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PAPERS
Pluralism in PMO Performance: The
Case of a PMO Dedicated to a Major
Organizational Transformation
Monique Aubry, School of Business and Management, University of Quebec at Montreal,
Montreal, Quebec, Canada
Marie-Claire Richer, McGill University Health Center, Montreal, Quebec, Canada
Mélanie Lavoie-Tremblay, School of Nursing, McGill University, Montreal, Quebec, Canada
Guylaine Cyr, School of Nursing, McGill University, Montreal, Quebec, Canada

ABSTRACT ■ INTRODUCTION ■
n the recent years, interesting academic research has been done on the
The focus of this article is on the contribution
made by the project management office (PMO)
to organizational performance. It explores the
particular case of a PMO dedicated to a major
organizational transformation within a Canadian
university hospital. The national government
I theme of project management offices (PMOs). Most of this research was
focused on PMO characteristics and functions (Hobbs & Aubry, 2007),
structure (Aubry, Hobbs, & Thuillier, 2007; L. H. Crawford, 2010), per-
formance (Aubry & Hobbs, 2011; Dai & Wells, 2004), and transformation
(Aubry, Müller, Hobbs, & Blomquist, 2010; Hurt & Thomas, 2009; Pellegrinelli &
Garagna, 2009). Major results from research reveal (1) a wide variation
has asked hospitals to provide strict control
between PMOs and their resulting performance and (2) the difficulty of
over their budgets through implementing strong
explaining this variation based on the usual contingency approaches includ-
governance mechanisms. How can PMO per-
ing region, industry, public/private, etc. An important trend in current PMO
formance be assessed within this context?
research involves discussions on PMOs evolving organizational entities
Perception of two different groups has been
within a sustainability paradigm or as an emptying process. There are multi-
analyzed within a competing values framework,
ple reasons for transformation and no clear patterns have emerged.
allowing for a combination of four different per-
Very little research has been done to shed light on PMOs dedicated to
formance conceptions. Results show certain
organizational change, except for that put forward in two articles:
similarities in the barriers to PMO performance
L. Crawford (2004) addresses the PMO as an instance for developing project
but, most importantly, they reveal that between
management dynamic capabilities, and Winch, Meunier, and Head (2010)
the two groups a paradox exists regarding what
present the PMO as both the subject and object of change. From this per-
is valued in PMO performance. Results bring
spective, PMOs are not just a matter of organizational structure but are put
empirical evidence of the application of the
into place to more or less accompany organizational changes leading toward
competing values framework to the health care
strategic objectives.
sector, but also to a wide variety of industries,
In parallel, the PMO’s contribution to organizational performance is
public or private.
a continuous quest. Unsatisfactory PMO performance is often linked to a
short life span. It may explain the reason for its frequent dismantling
KEYWORDS: performance; competing val-
and reorganizing, as suggested in the emptying process from Pellegrinelli and
ues framework; project management office;
Garagna (2009), or perhaps to explain their value creation through evolution,
health care; organizational transformation
such as in the sustainability case proposed by Hurt and Thomas (2009). As
seen in the literature, a PMO’s performance undoubtedly makes a direct
contribution to the organization’s return on investment (ROI) (Kendall &
Rollins, 2003). Thomas and Mullaly (2008) have convincingly shown that it is
quite impossible to calculate any direct relationship between project man-
agement implementation and ROI.
Project Management Journal, Vol. 42, No. 6, 60–77 This is particularly true in the public sector, where strategic objectives
© 2011 by the Project Management Institute are not expressed in terms of profit and value to shareholders as in the pri-
Published online in Wiley Online Library vate sector, but rather in terms of user satisfaction and value for a wide range
(wileyonlinelibrary.com). DOI: 10.1002/pmj.20269 of stakeholders, including politicians. The health care sector constitutes a

60 December 2011 ■ Project Management Journal ■ DOI: 10.1002/pmj

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good example for exploring the multi-
ple facets of a PMO’s contribution to
organizational performance. As an
example, projects serve different inter-
ests of cutting on costs on the one hand
and delivering quality care to the
patient population on the other hand.
The former reflects the objective of
finances, while the latter translates the
goal of health care professionals. Can
performance in this sector be expressed
in terms of ROI or in terms of added
value for the patients and for the care
system?
In Western countries, common
sense holds that that investment in
health care systems should represent a
huge portion of national budgets. Yet,
within these health care systems, com-
mon causes of stress cited often include
aging populations and shortages of
health care human resources, among
others (Quality Worklife Quality Health-
Care Collaborative, 2007). Services cur-
rently being offered in older hospital
buildings have been available across
several decades, yet they suffer from
underinvestment. Implementation of
new technologies and processes often
involves many structural difficulties.
This is also true for university hospitals
where recent rationalization of health
care costs has required major invest-
ments in systems renewal. This global
situation results in a proliferation of
major projects in the health care sector.
In their research on PMOs, Hobbs and
Aubry (2007) found that 36% of the 500
PMOs they sampled were from the pub-
lic sector (versus private), while only 5%
were from the health sector. Within this
sector, a quest is currently under way
to learn more about the best practices
in this specific domain of project man-
agement.
This article presents the results of
explorative research on the health care
sector within a Canadian university
hospital. This multisite health care cen-
ter received major investments that will
involve the relocation and reorganiza-
tion of its six hospital sites into only
three: a new mega-hospital and two
major renovations to existing sites. This
project is thus a major organizational
transformation. A Transition Support
Office (TSO) has been created, and its
mandate is to provide leadership, guid-
ance, and support to key players (man-
agers, clinicians, and their teams)
throughout the various phases of the
redevelopment projects, where the objec-
tive is to successfully maintain and/or
optimize care and service deliveries.
While this TSO falls under the defi-
nition of a PMO, specific governance
mechanisms have been put into place
to tightly monitor and control the over-
all project. A specific request was thus
made to demonstrate that the PMO
should contribute to the global project’s
ROI. Given that the TSO management
team has had certain doubts on how
this specific ROI contribution should be
calculated, it was decided to undertake
an alternative approach to perfor-
mance within this research project to
target their managerial contribution
to the project performance role.
This article is part of a nursing
research program in which the objec-
tive is to assess the PMO’s contribution
to the success of a major organizational
transformation. This article focuses on
the first phase of the research related to
experimentation using a performance
model. Based on what has been men-
tioned previously, the research ques-
tion is: “How does one assess the PMO’s
contribution to organizational per-
formance within the context of organi-
zational transformation?”
An interesting outcome of this
research is the recursive knowledge
transfer between the worlds of project
management and health care. The proj-
ect management field contributed
knowledge on managing multiple proj-
ects, PMOs, and performance models,
among others. These contributions are
in line with what was expected from the
health care research team. From anoth-
er perspective, however, the health care
research team’s management approach
contributed a great deal of knowledge
regarding PMOs within organizational
December 2011 ■ Project Management Journal ■ DOI: 10.1002/pmj
transformation situations. Together,
their work consisted of a dynamic learn-
ing mechanism that directly helped the
PMO management team to reach better
performance results.
The article is structured as follows:
(1) the next section includes a literature
review covering three complementary
topics and should provide a better
understanding of previous research
work, and also introduces the theoreti-
cal framework; (2) the methodology is
presented in the third section and
includes details on this research quali-
tative approach; (3) the case study is
described in the fourth section; (4) the
major findings are presented in the fifth
section; and (5) the final section
includes discussions and conclusions.
Literature Review
Health care has been identified as a
complex adaptive system (Begun,
Zimmerman, & Dooley, 2003; Plesk &
Greenhalgh, 2001). Plesk and Greenhalgh
(2001) define it as: “[. . .] a collection of
individual agents with freedom to act in
ways that are not always totally pre-
dictable, and whose actions are inter-
connected so that one agent’s actions
changes the context for other agents”
(p. 615). Health care can also be defined
as pluralistic organizations (Denis,
Lamothe, & Langley, 2001) because it
involves divergent objectives, including
the care of individual patients and a
specific patient population in a cost-
controlled environment, where the
interplay between multiple actors
involves health care professionals,
managers, and community groups
linked together in ambiguous power
relationships. The health care sector
has also been explored as a field charac-
terized by innovation (e.g., Schroeder,
Van de Ven, Scudder, & Polley, 1986), as
well as organizational change (e.g.,
Denis et al., 2001).
The literature review for this specif-
ic research question includes three com-
plementary components including (1)
project management in the health care
sector, (2) PMOs, and (3) performance.
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PAPERS
Project Management in Health Care
Sector
In the health care sector, project man-
agement practices are generally rela-
tively new. The number of articles on
the health care sector published in aca-
demic journals specializing in project
management should serve as a good
indicator. From the 22 articles found in
the three major journals in the field, 14
were published since 2007. Most of
these research articles considered
health care as a specific case within the
public sector, under a more general
research issue such as in portfolio man-
agement (Jonas, 2010) or as private-
public partnerships under construction
projects (Tang, Shen, & Cheng, 2010).
A large number of these articles deal
with the ethical or human aspects of
project management in the health care
field. This is not surprising, given that
in this particular sector major issues
concern patients and medical person-
nel. Suhonen and Paasivaara (2010)
provided an extensive literature review
on human capital, arguing that this
topic is of prime importance to project
delivery in the health care sector.
While it may appear there were no
projects in this sector, the opposite is in
fact true. Medical technology innova-
tions have been continuously imple-
mented in various medical specialties
(e.g., Schroeder et al., 1986), while
information systems (IS) and informa-
tion technology (IT) were also largely
implemented in health care centers (for
example, the national personal health
records).
A search of published research with-
in medical databases (e.g., PubMed),
using keywords such as project man-
agement will return thousands of hits.
Yet a detailed look at these references
reveals that the articles do not address
project management issues as intended
here. In medical science, for example,
the objective is the management of
pain, sickness, medication, and the like.
Thus, the concept of “project manage-
ment” takes on different meanings in
the two fields of health care and project
62 December 2011 ■ Project Management Journal ■ DOI: 10.1002/pmj
management. This point could be an
important consideration in any effort to
avoid confusion, especially when the
time comes to introduce project man-
agement practices within the health
care field. As such, the literature review
does not include any research from the
medical databases specifically dealing
with project management in the sense
that is being used in this article.
Not only are technological projects
being undertaken in health care organi-
zations, but there are also clinical projects
that specifically target the standardiza-
tion of practice or service improve-
ments. Effective project management
in the health care system allows organi-
zations to develop new clinical services,
solve problems related to operations,
reduce spending, and finally develop a
management approach oriented toward
clients (McLaughlin & Hays, 2008). In
health care, as in any other sector,
adopting and disseminating project
management best practices, assigning
project priority, monitoring and con-
trolling multiple projects, and sharing
lessons learned at the closure of a proj-
ect are elements that can greatly con-
tribute to the success of a project.
A PMO would thus allow the coordi-
nation of efforts from different depart-
ments, including standardization of
project management and change man-
agement or process review practices.
When faced with a changing external
environment, any organization wishing
to survive should also be continuously
readapting its internal environment
(strategy, structure, culture), and from
the organizational perspective, this
requires flexibility and constant reposi-
tioning (Winch et al., 2010).
The health care sector also faces a
turbulent environment. Particularly,
the costs of medical services never stop
increasing, and in order to provide
access to a greater number of people, it
needs to secure better control over
costs (Schlichter & Thomas, 2009).
Within this context of cost cutting and
providing innovative services of good
quality, project management takes on
much more importance. The research
on PMO performance in terms of cost
reduction has not yet provided any
empirical foundation (Dai & Wells,
2004; Kwak & Ibbs, 2000; Thomas &
Mullaly, 2008). As suggested by Dai and
Wells (2004), however, it has been
assumed that a PMO would lead to bet-
ter project performance results within
an organization (cost and time reduc-
tions, and the best quality). This
assumption should hopefully lead to
more applications in the health care
sector and thus help in cost reduction.
In general, the services offered in
health care organizations correspond
to project characteristics (Sa Couto,
2008). Given that clinical services are
unique and temporary and provided
within very specific phases, Sa Couto
(2008) highlighted that these three
characteristics are often used to
define a project. Yet, a medical service
always has a start and an end, the
service is as unique as each patient is
particular, and finally, from medical
diagnosis up to the treatment execu-
tion, the service is executed in distinct
steps (Sa Couto, 2008). Schlichter and
Thomas (2009) are convinced that
competitiveness between organiza-
tions offering health care services will
be determined by their capacity
to undertake the right projects and to
properly manage them. The structural
contexts of these various organiza-
tions could engender conflicts
between the different stakeholders
(doctors, pharmaceutical companies,
medical material manufacturers, etc.).
While these tensions between stake-
holders do not apply uniquely to the
health care sector, the inherent power
system takes a particular turn in pro-
fessional organizations where general
management has to face well-structured
and powerful professional organiza-
tions. In such cases, PMOs are expect-
ed to contribute more transparency
and equilibrium to the project selec-
tion and prioritization processes, and
more generally to the management of
projects.
60-77PMJ0411.qxd 11/4/11 8:02 AM Page 63
Defining PMO This is in line with the PMO descrip-
Research on PMOs confirms the variety tive model proposed by Hobbs and
of mandate, structure, roles, and the like Aubry (2010a). Their model is empirically
(Hobbs & Aubry, 2007). While the search validated, as it is based upon a sample of
for typology has naturally taken place, more than 500 unique PMO descriptions.
deductions based on statistical analyses They suggested representing a PMO in a
have not supported their functional model consisting of four classes of data
speciality (i.e., strategic, tactical, or (see Figure 1). From this model, the PMO
operational PMO) or their degree of is anchored in the internal organizational
centralization (Hobbs & Aubry, 2008). context; one that plays a role in the over-
However, PMO typologies exist based all organizational project management
upon an intuitive practical approach on approach, and should be taken into con-
which most of the current PMO models sideration by PMOs (e.g., Engwall, 2003;
in the professional literature are based Pellegrinelli, Partington, Hemingway,
(K. J. Crawford, 2002; Dinsmore, 1999; Mohdzain, & Shah, 2007). The PMO can
Kendall & Rollins, 2003). In this context, thus be described using two classes of
the best way to describe a PMO, there- data: structural characteristics and roles
fore, is to look back to their basic char- or functions. In this particular PMO
acteristics and how they have evolved. model, performance is resulting from a
This is exactly the point made by L. H. perceived descriptive component.
Crawford (2010) under the provocative This research adopted this PMO
title “Deconstructing the PMO.” This descriptive model but excluded the per-
approach serves also to define with formance component. While this empir-
more precision what is in the construct ical approach to performance provided
of PMO. This refers to a definition by a good starting point, we chose to turn
components, where a term (in this case, to a theoretical based framework in this
PMO) is given in reference to its con- particular research—that is, the compet-
stituent parts or its characteristics (Van ing values framework, which is des-
de Ven, 2007). cribed in the next subsection.
ORGANIZATIONAL CONTEXT
PMO DESCRIPTIVE MODEL
Roles and
Structural
functions of the
characteristics
PMO
Performance of the
PMO (Perceived
performance)
Figure 1: PMO descriptive model after Hobbs and Aubry (2010a).
December 2011 ■ Project Management Journal ■ DOI: 10.1002/pmj
Performance and the Competing
Values Framework
The ultimate outcome expected from
any organizational action is perfor-
mance. In the field of project manage-
ment, intensive research was recently
undertaken to approximate this per-
formance and to determine how it
could be assessed (Thomas & Mullaly,
2008). These authors further state that
this assessment needs to be adapted to
the term value instead of performance
in order to capture the business signifi-
cance of project management process-
es and tools implementation. Their
findings suggest that the search for a
direct impact from project manage-
ment on ROI is quite impossible to
measure. In turn, their most significant
result is that the notion of fit between
the organization and the project man-
agement components play the most
important role when it comes to obtain-
ing value. Given that PMOs form a sub-
stantial component in many of today’s
organizations, we thus suggest in this
research to explore its performance.
There is an assumption in this arti-
cle that organizations are pluralistic
entities (Denis, Langley, & Rouleau,
2007). Following this assumption, the
strategic objectives (as expressed in
terms of organizational performance)
may differ from one department to
the other and from one project to the
other. When considering the coexis-
tence of multiple (and sometimes con-
tradictory) views on organizational
performance, it needs to call upon a
performance approach capable of
capturing these views and offering a
platform that leaves room for dia-
logue. In this pluralist perspective,
Aubry and Hobbs (2011) propose using
the competing values framework to
evaluate a PMO’s contribution to orga-
nizational performance.
The competing values framework
was first developed during a proposal
made by the U.S. government as a means
of assessing the outcomes expected from
their massive investments in the public
sector during the severe recession of the
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Pluralism in PMO Performance
PAPERS
1980s (Cameron, 1981; Quinn &
Rohrbaugh, 1983). This model recog-
nized the coexistence of sets of values
used to underline people’s perception
of organizational performance. It sup-
poses that a dialogical approach can be
used to acknowledge the differences
and make sense of them within a coor-
dinated organizational view. As illus-
trated in Figure 2, the model articulates
around two axes: flexibility/control and
internal/ external focus. Each concep-
tion contains specific criteria. The cen-
tral position is held by a standalone
criterion that holds for output quality.
From in-depth analysis on four case
studies, Aubry and Hobbs (2011) pro-
vided some empirical validation of the
competing values framework’s ability to
capture the pluralistic view regarding
the contribution a PMO could make to
organizational performance. They have
shown that paradoxes existed in those
organizations, based on what was val-
ued regarding the contribution of PMOs
to the organizational performance.
The competing values framework
has a great deal of potential for encour-
aging discussion on PMO performance.
HUMAN RELATIONS
1. Value of human resources
2. Training and development
3. Moral
4. Cohesion
Internal
5. Information quality
6. Processes stability
7. Control
INTERNAL PROCESS
Note. The 17 elements listed are the criteria associated with each conception.
Figure 2: Competing values framework according to Quinn and Rohrbaugh (1983).
64 December 2011 ■ Project Management Journal ■ DOI: 10.1002/pmj
Instead of opting for a single set of cri-
teria and rejecting all other views on
performance, it acknowledges diversity.
This is particularly pertinent in a health
care sector where, as was said previously,
a paradox exists between the govern-
ment’s primary focus on efficiency, pro-
ductivity, cost control, and ROI and that
of all medical personnel who value per-
sonal care.
In conclusion, as evidenced by our
literature review, in the health care sec-
tors of Western countries, there is a
great need to increase project manage-
ment capabilities. This is currently
being done through PMO implementa-
tion, but the remaining challenge is
to evaluate how they can contribute to
organizational performance.
Methodology
This explorative research is designed to
provide an understanding of the PMO
phenomenon within the context of
health care and the various perspectives
on its contribution to organizational
performance. Qualitative approach has
been privileged to reach the research
objective with a single case study. The
Flexibility
OPEN SYSTEM
12. Growth
13. Flexibility/adaptation/innovation
14. Evaluation by external parties
15. Links To external environment
16. Readiness
17. Output quality External
8. Profit
9. Productivity
10. Planning goals
11. Efficiency
RATIONAL GOAL
Control
objective of this research is thus to pro-
vide an in-depth understanding of how
stakeholders dealing with the PMO val-
ued its performance, and we can best
attain this objective by studying a single
case (Yin, 1989). Other phases of this
research will help resolve any limitations
linked to this single-case approach.
This qualitative exploratory re-
search was conducted in a university
multisite health care center in the
province of Quebec, Canada. The par-
ticular interest in this case is that the
PMO’s implementation took place con-
currently with this research, thus allow-
ing us to observe organizational
changes unfolding as the research was
progressing. This provided rich data
with fresh elements to nourish the
research, although certain respondents
may not have had time to reflect upon
certain elements and put them in per-
spective (Van de Ven, 2007).
Data were mostly provided through
semistructured interviews and comple-
mentary documents obtained from the
respondents. The interviews were con-
ducted with two groups of respondents:
TSO members and executive board
partners, two groups deliberately cho-
sen (Patton, 2002) to provide potential-
ly paradoxical positions regarding the
TSO. Although members working
within the TSO provided a rich internal
perspective, it may have contained a
positive bias (which we will take into
account during data analysis). On the
other hand, the executive board part-
ners represent the organizational man-
agement team and, as such, provide an
external perspective on the TSO. At the
time of our interviews, this board had
been implemented for a period of one
year.
All interviewees were asked to par-
ticipate in this research on a voluntary
basis, although approval was obtained
from the organization’s ethical review
board. The TSO members met the
researchers during their team meeting
and the research study was explained to
them. A parallel approach was followed
for the executive board partners who
60-77PMJ0411.qxd 11/4/11 8:02 AM
met with the researchers during their
monthly meeting. Following the meet-
ing in each group, the research team
sent an e-mail to each member and
partner with the consent form attached,
inviting them to participate in an indi-
vidual interview. Members and part-
ners interested in volunteering for an
interview were invited to contact the
researcher and select a time for the inter-
view. The researcher then verbally
explained the study to each participant,
while also obtaining written informed
consent from them. To protect confi-
dentiality and anonymity, each partici-
pant was assigned a code for research
purposes (for demographic details on
the interviewees, see Table 1).
An interview guide served as the
data-collection tool for the interviews.
The main themes addressed were: TSO
description, TSO implementation con-
text, and its TSO impact. A sociodemo-
graphic profile was recorded at the start
of each interview. The interviews lasted
an average of 45 minutes and were
conducted by a researcher in a private
location within the organization. All
interviews were recorded with the
interviewee’s permission. They were
then transcribed to a text format.
Characteristics
Interviewees:
Number
Percentage of participation
Gender:
Female
Male
Mean age:
Education degree:
Undergraduate
Master’s
Doctorate
Job status:
Full-time
Part-time
Table 1: Interviewee profile.
Page 65
The data generated by the interviews
were analyzed using NVivo (QSR
International Pty Ltd., 2006), the method
suggested by Miles and Huberman (1994).
According to this method, data analysis
was divided into three concurrent streams
of activities: condensing the data (coding of
individual interview data to identify major
themes and categories), presenting the
data (data display based on themes from
all interviews), and elaborating/verifying
the data. Two researchers coded the tran-
scripts independently, based on a set of
data intended to ensure consensus, and
then met regularly to discuss data analysis
and interpretation. The common themes
that emerged from all of the interviews
were then combined.
Description of Case Study
Based on recent project management
research, a common finding was that
the context must be taken into account
when researching quite complex organi-
zational phenomena (Müller, Martinsuo, &
Blomquist, 2008; Pellegrinelli et al., 2007).
This is in line with the epistemological
position on critical realism, which
diverges from the positivist approach
involving the “one-size-fits-all” concept
(Van de Ven, 2007).
Transition Support Executive
Office Members Board Partners
11 11
100% 69%
10 9 hopefully ensure more autonomy in
1 2
41 54
2 3
7 6
2 2
7 11
4 0
December 2011 ■ Project Management Journal ■ DOI: 10.1002/pmj
General Health Care Context
The health care system in Canada is a
publicly funded service and is widely
considered to be one of the best social
care systems in the world. Health care
management falls under provincial
responsibility, and in Quebec it repre-
sents 45% of the total government
budget (Gouvernement du Québec,
2010a, 2010b). Currently in many
Western countries, several factors have
contributed to a phenomenal increase
in the need for health services and
health budgets. Major investments are
therefore being made in health systems
to generally modernize their services,
with a clear objective of increasing effi-
ciency. This article is concerned with
neither global budget control strategies
in the health care sector nor with pro-
viding a prospective view on it. Rather,
the objective is to focus on current
investments and thus understand how
a large university hospital organization
can meet the challenge of enhancing
its efficiency and thus providing
high-level health care services to the
population.
The health care environment is gen-
erally recognized as a complex system,
while in Quebec, in particular, a strong
period of financial and professional
resources rationalization began in 2003.
This contributed to an overall reorgani-
zation of clinical services and practices
within its health care system and result-
ed in three layers of health care manage-
ment being created: ministry, regional,
and local. University health care centers
were linked to the local level but were
also given special status that would
their operational management. The case
study presented in this article involves a
major investment from the ministry
level for the construction of a new uni-
versity health care center.
At the ministry level in Quebec,
strong project governance mechanisms
have been put in place, targeting tighter
and more secure control over both
project costs and benefits. Given these
circumstances, a strong push is being
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made not only to deliver good project
management performance (schedule,
cost, and scope), but also to provide
indicators that illustrate the project’s
positive financial outcome. This type of
monitoring should also ensure a better
return on investment for the project.
Case Study Context
This multisite health care center is one
of the most complex university-affiliated
centers in North America. For this rede-
velopment project, the health ministry
mandated the implementation of a
“clinical plan” increasing the focus on
this ultra-specialized care mission and
transferring less specialized activity to
the health care network. This project
thus extends well beyond the dimen-
sions of a typical brick-and-mortar
project. Instead, the main concern is
harmonization and optimization of
clinical and administrative practices,
based on a best-practice method, and
which will also foster the integration
of education and research, as well as
the strategic use of technology and
information. It was therefore clear to
the top-level management team that
this project was to be one character-
ized by major organizational transfor-
mations.
Given the extent of the task, certain
members of top management were
convinced that such a project would
have a major impact on the organiza-
tion’s 14,000 employees and physicians.
They envisioned a major multiphase
reorganization of care delivery along
with a physical move. In other words, it
has the mandate to successfully main-
tain and/or optimize the delivery of
both care and services.
Transition Support Office Description
The TSO was first implemented in 2008,
and its mission can be summarized
under three major points:
1. To accompany the major partici-
pants in the general coordination of
the organizational transition in order
to increase and ensure patient care
and service continuity during the
66 December 2011 ■ Project Management Journal ■ DOI: 10.1002/pmj
redevelopment project’s various
phases;
2. To offer support to managers in
terms of project management and
change management approaches
and methodology in order to ensure
an optimal use of resources and
expertise during the various transi-
tion projects; and
3. Create and maintain a culture that
will encourage learning and innova-
tion relative to the transition toward
the new health care center.
It has been recognized from the
beginning that certain organizational
conditions should be in place if a suc-
cessful transition is to be ensured:
• At the strategic level, top management
needs to ensure the alignment and
coordination of diverse organizational
initiatives/efforts to achieve common
objectives in line with the organiza-
tional transition requirements and
minimize the impact on patient care.
• At the mission level, clinical leaders
and managers need to identify and set
transition project priorities that will
both address current deficiencies and
promote the creation/adoption of
new/innovative models of care deliv-
ery needed to improve patient care.
• At the employee level, employees need
to be involved and see the added value
of undergoing the changes needed for
the transition (to improve both
patient care and the quality of their
work environment).
In the following subsection, we will
look more deeply at the TSO, based on
the PMO model description.
Transition Support Office as a Project
Management Office
We have already accepted the very gen-
eral PMI definition of a PMO in an effort
to include the current PMO’s diversity
(Project Management Institute, 2008).
The TSO meets this definition through
being directly involved in the manage-
ment of multiple projects and by offering
a range of services to project managers
and also to diverse stakeholders. As such,
the TSO can truly be defined as a PMO.
In the following paragraphs, we
describe the TSO as being based on the
PMO model (see the Literature Review
section). This will provide a better under-
standing of the TSO’s organizational
context, its characteristics, and func-
tions. The detailed analysis of the TSO
components, using the PMO descriptive
model, is presented in Table 2. Only spe-
cific elements of interest are pointed out
in the following items:
Within the organizational context,
the elements below should be high-
lighted:
• Hospitals are “professionalised organ-
izations” as described in Mintzberg’s
organizational configurations (1989).
The major characteristics of this con-
figuration can be associated with the
power of specific groups, such as
physicians in hospitals.
• In the past, project management has
not always been considered as a core
competency. For years, project man-
agement services in this health care
sector were thus provided by multiple
consultant agencies, resulting in a
poor internal level of project manage-
ment maturity. With the TSO, there is a
clear orientation to develop internal
project management skills, and this
can be accomplished by establishing
more positions and by hiring a greater
number of personnel and fewer con-
sultants. The objective is to build
organizational capabilities to address
the sustainability of changes.
• The project’s clients are multiple and
diversified, and when this adds up to
the professionalized configuration,
problems related to processes such as
managing harmonization, tensions,
and conflicts are more likely to occur.
This element requires that project
managers be more skilled in managing
stakeholder relationships.
• The TSO implementation can be char-
acterized by strong top management
supportiveness. From this context, the
TSO has to make the organization
take a major turn.
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Table 2: Detailed comparison between generic PMO descriptive model and TSO description.
Generic Descriptive Model
Data Classes Data Elements
PMO Organizational • Economic sector
Context Context • Public or private
• Size of organization
• Percentage of resources reporting to same
management as the PMO manager or
matrixed throughout organization
• Internal or external project clients
• Single- or multiple-project clients
• Organizational project management maturity level
• Organizational culture support level
Types of • Scope expressed as number of people working
Projects in on project
the PMO • Scope in terms of duration
Mandate • Type of product or service delivered
• PMO project primary performance criteria
• Inclusion of postdelivery activities within
project scope
• Involvement in outsourcing contracts
PMO Structural • Name used to identify PMO
Description Characteristics • Time to implement PMO
• Location within organizational hierarchy
• Relationship(s) with other PMO(s) in
same organization
• PMO staff (other than project/program managers)
• Size expressed as number of people working on
project; this is also a measure of PMO size
• Experience of staff
• Professional background of staff
• Presence of business analysts or business
architects among the staff
• Age of PMO
• Percentage of projects within PMO’s mandate
• Percentage of project managers within PMO
• Decision-making authority of PMO
• Status of project management methodology
• Homegrown or brought in from outside
• Use is compulsory or discretionary
• Degree to which methods are actually followed
• Adequacy of PMO’s funding
• Means of funding, including billing for services
December 2011 ■ Project Management Journal ■ DOI: 10.1002/pmj
Transition Support Office
• Health care
• Public
• 14,000 employees and physicians
• Internal only
• Multiple projects in same area (mission,
hospital, etc., and transversal services)
• Both single- and multiple-project clients
• Project management office relatively new
• Support from upper management
• Projects have different scope and duration—
from 7 months (shorter) to over 2 years
(some will last until the actual move years)
—Service delivered by TSO:
1) project management;
2) change management, process review
(work redesign, service optimization)
3) harmonization of clinical and administrative
practices
4) EIDM (helps making decision on best
possible evidence—clinical or
administrative)
5) Evaluation
• Primary performance: service optimization
(efficiency gains, quality and safety
improvements)
• Evaluation postdelivery done on some
projects (3 to 6 months after completion)
• Outsourcing contracts only for specific
mandates requiring very pointed expertise
(example: modelization and simulation)
• Transition support office
• 6 months to 1 year (strategy and tool
development)
• Reports to CEO
• Works in close collaboration with planning
and construction
• Staff include: project managers, clinical
content experts (EIDM), knowledge brokers,
clinical practice experts, evaluation
consultants, financial analysts (for ROI),
change management experts, process experts
• Professional background: nurses and other
health care professional background, MDs,
engineers, accountants, MBAs
• PMO, 3 years old
• Close to 50% of staff are project managers
• Project management methodology based on
PMBOK and adapted for health care and
transition context
• Compulsory
• Method followed in over 30 projects
• Funded as part of the construction project
(1% of total budget)
• Services not billed
(Continues on next page)
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Table 2: (Continued)
Generic Descriptive Model
Data Classes Data Elements
Roles or 1. Monitor and control project performance
Functions • Report project status to upper management
• Monitor and control project performance
• Develop and maintain project scoreboard
2. Develop and implement standards and
competencies
• Develop and implement a standard
methodology
• Promote project management within
organization
• Develop personnel competency, including
training
• Provide mentoring for project managers
• Provide set of tools without making effort
to standardize
3. Multiproject management
• Coordinate between projects
• Identify, select, and prioritize new projects
• Manage one or more portfolios
• Manage one or more programs
• Allocate resources between projects
4. Strategic management
• Provide advice to upper management
• Participate in strategic planning
• Benefits management
• Network and provide environmental scanning
5. Organizational learning
• Monitor and control PMO performance
• Manage project documentation archives
• Conduct postproject reviews
• Conduct project audits
• Implement and manage database on lessons
learned
• Implement and manage risk database
6. Client interface management
7. Recruit, select, evaluate, and determine
salaries for project managers
8. Execute specialized tasks for project managers
Performance
68 December 2011 ■ Project Management Journal ■ DOI: 10.1002/pmj
Transition Support Office
•Evolution of projects reported to steering
committee comprising higher management
• Time and earned value follow-up for all projects
(currently done for all projects)
• Quality performance indicators follow-up for
each project
• Develop standard tools and methodology
aligning resources within the TSO
• Promote project management due to success
witnessed in completion of transition projects
• Provide training to transition personnel:
examples: PMP, change management, LEAN,
performance management
• Pair new hired project managers with more senior
employee in TSO
• Standardize, review, and improve tools
(continuous improvement cycle)
• Coordinate projects that are within transition
support office
• Prioritize new projects both by clinical leaders—
directors of clinical operations and director of
professional services—and by redevelopment
oversight committee
• Manage more than one portfolio and more than
one program (or mission)
• TSO allocates right resources to right project at
right time
• Reports to CEO
• Links TSO priorities to strategic priorities within
organization
• TSO develops tools that benefit quality and
performance department (for example, ROI tool)
• Evaluate PMO as part of LEAD project
• Track projects on a project tracking system
• Finish each project with a postmortem—lessons
learned and strategies are shared between
project managers during monthly team meetings
• Risk database under development
• Provide director as well as project managers with
access to mission and operational meetings
• Carry out recruitment, salaries, and evaluation
according to institutional standards (recruitment,
incentives, yearly evaluation, bonus, etc.)
N/A
Object of our research
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Quality and
Performance
Evaluation Evaluation
LEGEND:
Hierarchical links
Collaborative links
Figure 3: The TSO chart.
Types of Projects Included in PMO
Mandate
The TSO is dedicated to accompany and
support change. There are basically
three types of projects under its respon-
sibility, as shown in Table 2 (examples
are provided to help in understanding
the types of projects, not to give the full
details of the projects).
Structural Characteristics
The TSO has been positioned at the
organization’s top level, with the TSO
director reporting directly to the hospi-
tal’s executive director. Governance
mechanisms include a steering com-
mittee, accounting to the project’s over-
all results. This committee is formed by
senior managers under the chief execu-
tive officer.
Certain types of expertise encoun-
tered in the TSO are rarely seen within
the PMO context, such as process
experts and knowledge brokers. In light
of the TSO’s mission, these experts play a
crucial role in helping the PMO to meet
its objectives. Knowledge translation and
exchange are therefore central aspects
of the TSO’s responsibilities. The level of
education of PMO members is quite
Page 69
CEO
Transition
Support Office
Director
Project Knowledge
Admin
management transfer
high. Professional certification such
as Project Management Professional
(PMP)® certification and postgraduate
education are valued and encouraged.
Roles and Functions
Figure 3 shows a simplified TSO orga-
nizational chart. In addition to provid-
ing administrative support, the TSO
performs three major functions: proj-
ect management, knowledge transfer,
and evaluation. TSO staff includes
project managers who are responsible
for the direct management of projects.
These three functions from the TSO
chart can be associated with their
equivalent in the PMO model. While
the TSO actually performs almost all
of the functions identified in the PMO
model (see Table 3), it plays a key role
in organizational learning. This func-
tion includes learning mechanisms
related to project management, but
also PMO performance monitoring.
The TSO, with its two dedicated
groups, knowledge transfer and evalua-
tion, reinforces, in a very unique way,
the role of a PMO. The knowledge trans-
fer group is responsible for continuous-
ly scrutinizing literature, identifying the
December 2011 ■ Project Management Journal ■ DOI: 10.1002/pmj
HR
Department
Process Change Manpower
review management planning
best clinical and managerial practices
and then working with the project
teams to implement these new practices.
The TSO ensures that any decisions
made within the context of organiza-
tional changes are built on the best
evidence-based data and that their
implementation is being planned at the
best possible moment. The evaluation
group is responsible for developing a
TSO performance evaluation frame-
work and for assessing how well the TSO
meets its performance goals. Perfor-
mance goals include improved quality,
safety, efficiency, and accessibility dur-
ing the transformation and the move to
new buildings. Specific indicators can
be tailored to each project.
Another noteworthy element of the
TSO’s organizational design is its strong
relationship with the human relations
(HR) department and the quality and
performance (QP) department. The
TSO works in close collaboration with
change management experts from
the HR department as well as quality
advisors from the QP department.
Responsibilities were discussed and
shared between the TSO, the HR,
and the QP departments covering the
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No. Types of TSO Projects
1 Harmonize and optimize
clinical and administrative
practices when they vary
across sites
2 Attempt to optimize project
efficiency, particularly in care
and service delivery
3 Provide support to
implementation phase of
technological transitions
Table 3: Types of TSO projects.
entire project cycle. The TSO’s involve-
ment in change management and its
special collaboration with the HR and
QP departments add a new dimension,
one on which the PMO might increas-
ingly focus upon. For more on this
subject, refer to the Discussion section.
The TSO is also part of a specific
committee that was set up to handle
interdisciplinary clinical practices
within the organization.
Findings
This section describes results obtained
from the qualitative analysis of
responses to the semistructured inter-
views with two groups of respondents:
TSO members and executive board
partners. This section compares and
contrasts the results obtained from
these two groups of respondents. The
first subsection presents the findings
related to the TSO description and
mandate, while the second focuses on
the competing values framework.
Transition Support Office Description
and Mandate
Generally speaking, all TSO and execu-
tive board respondents share the same
understanding of the reasons for the
implementation of their units: to help
the organization in its move to its future
70 December 2011 ■ Project Management Journal ■ DOI: 10.1002/pmj
Examples
Postoperative analgesia
Optimize organizational efficiency
Optimize ambulatory care whereby primary
and secondary care services need to be
integrated within networks external to the
university health care centers, and also
optimize tertiary care within the organization
Support clinicians and managers in the
implementation of new information systems
(i.e., IT applications for emergency and
operating rooms)
site. The following excerpts from both
TSO members and partners show this
convergence:
It is to facilitate the development of
the activities’ health care center. We
have a project to move from six sites
to three sites. There are activities that
will be grouped together. And to
facilitate this transition, there is an
office that was implemented with
available resources to facilitate this
process. The mandate is to support
the health care center teams with the
aim of reaching this objective that is
the redevelopment. (TSO member)
It is to facilitate the reorganization of
the work and clinical processes in the
context of redevelopment. (Partner)
The transition office is there because
we’re building new and we’re redevel-
oping. (Partner)
When asked for a more precise
description of the TSO mandate, the
two groups provided significantly dif-
ferent perceptions (see Table 4).
Highlighted below are two major gaps
between the TSO official mandate and
perceptions.
• Only the partners mentioned the
PMO’s technical dimensions (i.e.,
planning and coordination), while the
TSO members perceived their role as
providing people with support.
However, project planning and coordi-
nation are in fact a part of the activities
undertaken by the TSO. One possible
interpretation of this result might be
that the TSO’s members see this activ-
ity as a normal project management
task and do not include it as a man-
date. On the other hand, partners
explicitly expect these tasks to be a
part of the TSO’s mandate.
• Opposition voiced by a few individu-
als (the partners) who stressed that
the TSO mandate is not being intru-
sive in the clinical expertise roles and
concentrated its efforts on adminis-
trative tasks only. Each partner plays a
major role within general project gov-
ernance, and this situation sheds light
on the unequal adhesion to the TSO
mandate. It clearly identifies different
perspectives on regarding the exact
nature of the TSO mandate and on the
existence of tension.
Transition Support Office
Performance
In this section, we contrasted responses
given by both groups to questions
regarding TSO performance. The re-
sponses are classified under the four
organizational performance concep-
tions found within the competing values
framework. Some indicators may be
classified within two conceptions, and in
these situations, researchers would place
the indicator under the most coherent
conception. The main objective was to
identify common and contrasting indi-
cators regarding the TSO’s organizational
performance within the two groups: TSO
members and executive board partners.
Is there any paradox?
Common Indicators
Common indicators were identified
among positive views regarding TSO
performance and also on negative or
challenging indicators representing
barriers to organizational performance
contributions. Table 5 provides a
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Executive Board Partners Transition Support Office Members

The TSO consists of experts dedicated to organizational redevelopment at
three levels: macro (organizational), meso (higher-level missions), and
micro (project teams) (11/11).
For most executive board partners, the TSO’s All TSO respondents share the same understanding on the TSO mandate
major mandate consists of four elements (8/11): (11/11):
• Plan redeployment (moving from multiple sites • Accompany people in the transition (change management facilitator).
to one). • Provide people with follow-up in implementing their clinical or
• Accompany and support clinical and administrative projects (implementation facilitator).
clinic-administrative project teams during
the transition.
• Facilitate work reorganization, review processes.
• Harmonize practices.
Some partners indicated (4/11): The majority of respondents acknowledged other elements within the
• Assess the TSO’s contribution to the services it offers. TSO mandate:
• Harmonize practices through evidence-based data. • Harmonize practices based upon evidence-based data (10/11).
• Support the technical transition. • Establish liaisons that cross the organizational hierarchy (interlevels,
interteams, etc.) (10/11).
• Assess the TSO’s contribution to organizational performance. This should
consist of links with quality management, performance indicators, clinical
efficiency, profitability, patient care, and security improvements, among
others (9/11).
Individuals have mentioned the following elements
relative to the TSO’s mandate:
• [Contradiction]: One respondent stated that the
TSO’s major mandate is to accompany
clinical-administrative project teams with the
exclusion of clinical project change management.
• [Restriction]: The major element in the TSO’s
mandate strictly consists of coordinating the
global transition project, with the exclusion of
“carrying out” the transition or harmonizing
practices and processes.

Table 4: Perceptions of the TSO mandate.

synthetic view on these common views
under the four quadrants of the com-
peting values framework. There is only
one common positive indicator with-
in the human relations quadrant.
Acknowledgment of the influence and
engagement from major stakeholders
is, however, a great performance indi-
cator, even though of little importance.
In the rational goal quadrant, there are
no common indicators. This result is
quite interesting given the pressure
from hospital management and from
government, which is particularly
strong regarding the project’s financial
performance. Other TSO indicators are
negative or challenging and they often
indicate high levels of importance for
both groups.
In short, results show that common
indicators between the two groups were
mostly found among the negative or
challenge indicators. They all recog-
nized two difficulties:
• difficulty in making changes given the
hierarchical and practice cultures and
• lower levels of importance assigned to
power systems within the organiza-
tion.
Contrasted Indicators
Findings from this research show differ-
ent views on what is of value in the
TSO’s contribution to the organizational
performance. Table 6 presents a syn-
thetic view on contrasted indicators
between the two groups of respondents
in a sequential order of the perfor-
mance conceptions from the competing
values framework. In human relations,
TSO members are the only group
underlining the importance of the team
in place and the quality of its leader-
ship. It seems to be invisible to the part-
ners. This same pattern is observed
within an open system, and in this
respect, TSO members identified bud-
get restrictions and ROI pressures as
barriers to project management inno-
vation. Partners mentioned the board’s
creation was a positive indicator.

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Human Relations Open System

• Influence and engagement from clinicians, • Organizational complexity (big organization, silo culture)
champions, and executives toward the slow transitions, and TSO’s work as a consequencea
project’s successc (bespecially among the partners)
• Power games, politics, and private territory
protection by certain partnersc
(bfor the partners)
Internal Processes Rational Goal

• Lack of communication and knowledge about the —

TSO and its role: certain gray areas that kept
individuals from understanding its mandate,
services, and activitiesa
• Resistance to change and difficulty in modifying
practice cultures, and finding points of convergence
among the various practice and hierarchical culturesa
Note. Normal typeface: positive or neutral element. Bold typeface: negative or challenging element.
a A clear majority agree. bAbout half agree. cFew individuals agree.

Table 5: Common indicators of TSO contribution to organizational performance.

Executive Board Partners TSO Members

Human • The team consists of members having complementary
Relations expertisea
• Harmony within the teama
• Excellent leadership: openness, solid knowledge,
expertise, trust, and autonomy among membersb
Open • Pressures and government requirements (which wants
Systems ROI) and budget restrictionsb
• Continuing delays in Private Public Partnership (PPP)
announcement resulted in people being skeptical about
the project’s feasibilityc
Internal • Executive board’s implementation: orients the —
Processes TSO toward organizational prioritiesc
Rational • Delays in making clinical choices and prioritization • Budget c
Goal had negative consequences on TSO’s development
and led to lack of understanding about what was
being donea
• Delays due to organizational culture:
° Bottom-up: difficult to centralize organization’s
priorities and make clear decisions about themb
° TSO’s difficulty in making decisions: its authority
is diffusedc
• TSO is being pressured to account for ROI resultsc
Note. Normal typeface: positive or neutral element. Bold typeface: negative or challenging element.
aA clear majority agree. bAbout half and half. cFew individuals.

Table 6: TSO’s implementation: Contributions to organizational performance.

Indicators listed under rational the difficulties in initiating projects for delay refers to the difficulty that the
goals mostly deal with planning and awaiting decisions. The executive board clinical staff (the raison d’être for a
priorities for both groups. At an opera- partners also mentioned that delays health care center) is having in identify-
tional level, TSO members mentioned were a major challenge. The first reason ing priorities. The second reason

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explaining delays and lacks in estab-
lishing proprieties is based on the pro-
found organizational culture where it is
difficult to centralize decisions. The
executive board hesitated in decision
making and the TSO has difficulty
showing real leadership in making this
type of decision. A last point mentioned
by a few partners refers to priorities
based on economic returns, thus lead-
ing to the health care center’s mission
being neglected.
Discussion
This article deals with the PMO’s con-
tribution (here, TSO) to the organiza-
tional performance by contrasting
qualitative data from two groups of
actors: TSO members and the executive
board partners.
Preparing for TSO Transition
As seen before, the TSO’s mandate is
expressed through three mission state-
ments. Table 7 reveals a synthetic view
of the findings, based on the perception
shown by the two groups of respon-
dents. A major point of interest is that
they agree with the first mission state-
ment, which appears to be the most
critical one. Certain nuances were,
TSO’s Mission Statement
1. To accompany the major participants
in the general coordination of the
organizational transition in order to
increase and ensure the continuity in
patient care and services during the
different phases of the redevelopment
project
2. Offer support to managers in terms of
project management and change
management approaches, and
methodology to ensure the optimal
use of resources and expertise
during various transition projects
3. Create and maintain a culture that
will encourage learning and
innovation linked to the transition
to the new health care center.
Table 7: Perceptions of TSO mandate.
however, mentioned by the executive
board partners regarding the TSO’s
mandate, which strictly limits its inter-
ference in the clinical field. This was
acknowledged by the TSO, which con-
firms that it has a “supporting” role. On
the second mission statement, some
noticeable discrepancies were identi-
fied. Findings have showed that the
planning and coordination role of
the PMO is well acknowledged by the
executive board partners but not by
TSO members. Interestingly, the PMO’s
embeddedness was identified as a good
explanation for the PMO’s performance
(Hobbs & Aubry, 2010b). One element
of embeddedness is that the “PMO’s
mission is well understood,” suggesting
that significant efforts should be made
to communicate the TSO’s mandate,
ensuring it is well known and under-
stood. Other actions undertaken to
increase the PMO’s performance may
well be ineffective should the TSO’s
mandate not be well understood by
major stakeholders, such as the part-
ners. One element must, however, be
taken into consideration. At the time of
the interviews, construction had not
started, and, as such, this new hospital
Executive Board
Members TSO Members
⫻ ⫻
with nuances to
not enter the
clinical field
⫻
barriers barriers
December 2011 ■ Project Management Journal ■ DOI: 10.1002/pmj
project had been up in the air for more
than 15 years. Part of this lack of
embeddedness could be therefore
related to not believing the project
would become a reality.
It should also be noted that, in Table
7, both groups negatively reported on
the third mission statement, in that
they identified important cultural bar-
riers that could prevent the TSO from
reaching any objectives linked to this
mission statement. Political barriers
and bureaucratic cultures may also be a
source of tension and conflict. This
finding is in line with previous research
in the health care field (Denis et al.,
2001; Schlichter & Thomas, 2009) on
how multiple stakeholders make it
difficult to introduce organizational
changes, and this is particularly true in
relation to the strength of professional
groups.
Organizational issues, tensions, or
conflicts have been also reported as
conditions that could lead to a PMO
transformation (Aubry et al., 2010). One
theme shared by all of these issues is
that they build up over time, and when
the TSO is faced with such tensions, it
might have to evolve in its mandate,
characteristics, and functions in accor-
dance with the project’s evolution and
the progressive implementation of
organizational changes. This requires
that the TSO be tightly coupled with its
internal environment and develop
sensing capabilities (Weick, Sutcliffe, &
Obstfeld, 2005). The strength of the
TSO’s function with respect to organi-
zational learning might cover this need
and contribute to maintaining a proper
fit with the organization’s needs.
Pluralistic Views on PMO’s
Contribution to Organizational
Performance
Findings suggest that the two groups
share certain common views on the
TSO’s contribution to organizational
performance, using the competing val-
ues framework. These common views
are often expressed in negative or chal-
lenging forms, and this finding con-
firms that both the executive board
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Flexibility
TSO
members
Internal
Control
Figure 4: TSO’s position within competing values framework.
partners and TSO members value cer-
tain common performance indicators.
When expressing what they value
about the TSO’s performance however,
the two groups present different and
stronger points of view. As shown in
Figure 4, the TSO members feel more
strongly about human relations, while,
not surprisingly, the executive board
partners strongly value rational goals. It
is worth mentioning here that this
focus is not expressed in black or white
terms, because their performance con-
ceptions do not exclude elements of the
others’ conceptions, and thus it
becomes a matter of intensity.
To better understand the duality of
the position held by these two groups
of respondents, we suggest going back
and reviewing how important the two
underlying axes are in delineating the
four performance conception quad-
rants (Quinn & Rohrbaugh, 1983):
• flexibility versus control and
• internal focus versus external focus.
Due to their situation with respect
to the rational goals, most of the execu-
tive board members value control and
external focus. In doing so, they con-
centrate their assessment efforts on
planning and controlling the TSO’s
74 December 2011 ■ Project Management Journal ■ DOI: 10.1002/pmj
External
Executive
Board
Partners
results. This governance authority has
the responsibility of presenting the
overall project results to external stake-
holders (e.g., the government), particu-
larly in terms of financial terms such as
ROI. It is not surprising therefore that
they will make an effort to monitor and
control the TSO to ensure that the
financial results will be satisfactory. On
the other hand, the TSO members, with
their human relations positioning, will
more likely assess the TSO’s perfor-
mance by means of HR indicators. They
will favor flexibility in their manage-
ment approach, and it is only natural
that they lean more toward their inter-
nal organization, given their desire to
maintain and develop a strong team—
one that shares their project manage-
ment engagement.
These results confirm the relevance
of adopting a pluralistic view on orga-
nizations (Denis et al., 2001) such as the
competing values framework. This
approach has shed some light on differ-
ent and opposite views on the TSO’s
contribution to organizational per-
formance between TSO members and
executive board members. It serves as a
means to identify the paradox and to
encourage dialogue on this paradox.
The objective is not to make the paradox
disappear (Cameron, 1986), but rather
to accept differences and to develop a
common view on how the TSO could
contribute to organizational perfor-
mance. The TSO could then play a lead-
ership role in providing a platform for
this dialogue.
Conclusion
In this article, we applied a qualitative
research approach in our efforts to
respond to the research question “How
does one assess the contribution of a
PMO to the organizational perfor-
mance in an organizational transition?”
A single case study in the health care
sector was selected in which a PMO was
implemented in the form of a TSO, with
the mandate to focus on accompanying
a major organizational change: the
construction of a mega-hospital and
the redevelopment of clinical services
across multiple health care sites. The
TSO’s description reveals a noteworthy
particularity in the learning function.
Based upon the competing values
framework, findings show that two
groups of respondents (TSO members
and executive board partners) hold
opposite positions with respect to the
value of the TSO’s contribution to orga-
nizational performance. These results
contribute to our consideration of a
pluralistic organization when assessing
PMO performance.
This article builds on the results from
a first investigation on PMO contribution
to the organizational performance in
four organizations (Aubry & Hobbs,
2011). Results from the first research pro-
vided evidence of pluralism of values on
PMO performance but did not scrutinize
specifically the application of the compet-
ing values framework in a real situation.
This article has allowed a more in-depth
understanding of the process of prepar-
ing and assessing PMO performance as it
unfolded. It shows that the competing
values framework is not a static instru-
ment for performance assessment but
rather a dynamic process for trust build-
ing and common understanding of what
is expected as a PMO contribution to the
overall performance.
60-77PMJ0411.qxd 11/4/11 8:02 AM Page 75
An important limitation in this arti-
cle relates to the fact that the available
data was only gathered during a first
step in the research program. More gen-
erally, this research focuses on one case
study, which, though pertinent enough
to answer the research question, still
has certain limitations when it comes to
generalizing the results to other health
care organizations or even to other
industrial sectors. However, the authors
are convinced that the competing value
framework constitutes a pertinent
approach in almost all PMO contexts.
This framework has not been developed
within a pure project environment, but
rather within a large public sector. And
more recently, the framework has been
applied to a wide variety of industries,
both private and public, to capture the
diversity of cultural perspectives in
organizational changes (Cameron &
Quinn, 2006). The single case reported
here is well aligned with this approach.
The competing values framework and
the process could then be valid in a wide
variety of PMO settings.
This research focuses on similari-
ties and differences based on the com-
peting values framework, while future
research should explore the negotiation
processes involved with the implemen-
tation of this approach to assess the
PMO’s contributions to organizational
performance. We shall therefore
hypothesize that the PMO could consti-
tute a suitable platform from which this
process might be initiated.
Acknowledgment
The authors would like to thank the
Canadian Health Services Research
Foundation CHSRF for providing finan-
cial support for this study. ■
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Monique Aubry, PhD, is a professor in the
School of Business and Management at the
University of Quebec at Montreal (UQAM). Her
principal research interest is in the area of
organizing for projects and organizational
design, more specifically on project manage-
ment offices (PMOs). Her second important
research area is in polar expeditions, where she
scrutinized the planning process to learn about
flexibility. The results of her work have been
published in major academic journals and pre-
sented to several international conferences,
both research and professional. She is a mem-
ber of the Project Management Research Chair
(www.pmchair.uqam.ca). Before joining UQAM,
she was a project manager in a major Canadian
financial group for more than 20 years. She is a
member of the PMI’s Standards Member
Advisory Group. She is involved in the local PMI
community of practices on PMOs, where she
contributes to reinforcing the links between
professionals and researchers.
Marie-Claire Richer is the director of the
Transition Support Office in the McGill University
Health Centre (MUHC) in Montréal, Québec,
Canada. She is leading the organizational transi-
tion as the MUHC prepares to undergo a major
redevelopment project that will generate the
relocation and reorganization of six hospital
sites into three. This transition will involve the
reorganization, consolidation, optimization, and
transformation of a multitude of clinical and
support services. She holds a PhD in nursing
from McGill University and is also an assistant
professor and joint coordinator of the FERASI
(Centre de Formation et Expertise en
Administration des Services Infirmiers) program
at the McGill University School of Nursing. Her
60-77PMJ0411.qxd 11/4/11 8:02 AM Page 77

PhD work looked at the impact of appreciative Douglas Institute Research Centre. She is a
Mélanie Lavoie-Tremblay, RN, PhD, is an associ-
inquiry intervention on the emergence of inno- nurse scientist at the MUHC.
ate professor at McGill University and holds a
vative ideas and the improvement of work envi-
FRSQ Junior 2 Career Award. She is the McGill
ronment in health care. Her research interests
co-representative at Centre FERASI (Training and
focus on organizational transition, change man-
Expertise in Nursing Administration Research) Guylaine Cyr, PhD, is a research coordinator in
agement, and the emergence of innovation in a
and a regular researcher at the Research Centre the McGill University School of Nursing at the
complex system. Her professional experience is
Fernand Seguin of Hôpital Louis-H. Lafontaine. McGill University Healthcare Centre and the
diversified and includes clinical work, manage-
She is also an associate researcher at the McGill Research Centre Fernand Seguin of Hôpital
ment, and teaching.
University Healthcare Centre (MUHC) and at the Louis-H. Lafontaine.

December 2011 ■ Project Management Journal ■ DOI: 10.1002/pmj 77