, execute and control a unique project within a limited lifespan by meeting the specification requirements of the organisation. Since the outcomes of the capital projects have strategic implications on the success and profitability of the business, the ability to deliver based on pre-determined objectives should be critical to the companys success. And yet one-third of all the oil and gas projects exceed budget and time projections by more than 10 percent. Failure to deliver big projects on budget and on schedule is highly publicized and damage the companies profile with capital markets that predictability and strong returns. Continual use of traditional project management techniques will not alter this trend. Companies that want to change and improve on their performance with critical capital projects will need to adopt new techniques. Munns and Bjeirmi (1996) also defined project management as a process used as a control to achieve the project objectives by utilizing the organisational structure and resources to manage a project with the application of tools and techniques, without disrupting the routine operation of the company. ‘Project management is the discipline of managing all the different resources and aspects of the project in such a way that the resources will deliver all the output that is required to complete the project within the defined scope, time, and cost constraints. These are agreed upon the project initiation stage and by the time the project begins all stakeholders and team members will have a clear understanding and acceptance of the process, methodology and expected outcome.(http://www.projectsmart.co.uk/introduction-project-management.html accessed on 30/06/09) Project management has been defined as â€Å"the process by which projects (unique, complex, non- routine, one-time effort limited by time, budget, and resources) are defined, planned, monitored, controlled and delivered such that the agreed benefits are realised† (APM, 2006:3) Other definitions have been offered, Reiss suggests that a project is a human activity that achieves a clear objective against a time scale, and to achieve this while pointing out that a simple description is not possible, he suggested that project management is a combination of management and planning and management of change. Despite all the suggestions about what is project management, the criteria for success, namely, cost, time, and quality remain and are included in the actual description. Meaning that Oisens definition of project management was either correct, or as a discipline, project management has not really changed or developed the success criteria over 50 years. Therefore project management is a learning profession. The significant point from all the definitions and suggestions of project management is that while the factors have developed and adopted, changes to the success criteria have been suggested but remain unchanged. In 2008, a survey undertaken by Booz Allen Hamilton (project management consultant) which comprises of 20 companies in engineering, procurement and construction; shows that 40 percent of all projects executed where faced with cost overruns and behind schedule. These overrun in cost and schedule has led to clients dissatisfaction on project performance; this view also agree with the research of M J Lang (1990). Therefore effective project management is very vital in such a volatile business environment. 2.4 Project Management Methodology Generally, projects are split into three phases Initiation, implementation and closure. Every stage of a project has multiple checkpoints which must be met before the starting of the next stage. The degree to which a project will be managed depends on the size of the project. For a complex project in a large organisation that involves a number of people, resources, time and money, a more structural approach is needed, and there will be more steps built into each stage of the project to ensure that the project delivers the anticipated end result. For a simple project in a small organisation, agreed milestones, a few checklists and someone to co-ordinate the project may be all that is required. 2.5 Defining Project Failure From Penguin English Dictionary (1992), failure is define as unsuccessful project that fails to perform a duty or an expected action, non-occurrence or non-performance. Whereas success can be defined as the achievement of something desired, planned or attempted (Cambridge Dictionary, 2007). It is also said that success is an event that accomplishes its intended purpose (dictionary.com, 2007). Anything short of that is failure. Project failure is an unpleasant event that cost large amount of money to the organisation. 2.6 Causes of Project Failure Pinto and Mantel (1990) carried out a research on the causes of project failure and revealed a good explanation that encompasses both internal efficiency and external effectiveness. They state that project failure is a vague concept, which has evoked much as to its definition, as the case with the definition of project success. A project is considered a failure â€Å"whenever a project does not meet the expectations of the stakeholders†. This has lots of impact to both the organisation and all stakeholders to the project. They include: cost and time overruns, quality degradation, frustration and stress, sometimes resulting to people quitting, low corporate market value, low public opinion and negative media campaigns. The total effect can be very costly to the organisation; at times even force the company into closure. Bienkoski (1989) identified ten factors that can lead to project failure and they are: * Lack of change management- happens when there is no method to handle or recognise changes. * Communication- causes delay or even failure since team members do not have the information they needed, issues or changes do not get escalated, project reporting is sluggish * Inadequate resources- Task take longer than expected to complete, deadlines and milestones get missed, and project completion date comes into jeopardy, one end of working more than necessary (double shift) to get the work done * No one is in control, not even the project manager, who is assigned to the project but not given the free hand to manage the project. This is most problem encounters in matrix organisation * Project lacks structure caused by things such as critical tasks being under rated * Inaccurate estimates. A top- down plan causes constraints on the prediction of the cost of the project * Poor risk management. The project initiation stage is not properly planned * Insufficient non-resources are not allocated to the project; for instance, it is not possible for a project to succeed if the right resources are made available for that project * Incompetent project management skill * Project changes from its original objective and goals. This can occur due to additional requirement from the client Pinto and mantel (1990) argue that the major causes of project failure are changes in the project environment, as it goes out of hands of the management. 2.7 Defining Project Success Lewis (2005) states that project success can be defined as meeting the required expectation of the stakeholders and achieving its intended purpose. This can be attained by understanding what the end result would be, and then stating the deliverables of the project. Shenhar et al. (2001) state the opposite: that project success is commonly judged by time and budget goals criteria, whereas in some cases this does not apply to some projects. Thiry (2006) argues that project success can only be defined if executives are able to consider the contribution of benefits and if the project is able to achieve these measures in relation to resources, competencies and complexity within the project parameters. 2.8 Key Performance Indicators (KPIs) as a Measurement for Project Success The purpose of the KPIs is to enable measurement of project and organisational performance throughout the construction industry (The KPI Working Group 2000). Collins (2000) advocates that the process of developing KPIs involves the consideration of the following factors: * KPIs are general indicators of performance that focus on critical aspects of output or outcomes * Only a limited, management number of KPIs is maintainable for regular use. Having too many (complex) KPIs can be time-and resource-consuming * The systematic use of KPIs is essential as the value of KPIs is almost completely derived from their consistent use over a number of projects * Data collection must be made as simple as possible. * A large sample size is required to reduce the impact of project specific variables. Therefore, KPis should be designed to use on every building project. * For performance measurement to be effective, the measures must be acceptable, understood and owned across the organisation * KPIs will need to evolve and it is likely that a set of KPIs will be subject to change and refinement * Graphic delays of KPIs need to be simple in design, easy to update and accessible. Key Performance indicators for measuring project success can be illustrated with the help of the diagram below (Albert Ada, 2004). They identified the following as the measurement of project success: Cost, time, quality, commercial profitable/value, environmental performance, user expectation/ satisfaction, health and safety and participants satisfaction. This will help in explaining what the project success might mean to different stakeholders. Key Performance Indicators Dvir et al. (2003) state that the ranking of success is a one-sided judgement, as the definition of success is difficult to define, because it has different meanings for different people; thus, the criteria of success should reflect the diverse interest and view that lead to a multi-dimensional and multi-criteria approach. Baccarini (1999) states: that success entails â€Å"hard† criteria which often linked with cost, time and quality. He also states that hard criteria which can be easily measured can lead to some form of substantial agreement. In contrast, soft criteria are known to be one sided, restrained and not easily assessed. This implies that project success is a fantasy of the mind and only an individual can turn such vision into reality. A contrasting view from Westerveld (2000) defined project success as â€Å"the satisfaction of all the stakeholders, meaning that as long as the stakeholders are pleased with the outcome and gain profits or revenue from the project, then it is classed as a success. One of the Squares root corners, organisational benefits, drew much attention because of its significance and it was further analysed. Kerzner (2001, p6) suggests three criteria from the organization perspective in order for a project to be successful. The first is that it must be completed with minimum or mutually agreed upon scope changes, even though stakeholders constantly have different views about projects results (Maylor, 2005, p288). Secondly â€Å"without disturbing the main work flow of the organization because a project has to assist organisations everyday operations and try to make them more efficient and effective. Finally, it should be completed without changing the corporate culture even though projects are almost exclusively concerned with change with knocking down the old and building up the new (Baguley, 1995, p8). A project managers main responsibility is to make sure that he delivers change only where is necessary, otherwise he is doomed to find strong resistance from almost all organisational departments (Kerzner, 2001, p158) which ultimately could lead to project failure. A more structured approach to project success is grouping the criteria into categories. Wideman (1996, p3-4) describes four groups, all of them time dependent: internal project objectives (efficiency during the project), benefit to customer (effectiveness in the short term), direct contribution (in the medium term) and future opportunity (in the long term). The characterization of ‘time dependent is based on the fact that success varies with time. Looking at the future benefits of the organisation can be really difficult, because in some cases they dont even know what they want, yet it is vital to know what the project is trying to achieve after completion time so that success criteria are clearly defined in the early stages. This is quite a different approach, because the focus moves from the present success criteria to the future, in a way that a project can be unsuccessful during execution if it is judged by criteria like cost and quality, but in the long term it can turn to be a thriving story. A good example of this hypothesis is hosting the Olympic Games in Athens, Greece, which received mass criticism both during the planning period, due to delays in construction time, and when it was finished, due to huge cost. But the benefits that Greece will gain from the Olympic Games can be fully understood after 5 or maybe 10 years from the hosting year (Athens2004.com). All the above success criteria should be simple and attainable and, once defined, they should also be ranked according to priority (Right Track Associates, 2003). Straightforward criteria are easy to understand by everyone involved in the project and therefore commitment is guaranteed. Unrealistic criteria can put a ‘failure label on many projects because of the unreachable standards, can generate low team esteem and team performance in future projects and finally generate unfair disappointment among stakeholders. As for priority issues, it is inevitable that things will go wrong and the project manager will be in a tough situation where he must make the right decision having in mind that he has to sacrifice the least important success criterion. Also Shenhar et ‘al (1997) are of view that project success can be seen from the four area: Project efficiency, impact of the project to the customer, business success and finally what the project holds for the future. This was further explain in the diagram in 3. 2.9 Defining Project Success Factors and Project Success Criteria Muller and Turner (2007) defined the two components of project success in relation to the use of project management as follows: Project success factors are the elements of a project that can be influenced to increase the like hood of success; these are independent variable that makes success more likely. Project success criteria are the measures by which judge the successful outcome of a project; these are dependent variable which measure project success. We often hear or read about various success stories. But what is success and what criteria should organizations use to identify success? What factors lead to a successful project? The purpose of this study is to define project success criteria, clarify their difference with success factors and analyse their importance in project management methodology. One of the vaguest concepts of project management is project success. Since each individual or group of people who are involved in a project have different needs and expectations, it is very unsurprising that they interpret project success in their own way of understanding (Cleland Ireland, 2004, p2). For those involved with a project, project success is normally thought of as the achievement of some pre-determined project goals (Lim Mohamed, 1999, p244) while the general public has different views, commonly based on user satisfaction. A classic example of different perspective of successful project is the Sydney Opera House project (Thomsett, 2002), which went 16 times over budget and took 4 times more to finish than originally planned. But the final impact that the Opera House created was so big that no one remembers the original missed goals. The project was a big success for the people and at the same time a big failure from the project management perspective. On the other hand, the Millennium Dome in London was a project on time and on budget but in the eyes of the British people was considered a failure because it didnt deliver the awe and glamour that it was supposed to generate (Cammack, 2005). In the same way that quality requires both conformance to the specifications and fitness for use, project success requires a combination of product success (service, result, or outcome) and project management success (Duncan, 2004). The difference between criteria and factors is fuzzy for many people. The Cambridge Advanced Learners Dictionary describes a criterion as a standard by which you judge, decide about or deal with something while a factor is explained as a fact or situation which influences the result of something. Lim Mohamed applied those definitions to project success and illustrated the difference. It is clear now that critical factors can lead to a series of events which ultimately meet the overall success criteria of the project, so they should not be used as synonymous terms. Project success can be seen from two different perceptive, the micro and macro viewpoint (Lim Mohamed, 1999). This can help in better understanding of what project success means to different people. 2.9.1 Success Criteria Many lists of success criteria have been introduced in the previous decades by various researchers. Primal success criteria have been an integrated part of project management theory given that early definitions of project management included the so called ‘Iron Triangle success criteria cost, time and quality. (Atkinson, 1999, p338) Atkinson continues that as a discipline, project management has not really changed or developed the success measurement criteria in almost 50 years. To meet the urgent need of modernizing the out of date success criteria, he suggest the ‘Square Route ( 3) success criteria instead of the ‘Iron Triangle, where he groups the criteria that other academics have proposed. The main change is the addition of qualitative objectives rather than quantitative, namely the benefits that different group of people can receive from the project. These benefits are seen from two perspectives, one from the organisational view and one from the stakeholders view. It is obvious that each part will have benefit differently from projects. For example one organisation can gain profit through achieving strategic goals when a project is completed and at the same time these goals have a serious environmental impact in the stakeholders community. This means that a successful project must bargain between the benefits of the organisation and the satisfaction of end users. The fourth corner of the ‘Square Root is the Information System which includes the subjects of maintainability, reliability and validity of project outcomes. Belassi and Tukel (2001) are of the opinion that criteria for measuring project success/failure can grouped into two groups: the factor and system response groups. The identified factor groups are: factor related to project manager, factor related to project team members, factor related to the project itself, the organisation handling the project and the factor related to the external environment in which the project takes place. The diagram below shows this in more detail. 2.9.2 Success Factors As mentioned earlier; success factors are those inputs to the management system that lead directly or indirectly to the success of the project or business (Cooke-Davies, 2002, p185). Some project managers intuitively and informally determine their own success factors. However, if these factors are not explicitly identified and recorded, they will not become part of formal project management reporting process nor they become part of the historical project data (Rad Levin, 2002, p18). Belassi Tukel (1996, p144) classified these factors into 5 distinct groups according to which element they relate to. 2.9.2.1 The Organization Top management support is the principal success factor for many independent research groups (Tukel Rom, 1998, p48) (CHAOS Report, 2001, p4) (Cleland Ireland, 2002, p210) (Tinnirello, 2002, p14), which means that no project can finish successfully unless the project manager secures true support from the senior or operational management. It is extremely difficult to work in a hostile environment where nobody understands the benefits that the project will deliver to the organisation. Stakeholder management and contract strategies (number of and size of the contracts, interface between the different contracts and the management of contracts) are separate success factors which are also considered part of organization issues (Torp, Austeng Mengesha, 2004, p4). 2.9.2.2 The Project Manager Having a project manager is not going to guarantee the success of a project. He must have a number of skills to use during the project to guide the rest of the team to successfully complete all the objectives. In the 2001 CHAOS report (The Standish Group International, 2001, p6), business, communication, responsiveness, process, results, operational, realism and technological skills are mentioned as some of the most important skills a project manager should have to deliver success. However, more resent research by Turner and Muller (2005, p59) has concluded that the leadership style and competence of the project manager have no impact on project success. It is very interesting to investigate why a highly respectable professional body for project managers published such a contradictive position. A possible answer could be found in the fact that project managers results are difficult to prove and even more difficult to measure. If the project is successful, senior management will probably claim that all external factors were favourable. On the contrary, if it turns to be a failure, project manager easily becomes the scapegoat. 2.9.2.3 The Project Team Project managers are very lucky if they have the option to choose their project team. More often, their team is inherited to the project from various sectors of the organisation. It is vital to have a good project team to work with, with core skills that can be evolved to core competences and capabilities for the whole organisation. All m