Project managing for spread and sustainability

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Project managing for spread and sustainability

• Insert name of presenter

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Outline of session

• Improvement within the NHS
• Creating improvement by project management
• To plan and how to plan
• Working with spread and sustainability

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The NHS

• 50 billion turnover
• 1.3 million staff
• 300 Primary Care Trusts
• 200 Acute Trusts
• Comprehensive, needs based care
• Funded from general taxation

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Investment in Improvement

• Over 600 million invested in improvement since
  1998

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• The modernisation process in the NHS is, to my
  knowledge, the largest concerted systematic
  improvement effort ever undertaken, anywhere, in
  any industry
• Don Berwick, Institute of Healthcare
  Improvement,US A

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Managing the change process

• or hands off project management

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What is project management?

• A project can be defined as a sequence of
  unique, complex and connected activities having
  one goal or purpose and that must be completed by
  a specific time, within budget and according to
  specification (Wysocki 1995)
• So project management can be defined as making
  the project happen (Burke 1996)

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What have you done?

• Think about a project that one or more of you has
  been involved in.
• Identify 3 good things about how the project was
  run
• and then 3 bad things

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Feedback

• Some examples of things that have helped projects
  to go well

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Characteristics of a successful project

• Strong team development - good relationships
• Project aims defined and targets set
• Early process mapping
• Good communication

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Feedback

• Some examples of problems you have had with
  projects

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Common project problems

• Bad planning
• Inadequate monitoring control
• Moving goalposts
• Poor communications
• Disappearing staff
• Lack of support

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Essential elements

• Leadership
• Structure
• Ownership
• Planning and controls
• Communication
• Clear aim, objectives and success criteria
• Regular reviews

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Controlling your project

• Agree reporting requirements
• progress reporting
• exception reporting
• planned actions

can be used as a project record and reporting
system http//www.chdcollaborative.nhs.uk/
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Projects in controlled environments (PRINCE2)

• Controlled start
• Controlled progress
• Controlled close

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Role of the project manager

• Facilitates project team
• Agrees objectives, targets and aims within team
• Runs project meetings (internal and external)
• Produces project plan
• Reports project progress
• Manages variations
• Delivers project objectives, targets and aims

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Suggested project steps

• Establish Project Team

• Agree Aims/Objectives

• Identify Baseline Data

• Agree Targets

• Develop Project Plan

• Establish Data Collection

• Agree and Test Changes - PDSA

• Monitor Project Progress

• Implement Change

• Sustain/spread

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Gantt Chart
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Excel Gantt Chart
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Useful information

• Microsoft Project
• Visio
• Timecalendar LE 1.6.3
• Commercial Draw Packages
• Gantt Chart Creation in Excel www.mhbs.soton.ac.u
  k/newgeneration/ipe/ganttintro.htm

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Sustaining and spreading improvement
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Sustainability and spread?

• Sustainability means holding the gains and
  evolving as required, definitely not going back
• Spread means that the learning which takes place
  in any part of the organisation is actively
  shared and acted upon by by all parts of the
  organisation.
• Resulting in improvement knowledge that is
  generated anywhere in the system becoming common
  knowledge across the system leading to
  improvement action.

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We have mastered the improvement project but we
are a long way away from the improvement
habitPaul Plsek 2002
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SustainabilityWhat does the future hold?
Good
Performance
Idea!
Bad
Before
Later
Now
Time
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Improvement Frustrations

• The improvement evaporation effect (lack of
  sustainability)
• The islands of improvement effect (lack of
  spread)

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Approaches to spread
push

• collective
• individual

• authority

pull
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Spread v. Adoption
Source Fraser and Plsek, 2001
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Throwing a Rock or a Bird?In order to adopt an
idea you need to be attracted
?
y x2 b
f ma
attractor
Source Paul Plsek, based on Richard Dawkins
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Benefits of change
Infrastructure
Credible Benefits
Adaptable Process
Fit with Goals Culture
11 key factors that increase the likelihood of
sustainability and continuous improvement
Monitor Progress
Barriers Removed
Senior Leadership
Involved Trained
Clinical Leadership
Empowered Believe
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The goal is to spread sustainable change
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Learning points from this session

• Improvement within the NHS is a massive project,
  and it needs a lot of input to succeed
• Proper Prior Planning Prevents Poor Performance!
• Spread and sustainability are major challenges
  and we need to keep up to date with the latest
  thinking