The People, Process, & Progress Podcast - What EMTs can Teach Us about Failing Projects

Episode Date: May 27, 2025

Welcome to the second full episode in our All-Hazards Project Management series, What EMTs can Teach Us about Failing Projects. I’m your host, Kevin Pannell—former Hospital Corpsman, nationally certified EMT, and longtime project leader. I’ve been on scenes where seconds matter, and I’ve led projects where early warning signs were ignored until it was too late.In this episode, we apply a trauma checklist used in emergency medicine—DCAP-BTLS—to assess and stabilize failing projects. Whether you’re in public safety, healthcare, tech, or leading your first big effort, this is a framework you can apply immediately to scan for trouble and stop the bleeding early.In emergency medicine, DCAP-BTLS stands for:DeformitiesContusionsAbrasionsPunctures/PenetrationsBurnsTendernessLacerationsSwellingFor failing projects, DCAP-BTLS stands for:DeviationsCommunication breakdownsAccountability gapsProcess misalignmentBottlenecksTeam tensionLeadership gapsStakeholder managementPeople first. Combined process. Progress together.

Welcome to the second full episode in our All Hazards Project Management series, What EMTs Can Teach Us About Failing Projects. I'm your host Kevin Pennell, former hospital corpsman, nationally certified EMT, and longtime project leader. I've been on scenes where seconds matter, and I've led projects where early warning signs were ignored until it was too late. In this episode, we'll apply a trauma checklist using an emergency medicine called DCAP-BTLS to assess and stabilize failing projects,

whether you're in public safety, healthcare, technology, or leading your first big effort, this is a framework that you can apply immediately to scan for trouble and stop the bleeding early. But first, please silence your cell phones, hold all sidebar conversations to a minimum, and let's get started with the People Process Progress Podcast.

Hey everybody, welcome back to episode two, what EMTs can teach us about failing projects, part of the All Hazards Project Management Series. So what is this DCAP, D-C-A-P-B-T-L-S? I'm going gonna tell you. So when you learn to be an emergency medical technician, when you assess a trauma patient, so if something happened, they fell, they got hit by a car, they got shot, stabbed, whatever the mechanism is,

you follow this acronym to do a good assessment. So the D is for deformities. Does anything look like it shouldn't on a human? What are the contusions? Those are bruises. Abrasions, that's like when you get road rash, punctures or penetration, stab wounds, bullet wounds, nails, whatever.

Where are the holes? Where's the blood coming from? Burns is B, that's pretty obvious. They could be little to full thickness, bad burns. Where's their tenderness? So where when I squeeze a little bit or push a little bit, does it hurt? Lacerations, those are cuts and swelling.

What is swollen and it shouldn't be? So that's what DCAP, D-C-A-P-B-T-L-S stands for. And it's a sweep that you do and you learn it when you're an EMT, you do it in the field, you may do it a little quicker, a little faster, you may not spell it out in your head every time. However, it's muscle memory, right?

You learn to apply it. And so now we're gonna walk through a version of DCAP DTLS, but for failing projects. And so what we're gonna talk about is deviations, communications, accountability, process, bottlenecks, tension, leadership, and stakeholders. But let's dive into each one of those. So for deviations like in trauma, right?

A deformity is pretty obvious. If your leg's 90 degrees the wrong way, that shouldn't be happening. In a project, deviations from scope, schedule, cost, quality, right? They can be small cracks. They can start to kind of happen slowly, but they can get big over time.

They can cost more money and more time. So what do we do about that? We do regular checks, right? As a project manager, you should be checking. It doesn't matter what field you're in. Are we in scope? Are we doing too much? Are we not doing enough for the scope?

Are we on schedule? If we're not, let's figure that out. We'll talk about that through some of the rest of the assessment. Are we spending too much money? What's our costs like? Are we right on? Are we gonna be under budget, which is awesome.

And then what's the quality? That's kind of the fourth thing of the big four for project management, scope, schedule, costs and quality. So those are deviations as opposed to deformities that we're gonna look for. And so a way to help prevent this and to keep track of these is some basic change to control process in your project, right?

Hopefully your organization has that. But at the project level, we don't wanna just change, no, let's just add this, let's spend more, let's buy this. We wanna talk about it, get approval, track those decisions. And so that's really important. So the D for project management is deviations. Where are we off in the big things?

The C instead of contusions, which are bruises, we're communication breakdowns, which could be bright communication bruises. So if your team isn't talking, they may not be listening or receiving the message to each other, there's tension that'll build, which we'll talk about later. But we need to have a good collaborative communication plan

because I can make a communication plan in like a minute, right? But I just make it and that doesn't mean everybody agrees with it and they know what we're doing or that they want to be communicated that way. So that's why I say collaborative, right? Communication plan. And then we need to validate it. Are we having too many meetings? Not enough meetings. Do we need to have some of them cancel them and come back? Are we using messages directly, text messages? So many different modalities. And so how we can look at these maybe near the end of the project is in our retros. If we're doing sprints and agile stuff, we're going to do retros every week, every couple

of weeks, every three weeks, whatever your sprint tempo is. And then for regular projects, we'll say the traditional waterfall, we're going to have lessons learned surveys. So I'm going to ask you, what are three things that work well? What are three things that didn't work well? I call out communication specifically in my after action reports or lesson learned surveys and say, how was communication one to five? How was resource coordination? So I call out those big things and that can help prevent these communication breakdowns in the future. And if we ask and keep track of it during the project and we can keep track of that before they become a problem. So A for accountability

instead of abrasions right they strip away the skin so accountability kind of strips away that ownership right so we need to know who owns this task right we don't want to lose coverage of the task and the knowledge that that person brings to the table and for us as project managers we need to clearly identify that early and ongoing, right? So the best way I've found to do that is an org chart. It's one of my, has been the big three, big four, et cetera, project management is an organizational structure,

boxes with names in it or positions that are connected that show who's working with who, and then a racy matrix, right? And that's where we can see who's responsible, who's accountable, who we should consult and collaborate with, and then who RACI matrix, right? And that's where we can see who's responsible, who's accountable, who we should consult and collaborate with, and then who do we keep informed, right, those are helpful, they're pretty quick to use, you go over that with your team, they know who's who,

who's who in the org structure, who's who in the RACI structure, and then you really wanna call out when you're doing your status meetings or you're helping your team facilitate maybe a planning meeting or requirements gathering is who's responsible for this, right? And if you're not here, who can do this in your absence or who should we ask, which is

typically kind of your resource manager. So we are checking for deviations. We are looking at communication breakdowns. We are owning accountability gaps by helping folks take ownership. And instead of punctures, we're going to look at process misalignment. A broken process makes people work in silos. So if we're not bringing folks together, then they're going to do the work on their own, how they think it should happen.

And that could be a problem. So let's not have process misalignment. And to do that, let's regularly compare what we're actually doing with our plan, with the most efficient type of plan that fits our project. Because remember, there's no one perfect style. doing with our plan with the most efficient type of plan that fits our project because remember there's no one perfect style. There's a core guideline and then we make that work for the team that we have and the skills and the definition of done or what done looks like, all those kind of things.

Then we look at where the gaps are. How far off? Is it okay that we're off and we're still working? If we're misaligned and we're defining kind of a new process or we weigh off and it's impacting one of those things that we talked about earlier, we have deviations, right? So I found that revisiting the process with the team, certainly at kickoff and then intermittently,

hey, you all, we agreed that we're gonna do this in sprints or we're gonna use waterfall or we're gonna use this combine board, which I'll talk about in a second, to just, everybody's gonna track through anything, whatever it is, we need to figure out what's being skipped if our process seems misaligned and people don't know what we're supposed to do and where we're headed.

So the B in trauma assessment is burns, right? Those are hugely important. They heal really slow, you lose heat, they hurt, they're awful, right? And bottlenecks for us in projects can happen when there's one resource, right? The team is overloaded, everything's backed up. They're also pretty painful when you're on a project.

And I just mentioned Kanban boards and that's those boxes you see on a screen you can drag around and change the status or the phase or whatever you wanna set it to, but it's a great visual tool to monitor task congestion, right? If you have these four things sitting in this one column and the others are moved ahead,

it's pretty obvious what's happening, right? It's a simple tool that provides immediate visual feedback on where the work is. And then you can reach out to the folks are moved ahead, it's pretty obvious what's happening. It's a simple tool, it provides immediate visual feedback on where the work is, and then you can reach out to the folks that own those, that are identified in those cards, typically they're on the common board, and say, hey, how can I get you some help? And that's the action really we wanna take,

is to talk to our team members openly about what's your work capacity? How are you feeling about this work? Can I help you get more time by talking to your resource manager? Do I need different people with different skills because we've gotten to a point where maybe they're over their head or You know, it's just not their area of expertise and that's okay But for us as project managers, we need to be looking at these bottlenecks

The tea instead of tenderness, right is team tension though folks can be pretty tender sometimes, right? If folks aren't getting along or they're angry or they're they're sad, or they just whatever reason. They may not say it out loud, but you can see the tension, right? With silence, or sarcasm, or disengagement, and even on virtual meeting calls, you can read body language, you can hear emotions in your team members' voices. And that's why I think it's so important in this kind of disconnected, but always connected age, that we be on camera, right? That we can see each other, hear each other clearly because that makes a big difference in our humanity

across all this technology. And as a project manager, don't ignore this, right? Set up some one-on-one time with your team members. When I was leading the IT portion of a big hospital build, I had one-on-ones with my project managers regularly so I could get a tempo, how can I help you? What's happening? Not necessarily a status report, right? It's do you have any blockers? There is there anything I should know about here's some things you should know about that I've heard

Right and dig into how you can support them more The other thing we need to do is is reinforce team norms and what's acceptable boundaries and what's not right early in throughout the project So I shared this in my book the stability equation the quote good buddy of mine, what you allow in your presence you promote. So don't allow negative team talk, right, or generally rude behavior, just stuff you wouldn't expect out in public, right during calls or team interactions, because that is for sure going to create team tension and you as a project manager need to help reduce tension and just help people be civil because people are going to be tired, they're going to work long hours, particularly when you go live or you're crunching through a build or whatever it is you're doing.

And so you need to be able to step away and look at that and see what's happening and help folks kind of ease the pressure valve, if you will, and be less tender. Leadership gaps. So that's the L. So lacerations are cuts, right? They're clean. But when there's leadership gaps, right? It's very clear that that's happening, but we'll lose support and momentum.

And the project with absolute reactive leaders becomes vulnerable, just like an open cut, right? So we need to have occurring or recurring rather, alignment meetings with project sponsors, right? In the business owner, I would say. So again, the sponsor is the person who's ultimately in charge of everything. They can approve scope, schedule costs.

We need to let them know about quality. They're the ones that said, I as the executive approve this project and I'll be your point of contact if you need anything all the way up. The business owners who we're actually gonna work with day to day to get things done, they are in that area. That's who we're doing the project for, they're people.

So those are the two folks that I would talk with a lot and see, you know, and one, let them know about things I notice. And then when they notice things in the team, they're gonna let me know and then I'm gonna help work them out. Right, so we talked about the racing matrix and the org chart.

We all know whoever's at the top of the org chart's in charge, but it's really good as a project manager to develop a professional slash interpersonal relationship with the sponsor of your project, because you all are going to be in lockstep and in the business owner the whole time and then probably for a while afterwards and then in other projects and things like that. So clearly document those decisions that the leader makes, ask for help from the leader,

especially when you're doing some change management stuff. Hey, I could really use your help in carrying this message out and reinforcing this message in these actions because it's a new process for your team and they're very uncomfortable. And then you've built that relationship with the sponsor and the business owner and then they can carry that out for you.

So the S in our trauma assessment is swelling, right? We hit something that swells up, it's our head, it's our leg, it's something like that. The S in projects is stakeholder misalignment, right? So just like the tension we talked about a few letters earlier, everything can look fine until it's too late. So let's say the stakeholders are the technology team

and the clinical team and there's a business component. Well, if we all don't agree on what done is, if we don't agree on what we're trying to accomplish, the problem we're trying to solve, this unique thing that we call a project, regardless of whatever process we're using, then someone's not going to be happy, we'll have wasted money and time. And you know, that's what we need to work out. So we want you to do those. And I've mentioned this theme is you don't just check alignment.

You don't just check that everyone's on the same plan once at the start and then go through the project. You're doing that constantly. You're constantly doing assessment, just like DCAP-BTLS. I might do that once on a trauma patient But I'm constantly assesses them as we're fixing different parts of the bleeding and the puncture and the swelling that's there I'm gonna keep going and looking back and forth and taking vital signs You do the same thing for your project, right? You're gonna help realign any misalignment that's happening with these stakeholders and We need you to do that and we can do that with with an anchor kind of a one sentence shared vision or an elevator pitch. Hey, everybody, remember this

project is about reducing documentation for our nursing so that they can give patient care. Hey, everybody, remember, the goal of this is to have no downtime so that we don't negatively impact our customers, right? It's a good thing to do. It's not as much of the high level kind of visions that you can hear that are too much that don't relate. These directly relate to what we're doing and who we're trying to help. And it can help realign the stakeholders or we may say that and the stakeholders say, oh, wait a minute, that wasn't it.

It should be more of this or that. So the call to action for this week's episode is to take this checklist to your team. So the checklist for projects is to check deviations, address communication breakdowns, give people ownership to close up those accountability gaps, check for process misalignment, address bottlenecks so that we can keep the project moving forward, talk through and be open about team tension. Notice the leadership gaps and mention that to the forward, talk through and be open about team tension. Notice the leadership gaps and mention that to the leaders, the sponsor and the business owner. Stakeholder misalignment, we need to make sure

that what we're trying to deliver and what we're working on and what we're going to deliver that it's meets everybody's needs. So use this as a triage tool, right? You don't have to solve everything today, but you do need to know where the damage is. So DCAP, D-C-A-P-B-T-L-S, and I'll put the notes for this in the show notes, what that means again.

Do it in your retro, your standup, your risk review, your weekly status meetings, your monthly steering committee, whatever it is. Where are we bleeding? Where's the pain that we're not talking about? And talk about it. Don't hide it. So DCAP-D-T-LTLS isn't just for trauma patients. It's a fast structured framework

that project managers can use to detect early warning signs and then respond with intention. So don't wait for the collapse. Don't wait until you get a call from the C-suite. Scan for the damage, stabilize and lead forward. Thank you all for listening to this episode of the All Hazards Project Management series of the People Process Progress podcast. I'm your host, Kevin Pennell. You can follow me on X and Instagram at Pennell, KG, P-A-N-N-E-L-L, KG. You can go to

peopleprocessprogress.com to listen to this episode, to look at back episodes, different posts. There's some resources there. You can buy my book, The Stability Equation, Seven Pillars for a Balanced Life. You can take a free assessment there, see where you need to focus on. Is it in your ownership? Is it your mindfulness, your movement, your boundary setting, your connection making? You have to get better sleep and have faith. So you can plug in where you're at, what you're doing, what you're not doing, and kind of get a start there. There's also a free field guide from that. So you can get in where you're at, what you're doing, what you're not doing, and kind of get a start there. There's also a free field guide from that so you can get some tools and techniques to help you balance yourself because again,

whether you are in public safety or project management, we need to take care of ourselves while we're trying to do all these other assessments for other people. And one way to take care of yourself is through fitness, right, and so I have a YouTube channel, Penelphi Fitness Club. Check that out, I share fitness 15 seconds at a time.

Workout ideas, jujitsu after action reports, cold plunges, because if you didn't video it, did you really do the cold plunge? Thank you all very much again for being here on the People, Process, Progress podcast. Stay safe out there. Keep putting people first, combine your processes, and make progress together.

Godspeed y'all.