Is Your Health Care Project Headed the Wrong Way?

As seen in HealthCare Business Today.

As well-known as they became for their pioneering aviation success, the Wright Brothers might never have gotten off the ground if not for their repeated and often painful project failures. The Wrights obviously did not allow these failures to impede their progress. They learned, refined and moved on.

Health care project leaders can relate to the potential for failure, especially with large-scale projects. According to a global Project Management Institute survey, 28 percent of strategic initiatives overseen by survey respondents were deemed outright failures. The same report found that due to poor project performance, organizations waste an average of about $1 for every $10 spent.

It’s easy to see why large-scale projects can be inherently unstable. Often, like the Wrights’ initial flight attempts, these are projects which have never been tackled before – for example, selecting and implementing a new technology or integrating operations due to a merger, acquisition or partnership.

However, just because a major project is treading new ground does not mean it is destined for failure. By knowing the warning signs of a troubled project, you can intervene more quickly and effectively. Based on our more than 45 combined years of experience rescuing faltering projects, here are five of the most common red flags – and what you can do about them:

1. Inadequate business case or scope – Health care organizations sometimes undertake major initiatives without properly vetting the business case or scope, leading to confusion or outright dysfunction around the effort’s mandate and desired outcome. Solution: Ensure a project’s intended objective is presented clearly and concisely, and has approval from all pertinent parties. Support the objective by equipping all key decision-makers with the information they need around the project’s cost, effort, likelihood of success and projected level of disruption.
2. Unclear deliverables – A project is headed for disaster if those charged with leading it are unclear about the deliverables. For example, we were engaged with a system changeover and discovered multiple deliverables-related issues up-front, including insufficient business requirements processes and documentation, a poorly developed system conversion plan and an inactively managed issues log. Solution: Employ a qualified, experienced program manager capable of overseeing not only the project’s “big picture” outcome but also the day-to-day deliverables. For example, with the troubled system changeover, we identified critical path tasks and properly sequenced deliverables across project teams to ensure focus on the right work. We also implemented an integrated resource plan to manage and adjust resources and ensure the right people worked on the right tasks.
3. Substandard project management – Nothing spells “imminent doom” like an inexperienced or inadequate project management team. Inexperience proves problematic when a project’s leaders lack the prior exposure and conditioning to sequence and manage the work. We found a troubled program lacking a singular leadership focus or emphasis on best practices. Project-level execution was unaligned with goals and there was no integrated work plan, resource plan or executive-level status reporting in place. Additionally, risks and issues were not actively managed. Solution: Be sure you have sound program governance, management and operations standards and processes. For example, for the program lacking proper leadership oversight, we clarified key staff roles and responsibilities and identified appropriate operational, risk management and change management responsibilities. This included managing the program’s go-live command center, tracking and reporting on support tickets and overseeing program communication to prepare stakeholders for a new system and processes.
4. Insufficient resources – When organizations try to get everything done, all at once, without prioritizing work, analyzing requirements or properly assessing and allocating resources, trouble often ensues. We encountered an IT project in which the software and integrator lead personnel were not working together effectively – a disaster waiting to happen. Additionally, some work teams were understaffed, and management support for analysis and reports was lacking. Solution: Bottom-line, a major initiative needs precisely the amount of resources required to fulfill its objectives and deliverables. If resource changes need to be made, better to do these sooner than later. For the troubled IT project, we ensured resource levels were appropriate and available, and replaced the original system integrator. We also implemented time-reporting practices and standards that were consistently measured and reported on a weekly basis.
5. Inadequate technical management – It’s easy to see the allure of a new technology, but often organizations buy it without fully considering their current work flow processes and inefficiencies, or establishing the requirements needed for system governance. We could foresee significant issues for an IT project in which the proof of concept and production build were occurring simultaneously. The project lacked any published current-state architectural diagram or future-state diagram to drive designs. This risked significant design delays and rework down the line. Solution: Be sure the management of all technical standards and specifications is at least equal to if not better than your overall program management. For the technically challenged IT project, we made sure that software development lifecycle best practices and standards were in place, that the technical work was managed effectively and that business and IT teams collaborated on reviews and testing.

Summary

As health care organizations become increasingly aware of the inherent challenges of project management – and proactively take steps to improve them – the success rate for major projects is climbing. Like the Wright brothers, learning from prior experiences, and making necessary changes and improvements, will help ensure your next large-scale initiative successfully takes flight.