Organisational changes in healthcare, part 1: The myth of IT projects
This blog article was published 21.08.2017 and thoroughly updated 22.11.2021.
Discussions on the public IT projects of healthcare easily give the impression that such projects always fail1,2. Either the schedule or the budget fails and the results are not what was sought. It is a well-known myth that the development of healthcare processes does nothing but consumes tremendous amounts of time and resources.
We can dispel this myth straight away, however: this is not always the case. Public IT projects can and do succeed, as long as project planning, implementation and evaluation are done carefully. By understanding the reasons that commonly make IT projects fail, it is also possible to avoid such an outcome. It is important to note that the IT projects always bring about a wider organisational change, which is a more complex phenomenon than a mere implementation of a technical solution. Organisational changes that are perceived as positive and successful have a positive connection to employer satisfaction and the organisation’s success factors3.
The most common stumbling blocks of IT projects are4:
- unfocused and changing objectives
- poor planning
- unrealistic time estimates
- lack of internal support and communication within the organisation
Making the purpose and objectives clear
It all starts with defining the need to change. It is vital to discuss on the ‘why’ at the very beginning of the project.
Simultaneuously, it is important to define clear objectives for the project. What do we want to achieve by conducting this project? Which factors are indicative of the change, how do we measure our success?
The objectives should be ‘smart’: specific, measurable, achievable, relevant, and time-bound5. A good baseline analysis helps to set achievable objectives. This way, the project participants don’t get discouraged by unrealistically high objective levels.
For example, improving the quality of care is a good objective, but it is also a broad concept, which is why measurable indicators are needed to support its analysis. Objectives and indicators should be set based on the baseline analysis.
It is key that all the project participants share the view on the necessity of the change, and have the objectives clear on their mind. The importance of the communication cannot be stressed too much. Even simple things, such as clearly organised agendas, minutes, plans of action and informative emails are of significance.
Similarly, the project should stick to its objectives. For example, there should be no slipping in the criteria required of suppliers: neither at the selection stage nor later during the project, when the promises get redeemed.
Planning from A to Z
Planning is another key factor for the success of an IT project. The plan should be developed in detail from the beginning of the project to the end. However, a margin of flexibility should also be left for any unexpected changes.
Important questions to be answered are, for instance: What concrete actions are needed to achieve the set goals and objectives? How do we make sure that we have all the competencies needed for this change? How do we get all the employees involved? Who will monitor the progress, when and how? All this requires a course of action containing rules, processes and tools for both project planning and management.
Furthermore, it should be taken into account already at the planning stage that healthcare information technology projects involve many moving components and different professional backgrounds (clinical, business and IT). In terms of the smoothness of the project, it is thus important for the project members to have mutually agreed expectations for the project from the very beginning. It is also essential to allocate the right duties to the right people.
Getting time estimates in shape
In order for the project to be successful and in conformance with both the budget and schedule, it is very important to estimate the time and resources to be spent on each task.
Without the existence of benchmark values from the beginning, it is difficult to define what is “on time”.
The progress of the project should be monitored regularly. Each stakeholder group should review the state of their own tasks and schedules regularly in order to keep the overall project on the right track.
However, schedules should not be too tight. Some flexibility is needed in case of unexpected setbacks, to enable corrective actions to be taken without ruining the original project schedule.
Having communication run smoothly
Communication breaks are often the downfall of any project. When information does not flow, project members are not able to prepare for unexpected situations, let alone being able to respond to them. This applies to the end users of the IT solution as well. If they do not know of the coming changes, they will quickly jump out of the sinking ship. Getting users to commit to the project already at an early stage facilitates the smoothness of the implementation itself.
Thus, active communication, training and member commitment should be emphasised during the entire project life cycle. In addition to internal communication within the organisation, there should be open communication with the suppliers.
Evaluating the change
In addition to the ongoing evaluation of the change, the final evaluation of the project is also important. The final evaluation should be carried out by the whole project team and its results communicated to the whole organisation. Did we achieve the objective, and how did we measure this? What did we learn, not only about the things we wanted to change and improve, but also about the process itself? How do we communicate the change and how do we move forward from here?
And above all – how do we celebrate the result?
References:
1. Talouselämä (2011): Suomella on pitkä IT-mokahistoria
2. Malinen & Pyykkö (2010): Julkishallinnon IT-kehityshankkeiden epäonnistuminen ja siihen johtavat syyt
3. Rastor-insituutti (2021): Specialist qualification in management and business administration, learning materials.
4. Dwyer, Liang, Thiessen & Martini (2013): Project Management in Health and Community Services
5. Sitra (2016): SMART-goals. Accessed 23.8.2021.
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