VUMCInformaticsCenterProject Executive Summary (PES)

Instructions:

A Project Executive Summary form must be completed for each request for each Informatics Center (IC) project. An IC project is generally defined as a systems selection, design, upgrade, programming enhancement, replacement, or install. Submission and approval of a Project Executive Summary by an Executive Sponsor is required before the project can be prioritized in the Project Evaluation Process *. Form must be approved and signed by CEEC member as Executive Sponsor. All signed requests need to be faxed to Informatics for review.*See for Project Executive Summary (this document) and the Project Evaluation Process.

Project Name: / Date of Request: / Requested by Name: / Title: / Phone:
Detailed Project Description:
Expected benefits and measurable outcomes (explain in brief for each selected): Note: Additional details on how to achieve benefits and outcomes may be requested.
Regulatory Compliance:
Capital / Operational CostSavings: (Please estimate the source and amount of potential savings)
Revenue Enhancement: (Please estimate the source and amount of potential enhancement)
Patient Safety:
Patient satisfaction and/or outcome:
Staff and/or faculty satisfaction:
Work flow Improvement/Efficiency: (Please estimate the source and amount of efficiency)
Other:
Describe any external time factors to be considered:
Project Costs:
This section looks to identify and document the financial resources that are required for the project under consideration and identifies anticipated funding. It is understood that costs may be divided among multiple departments. All departments responsible for operational costs should be listed below. A VMC authorizing executive will be asked to approve the project as well as the executive sponsor if multi-entity funding sources are required.
Category / Estimated Project Cost / Current FY Funding Available? (Y/N) / Funding Dept Name / Authorizing Executive
(if needed beyond the Exec Sponsor)
Capital (One-Time) Cost
Operational (Ongoing) Costs
Ongoing Support (Annual)
Other (ex: FTEs)
Operational Leader for this project
Name: / Title: / Phone:
Clinical Leader for this project (if Clinical impact expected)
Name: / Title: / Phone:
Executive Sponsor for this project: Must be one of the following: Balser, Beck, Churchwell, Dubree, Goldberg, Pinson, Posch or Sandler
Print Name:
Executive Sponsor - Project reviewed by and signed. Fax to 31214 Attn: George McCulloch:
Signature: / Date:
Additional Comments

Revised: February 2009