Ten Branches, Forty-Five Work Packages and Seven People Who Can Stop the Work: Breaking Down a Hospital Cleanroom Project
Student Name
American College of Education
HLTH5683: Project Management for Healthcare Administrators
Module 2 Assignment
Instructor Name
September 11, 2028
Building the Breakdown
The charter for the composite 220-bed hospital's sterile compounding suite defined the scope: a certified ISO Class 7 buffer room and ISO Class 8 ante-room, dedicated air handling, two primary engineering controls, procedures, training and a temporary cleanroom to keep compounding running during construction. A work breakdown structure divides that scope into deliverables and then into work packages small enough to assign, estimate and track. The Project Management Institute (2021) describes the breakdown as a hierarchical decomposition of the total scope of work, and the team applied its central rule, sometimes called the 100 percent rule: the breakdown must include all the work in scope and nothing outside it.
The team organized the top level by deliverable rather than by department, so that each branch ends in something that can be inspected. Work packages were sized to take between one and four weeks and to have a single responsible person. A work package that belongs to two departments belongs to neither, and will be the first one late.
The Ten Branches
Branch 1, project management, has three work packages: the plan and its baseline, monthly reporting to the sponsor and closeout. Branch 2, design, has four work packages: site survey, schematic design, construction documents and a design review in which the pharmacy's designated person for sterile compounding and infection prevention must sign off. Branch 3, approvals, has three: the building permit, the infection control risk assessment and notification to the state board of pharmacy. Branch 4, interim operations, has five: specifying, procuring, installing and certifying the temporary modular cleanroom and moving compounding into it. Branch 5, construction, has eight: demolition of two walls, new walls, cleanable ceiling and floors, doors and pass-through, hand-washing station, electrical, finishes and the protection package for the hazardous drug room described below.
Branch 6, air handling, has six: procurement of the dedicated unit, ductwork, filter housings, pressure monitoring, controls and air balancing, the last two split out of larger packages during the check below. Branch 7, equipment, has three: procurement, installation and start-up of the two primary engineering controls. Branch 8, certification, has four: initial certification of the rooms, certification of the engineering controls, initial environmental sampling and the three months of monitoring required before closeout. Branch 9, procedures and training, has five: garbing, cleaning, environmental monitoring and compounding procedures, and training with competency assessment for 18 staff. Branch 10, transition, has four: move from temporary to permanent suite, return of the temporary cleanroom, the handover package and acceptance by the director of pharmacy.
Checking the Breakdown
The team checked the breakdown three ways. First, it traced every in-scope item in the charter to at least one work package, and found one gap: the charter's commitment to protect the hazardous drug room during construction had no work package. A package for temporary barriers and daily pressure checks at the shared wall was added to Branch 5. Second, it traced every work package back to the charter, and found one package that did not belong: a request from the pharmacy to include shelving for the main dispensing area, which was removed because the charter excludes changes outside the suite. Third, it asked each responsible person to confirm they could estimate their packages; two air handling packages were split because the mechanical contractor could not estimate them as written. With those changes, the final breakdown has 45 work packages, each with one responsible person, an estimate of effort and duration and a short statement of what done looks like, such as a signed certification report or a completed competency record for every compounding employee.
Stakeholders Who Can Stop the Work
Many people are affected by the project, but only some can stop it. Mitchell et al. (1997) proposed that stakeholders become salient to managers according to three attributes: power to influence the organization, legitimacy of their relationship and claim and urgency of their claim. For this project, the team asked a narrower question: who has the formal power to halt construction or prevent the suite from being used? Seven stakeholders do. The local building official can refuse the permit or the certificate of occupancy. The state board of pharmacy can inspect the suite and prohibit compounding in it. The hospital's infection prevention director can halt construction under the infection control risk assessment if dust containment fails. The fire marshal can stop work if fire-rated walls are breached without protection. The independent certifier can fail the rooms. The designated person for sterile compounding can refuse to release the suite for use. And the chief financial officer can withhold release of capital funds in tranches.
Other stakeholders matter but cannot stop the work: nursing units and the operating rooms, which depend on compounded preparations; pharmacy technicians, who will work in the temporary cleanroom for months; and the outsourcing vendor, whose volume will fall. Their needs shape communication, covered in a later module.
Engaging Each Blocking Stakeholder
Each blocking stakeholder is tied to the work package where their power applies, with an engagement plan to bring them in early. The building official and fire marshal will review schematic designs at a pre-application meeting in Branch 2, before construction documents are drawn. The state board of pharmacy will receive written notification with drawings in Branch 3, and the pharmacy will request any pre-opening inspection date as soon as construction is scheduled. The infection prevention director will co-author the infection control risk assessment rather than review it, and will join weekly site walks during construction. Bartley (2000) described the role of infection control professionals throughout health care construction, from planning through completion, as central to preventing construction-related infections, which is the reason this stakeholder is a partner, not an inspector.
The certifier will review the air handling design in Branch 2, because a design the certifier doubts is cheaper to change on paper than after balancing fails. The designated person for sterile compounding sits on the project team and signs off on design, procedures and training, so the release decision at the end contains no surprises. The chief financial officer will receive the monthly budget report and a forecast before each funding tranche is released. The stakeholder who can stop a project should hear about it first, not last.
What the Analysis Changes
The stakeholder analysis changed the plan in three ways. It added a pre-application meeting with the building official and fire marshal to the design branch. It turned the infection control risk assessment from a review into a joint work package with shared ownership. And it moved the certifier's design review forward by four months. None of these was in the first draft of the breakdown, which is why the two tasks, breaking down the work and identifying who can stop it, belong in the same module. The next step is to sequence the 45 work packages until the critical path, the chain of work that determines the opening date, becomes visible.
References
Bartley, J. M. (2000). APIC state-of-the-art report: The role of infection control during construction in health care facilities. American Journal of Infection Control, 28(2), 156-169. https://doi.org/10.1067/mic.2000.106055
Mitchell, R. K., Agle, B. R., & Wood, D. J. (1997). Toward a theory of stakeholder identification and salience: Defining the principle of who and what really counts. Academy of Management Review, 22(4), 853-886. https://doi.org/10.2307/259247
Project Management Institute. (2021). A guide to the project management body of knowledge (PMBOK guide) (7th ed.). Project Management Institute.
How this HLTH 5683 Module 2 example is structured
HLTH 5683 Module 2 typically breaks the work down and identifies the stakeholders who can stop it; your classroom's instructions decide the depth of the breakdown and the stakeholder tool. This example presents the work breakdown structure by branch, explaining the principles used to build it and how it was checked. The stakeholder section uses a published salience model to separate stakeholders who can halt the work from those who are affected by it, and gives each blocking stakeholder an engagement plan tied to a specific work package.
HLTH5683 Module 2 questions, answered
What does HLTH5683 Module 2 usually ask for?
HLTH5683 Module 2 typically asks students to build a work breakdown structure for a health care project and to identify and analyze stakeholders, often focusing on those with power to stop or significantly change the project. Your classroom's instructions decide the depth of the breakdown and the stakeholder tool.
What is the 100 percent rule in a work breakdown structure?
The breakdown must include all of the work defined in the project scope and nothing outside it. Checking it means tracing every scope item to a work package and every work package back to the scope.
How do I identify stakeholders who can stop a project?
Ask who has formal authority to halt work or prevent use of the result, such as regulators, inspectors, funders and internal approvers. Then link each to the work package where that authority applies and engage them before they need to use it.
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