How to Plan Health Improvement Projects
Improving and transforming healthcare encompasses diagnostics, identifying solutions, implementing, managing and embedding change solutions to evaluations. These projects cover processes, people, strategies, information and systems. Whatever the point on that spectrum, be clear about your values and principles.
My approach to planning recognises collaborative multi-disciplinary stakeholder engagement, a focus on outcomes for patients and populations, buy-in from leadership, consulting the evidence base and data, project management and resourcing as crucial.
You can visualise the improvement and transformation journey as parallel lanes on a motorway or simply as steps. Progress on these lanes and steps is rarely strictly chronological. Reverse manoeuvres are likely as you head towards an agreed project plan.
Step 1: Systematically identify your stakeholders.
Figure out who your stakeholders are early on. Analyse their needs and expectation and take these into account in your planning. Develop the communication plan and decide your key stakeholders to include in your project’s governance arrangements.
Step 2: Design your projects with success in performance, outputs, outcomes, legacy and strategic impact upfront.
You must secure clarity around aims, objectives and priorities by listening and collaborating with the client or customer.
This also applies to your project’s performance. By instituting tracking and reporting for cost, timelines, scope and quality parameters, you give yourself a better chance of success and demonstrating value.
The same goes for the outputs or deliverables, be it for equipment, IT systems, staffing, pathways; and the outcomes, especially for patient and process measures.
Step 3: Select and use appropriate tools and methodologies.
You can draw on established project and programme management (PPM) approaches, tools and project and programme methodologies. PRINCE 2, MSP and MoP are my preferred PPM approaches. These are largely often already in use in the types of organisations I work with, providing the team with a common language. These allow for a controlled start, delivery and close.
Gantt charts and interdependency maps, developed in MS Excel and Projects, can assist with your scheduling and tracking.
Breaking down the work into manageable chunks and piloting are prudent. I often start small, scale rapidly if possible, deliver value and continuously improve as encapsulated within Lewin’s model of change and Plan, Do, Study, Act (PDSA) cycles. A change is trialled and its impact assessed, building upon the learning in a structured way before wider implementation. The project team, client and stakeholders can collaboratively arrive at an informed decision on what change to adapt, adopt or discard.
There are alternative approaches, tools and methodologies available including Six Sigma and Lean, that aim to improve processes by removing activities that are non-value-added.
Step 4: Put in place contingencies and plans to minimise and manage risks, issues and complexities.
Build in some flexibility in your plans as far as practical to deal with emergent complexities and issues. Scenario planning and futures thinking may be additional useful tools.
Step 5: Share your project plans
By making your plans available to stakeholders, you ensure a common understanding of the project, their roles, actions and responsibilities.
What may emerge from the pandemic recovery is the need to build resilience — the capacity to withstand and recover from challenges and stressors — and ‘redundancy’ in our planning, resourcing and teams to address volatility and uncertainty.
Although these lanes or steps have focussed on healthcare improvement projects, you can adapt them to other industries. Planning projects for improvement and transformations cannot be fixed and immovable. It must be dynamic and responsive to the wider context.
Good luck with your project and enjoy the journey!
