June 2026
By Laurence Smith, Greybeard Healthcare Co-Founder
Program management is becoming an essential driver of hospital transformation, as operators reinvent themselves to thrive during the period of rapid change we are seeing throughout the sector.
There is some literature suggesting that, within the healthcare ecosystem, change will inevitably involve an element of chaos: it can “resemble a chaotic process that is sensitive to initial conditions, highly variable, and difficult to predict, [exhibiting many features of] modern chaos theory are often linked to a meteorologist named Edward Lorenz” [1]. This is because innovation can require thinking or behaviour that steps outside linear, deterministic approaches. Program management is not intended to quash this type of activity; on the contrary, it can ensure a framework in which disruptive ideas can be nurtured, marshalled, resourced and brought to fruition within an appropriate framework.
Existing operators are modernizing their services and processes to deliver in the face of rising expectations and mounting competition. And challenger brands are using their ability to be nimble and opportunistic to build their track record. Program management offices can be the key to aligning all functions and expertise within healthcare operators in order that change can be delivered rapidly and effectively.
Greybeard Healthcare has been involved in the set-up and leadership of many PMOs throughout the Gulf region. In a previous article, we posited the “four essentials” when using a PMO to deliver hospital transformation [2]. In this companion piece, we describe the ten functions which, ideally, should fall within the delegated scope of the PMO. The list has been adapted (for example, replacing specific references with generic ones) from a ‘responsibilities charter’ we constructed to embed the role of a successful program office for Johns Hopkins Aramco Healthcare, where we managed the clinical transformation PMO over a number of years.
Program governance and reporting
- Preparing updates for Board, CEO, C-suite, Program Steering Committee (SteerCo), and/or Program Oversight Committee (OversightCo).
- Coordinating the agendas for the SteerCo and/or OversightCo.
- Participating actively at the SteerCo and/or OversightCo meetings, including delivering verbal updates, highlighting issues for resolution, and answering questions.
Regular, detailed and structured project reviews
- Supporting project champions and managers in the production of regular monthly project-level updates.
- Collating information for key issues resolution as the SteerCo and/or OversightCo.
- Recording the actions arising and working with project champions and managers to ensure actions are implemented.
Champions workshops
- Organizing regular meetings of all Project Champions during which they can share progress, discuss interdependencies, and learn from one another and from external speakers.
- Including in these workshops a range of ‘Development Moments’ for the Project Champions, strengthening their project capability and competency – these Moments can include new analytical tools, scenario discussions, role play.
Program documentation
- Agreeing with project champions and managers on the key information to be contained in key program documents, including:
- Key Performance Indicators.
- Milestone plan.
- Detailed action plans.
- Achievements log.
- Relevant project appraisal materials.
- Maintaining these documents in real time.
Project initiation
- Working with Project Champions on Project Initiation Documents (PIDs) which set out the purpose, rationale, benefits, priorities, KPIs, milestones, team members, action plans, dependencies and risks.
- Supporting Project Champions as their PIDs are presented to the SteerCo and/or OversightCo for scrutiny and (where appropriate) endorsement.
Project closure
- Working with Project Champions as they conclude their activities in-Iine with the agreed project closure process.
- Ensuring any remaining or continuing activities are transitioned to business-as-usual.
- Recording lessons learned, personal development achieved, any further communication required, future risks.
Mentoring and coaching
- Mentoring the Project Champions and Project Managers on the leadership of their teams, project management essentials, and issues resolution.
- Mentoring in-house employees within the PMO so they can continue to develop as project professionals.
- Delivering project management training sessions where required for staff development.
Case studies – to build a legacy
- Drafting case studies for appropriate projects as they conclude, which record the project’s journey, its outcome, lessons learned.
- Liaising with MarComms professionals in the client organization to ensure the maximum leverage of these case studies with multiple audiences.
Turning around red / amber-rated projects
- Mobilizing focused assistance to any projects with a red or amber rating to support them as they get back on track.
- This focused assistance can take a number of forms; for example:
- ‘Hot house’ environment for rapid decision-making.
- Task force of turnaround experts with delegated authority to make changes.
- Facilitated workshops involving key stakeholders.
- Additional resourcing, including technical subject matter support as required.
- Issues escalation.
A learning organization
- Identifying personalized learning opportunities for all project team members at the outset; this can take the form of exposure to new technical knowledge (finance, supply chain…), engagement with new project management tools (PIDs, issues resolution…), or application of new behavioural skills (brainstorming, team participation, internal challenge…)
- Working closely with those individuals to ensure the learning is progressing as expected, pivoting to different arrangements if it’s not being achieved.
- Discussing with those individuals about how their learning can prove beneficial to their own careers, as well as the sponsoring organisation, over the years ahead.
We trust this brief overview of the recommended core functions of a high-performing PMO will be of interest and value to healthcare leaders in ambitious organizations, especially those in the foothills of a journey of change and transformation.
Notes
[1]. Kenneth Resnicow and Scott Page, ‘Embracing Chaos and Complexity: A Quantum Change for Public Health’, American Journal of Public Health August 2008, available from the National Library of Medicine (https://pmc.ncbi.nlm.nih.gov/articles/PMC2446457/)
[2]. Laurence Smith, ‘Four essentials when using a Programme Management Office (PMO) to deliver hospital transformation’, May 2026, available at https://greybeardhealthcare.com/insight.
