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For 20 years, healthcare providers, payers, vendors, and other organizations have asked IPM to help save their struggling initiatives. And we typically know what we are going to find. As transformational strategies have grown in scale, complexity, and ambition, more and more initiatives are encountering the same root problems, whether those projects involve preparing for more value-based care, selecting and implementing new technology, improving quality, or integrating the operational aspects of completed mergers, acquisitions, or partnerships.
Here are the most common core issues we work to address to get initiatives back on track, and that you can avoid so your projects won’t need to be rescued later.
Many find it hard to believe that the best way to accelerate an initiative is to invest time in planning. Too many leaders in healthcare organizations say things like, “We need to move fast and don’t have time to plan.” They schedule a kickoff meeting the week after the initiative has surfaced to start implementing. Cause, meet effect.
Initiatives need to include a planning phase, the scale of which is dictated by the size and complexity of the initiative. In effective planning, you will
Even if you are the best and smartest leader in the world, you can’t orchestrate a cross-functional team to implement a complex initiative without a planning foundation. It is the sheet music upon which you as conductor and all the orchestra players rely.
Healthcare executives are often under pressure to get fast results, and purchasing new technology is often the default way to get there. Many see technology as an easy answer. However, technology implementations are among the most disruptive, complicated, behavior-changing, and over-hyped initiatives there are.
Technology may indeed be part of the answer. But don’t put the cart before the horse by simply picking a system. Begin the project instead by determining if the root cause or need is more behavioral or process related. If thoughtful evaluation still determines technology is part of the solution, do the upfront work of assessing business and work flow processes, identifying and correcting inefficiencies, and then establishing the requirements that will govern the system choice. If you implement a system without identifying the true need, you will invest significant time and energy and end up still needing to address the underlying problem.
Often initiative teams focus so intently on the technical details or meeting a specific deadline that they fail to engage with the people critical to sustainable performance. For example, projects that health information technology (HIT) experts lead tend to focus on HIT aspects of the project. But in reality, most HIT projects are change management projects with a technical component. Go-live is a key milestone in the project, but it is not the end of the project.
In other cases, initiative teams don’t want to bother busy stakeholders, so they delay engaging users until rollout. But training at the end is not good change management. Change management is driven by stakeholder engagement and begins during planning. The initiative team should strive to ensure stakeholders’ involvement is thoughtful, efficient, and productive, but there is no substitute for engagement.
Often the problem is not in what the initiative is delivering; it’s in the disconnect between what it is delivering and what stakeholders expected. We are often amazed at the large initiatives health systems and other healthcare organizations undertake (centralize vs. decentralize shifts, partnerships, mergers and acquisitions, outsourcing vs. insourcing, new technology implementations, new capital projects, expansion of services, etc.) without preparing or vetting the business case. Most assume business cases are only for financially driven initiatives, but that is not true. The business case is the upfront work to determine if and how it can deliver on its promise to the organization, whether that promise is a benefit to safety, operations, financial performance, growth, transformation, or something else. There is a reason behind each initiative that needs to be understood before it is approved to move into planning.
Keep in mind that initial business cases are often overoptimistic and designed to ensure approval. Pressure test key assumptions to help establish realistic expectations. Fully vetting the business cases allows decision makers to better understand the scope of what is actually needed to achieve the ROI or other intended goals and determine its level of prioritization.
Chances are you’ve heard administrators proudly state how good the organization is at finding a way “to get it all done.” This is a sure sign that the organization is overly diluted, and most healthcare organizations are. When an organization spreads its resources across too many initiatives, it slows everything down. Providers all have transformational strategies packed with initiatives, and the people who have to execute them still have full-time day job responsibilities. Although the most strategically important projects may indeed “get done,” the cost of this effort dilution is high. Having a prioritization process in place to “protect” the few most critical projects makes the process quicker and more effective.
If you can’t fix your organization’s dilution problem, the more detailed plans you make for your initiative, the more likely you can get the resources you need when you need them. And over time you can educate the organization on the opportunity cost to your initiative that came from resource constraints.
If you’re kicking off a new initiative or starting to plan for next year, start with solid planning. Taking a sound project management approach can help you successfully execute projects, and having effective project portfolio management processes in place can assist in evaluating and prioritizing so you can focus on the most critical and impactful work.
If your initiatives are moving too slowly or taking a turn for the worse, evaluate them on these five common issues and address the gaps. And if you’re still struggling, reach out for help from an experienced, “seen it all” consultancy such as IPM.
To learn more about how you can accelerate implementation of your most critical projects, read the article “Lessons on Healthcare Execution.”
Author: Greg Kain, Managing Director, Healthcare
Integrated Project Management Company, Inc.
Service: Project Leadership
Industry: Healthcare