Why It Matters
In the middle of the summer vacation season, what made over 1,500 people attend a recent WIHI about project management? What was so compelling about a topic that might at first seem so mundane?
Maybe it’s because few health care professionals learn about project management during their training. Most learn the hard way, through trial and error. Perhaps the promise of getting tips from experts seemed too good to miss.
Whatever the reason, the discussion on a recent WIHI was lively and full of practical advice from IHI faculty, including IHI Executive Director Karen Baldoza, IHI Executive Director Christina Gunther-Murphy, and University of Wisconsin Health Improvement Coach Julianna Spranger.
Their premise was simple: Even when you have the key ingredients for a promising improvement project — a clear aim statement, a good list of change ideas to test, a solid measurement strategy, an enthusiastic team, support from leadership, even strong quality improvement skills — they won’t guarantee success. You still have to know how to manage the project.
Running an improvement project is rarely a full-time job for most people. So, how do you make the most of the time you have? The presenters described five key strategies for setting up and managing effective improvement projects:
- Frontload the work — Gunther-Murphy noted that it's important not to skimp on putting time into planning, gathering baseline data, developing a measurement plan, and organizing your team. One tip she shared was to block time on your calendar at the beginning of an improvement project to focus on the upfront work. Spranger promised that devoting time in the early stages of work saves time later.
Build a big tent — Gunther-Murphy described ways to take full advantage of the talents and skills of all the people who can contribute to a successful QI project, including how a team leader can avoid being the one doing all the work. She shared a matrix tool (pictured below) to help teams identify the key people in their organization who have the ability to stop their project, let it happen, help make it work, or ensure its success.
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- Make it easy — Since improvement work is often added to team members’ full-time jobs, successful project teams must take full advantage of existing structures to get work done. Gunther-Murphy advised incorporating improvement work into already scheduled meetings. She also suggested thinking about how to “make the improvement meeting the best part of a team member’s day.” Some teams have done this by sharing how their work is making a positive impact on patients’ lives.
- Focus on learning, not perfection — Many teams waste time trying to perfect their aim, measures, and tests of change before they start their project. Instead, they should keep them flexible throughout the project as the team learns. “Everything should be in pencil,” Baldoza noted. “Focus on learning, not laminating.”
- Set an end date — Baldoza observed that improvement projects rarely have a natural conclusion. “There is always more to do!” she acknowledged. To maintain improvement momentum, however, determining an end date forces you to keep your goal in sight. She advised then working backward to plan when specific activities need to happen to reach important milestones.
A theme that ran through much of the program was how to figure out what was “good enough to drive improvement” rather than getting bogged down striving for an unnecessary ideal. The presenters recognized that there were trade-offs between, for example, tests that replicate exact conditions versus tests that provide learning opportunities. Baldoza shared some advice from her mentor that seemed to resonate with many participants: “Good enough data collected today beats exquisitely precise or official data that costs a lot and delays your need to test and act.”
IHI's Christina Gunther-Murphy and Karen Baldoza choose their favorite of the Five Practical Strategies for Managing Successful Improvement Projects.
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