Assume you are an internal Project Manager working for a large travel agency called TravelWell that specialises in Medical Tourism. It offers services to people who travel to other countries to obtain lower-priced medical treatments, or where the required treatment is unavailable or non-licensed in their home country. The most popular sorts of treatments are those which involve surgical or other procedures for cancer, cosmetic, dental and fertility purposes. TravelWell’s services are widely used by American citizens and employers struggling with their medical insurance costs.

 Note: In developing your answers you can make any assumptions you wish, provided these are reasonable, do not contradict the content of the case study and are clearly written down.
 Note: Company and individual names are shown in italics.
 Assume you are an internal Project Manager working for a large travel agency called TravelWell that specialises in Medical Tourism. It offers services to people who travel to other countries to obtain lower-priced medical treatments, or where the required treatment is unavailable or non-licensed in their home country. The most popular sorts of treatments are those which involve surgical or other procedures for cancer, cosmetic, dental and fertility purposes. TravelWell’s services are widely used by American citizens and employers struggling with their medical insurance costs.

TravelWell has recently signed a deal with a big American corporation to provide medical care packages for its 37,000 employees. This project, called StaffCure2020, involves mapping the assessment of all employees’ needs against the service offering of medical practices in those countries, by specialist surgery clinics TravelWell has commercial connections with, followed by the formation of appropriate travel and medical packages.

As the appointed project manager of StaffCure2020, you will report to the Director of Americas. The project team currently comprises you as Project Manager and several functional managers who lead a number of internal departments, including Travel, Hospitalisation, Account Managers and Finance. The project is internally sponsored by the Executive Vice-President for Marketing and managed in a weak matrix structure. The Directorate of Americas is located in the United States and the relevant Account Managers report to them. The functional managers who comprise the project team all report to the relevant member of the Executive Board.

TravelWell also operates a Change Control Section and a Legal Services Section. The Change Control Section is responsible for monitoring and authorising all change requests above a specified value. The Legal Services Section is responsible for the issue and administration of all contracts with the external parties that form part of the project team.

There is no external consultant project manager and you are solely responsible for managing and controlling all the external parties contracted by your company. You will be able to employ a Liaison to assist you in communicating and administrating external parties. All external communications, instructions, etc. are relayed via the TravelWell Interface Department, under which your Liaison will locate. TravelWell has appointed two specialist consultants to support the StaffCure2020 project. Healthy World is responsible for coordinating special needs assisted travel with airline carriers and Maximal Health & Safety (MHS) is responsible for assessing legal and professional health risks with surgery clinics in destination countries.

The operations will be carried out by a specialist contractor called Health Support Systems (HSS), who is appointed under a standard form of contract. HSS has subcontracted parts of the work to two domestic subcontractors called Personal Care and Timely Manner.

The client corporation has stipulated that parts of the care work for the employees must be carried out by nominated subcontractors called US Health Corp and Hospitality Experts. In addition, the client has stipulated two specialist nominated suppliers for medicines and paramedical equipment called Medic Supplies and PME Systems.
All surgery clinics are inspected, assured and certified by the American Foreign Medical Advisory (AFMA) before they can treat clients.

Question 1                Maximum Word Count 1125 words

  • Describe the likely arrangement of internal and external contractual, authority and (formal and informal) communication links in the project and explain its

(15 marks)
There is no single answer to this question and the description can vary considerably depending on student assumptions.
Internal arrangement and hierarchy in TravelWell should include the Project Manager, their superior (Director of Americas), internal departments, functions and managers, senior management (including the sponsor and executive board), change and legal sections, and the interface department (with the Liaison). There should be a surrounding suitable organisational boundary. The Interface should be shown on the organisational boundary and all external linkages should route through it.

External authority will be radiated from the Project Manager, through the Interface Department. There should be authority radiated from the client organisation to TravelWell.

Contracts will be radiated from the Legal Services Section.

There will be a standard form of contract with the client corporation.

There will be a professional services contract with Maximal Health & Safety. There will be a standard form of contract with Health Support Systems, as they are the main operating contractor. HSS will have a domestic standard subcontract with Personal Care and Timely Manner. There will be tripartite nominated subcontracting contracts between TravelWell, the client and US Health Corp and with Hospitality Experts. In addition, there will be tripartite nominated supply contracts between TravelWell, the client and Medic Supplies and with PME Systems. Inspections by American Foreign Medical Advisory (AFMA), will be based on a statutory inspection permit.

In general, internal communication will follow the organisational hierarchy, while specific communication channels will be established for the project team, managed as a matrix structure.

The formal communication links will include contract documents, drawings, specifications, schedules, etc., together with letters, instructions, emails and so on.

The informal communication links will not be part of the formal operating arrangement and could be various verbal and written means.

There will be a formal communication link between the Project Manager and the Director of Americas. This has high importance, as the latter is located in the US and should be updated in more detail. The Sponsor (Executive Vice-President for

Marketing) will maintain a formal communication link with the Project Manager and the Executive Board. The Project Manager will establish formal communication links with relevant functions that form the project team. The Project Manager and the Liaison will maintain both formal and informal communications as they work closely together. The internal formal communication will include the Legal Services Section and the Change Control Section in order to control and maintain contracts and change requests. The Liaison and the TravelWell Interface Department will manage the external communication for the Project Manager.

There will be communication links with the two appointed consultants, the main contractor and the nominated consultants and subcontractors. It is an option to establish informal communications with the domestic subcontractors in case this contributes to the project control.

There will be a communication link between Maximal Health & Safety and the AFMA that authorises clinics, for making the clinics aware of the inspection and certification criteria. This channel will also be shared through the Liaison with the Project Manager.

It can be assumed that there is no formal communication between the Project Manager and the client and that the Director of Americas is the focal point in case of need. Other informal communication could be established according to needs and personal preferences.

  • Discuss the concept of Project Include a summary of the likely main duties and responsibilities of the project sponsor and make clear his or her likely level of responsibility relative to the other most powerful individuals involved in the project.

(10 marks)
The sponsor introduces the project to the rest of the organisation and associates himself or herself with it. This gives the project additional status and kudos within the organisation and makes it more likely to be respected by the functional divisions. In addition, the project sponsor ensures that the functional managers and project manager operate together and that the common good of the organisation and the overall strategic objectives are remembered and maintained. Without this role, the functional managers might act to curtail the effectiveness of the project manager.

The project sponsor is likely to be a senior manager and/or a member of the board. To work effectively he or she has to have authority over both the functional managers and the project manager. He or she has to be able to adjudicate and have the final say in any conflict between the project manager and any of the functional managers.

The project sponsor ensures that project and strategic goals remain aligned. It is a very common problem area when project teams become fully focused on the project and concentrate primarily on project goals, disregarding the strategic goals.

In many cases, projects are set up to enable strategic goals to be realised. Project managers sometimes forget this and find themselves detached from strategic goals. The project sponsor ensures that all project managers continue to pull in the right strategic direction.

The project sponsor is often a type of programme manager and, as such, may be responsible for running a series of different projects, each managed by a different project manager. The project sponsor, therefore, has a wider view than any individual project manager has and may have access to financial reserves across a number of different projects that he or she can switch around as needs develop on individual projects. The project sponsor may also have access to large-scale strategic reserves should an exceptional need arise.

Question 2                Maximum Word Count 1125 words
Refer to Table 1. This table shows normal durations and costs and crash durations and costs for the activities involved in one of the new project work elements.

Table 1 – Activity normal and crash durations and costs for the package
Note: The crash duration represents the minimum duration where an activity is speeded up as much as possible. The crash cost represents the increased cost of the activity after it has been speeded up as much as possible.

Note: Where the normal duration and crash duration are the same this activity cannot be crashed.

Activity Normal duration
Crash duration (weeks) Normal cost (£) Crash cost (£)
A–B 6 5 10,000 20,000
A–C 8 6 60,000 120,000
A–D 2 1 5,000 10,000
B–F 3 2 100,000 120,000
B–I 3 2 500,000 600,000
C–E 4 3 100,000 120,000
D–H 3 2 50,000 60,000
E–G 3 2 100,000 500,000
E–H 6 5 400,000 440,000
F–M 2 2 10,000 10,000
G–J 2 2 20,000 20,000
H–K 10 8 100,000 220,000
H–L 3 2 250,000 300,000
I–M 2 1 400,000 500,000
J–M 6 5 80,000 180,000
K–L 4 3 50,000 100,000
L–M 8 6 10,000 30,000
  • Draw a network for the work element, showing the activities, critical path and package duration. Explain your

(5 marks)
The network should look something like the one show below. The critical path is shown in bold. The critical path runs A–C (8 weeks), C–E (4 weeks), E–H (6 weeks), H–K (10 weeks), K–L (4 weeks) and L–M (8 weeks). The package duration is 40 weeks.

  • Due to the client’s pressure, your sponsor has ordered the works to be completed within 31 weeks. Calculate the most cost-effective way of completing the package in this time, giving the cost increase associated with this crash Explain your calculations.

(10 marks)
The calculation is as follows:

Activity Normal duration (weeks) Crash duration (weeks) Normal cost (£) Crash cost (£) Cost of crashing (£) Crash cost per unit time
Crash sequence
A–B 6 5 10,000 20,000
A–C 8 6 60,000 120,000 60,000 30,000 3
A–D 2 1 5,000 10,000
B–F 3 2 100,000 120,000
B–I 3 2 500,000 600,000
C–E 4 3 100,000 120,000 20,000 20,000 2
D–H 3 2 50,000 60,000
E–G 3 2 100,000 500,000
E–H 6 5 400,000 440,000 40,000 40,000 4
F–M 2 2 10,000 10,000
G–J 2 2 20,000 20,000
H–K 10 8 100,000 220,000 120,000 60,000 6
H–L 3 2 250,000 300,000
I–M 2 1 400,000 500,000
J–M 6 5 80,000 180,000
K–L 4 3 50,000 100,000 50,000 50,000 5
L–M 8 6 10,000 30,000 20,000 10,000 1

The crash calculation is as follows:

Activity Time saved Package
Cost of
cost of crash
0 40 0 0
L–M 2 38 20,000 20,000
C–E 1 37 20,000 40,000
A–C 2 35 60,000 100,000
E–H 1 34 40,000 140,000
K–L 1 33 50,000 190,000
H–K 2 31 120,000 310,000

The cheapest sequence is L–M, C–E, A–C, E–H, K–L, H–K. This reduces the project duration to 31 weeks at a cumulative cost increase of £310,000.

  • Discuss the main differences between critical path method (CPM) and programme evaluation and review technique (PERT), and give an example of a typical project where each approach might be appropriate. Make a recommendation and conclusion on which approach should be used in the case of project StaffCure2020.

(10 marks)
The CPM approach is used where the duration of each activity can be estimated with a reasonable degree of accuracy. Examples include work that can be easily broken down into its component elements and/or work that has been done before, so the contractor is familiar with how long it is likely to take. Typical examples include manufacturing and engineering applications such as building car engines.

The PERT approach is used where it is not possible to break down the works and/or where the work has not been done before and/or where the work is of a new or innovative nature. Typical examples include research and development projects and transport systems design.

In the case of project StaffCure2020, it can be assumed that TravelWell has the professional know-how for establishing commercial connections with clinics and other tourist, travel and medical providers in order to present the client with treatment packages for its employees. It means that it can estimate the work packages’ durations with a high degree of certainty. It would be recommended to use the CPM approach, although it is advised to add time ‘buffers’ to handle any delays and other unforeseen risks.

Question 3                Maximum Word Count 1125 words
Table 2. Cases’ output performance for Teams 1, 2, 3 and 4
Note: Table 2 below shows the output figures of four teams which are establishing some of the personal treatment package cases for the corporation’s employees. The figures for the teams cover the first six weeks of the relevant work package. The teams are progressing at a planned rate of 1,000 cases per week per team over a 10-week total period. Each case has an estimated internal cost of £100.

Week Team Number of cases
Actual costs
1 1 1,000 100,000
2 900 100,000
3 1,100 100,000
4 1,000 110,000
2 1 2,000 200,000
2 1,800 200,000
3 2,100 200,000
4 2,000 210,000
3 1 3,000 300,000
2 2,700 310,000
3 3,200 310,000
4 3,000 320,000
4 1 4,000 400,000
2 3,600 400,000
3 4,300 420,000
4 4,000 430,000
5 1 5,000 500,000
2 4,500 520,000
3 5,300 520,000
4 5,000 540,000
6 1 6,000 600,000
2 4,600 610,000
3 6,100 600,000
4 6,000 650,000
  • Comment on the performance of each team and on the performance of the work package as a whole over the six-week Include a forecast of the likely end performance of each team based on performance at week 6. Detail your assumptions and calculations.

(10 marks)
Team 1 is consistently on programme and on cost. If Team 1 continues like this, it will finish on time and on cost.

Team 2 is consistently behind on programme and over cost and the performance of the team appears to be deteriorating over time. If Team 2 continues like this, it will finish late and over cost.

Team 3 is consistently ahead of programme and under cost. If it continues like this, Team 3 will finish early and under cost.

Team 4 is consistently on programme and over cost. If it continues like this, Team 4 will finish on programme and over cost.

The project as a whole starts off more or less on programme, but over cost. As it continues, the project is falling further and further behind programme and heading more and more over cost.

  • Calculate estimate at completion (EAC) and indicate likely eventual overspend/underspend for Team 1 at week 2, Team 3 at week 4 and for the package as a whole at weeks 4 and Show your calculations.

(5 marks) BAC (team) = 1,000 units per week × 10 weeks × £100 per unit = £1,000,000 BAC (package) = £1,000,000 per team × 4 teams = £4,000,000
EAC (Team 1 week 2) = (200,000/200,000) × 1,000,000 = 1,000,000
Forecast underspend = £1,000,000 – 1,000,000 = £0 (break even)

EAC (Team 3 week 4) = (420,000/430,000) × 1,000,000 = 976,744
Forecast underspend = £1,000,0000 – 976,744 = £23,256 (underspend)

EAC (package week 4) = (1,650,000/1,590,000) × 4,000,000 = 4,150,943 =
£150,943 (overspend)

EAC (package week 6) = (2,460,000/2,270,000) × 4,000,000 = 4,334,802 =
£334,802 (overspend)

The performance of the package as a whole has deteriorated significantly between weeks 4 and 6.

  • As the project manager, you are expected to exert proper control over any additional works costs. Discuss and demonstrate the use of the cost account code (CAC) concept in the context of the case study and how it may assist you in managing project StaffCure2020.

(10 marks)
The cost plan for the project works might recognise a number of different elements and sub-elements of measured works based on the work breakdown structure (WBS). Those individual cost elements can be grouped and controlled in terms of cost, based on their nature or function. Each piece of work has its own cost account code (CAC). Codes usually consist of numeric characters with an account title. Cost coding is used to facilitate easy classification of costs. For example, in the case of the StaffCure2020 project, costs related to ambulance hire might be classified under travel expenses with a cost code of 001. The overall CAC for travel is 1300. Therefore, the ambulance rental would be coded as 1300.001.

This way, a cost limit for each group of CACs can be established and would also have a projection of when expenditure should start and finish in each case. These would thus be used as a navigation line for expenditure for all travel expenses (CAC 1300) that would represent the sum of the subtotals for CACs 1300.001, 1300.002 and 1300.003 and so on.

Once the activity has been authorised and performed, it is implemented in the accounting system and costs are incurred. This way, the budgeted (planned) work can be compared with the actual (performed) work, in cost terms. This can be illustrated thus:

Question 4                Maximum Word Count 1125 words

  • Discuss likely main components of the risk management system you will use for the StaffCure2020 Give examples of the function of each component based on the case study.

(15 marks)
Most risk management system designs are based on ISO 31000:2012 and it is reasonable to assume student answers will contain the main elements referred to in this standard. While a range of different formats and components may be acceptable, the answer should be based on the general headings put forward in this standard. The main elements are as follows.

  • Risk strategy. The operational philosophy for the system and the confirmation of the risk management strategy that is applicable. The risks related to health and well-being of people require TravelWell to take a comprehensive approach towards risk management. It will be subject to regulatory inspection and the tourists will be treated in specialist surgery clinics that should constantly be assessed for
  • Risk identification. The system needs to be able to identify all of the relevant risks facing the project. Typical tools include brainstorming techniques, such as the Delphi Technique and Nominal Group Technique. Other alternatives include SWOT and PEST analyses. Other valid alternatives could be put forward. The outcome has to be a listing of all the risks in the profile covering all levels. In some cases, it may also be necessary to determine all relevant risk interdependencies. In the case study, the company can employ specialist risk consultants to advise on medical, travel and general tourism-related risks around the
  • Risk classification and risk analysis. These may be regarded as two separate processes or may be combined as a single process. Risks are analysed in detail and classified, with the most common classification system using likelihood of occurrence and impact. Other classification systems may be acceptable. Once classified, risks have to be re-analysed as they change over time. In the case study, the clinics would probably be high impact–high
  • Risk attitude. Typical attitudes include risk-averse, risk-neutral and risk- seeking. The decision maker uses a combination of approaches. The appropriate attitude in the case depends on the organisation or individual considered and the type of decision. TravelWell would probably be very risk- averse in terms of safety and reliability and more risk-neutral in terms of travel arrangements with
  • Risk response. Typical response options include accept the risk, transfer it, mitigate it, ignore it, etc. The answer should make clear the range of response options, and a combination of different responses may be appropriate. In most cases, there will be an element of residual risk left over after any form of

treatment and this is accepted by the individual or organisation making the decision. It is usually not practicable or desirable to eliminate all risk. For example, a valid response for unexpected cost increase of treatments could be the allocation of reserves, contingencies and insurance against currency fluctuation, while enhancing monitoring and control of operational cost deviations.

  • Long-term monitoring and control. There is always a requirement for long- term monitoring and control as risk profiles change over time, as does the sensitivity and exposure of the organisation. It can be dangerous for an organisation if senior managers think they have a reliable risk management system in place when in fact the system is not. In some cases, this can be worse than having no system at all, as it generates a false sense of

The answer should stress how these elements work together as part of the overall system. A risk management system is rather like a chain in that it depends on each element equally. If any single element is neglected or fails, the entire system fails.

  • You have been asked to present the board members with a report detailing why you were chosen for the position of project manager. Discuss the characteristics of an effective project manager and what ‘soft’ skills they should

(10 marks)
The project manager is the most effective (in terms of qualifications and characteristics) person, capable of achieving the target of a specific project.
He or she is expected to have a detailed understanding and awareness of both the technical aspects and the human aspects. An effective project manager must do:

  • Planning
  • Controlling
  • Leading
  • Directing
  • Authorising
  • Negotiating
  • Persuading
  • Organising
  • Team-building
  • Adapting

The classic characteristics of a project impose special demands that require a highly structured but flexible approach on the part of the project manager. In addition to technical and business skills, the project manager has to acquire personal, managerial and leadership skills, such as:

  • Flexibility and adaptability. Be able to modify his or her approach as the project team evolves and as the technical aspects of the project develop through the project life cycle.
  • Multi-tasking. Be able to appreciate and balance multiple specialisations and points of view at the same time and, somehow, try to develop a workable consensus.
  • Be able to see how things are developing and respond quickly and reliably, developing innovative solutions as required.
  • Communication, negotiation and persuasion. Use effective communication to deal with the multidisciplinary nature of the project team and the high levels of change. Use negotiation and persuasion to drive stakeholders and compensate for lack of
  • Organisational problem-solving. Overcome problems of complex structures and contractual, authority and communication
  • Decision making. Be decisive. There is no time for prevarication. Any delay in arriving at a decision can have damaging
  • Diplomatic and political. Be able to balance the needs and objectives of the project with those of the organisation as a whole. Have well-developed political awareness to operate and make alliances in a complex environment where the project’s status within the organisation as a whole may vary significantly over time, and be able to negotiate for resources in variable conditions while having limited power and

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