PMO / TO Build and Program Management
A Transformation Office (TO) is not a reporting function. When built correctly, it is the operational backbone of a complex program — the structure that keeps workstreams aligned, decisions moving, and accountability visible when a transformation gets difficult.
Approach Consulting builds PMOs and Transformation Offices for healthcare organizations, PE-backed companies, and enterprise clients managing multi-workstream programs. That means designing and standing up the governance model, not just advising on it.
What a PMO / TO Build Actually Involves
Most PMO implementations fail for the same reason most transformations fail: the structure is designed for reporting rather than accountability. Dashboards get built. Status decks get produced. But the decisions that need to happen at the right level, at the right time, do not happen.
Building a PMO that works requires defining the governance model first — who owns what decisions, how escalations move, where program authority actually sits, and what the review cadence looks like at each level. The tools and templates come after the structure, not before.
Approach Consulting has stood up Transformation Offices from scratch on programs ranging from technology implementations to merger integrations. The design methodology is grounded in what works under execution pressure, not in what looks clean in a framework presentation.
Who This Is For
- Healthcare organizations launching a major implementation or multi-year transformation initiative
- PE-backed companies building program governance for the first time ahead of a platform build or integration
- Organizations whose existing PMO has become a reporting function rather than a delivery structure
- Programs that are in flight but losing cohesion and need governance redesigned under real conditions
How Engagements Work
PMO build engagements typically run in two phases: design and stand-up. The design phase establishes the governance model, decision rights, escalation paths, and reporting architecture. Stand-up implements the structure, trains program leads, and runs the first operating cycle with direct practitioner support. Ongoing program management support is available for organizations that need embedded leadership through a defined program lifecycle.
About Approach Consulting
Christopher Gunn has built and led PMO & Transformation Offices on programs from $100M to $500M+ in scope, across healthcare, regulated industries, and complex enterprise environments. Approach Consulting brings a practitioner’s view of what governance actually needs to do under execution pressure.
To discuss a PMO build or program management engagement, contact Christopher Gunn at chris@approach-consulting.com.