The first important concept to understand is the level of project management.

Lots of organizations use the terms Product and Project Management interchangeably. But it is important to differentiate between the two in consolidation because Regional Managers are – program managers and Hospital Managers are Project Managers.

The Program Manager (Regional) thinks broadly. They set the schedule and budget for the program and are responsible for the success of all the projects in that program. Their goal is to support the long-term growth of the business on an ongoing basis.

The Project Manager (Hospital) is more tactical. They coordinate the cross-functional work required to implement a specific Decentralized Growth Lever on schedule and within budget. Their goal is to facilitate the delivery of a project with a finite start and end date.

Why is this important?
While designing the organizational Growth Levers, you need to focus on both levels of management because Regional Managers/ Operational Advisors are most successful in managing the process of applying tools for metrics corrections and hospital-level managers are the actual implementers. If this distinction is clear, then the regional manager is managing relationships between the department change agents and the hospital; managing capacity and change. This provides maximum capacity to Regional Managers as they do not need to know all the Growth Levers; they just need to know what metric can be corrected with a certain process.


The job description of the regional manager becomes much easier if you do not require them to know how to improve the business of the individual hospital, but just train them how to manage change and which metrics can be influenced by which Growth Lever. If this is not achieved, your corporate overhead will grow linearly by increasing the number of Regional Managers as the organization grows. However, their ability to initiate change by implementing all of the growth levers at the hospital level makes them Project Managers and decreases quality and capacity.

Connected Processes

  • Culture/People Integration
  • HR Process/Onboarding
  • Knowledge Accumulation
  • Core Processes Implementation
  • Strategic Filter
  • Prioritization (WSJF)
  • Talent acquisition
  • Pre- and Post-Acquisition Assessments
  • Training
  • Quarterly Goals/Rock Planning
  • Recruiting at the Hospital Level
  • Implementation of VCP Processes
  • Capacity Reservation Process
  • Change Management
  • Data-Driven Change Management
  • Data-Driven VCP Initiative Process


Potential confusion between project and program management can lead to lack of change management at the hospital level. This can result in failure to integrate the hospital post-acquisition and burnout at the level of both Regional Management and the hospital. Triggers that can be avoided by proper project/program management: Lack of control, value conflict, insufficient reward, work overload, unfairness, and breakdown of the community.


A properly designed hierarchy of program management is of paramount importance to both de-novo and franchise models. The organizational processes first erupt from the departments and the department heads are responsible for Growth Lever Development and roll-out. As the organization matures, the Regional management layer is created and there has to be training available from all the departments to position the regional managers for success.