The Evolution of EPPM at Mayo Clinic
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The Evolution of EPPM at Mayo Clinic

Teresa A. Knudson, Director, Mayo Clinic EPMO
Teresa A. Knudson, Director, Mayo Clinic EPMO

Teresa A. Knudson, Director, Mayo Clinic EPMO

Dr. Charlie Mayo once said in 1928, “if we excel at anything, it is our capacity for translating idealism into action”. This is one of the reasons Mayo Clinic leadership began searching for a better way to manage their large, complex, project portfolio in 2007. With the changes and challenges in the healthcare environment, new and more advanced business practices were needed to enhance the success of achieving the vision for patients. To accomplish this, the concept of Enterprise Project Portfolio Management (EPPM) was introduced to Mayo Clinic as an approach successfully used by many other large, industry-leading organizations.

As the first and largest integrated, non-profit medical group practice in the world, Mayo Clinic is in a unique position to serve as a leader in many areas of healthcare and business management. The Mayo Clinic staff consists of almost 60,000 persons worldwide and cares for patients on campuses in Minnesota, Florida, Arizona, and in over 70 communities in the upper Midwest. Mayo Clinic has an established reputation for providing the very best in patient care as emphasized by our primary value - “The Needs of the Patient Come First”.

Managing a healthcare organization of the size and scope Mayo Clinic requires a variety of advanced business practices for integrating this large, complex organization. This began with an assessment of both internal current practices in combination with external best practices resulting in the adoption of Project and Portfolio Management throughout Mayo Clinic.

  It is also recognized that EPPM can be implemented universally for any type or size of organization 

With the endorsement of executive leaders, the EPMO (Enterprise Portfolio Management Office) was established in 2008 providing the means to create and implement the components needed to build a solid EPPM infrastructure. Part of this infrastructure involved creating the structure and roles of the EPMO in relation to the Project Management Offices (PMOs) already in existence across the organization. The following framework provides a model that has worked well in depicting both internal and external relationships while illustrating our collaborative working environment. Another part of this infrastructure required development of key service lines that aligned with the needs of the organization. Over the first few years a couple of different models were tried. The first one having too many services lines, the next one having too few. Through our experiences we finally identified the following five services lines that have served us well the past several years and continue to align with our organizational EPPM needs.

Implementing EPPM at Mayo Clinic required a combination of research, external expertise, and engagement by leaders and staff through the organization. We realized very early in this process the importance to relating to internationally recognized expertise. In the case of EPPM, that organization was the Project Management Institute (PMI). PMI offered the perfect blending of standards, education, networking, and certifications and has served as a tremendous reference point for our EPPM journey. In working with PMI and other organizations, we realized that this journey has several steps. The following outlines some of the main ones we have taken so far:

Step 1 – Project Portfolio Management - We began by introducing executive leaders to project portfolio management by creating portfolio structures organized to support their needs. This initial step consisted of taking an inventory of the projects, identifying responsible persons, establishing processes for regular reporting and review, collecting critical information, and developing standardized approval and prioritization processes. Currently, there are over 1,000 projects within the enterprise portfolio with over 130 dashboards for key leadership groups. This increased transparency has provided a much higher-level awareness, improved integration, and enhanced decision making at many levels of the organization.

Step 2 - Strategic Alignment – A major part of any EPPM initiative is alignment with the organization’s strategic plan and operating objectives to ensure project investment decisions are supporting the future direction and priorities. The EPPM project portfolio focuses on this alignment and uses dashboard reporting established by the EPMO to provide visibility for how activities directly impact the organizational objectives.

Step 3 – Project Management Standards – Another critical effort was focusing on doing things ‘the right way’ by creating project management standards, methodologies, tools, and terminology for use across Mayo Clinic. This was accomplished through partnerships with numerous departments with expertise in these concepts. More than 80 staff from across the organization volunteered to participate in work groups to bring the ‘best of the best’ ideas together in the formation of a complete set of PMI based enterprise standards.

Step 4 – Education and Training - To support the utilization of these new enterprise PM standards, a training curriculum was created and made available to staff across Mayo Clinic. This provided an opportunity for people in any role within the organization to learn directly from skilled project managers regarding PM methodologies, tools, and best practices.

In conjunction with this educational effort, another major accomplishment in 2009 was when over 100 Mayo Clinic staff became PMP (Project Management Professional) certified by PMI. This was the result of significant efforts by internal partners, the local community college, and a Minnesota state grant. Since then, this course is available to people throughout the community.

Step 5 – Project Management Resources - As noted by PM Solutions, a best practice by over 72 percent of the PMOs is engagement in project management staffing. The Mayo Clinic EPMO recognized the need for this role and developed a centralized staff of skilled project managers assigned to the largest projects across Mayo Clinic. Another area of focus has been the creation of a Project Management Career Framework outlining roles, developing skills and abilities, assessing competencies, and identification and assignment of staff to projects across the organization.


Based on our experiences and successes at Mayo Clinic, the adoption of EPPM as a core business process has the ability to offer value to any organization. It is also recognized that EPPM can be implemented universally for any type or size of organization. Just as Mayo Clinic has learned from other organizations, these practices can assist any company in significantly enhancing their business management operations.

Mayo Clinic has realized great value from the implementation of EPPM as illustrated through the many experiences shared. As our organization engages in new EPPM activities in the future, it is fully realized that this will not only move Mayo Clinic to a higher level of EPPM maturity but much more importantly support the organization’s success in effectively achieving our strategic objectives which allow Mayo Clinic to better serve our patients.

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