By Michelle Mader
Behind every successful initiative are a clear strategy, a solid implementation plan and a dynamic champion. The success of any health care initiative depends on its champion’s abilities with respect to a number of key drivers, including effective communication; identifying reliable, attainable metrics; and answering the inevitable “Why?” questions with correlations to outcome.
The champion must first gain consensus and then design an effective implementation plan.
Toward that end, he or she must identify reliable, attainable metrics to gain stakeholders’ support and to justify personal and/or financial investments in the strategy. The champion must set a moderate timeline that will allow for the strategy to get off the ground, gain momentum and achieve the objective in a timely manner. Throughout the process, he or she must be an effective communicator with all stakeholders.
One of the key drivers of a successful strategy is the ability to correlate the strategy with an outcome that answers the question, “Why?” In fact, successful health care and design initiatives are structured around the answer to “Why?” in relation to their direct correlations to patient care, patient experience, patient safety and infection control, provider sustainability, staff efficiency and financial improvements.
These correlations are necessary to motivate people and get them behind a strategy even if it does not seem to benefit them. For example, an ambulatory care strategy that locates clinics in communities rather than at hospitals has clear correlations with patient convenience and satisfaction, positive outcomes and cost-effective care — even though it means that providers will need to leave their offices and go into the community to see patients. A champion must present reasons that are both larger than any of the stakeholders’ personal agendas and more specific than “We ought to do this.”
If a champion can validate the projected outcome with reliable, attainable metrics — for example, industry statistics and examples of other locations in which the strategy has succeeded — then stakeholders will understand that the initiative is worth getting behind.
Of course, due diligence requires the champion to look at all the possible scenarios, including the negative ones, and this takes time. The champion needs to assure that the strategy is valid. One can fake knowledge and momentum, but it is not possible to “fake it ’til you make it” on strategy. In the end, its implementation will tell everyone whether or not the strategy has been a success.
Moreover, the success of a great strategy depends on a great implementation plan. And the best implementation plans have an effective communication plan, doable metrics and evidence of steady momentum as defined by clear, successive goals.
Feasibility: Thumbs-Up or Thumbs-Down?
The initial “thumbs-up or thumbs-down” decision is crucial. If the organization rushes forward with an idea lacking a clear strategic thumbs-up or thumbs-down decision, the organization will suffer either way. That is, if the team pushes forward before deciding whether or not the idea has merit — with solid content and a long-term viability of success — then the first phase of implementation will be dominated by an attempt to make this determination. Even if the organization concludes that it is a thumbs-up initiative, the actual implementation plan will require a longer timeline. In contrast, if the organization reaches a thumbs-down decision on the idea, then considerable resources — including time, effort and money — will have been wasted.
In most cases, a formal feasibility study is required to avoid these unproductive scenarios. Although a consultant may require several weeks to conduct a feasibility analysis to determine if an idea has merit, in the end, the investment in pursuit of a non-viable idea can easily be three to four times the cost of the study.
In one case, a feasibility study was conducted for a hospital considering expanding its OR platform with additional capacity to serve existing high demand and accommodate market growth in several key service lines. The data confirmed existing high demand, but it also showed that the surgical unit could grow incrementally and increase revenue without building new ORs. Based on the analysis, the consultants concluded that building new ORs was a thumbs-down idea. However, the hospital culture did not motivate and encourage its surgeons to use their block time efficiently. Rather than address culture to increase efficiency, the hospital leaders compromised, building four new ORs and flooding them with service lines such as GYN, podiatry and ENT, which produce low revenue. Bottom line: The hospital lost money on the investment.
In contrast, if the feasibility study results in a thumbs-up decision, then the implementation team can proceed with a clear plan. In one case, a feasibility study was conducted for a micro-hospital joint venture between a hospital and a Native American tribe, which was to be located between the reservation and the site of the main hospital. The consultant posed the thumbs-up/thumbs-down question: Will it be financially sustainable? The partners were skeptical. The study analyzed key factors, including population density, utilization rate and demand for various types of services, and the consultants concluded that it was a “thumb-sideways” or “bubble” project.
The partners were presented with the steps required to turn it into a thumbs-up project. They agreed to the required steps, which shifted the project to a thumbs-up initiative.
By shifting a project early on from a neutral to a positive position, the building blocks for success are set in place. It helps to be able to anticipate future issues and to determine areas where the impact is greatest. As the first part of a multi-stage process, the feasibility study is the ideal tool for examining operational and economic issues and strengthening the project team’s ability to meet challenges that occur as a project moves from concept to reality.
Michelle Mader is the president of Catalyst, FreemanWhite, based in Charlotte, N.C. Part II of this two-part series will be available online soon.