How project surgeries can keep programmes on track (1)

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When I’ve run large change programmes I have often used project surgeries to minimise programme risks and to keep a programme on track to deliver its benefits. So what are surgeries?

A surgery is when you select a project within your programme and undertake a detailed health check or ‘deep-dive’.

If you are running a programme with 50 or more projects then the programme manager cannot possibly understand what is happening on all projects. He or she does not need to if there is appropriate governance or reporting processes in place. However, even with the right governance processes in place, surgeries on the key projects in a programme are beneficial in order to provide confidence that these projects are being run in a competent manner and that there are no significant risks to the overall programme.

Selecting projects for surgery

The first task is to select the projects that you want to perform the surgery on. The following criteria are commonly used;

  • The project manager gives me cause for concern;
  • The project is critical to the success of the programme;
  • A delay or failure of delivery has a disproportionate effect on the overall programme;
  • The project is consistently reporting a red status;
  • The project is always green (usually evidence of a massaging of the RAG statuses);
  • The project is technically challenging;
  • The project is in danger of overrunning


Once the projects have been selected, the project manager should complete a pro forma presentation that the project manager must fill in and – importantly – present back to the ‘Health Board’. The Health Board would usually be made up of: sponsor, programme manager, IT Director (if there are lots of IT projects), finance and technical architect.

The seniority of the health board means that the project manager treats it seriously and is likely to provide high-quality data. An informal chat around a coffee means you will get a more ‘casual’ set of information.

The project manager should be able to present the following to the board:

  • Project objectives
  • Current plan
  • Cost and resource estimates (and basis for these estimates)
  • Key risks
  • Overview of solution
  • Key issues and mitigation factors
  • Help you may need from the sponsor or the board in general

At the surgery, the various members can drill down in more detail and uncover any concerns, etc.

These formal surgeries are a great way of discovering problems with key projects or giving the programme manager the confidence that all is indeed well and the patient is healthy. The bigger the programme, the more important I have found these surgeries to be.

In my next blog I will talk about some of the benefits that can be derived from project surgeries. For more information about running projects with reviews we have recently developed the Project Risk Gauge iPhone app. More information can be found at: or can be downloaded from the App Store.


David Walton
About the author
David Walton

I am David Walton, Programme,Project and Portfolio Management specialist and director of Bestoutcome here in the UK. We make the PMO tools PM3, PM3time and PM3change, the only PMO tools designed by practitioners for practitioners.

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One Response to “How project surgeries can keep programmes on track (1)”

July 12, 2013 at 10:15 am, How project surgeries can keep programmes on track: 2 | Bestoutcome said:

[…] We instigated a number of project surgeries using some of the criteria that I mentioned in my previous blog, but one in particular is worth commenting […]