5 rules for planning a winning healthcare improvement project
In my last blog entry, I discussed the importance of understanding the root cause of a problem before jumping to a solution.
Let’s say you played along and identified the root cause, generated a list of potential solutions and selected the most promising one, based on its potential impact and ease of implementation. Phew! That was a lot of work… Can you go live with your solution? Not yet. Before you jump into the implementation phase, take time to plan your project. While even well-planned projects may not succeed, poorly planned and executed projects are destined to fail.
Here are 5 ground rules for planning a winning healthcare improvement project.
Rule #1: Assemble the right team
Start with identifying an executive sponsor and a project leader. Usually, the project sponsor is a senior executive whose role is to keep the project aligned with organizational priorities, engage stakeholders, help secure resources and remove barriers. The project leader is one person accountable for planning, executing and closing a project.
When assembling the rest of team, include representative from all major stakeholder groups, but keep it small enough to be effective. For example, if your project focuses on improving length of stay, seek representation from hospitalists, nurses, case managers, physical therapists and occupational therapists.
When selecting specific team members, look for 3Cs:
Capability – Do they have the right knowledge and experience for the project?
Credibility – Are they respected by their peers and can they influence opinion?
Capacity – Do they have time to contribute to the project?
Rule #2: Set SMART goals
I want to emphasize the importance of setting up SMART (Specific, Measurable, Achievable, Relevant and Time-bound) goals for your project. Ultimately, your project’s success will be measured against its goals, so use your best thinking to define them. In addition, SMART goals will provide focus for your project team, engage front-line staff impacted by the project and help manage expectations of your executive team.
Here are two examples of project goals:
Not SMART: Improve length of stay at Hospital A.
SMART: Improve severity-adjusted average length of stay on the Medical-Surgical Unit from 3.5 to 3 days within 6 months of project go-live.
Rule #3: Clearly outline your solution
If you design a tool (e.g., a checklist, new EHR functionality), be crystal clear regarding WHO, WHEN and HOW would use this tool.
If you design a process, map it out step by step, and clearly define who is accountable for completing each step. For a simple process, you can use SmartArt graphics in PowerPoint. More complex processes may require more advanced tools, like Visio, for documentation.
Rule #4: Choose the right outcome and process metrics
Outcome metrics measure the ultimate results of your project (e.g., length of stay, readmission rate). You may not see the full impact of your project until 6 months post-implementation, especially if your solution is novel to your organization. Process metrics provide timely feedback regarding adoption and compliance. You cannot expect to move a needle on the outcome metrics if your solution has low adoption rates or is not being used properly.
Example:
Your project is focused on improving length of stay by proactively identifying discharges that will occur in the next 24-48 hours. The outcome metric is length of stay, and the process metric is the percent of discharges proactively flagged 24-48 hours prior.
Clearly outline the data source and frequency for both outcome and process metrics, and the person accountable for getting them in a timely manner.
Rule #5: Select the right place and timing to start
I am often asked where you should start first. The default is to start with a unit, hospital or group of providers that has the largest opportunity for improvement. My experience suggests that you should start where you will have the highest chance of success, which boils down to having the right leadership and an engaged staff. If you cannot make your project work with your A players, you will most certainly fail elsewhere. In addition, A players will help identify and provide a timely fix for issues that are bound to arise in the early implementation stage.
Choosing the right timing for your project to go live is critical. Postpone your go-live date if you identify factors that may impact your success (e.g., change in leadership or staffing, significant increase in workload, concurrent implementation of other major projects).
By taking the time to thoughtfully plan your healthcare improvement project, you can ensure that your project is a win.
Stay tuned for my next blog post, where I discuss how to successfully implement your healthcare improvement project. Contact me if you have questions or want information about my services.
