The Big “Little” Things in Big Healthcare Projects

A large project such as an Electronic Health Record (EHR) or Enterprise Resource Planning (ERP) implementation is daunting and intense for any organization. These type of transformational projects are typically larger than any previous organizational coordinated effort; and success in the project will influence the health system’s success as a whole. Directing a large project is more than maintaining a project plan, being attentive to the time frame, and keeping the budget under control. The softer elements of change management, culture, and personnel interactions can get lost in the structured work but are just as important.

Therefore, keep the following in the forefront of your mind as you implement a large transformational project:

Setting Expectations
This one is simple. Employees will be happier and more satisfied if you set clear expectations for their work and behavior. This does not mean micromanaging them, in fact, it is quite the opposite. This means giving them their expected outcomes, the cultural framework, documentation and change control processes, and the guard rails for communication and behavior; and then letting them own how to get there. If you do not set expectations, each individual will set his or her own. Management cannot hold staff accountable for unstated or undocumented expectations.

Change Management
Change management is different than operational readiness. It is about how the people in your organization will react to the new work, processes, and expectations that come as a result of a large project. Be honest that change is difficult but that it is also here to stay. Your staff’s value in today’s healthcare industry is in their ability to change, adapt, and incorporate change into the ever evolving business landscape.

Promote self-awareness in your staff by moving through the change process. We cannot expect everyone to be advocates or champions from day one. Below is the Kubler-Ross change curve, initially developed to identify the stages of the grieving process. The same stages can be applied and recognized in adaptation and acceptance of change.

Staff who excel at change can manage the depth (decrease in performance) and duration of moving through the process with the rapid-fire changes in today’s world.

How can leaders help? Show individuals who are stuck or lagging in the change process where they are on the curve. Provide the right message at the right time to your audience. Start with informational messages and save the inspirational communication and benefits promotion until your audience is on the right side of the curve.

Transparency and Learning Culture
Every project will have issues. And every large project will have many issues. Perfection is an aspiration but not a realistic goal. When issues do occur, address them head on and start with communication to those affected. One does not need a solution to the issue to acknowledge the effects first. Outward transparency with those leaders and people who have entrusted you to lead their project is key.

Looking inward to the project, it is important to create a learning environment. If project team members are afraid they will be punished for mistakes, errors will be hidden and go unreported until they blossom into larger issues. Teams will shift blame instead of focusing on the issues.

Instead, create a culture that focuses on communication and solutions first; one that pulls together in times where a difficult issue needs to be solved. Empower your staff to own their work, their issues, and their solutions. Don’t look for heroes; instead reward collaboration. Only after an issue is resolved should the team focus efforts on finding the root cause, then put in place measures to prevent recurrence. It’s OK to make mistakes as long as we continue to learn from them.

Trusted Partner
Chances are that your organization is not the first to be blazing a trail for whatever large project you are undertaking. Wrong decisions, time needed to research options, or delays due to indecision can cost real dollars in both operational and capital expenses in a project. Choose a partner that has been there before, that has seen both success and managed through failures, and that can help guide your project toward success. In the fast paced world we live in, there is not time to repeat others’ mistakes or “find our own way.” A partner can help bridge the gap from project start to end success.