You have a project problem and it’s bigger than you think

What can be done to solve it?

There’s a better than decent chance a project you’re working on right now is headed for disappointment. The academics tell us that 70% of the projects organizations start will fail to meet their original business intent.

That’s a lot. Cut the rate in half and it’s still a lot.

Take a look at your work calendar and count the number of projects you’re spending time on this week. How many of those are you willing to settle for less than expected results? One? Two? Half?

None?

The research is not on your side.

And a failed initiative is just the start. Bad projects have consequences.

Missed competitive opportunities, runaway budgets, vendor lawsuits, and frustrated employees are just a few of the negative outcomes. The more personal results include sleepless nights, crippling anxiety, career speed bumps, and the like.

Separate research tells us the long list of “Why?” includes a lack of executive sponsorship, poor communication, an unprepared project team, scope creep, misunderstood workflow, an inability to articulate requirements, and a mess of other organizational complexities preventing the project team from getting the job done.

Unfortunately, it seems we’ve created an environment in healthcare delivery organizations where perfect conditions must exist if a project is to reach it’s full potential, not to mention within scope, cost, and schedule expectations.

Yet perfect conditions rarely (never?) exist. The list of what-could-go-wrongs is longer than the list of potential project challenges. So it’s time we admitted something: we have a project problem. And it’s a bigger than we think.

Projects are How Organizations Change

The only way to change anything in an organization is through a project.

Yes, a project: a temporary endeavor to produce something beneficial.

David Cleland, hailed as the father of project management, said it well, “Projects provide an organizational focus for conceptualizing, designing, and creating new or improving products, services, and organizational processes.”

Projects are how organizations improve, innovate, and implement anything and everything. There’s no other way.

So projects have become the de facto way of working for most managers in healthcare delivery organizations. That means projects are happening (and failing?) at all levels of the organization.

Yet as the work has shifted to projects, our ability to implement them hasn’t much improved from already dreadful results: change management initiatives have had a consistent success rate of 30% for decades.

And, in my experience, actually getting better at implementing projects hasn’t recently emerged as a priority in most organizations.

Add it up and it’s no wonder prospective project team members shudder at the idea of adding another responsibility to their project docket. Bad projects are taxing, anxiety-ridden, and full of frustration. It is more work even if the hours in the office don’t seem to change.

Bad Projects are Bad

In the case it isn’t obvious: bad projects are bad.

Change is slowed or doesn’t happen. Resources are wasted. Project teams get frustrated. Careers can occasionally turn on poor outcomes.

A bad project is a project that experiences preventable challenges as a result of factors within an organization’s control. And frankly, most of the factors that lead to challenged projects are within an organization’s control. Unfortunately those factors aren’t usually revealed until a bad project is well into its badness.

In the case it isn’t obvious: bad projects are bad.

Bad projects, just like successful projects, come in an abundance of varieties making bad projects difficult to identify. The thing that makes a bad project a bad project this time, may not be what makes a bad project a bad project next time.

But a bad project does have a feeling. A feeling that something isn’t right. It can be hardly noticeable at first, perhaps brought on by a wasted meeting or missed deadline. The feeling can grow — sleepless nights and dreaded “red light” updates — until it’s obvious to everyone on the project team that this one is nearing disaster.

That feeling, I believe, is caused by the looming failure that arrives with the loss of project momentum.

Project momentum — a fragile and squishy characteristic unmeasurable with project management tools — is the force that relentlessly moves a project toward completion.

Because what’s a project if it’s not speeding toward implementation?

Likely a bad project.

What can we do about it?

Of course some bad projects are bad and still turn out okay. That’s the result of a foggy memory, lowered expectations, dumb luck, or the rescue effort of an individual hero.

Absent heroes — because to be direct, a project should not require a hero for it to be implemented successfully — what can be done?

There’s an easy answer. Truly. But it comes with we-have-work-to-do news: we (us!, individuals and organizations) have to get better at implementing projects.

And I’m not talking about project management. I’m talking about project implementation skills.

Projects are challenging. They require extra work, collaboration, domain expertise, communication(!), critical thinking, situational awareness, problem-solving, faith, support, oversight, planning, preparation, and a whole bunch of other skills, traits, and experience many project leaders haven’t spent sufficient time developing.

It’s tempting, I think, to try and solve the bad project problem with centralized efforts like an enterprise project management office or a One Best Way Edict™.

Neither is a sufficient response.

Even a great project manager outfitted with a sanctioned implementation methodology isn’t enough to wrangle the complexity of a project in a healthcare delivery organization without the full and necessary participation of an entire project team equipped with the ability to make a project happen.

The only way to get better at implementing projects is to learn how to implement them and hone learned skills by implementing more projects.

Which is actually good news, in my opinion, because as we all know healthcare delivery has plenty of opportunities to do better.

Getting Better at Projects Improves Everything Else

Getting better at implementing projects will help our organizations be better at everything else because projects are how organizations improve, innovate, and implement.

Of course, projects will continue to fail because projects happen to fail for a multitude of reasons outside the control of an engaged project team.

But they should not fail because of factors within an organization’s control. That’s a bad project. And bad projects need to be eliminated.

There are real costs to bad projects — not the least of which has made projects a burden to both organizations and individuals, something to be feared and avoided. That’s a real shame because projects are the vehicle to do really great work in making our organizations, communities, and healthcare delivery better for everyone.

Which, you know, is all of us. And the reason we’re here.

I’m scouring the country for people and organizations that have solved the bad project problem and/or are just really good at getting things done. Send me a note if you know someone or an organization that fits the bill.

Innovation Autoimmune Disorder is killing your organization’s innovation strategy

And why a heretofore taboo approach to organizational problem solving — vendors — may now be part and parcel to the solution

Every day, almost every employee in your organization is saying no to innovation. They don’t mean to, of course. But it’s happening. And the thing of it is: you are absolutely encouraging it.

That’s because your organization’s structures and systems have been optimized to be profitable and efficient and reliable at carrying out the day-to-day operations of delivering healthcare services.

That’s unquestionably good.

It’s also bad.

Those same structures and systems the organization relies on for normal day-to-day operation are also very much preventing innovation. On purpose.

An organization’s structures and systems can be thought of as an immune system, a defense mechanism against variation — the scourge of profitability, efficiency, and reliability.

That has produced a crushing paradox: at a time when innovation is needed most, most organizations don’t have the capability to innovate.

This paradox is called Innovation Autoimmune Disorder and it’s killing your innovation strategy.

Diagnosing Innovation Autoimmune Disorder

There’s a notion in technology circles that a company produces products in the image of how the work gets done in that organization.

In other words, a company’s products or services come with similar properties and capabilities as the organization’s structures and systems.

The phenomenon even has a name: Conway’s law. The adage goes, “Organizations which design systems…are constrained to produce designs which are copies of the communication structures of these organizations.”

It makes sense: organizational structures and systems necessarily influence the way the work is delivered because structures and systems are what an organization uses to communicate.

This idea, however, isn’t only present in technology companies. All companies design systems. So all companies are constrained by the structures and systems of their organizations, including healthcare delivery organizations.

How does a healthcare delivery organization launch a new service? By designing a system.

The process of launching, creating, starting, building, embarking, initiating, and any other effort of commencement in a healthcare delivery organization follows a similar path: an approach almost always governed by time-tested methods of planning, direction, and control. That’s because accepted methods of planning, direction, and control have consistently produced profitability, efficiency, and reliability.

A business plan is created. Funding is approved. Space is acquired, built out, and outfitted. Staff is hired and trained. Technology is installed and connected. Marketing and internal communication plans are created. All stakeholders are given the opportunity to provide input, concerns are stated and addressed, the project is scoped, a project schedule and budget are established, and the service opens for business according to plan.

Innovation is designing new systems too, of course, and healthcare delivery organizations that attempt to apply traditional planning, direction, and control methods to make it happen often find it doesn’t.

That’s Innovation Autoimmune Disorder: the implicit and explicit rejection of potential innovation caused by an organization’s structures and systems. It is the ultimate statement of “that’s not the way we do it around here.”

Support departments say no to — or fail to make exceptions for — a new idea, a new approach, a new vendor partnership, or some other request because of traditional planning, direction, and control reasons.

Brick Walls by by David Pisnoy, Shoot N’ Design, Michał Grosicki on Unsplash

IT, HR, vendor management, project management, and every other centralized function are all governed by previously established processes. Policies and procedures have been honed over the course of decades. Management practices — for all things: employees, interdepartmental relations, budgeting, performance management, etc. — have been optimized to serve large bureaucracies.

Innovation fails to materialize as a result.

New ideas go unpursued because project charter, scoping, and committee-approval requirements are burdensome. Procurement procedures prevent the purchase of anything outside what the bureaucracy deems acceptable. Administrators concentrate on budgets and efficiency because performance management focuses on short-term deliverables.

So while C-suite survey results continue to indicate that innovation remains an important strategic priority for healthcare providers, desiring innovation is rarely enough to make it so. Organizations that rely on the same structures and systems to innovate that they do for planned, directed, and controlled change are systematically rejecting innovation every day.

Treating Innovation Autoimmune Disorder

The healthcare delivery organization is organized and operated purposely so that each day is unremarkable from any other.

The problem for organizations is that the industry in the midst of remarkable days. The operating environment is changing faster than any organization’s current ability to respond. The challenges are arriving on multiple fronts — regulatory, operational, reimbursement, consumerism, workforce.

Industry norms are shifting. Tactical paths forward are relatively unclear. A dramatic technology conversion beyond the electronic health record is underway.

These are the reasons innovation is so urgently desired in healthcare provider organizations. But Innovation Autoimmune Disorder too often gets in the way. Shifting an organization’s structures and systems to incorporate innovation as an accepted exception is the required long-term approach.

Overcoming Innovation Autoimmune Disorder will require healthcare delivery organizations to craft structures and systems that explicitly support innovation.

While those structures and systems will be unique to each organization’s specific objectives and distinct characteristics, there are three essential objectives every organization must pursue to explicitly support innovation.

Shining light on a different approach. Photo by Crown Agency on Unsplash

Make it okay to try new ideas. Innovation requires trying ideas. Innovation activities will produce unsuccessful outputs, but many can’t be labeled failures until experimentation has occurred. Choosing the right idea to develop further is surprisingly difficult in a planning-oriented environment. It can be made easier by testing in real-world environments. That requires experimenting with ideas which will occasionally lead nowhere but may serve as a building block to something better. It’s impossible to know the extent to which a new idea will improve value, increase revenue, and grow market share until it is tried.

Incentivize working together in new ways. Innovation requires business units, departments, and service lines to collaborate in new ways and be open to the possibility that a predefined outcome may not always be a basis for participation. Traditional interaction patterns should be set aside to explore something different. Take support departments and the operation, for example — instead of being perceived as gatekeepers of resources, departments like IT, HR, and project management can become partners in solving business problems with no predetermined approaches.

Make technology available to support new ideas. Innovation requires making technology available and accessible. While technology is only part of a solution — every innovation project utilizes a combination of people, process, and technology resources to create an output — even prototypes increasingly rely on technology for initial demonstration. Traditionally, administrators have had decision-making authority over elements of people and process decisions, but technology choices have remained the domain of IT. A budget is vital, but to innovate administrators must have access to all resources and, more importantly, agency in using them.

Finding Support Along the Way

Of course innovation-focused structures and systems are a long-term shift — and potentially longer than what organizations may be comfortable with given the pace of industry transformation. That reality is giving way to the realization that a heretofore sacred belief may be open to reexamination.

“More than 75% of leader respondents,” to a recent innovation survey from the American Hospital Association and AVIA, “believe that innovation must include partnering with other innovative organizations.”

Partners can help. Photo by Todd Diemer on Unsplash

The previously taboo approach to organizational problem solving — vendors — may now be part and parcel to the solution. Outside help may not only be needed, but required.

Healthcare delivery organizations have traditionally addressed strategic challenges with a mix of internal subject matter knowledge, technical proficiency, and industry best practice. The limits of that approach are evidenced by the survey results above. This version of healthcare transformation requires organizational capabilities not currently found in most contemporary provider organizations.

The shifting operating environment requires new organizational expertise in digital technology, emerging operating domains, and efficient implementation methods. Vendors, or in this new paradigm, partners — with their products, services, subject matter expertise, industry expertise, technical skill, and ability to execute with urgency — are the most reliable method to immediately leverage required know-how that doesn’t exist in most organizations.

There is no quicker way to overcome Innovation Autoimmune Disorder than to involve partners. Partners offer a plethora of opportunities to operationalize innovation across the organization.

Some organizations are starting to realize a partner approach may prove strategically beneficial for these reasons. GE Healthcare has launched partnerships with several organizations including Jefferson Health in Philadelphia and Partners Healthcare in Boston, AVIA’s innovation network business model is built on the idea, and industry integrator Catalyst HTI is opening a building in Denver explicitly for this purpose.

These partnerships are a good start at the executive level. But the strategy must diffuse deep into the organization if it is to find its full potential. Perhaps partners — of all types and sizes — can help the middle of the organization innovate right now if they were made available.

Industry partners will play an increasingly larger role in the transformation of healthcare delivery given the dramatic shifts on all fronts. To that end, organizations must become comfortable with new people, new concepts, and new ideas coming into the organization.

An organization’s structures and systems will adjust in time. Because just as structures and systems ensure profitable, efficient, and reliable operation, they also adjust as organizations realize the necessity of adapting and evolving.

And until then, partners can help.

As they always have, the competitive, regulatory, and operating environments are shifting. This time, however, the traditional model of adapting and evolving is preventing healthcare delivery organizations from doing just that.

Innovation Autoimmune Disorder is killing your organization’s innovation strategy. Do something about it now that you know: call a partner.

The Missing Ingredient from Healthcare Transformation

And How to Get Your Hands on Some Magic

As a healthcare administrator, you know there’s a missing ingredient from the proclamations about the Future of Healthcare Delivery™ emanating from conference stages, press releases, and white papers.

The magic to make it all happen.

Until now.

Introducing: Healthcare Transformation Magic Crystals

I was once a let’s-make-this-better, imagine-the-possibilities, nobody-can-stop-us real-life healthcare administrator.

It’s that perspective that gives me levitating excitement for the future of healthcare delivery — the future predicted by the technologists, consultants, and thought leaders: an innovative, data-driven, value-based, machine-learned, digital nirvana.

But there’s a secret every healthcare administrator knows and every disruptor is learning: changing healthcare delivery requires work. A lot of it.

It’s that perspective that makes me think magic is the missing ingredient preventing the promised future from being pulled out of a hat like the promises that come with it.

So I know we’re solving a wide array of healthcare provider execution challenges with a product perfect for boards of directors, executives, and administrators wishing to make healthcare transformation appear in their organizations: Healthcare Transformation Magic Crystals.

Mined from the deepest, richest, and most magical gem source in the world, Healthcare Transformation Magic Crystals can make any strategy appear out of thin air — no matter where the strategy originates including, but not limited to, conference stages, consultant deliverables, technology vendor promises, and even the hopes, dreams, and wishes of an internal planning session.

They’re easy to use. No wand required. Previous experience with magic isn’t necessary.

Just combine a copy of a shredded project plan document with an ounce of the Healthcare Transformation Magic Crystals into a 9×12 manila envelope. Seal. Place on a shelf. Wait.

Abracadabra.

You could be amazed with the results.

Ignoring the Required Work

Healthcare transformation is real. It’s happening. It will continue to happen. We’re complete believers.

But without magic it’s not arriving via moonshots, grandiose op-ed think pieces, or generality-plagued conference talks. Because without magic those pronouncements, platitudes, and prognostications are going to require a lot of work.

And, from the back of the theater, it seems the future is arriving much too quickly for anyone to be bothered with real, actual work.

That reality is completely irrationally understandable.

Just think about the sheer amount of work that must be accomplished to operationalize a single transformation strategy in a single healthcare provider organization. It’s striking!

This Harvard Business Review article about a completely logical way of involving clinicians in managing the cost of care is a great example.

How long would an initiative like that take in your organization? Think about how much work — how many projects — are required to actually make it happen. It’s a lot. Like a lot a lot.

But at least the thinking is manageable. Ask the same question for this completely sensible way to transform an entire healthcare delivery organization, also in the Harvard Business Review, and you’re likely to struggle just figuring out where to start.

It’s obvious why ignoring the work is such a tempting detail to overlook: it gets in the way of overpromise, hype, and illusion.

The Fine Print and Some Free Advice

It’s here that I must inform prospective buyers that the Healthcare Transformation Magic Crystals come with no product guarantees.

But they do come with this piece of rock-solid advice: Get started and do the work.

It may not be as immediate, it may not be as sexy, and the projects may not be as fun as the promised near-future would lead us to believe.

But it will be successful.

In fact, it’s the only way transformation happens. Project by project.

Of course, looking back, it will have arrived in part through those pronouncements, platitudes, and prognostications, too. But the journey is likely to be much longer than the future-is-coming-sooner-than-you think dogmatists would lead us to believe.

It’s okay to be realistic about making change happen. It’s okay to be content with the day-to-day activities of doing the work. Not only do we think it’s okay not to subscribe to a dramatic vision of the future, we believe it’s pragmatic and practical and the path to real progress.

However, if you’re looking for a shortcut, definitely give these Healthcare Transformation Magic Crystals a try. We’ll send you a free sample if you’re interested. Fill out this form and we’ll drop them in the mail.

They’re real.

Well, as real as magic can be.

But if they seem to have lost their magical powers before you can use them: call us.

We’re ready to work.

With you.

And we know where to start.

Every month we deliver an email with project ideas, healthcare insights, and tips to help you do your job better. Sign-up here.

Status:Go creates software for healthcare delivery organizations so they can improve operations, execute strategies, and try new ideas. We know healthcare, Salesforce, and how to get things done. Get in touch to get your project started.

Shitty Work Thing

A … thing … for healthcare administrators braving their way through shitty work things

Airfares in and out of Las Vegas’s McCarran International Airport are relatively inexpensive.

That’s good because that’s where you are.

But you’re not on the strip, nor touring the Hoover Dam, nor hiking in the Grand Canyon.

No, you’re at Clark County’s most infamous tourist attraction: America’s largest landfill.

You’re standing on a mountain of garbage in the middle of the 2,200 acre Apex Landfill with nothing but trash all around you. There are the remnants of bulldozed refuse for as far as you can see. There are neon-colored puddles of liquid at every step. There are so many birds they block the sun.

And that stench! It’s enough to take your breath away.

Standing in the middle of America’s largest landfill wondering how the heck you got here is what it feels like to go through a shitty work thing as a healthcare administrator. People suck. Bosses are assholes. The job’s requirements are out of touch.

You’d love to sit down and rest: trash. No matter how high you try to climb: still standing on trash. The path out: through lots of trash.

It’s lonely. It’s depressing. It’s difficult.

Time and again I’ve seen healthcare administrators get stuck in a rut at work and struggle to climb out — including myself.

This is My Story

Her assistant phoned and asked for my presence. I immediately made my way to her office. We exchanged hollow pleasantries.

“Have you seen the movie Sophie’s Choice?,” she started.

“No,” I responded. It wasn’t the first time she’d attempted to use the premise of a movie to communicate something important. So I knew something was coming.

“It’s the story of a Holocaust survivor.”

“Okay.”

She got to the point.

“Sophie arrives at Auschwitz with her two children. The Nazis force her to choose which child gets to live — her son or her daughter. She agonizes over the decision and ultimately chooses her son.”

That’s dark, I thought to myself.

It was the beginning to the end of something that just six months prior felt like a remarkable opportunity.

It was the beginning to the end of something that just six months prior felt like a remarkable opportunity.

The department I was leading had been eagerly gobbled up by an organizational restructuring as part of a shiny new unit created to carry out an exciting new strategy. I was excited! The forefront of change! A career-altering moment!

But a week into the new world I was ask-told to take leadership over a dysfunctional department in addition to my cutting-edge program responsibilities. “I think you have capacity,” she said.

A few days later I followed with a dutiful yes after convincing myself of the “opportunity.”

But it was too much. The problems on one side kept me from the opportunities on the other. It was an exhausting six months of slow progress, limited access to leadership, murky communication, 30+ direct reports, limited HR support, non-existant IT support, angry colleagues, torturous meetings, missed (unrealistic) deadlines, and even a co-worker backstabbing.

My reward was this excruciating conversation.

“Drew, you have a Sophie’s choice to make,” she presented, “You must choose between this amazing opportunity (it wasn’t), working for a great boss (they weren’t), and doing important things for the company (it was a disaster) or going to work in an area you’re passionate about (true), as part of a new department (uh oh), for someone who until this moment has been your peer (backstabbers are never pleasant to work for).”

“And since both of those leaders are at the director level you’re going to have to become a manager.”

Six months of landfill walking had climaxed with a Choose Your Own Demotion Adventure.

A Shitty Work Thing is Difficult and You Need a Little Help

It wasn’t supposed to feel like this. It wasn’t supposed to be like this. It wasn’t supposed to be this.

But here you are.

Shitty work things are shitty because they get in the way of doing good work — which is the reason we got into healthcare administration to begin with. Being a healthcare administrator is already hard enough. Add a shitty work thing on top and the job can quickly become undoable.

So I created a … thing … for healthcare administrators braving their way through shitty work things. It’s called, wait for it … Shitty Work Thing for Healthcare Administrators.

A shitty work thing is just that: a prolonged period of job dissatisfaction stemming from something shitty at work.

Shitty Work Thing for Healthcare Administrators is designed to help you move through it. It’s part reflection, part inspiration, and part motivation. Shitty Work Thing for Healthcare Administrators delivers twenty emails over twenty work days to help you focus on the work, tune out the noise, and find a path out.

That’s what we’re after: getting to the other side. Because there is a path out of this landfill.

This experience — this right now — is something you’ll learn from. And you’ll get to apply what you learned to new situations with new employees, new bosses, new projects, and new anything else that needs to be managed. Going to work will become enjoyable again.

But that’s getting ahead of ourselves.

My friends made it through shitty work things. My colleagues made it through shitty work things. Employees that worked for me made it through shitty work things. I’ve made it through shitty work things.

As in the cases of all those, you just have this difficult task before you: getting through yours.

They did it. We did it. I did it. You can do it.

And the twenty emails of Shitty Work Thing for Healthcare Administrators were crafted to help you do just that.

Learn More: Shitty Work Thing for Healthcare Administrators

That new innovation center could make the innovation problem worse in your healthcare organization

And why what you need instead is an innovation workshop

“It’s hard. It’s just too difficult,” a healthcare administrator recently shared with me, “But we have a new CEO starting soon and he wants to create an innovation center.”

Healthcare delivery’s innovation problem has become apparent when those managing in the middle of the organization — where strategy is executed — are beginning to express concern.

Innovating inside a healthcare delivery system is difficult. Existing structures and systems (how the work gets done) are designed to say no to new ideas. They are designed to promote profitability, efficiency, and reliability — all great pursuits for an organization but too often prevent innovation from even getting started.

So it’s no wonder the idea of carving out innovation from the rest of the operation is so appealing: without the distractions and barriers of the operation, innovators are freed to innovate!

“Innovation isn’t a core competency of many healthcare organizations,” said a respondent to a recent innovation survey from the American Hospital Association and AVIA, “The industry needs help identifying options for advancing meaningful innovation and building the structure needed to support it.”

It’s the second half of that statement that is so revealing of the report’s finding that “72% of hospitals with over 400 beds are planning to or have already built an innovation center.” An innovation center is a direct answer to the innovation core competency problem in healthcare delivery organizations.

But will it be an effective response?

The Appeal and a Paradox

The difficulty of innovation has led a growing number of healthcare delivery providers down the path of creating innovation units separate from the operation. An innovation center is usually a dedicated space outfitted with all the creative necessities. It’s often set-up and managed outside the normal org chart and management requirements. It is staffed by employees with skills to fulfill the center’s innovation model.

The appeal of the innovation center idea is apparent — by design it overcomes the distractions and barriers that often prevent innovation. Innovation centers create innovation. They produce innovative things. And they do so because of their deliberate focus on innovation.

But the experiences of some early corporate diffusors of an idea similar to the innovation center — the innovation lab — prove cautionary and may be an indicator of what’s to come. Nordstrom, Coca-Cola, The New York Times, Disney, Microsoft, among others have all scaled back or eliminated their once promising innovation lab efforts.

It seems that translating innovation back into the operation proved more difficult than originally anticipated.

“It’s time to ditch your innovation lab,” was the title of a VentureBeat commentary assessing the downscaling announcements.

“Rather than just a team focused on innovation, it’s now everyone’s job,” said a Nordstrom spokesperson at the time of Nordstrom’s decision to shut down its lab.

In fact, one observation from a report compiled by digital product studio Made by Many might end up being the definitive conclusion on innovation labs: “… we found that the innovation lab model often promises a lot without delivering quite so much in terms of tangible success.”

Producing Enabling Innovation

These thoughts are indications that innovation centers might exacerbate the innovation problem in healthcare delivery organizations, not solve it. And if that’s the case what’s an innovation-hungry healthcare delivery organization to do?

It’s not the innovation center (or lab) that is the problem in my estimation — it’s the type of innovation it focuses on that proves problematic. And it’s only problematic because the innovation being pursued in the innovation center isn’t the type of innovation organizations were seeking when the strategy was created.

An innovation center produces emerging innovation — futuristic technology, what-if scenarios, pioneering business models, and the like. The issue in an innovation-poor environment is that most of the organization (departments, service lines, administrators, etc.) isn’t searching for those things. Let’s go back to the survey respondent’s comments, “The industry needs help identifying options for advancing meaningful innovation and building the structure needed to support it.”

Most of the organization is on the hunt for enabling innovation — innovation that makes a job easier, an experience better, moves an operating strategy forward, and the like.

Emerging innovation may be important to the future of the business. Enabling innovation is essential to making healthcare better for patients, providers, and employees right now. It’s critical to the operational leader meeting and exceeding job expectations. It’s necessary to the step-by-step nature of how healthcare transformation actually happens.

It also creates the structure that will allow emerging innovation to become useful in the future.

So instead of innovation centers I think healthcare delivery organizations need innovation workshops to bring innovation where it’s needed most: directly to the operation.

The Innovation Workshop

A workshop is a place to produce useful things. It has similarities to a lab: experiments, investigations, observations, and such. But a lab does those things to discover. A workshop does those things to solve problems.

The innovation workshop embraces projects directly connected to solving problems and executing operational strategy.

There’s no one-size-fits-all approach to innovation workshops. They can be permanent or temporary. They can live in a department or be placed on wheels and move around to where they’re needed next. They may employ in-house resources, or be operated by a partner, or a mixture of both.

They are required to have capabilities (facilitation, technical, domain expertise skills, and the like), resources (agency over people, process, and technology decisions to prototype solutions), financial support, be commissioned to navigate the bureaucracy, and exist as part of the operation.

Innovation workshops would give administrators a path forward to solving real and immediate business problems. The work would build on itself, identifying new needs and implementing new solutions along the way. They could deliver innovation at scale throughout an organization by making innovation available to everyone that needs it.

Innovation workshops would produce the enabling innovation required for healthcare transformation by embracing the constraints and affordances present in the operating environment.

Because when innovation is part of the operation it can answer specific questions, solve real problems, and foster strategy execution. That doesn’t happen when something has been conceived in a lab’s sterile environment. The best place for enabling innovation is right there where it’s needed as a part of the operation.

And that place is in an innovation workshop.

Wouldn’t you know it? We just launched a new solution we’re calling Innovation Workshop designed to overcome the organizational inertia preventing you from innovating. Learn more here.

Every month we deliver an email with project ideas, healthcare insights, and tips to help you do your job better. Sign-up here.

Transformation on your plate? Pick a project. Start. Execute. Repeat.

Healthcare delivery organizations, and departments or service lines in particular, need an approach to adaptation that matches the volume of change within the industry.

The refrain “It’s coming at us all at once” is echoed in organization after organization after organization. The demands of transformation are constant and unrelenting.

Since projects are how organizations change, and change is constant, projects should be constant, too.

Start. Finish. Repeat. It’s the only way to transform.

Constant projects? But how?

Keep it short. Limit the scope of any project to a timeframe that is manageable, keeps participants engaged, and quickly produces an outcome. A twelve-week timeline is a respectable benchmark. Is the initiative larger than the single project? Do another one! More than that? Do another project! What’s that old project management adage — when’s the best time to start another project? Right after you finished the last one! (Oh, maybe that came from sales…)

Ditch the meetings. Instead of using meeting time to update project status or badger slowpokes for the work they promised or manage pending risks or etc., use that time to work on the project. Limited scope projects have timelines that demand constant action. Project participants will actually show up and participate if you get actual work done during a reoccurring calendar block. Save the weekly status updates for the end-of-the-project celebration!

Think real time and show progress. Try new functionality — changes in people, process, and technology — first in the meetings-where-work-is-done and then in the real world. Review it! Validate it! Encourage participants to provide input — “yes, I like this;” “no, I don’t like that” — and make decisions to adjust or move forward — “yes, thanks for your opinion and that’s a great addition;” “yes, thanks for your opinion and we’ll save that for a future phase.”

Enhance! Enhance! Now it’s time to improve. To iterate. No project is ever, ahem, finished. Of course it will be introduced into the world and become the new way of doing but that doesn’t mean it can’t be improved or altered or added to. A solution should be adjusted as the project outcome meets the real world and feedback is received. Add small things. Add big things. Try new things.

Believe in temporary. Maybe something drastic changed and the project outcome needs to be eliminated just a year later — that’s okay!, it was such a short project and great utilization of resources that the project outcome did what was needed. It was the bridge from there to here. And if we really go macro on it: every solution ever has been temporary. Things change. All the time. Projects that help departments move from one state to another are successes. Time to get started on the next project.

Increase the execution rate. Do projects. Lots of them. All the time. Finish projects. Keep going. It’s been said many different ways but the only known way to succeed is to try lots of things. Embrace the 10,000 Experiment Rule.

Train. Train. Train. Train. Train. Train. Projects go off the rails at this most important juncture: the translation of the new project into a live environment (and this advice isn’t only for technology projects). Resource-constrained organizations, most all of them, find that training is a convenient place to trim costs. Trimming costs is a fine objective — but don’t skimp on training time and resources. All that hard work of making a project happen shouldn’t go down the drain at the climax of execution.

Big transformation on your plate?

Pick a project.

Start.

Execute.

Repeat and keep going.

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This originally appeared over here.

An ode to projects

Projects are how organizations change.

A project is a temporary endeavor to produce something. Something that produces a tangible change in the way an organization does something.

The more projects an organization starts and finishes, the more change that is produced.

Demands on today’s healthcare delivery providers are marked by shifting external forces, rapid technology adoption, required cross-function collaboration, pursuit of new competencies, known knowns, unknown knowns, yes — even unknown unknowns, and probably a few others.

It’s a foggy future. Projects are how organizations navigate to it.

Projects are how an organization creates, how an organization adapts, how an organization eliminates. David Cleland, hailed as the father of project management, said it well, “Projects provide an organizational focus for conceptualizing, designing, and creating new or improving products, services, and organizational processes.”

Yep.

Projects are how an organization gets things done. Projects are how an organization executes. Projects are how an organization transforms.

Projects are the most important pursuit of every healthcare delivery organization.

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This originally appeared over here.

Do the Work: A pragmatic approach to transformation that makes healthcare better for patients…

Part three of many in the ongoing series: The (in)complete definition of healthcare transformation

Part One | Part Two

There’s a lot of work required to transform healthcare delivery organizations from where they are now to where they need to go. That work doesn’t happen at a single point in the near future — there is a long and winding path, not necessarily linear, that must be traveled.

That work is why healthcare transformation calls for constant motion that moves organizations closer to where they need to go. It calls for a pragmatic approach to doing the work. It calls for taking action.

It’s easy to get caught up in contemplating, discussing, and proclaiming the future of healthcare delivery.

Because the future of healthcare delivery is going to be great. Really.

In an industry with widespread agreement about the utility of sweeping transformation, it is exciting to ruminate about the power of health promotion, machine learning, digital health, patient centeredness, universal access, personalized medicine, service systemization, blockchains, partnerships, and the rest of our transformational aspirations.

Since transformation appears generally a desirable ideal and given that transformation is only visible from the future, it seems worth reaching a transformed state as quickly as possible.

But how?

Taking Action

Market responsiveness is what propels transformation. Strategies of expanded access, population health, network integrity, and the like are in direct response to emerging market forces.

But simply desiring transformation does not make it so.

No, that requires action.

The healthcare transformation discourse too often undervalues the present. It skips over the reality of how critical *now* is to enabling the aspirations the transformation rhetoric desires. That’s understandable — the future we desire is better than what we have — yet unfortunate, because the present is critical to arriving to that desired future.

The present, over and over, is filled with moments to transform.

There’s a deeply-held management belief that strategy is superior to execution. Sure, if your organization has shit strategy, it just might be in trouble. But, now that markets steer organizations, most healthcare providers of a similar type are pursuing homogenous strategies.

And that means that execution has become a competitive advantage.

But how does an organization execute on any specific transformation strategy? When should an organization get started? How quickly should a strategy be implemented? How, exactly, does an organization improve patient access, increase provider network integrity, establish a robust population health program, or the like?

Those questions have countless solutions making them nearly impossible to answer definitively. Answers, though, are much more easily revealed.

The specific tactics of executing on any single strategy are often uncertain. That’s not because great thought hasn’t been applied to what must be accomplished. It’s because the tactics of new strategies are uncharted territory for organizations. Replicating others, relying on adjacent experience, or the generalities of big consulting firms get an organization only so far. These uncertainties too often result in failed strategy execution.

William Owen, founder of digital product firm Made by Many, writes it best, “The best way to deal with the uncertainty involved is to move towards big goals in small steps, at progressively finer definition and with ever greater confidence.”

In other words: projects.

Do the Work

Let’s make it a thing. Do the Work:

Administrators execute strategy by creating change through projects using resources as a result of taking action, again and again.

Execute Strategy | The Result

This is what we’re after. It’s the outcome — or rather, a series of outcomes. Strategy execution is an intentional ongoing endeavor. Its success builds on itself and informs what comes next. It’s a rare moment when an entire strategy can be declared fully implemented because there is (almost) always another available tactic that furthers the strategy.

That “one more thing” idea represents a real twist to management dogma: execution is strategy. Somewhere, at some time, strategy was separated from execution. But it was Jack Welch, a noted strategist himself, that said, “In real life, strategy is actually very straightforward, pick a general direction … and implement like hell.”

In William Owen parlance: the big goal is the “general direction” and the small steps are the “implement like hell.” Implement the small-steps-like-hell by continuously creating change.

Creating Change | The Job

Strategy: executives declare it, administrators bring it to life. They do it by creating change: the job they were hired to do.

Writing a policy. Starting a new department. Implementing a new technology solution. Creating a training program. Designing a new service. Analyzing a capital investment. The units of healthcare transformation. There are many, many, many ways to create change. All of them happen as a result of a project.

Projects | The Units of Work

We live in a project-driven world. The work is projects.

Projects are the tactics of strategy.

They are the containers of work. They lead to promotions. They lead to notoriety. Most importantly, projects transform healthcare delivery.

And they are implemented using three resources.

Resources | The Inputs

Every administrator has three resources available to implement projects: people, process, and technology.

Some projects call for people changes (hiring, training, etc.), some call for process changes (how work gets done to serve a customer), some call for technology (the systems used to do the work).

Most call for a little of all three.

Historically, administrators have only had true agency over people and process decisions. Technology has been strictly the domain of the CIO and the IT department. That mentality is shifting as technology has become critical to enabling organizational change as both healthcare delivery and technology tools evolve.

A fully-empowered administrator has decision making authority over all three: people, process, and technology.

That opens the door for administrators everywhere to start Taking Action.

Taking Action | The Attitude and Approach

Taking Action is an attitude and an approach.

It’s a commitment to the reflexive habit of doing. Nothing happens without action. Doing creates and maintains momentum.

The pragmatism of actual action is critical to the future of healthcare delivery.

Taking action, in the moments of now, is how healthcare delivery is transformed.

It’s how a healthcare delivery organization overcomes uncertainty and reveals the answers to the question of “how” for any specific transformation strategy.

The future is going to be great. But we undervalue the present in our transformation ideals. It’s much too easy to forget the time-tested truth that, for the future to become reality, a number of successive nows must happen first. It’s in those moments that a tremendous amount of work must be done.

Taking action ensures the work happens. It’s the only way to transform.

Do the Work. It’s a pragmatic approach to transformation that makes healthcare better for patients, providers, and employees today, tomorrow, and yes, in the future.

And the only way transformation happens.

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Status:Go creates software for healthcare delivery organizations so they can try new ideas, improve operations, and execute strategies. We know healthcare, Salesforce, and how to get things done. Get in touch to get your project started.

The “Now What?” moment is a moment of action

Four days into a department reorganization and my new boss called me in for a conversation that concluded with, “Do you want to be the contact center manager?”

“NO!,” I silently shouted. I had been looking forward to focusing on building the population health program I was originally hired for and I didn’t have the slightest clue of what was required to manage a contact center.

“I think you have the capacity and capability,” the senior vice president ask-told, “Why don’t you take a few days to think about it and let me know.”

There really wasn’t any answer to give except “Yes.” So I did.

Now what?

The healthcare delivery operating environment is regularly producing “Now what?” moments — a moment when an administrator has beed told, asked, or discovered they now “own” a business problem that must be solved and find themselves in a moment of reflection asking, “Now what?”

Often the question is in silence to one’s self. Occasionally, people are more fortunate and get to ask it a little louder to a committee or an executive team. But even that can get tricky because topical expertise is a fleeting attribute in a fast-paced operating environment.

We’ve seen “Now what?” come in a variety of a flavors, but some seem to be more common, including the ask-tell flavor told above.

Another frequent variety is the execution imperative. There is a moment that arrives after the strategic planning activities of analysis, thought, and discussion when the new strategy must be operationalized and there isn’t a clear path forward. “Now what?”

Or our favorite, the innovation mandate. Someone, high from above, declares, “We need to be more innovative!” And proclaims to all in attendance that they must come up with three innovative ideas by the next meeting. “Now what?”

The last, which we cheekily call the oh-shi!, is when it becomes apparent to an administrator that the operation is facing a significant business problem — brought about by internal or external forces — that will impact the department, service line, or organization in some influential way. “Now what?”

“Now What?” moments often come from a place of fear, inexperience, or the unknown.

But the “Now What?” moment is a moment of action.

It means it’s time to do something. It’s time to shift attention to making something happen. Go.

There’s a long list of available actions. Do some research. Phone a colleague. Meet with IT or HR or project management. Plan a pilot. Discuss with your boss. Call a partner.

But the moment is now.

Don’t wait for permission, for more information, or for someone with more expertise to appear like I did in the contact center. Those weeks and months is a valuable time for doing. Because there is a moment that follows “Now what?” when no action is taken.

We won’t talk about that one. That moment is much more painful with much less individual agency. And, crucially, avoidable.

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The Ultimate Measure of Workplace Trust: You Decide What to Work On

It’s a panic-striking emotional state: I’m not contributing! I’m not on the career trajectory I need to be on! I’m not learning the skills I need to be learning!

That “I’m not a contributing member of this organization” feeling can be vicious.

My first healthcare job was as an administrative fellow, a sort-of management training program intended to provide exposure to the breadth of administrative positions throughout an integrated delivery system. It was a terrific experience and the people I worked for and with get credit for creating the foundations of my management style.

But there was a point early on, maybe a month or two in, when I felt exceptionally useless. The program wasn’t particularly organized — which turned out to be a great thing over two years — and resulted in open days with little to do early in my tenure.

I was gripped by the feeling of uselessness for months and didn’t know what to do about it.

Somewhere, somehow the thought struck me to find projects to work on.

It didn’t come from my boss — the last thing I wanted to share was that I wasn’t busy enough.

It didn’t come from colleagues — I wasn’t close enough with anyone at the time.

It didn’t come from friends or family — “this new job is great!”

I just started finding projects: some were participation only, some allowed me to make small contributions, and some allowed me to explore my interests in the organization. But nothing was particularly useless.

There was no one breathing down my neck. No one looking over my shoulder. No one assumed the burden of becoming my task finder. I was just trusted to find work to do.

[A quick aside.]

Don’t get me wrong, it’s entirely possible that no one gave a shit about me as my status hovered around the level of “intern,” but I take solace in maintained professional relationships with the people in that organization.

[Back to it.]

Trusted to find work. A novel concept.

By my second year I was finding projects to work on that were of strategic importance to the organization. More projects began to appear: from my boss, from the CEO, from managers throughout the system. The feeling of contribution! It’s a drug.

I’ve been coming back to that story lately because I recently started asking my employees to choose what they work on. Initially there was shock — a seemingly normal reaction to a different approach from any other previous school or job experience. After wading through initial resistance and a smidgeon of bewilderment, the experiment seems to have improved two persistent management problems left behind by industrial models of production.

The first is related to trust. We’ve been taught that employees must be managed. Create tasks. Fill their days. Ensure output. But management, in the traditional sense, left me with questions. What is an appropriate level of production in a workplace dominated by intangible things? How do you measure what someone should be producing when much of it is novel and creative thought? How do you trust that what employees do produce is the appropriate amount when no widgets are actually created? How much time should be spent in the office during the week?

The second is engagement. We’ve long abided by the idea that work must be cascaded down a hierarchy — that seems to be the secret to accountability: tell everyone what they work on and what the measure will be. Bosses know best. Do as I say. Why aren’t annual objectives being met? How do you rate an employee’s performance when the annual objectives set at the beginning of the year aren’t actually important any longer?

It turns out that everyone — me as a manager and they as an employee — benefits when employees get to choose what to work on. Here’s what we’ve found so far.

Employees choose work that interests them. We hire job candidates because of their experience and skills, which are manifested interests with documented results. The work that interests them is the work they are good at. It’s why they are working for the organization. It’s the work they want to get better at, too.

Employees choose work that helps the company. Employees deserve more credit for their instincts. They don’t need managers telling them what is the highest priority, although prioritization conversations can be helpful in figuring out what to work on first. Management, if anything, is creating the framework for knowing what is important and what isn’t. Employees know what needs to be created and improved because they work every day for the company. They see what the company needs.

Employees are engaged with the work. When employees lead the objective setting for the work they are demanding of themselves, highly accountable for results, and completely engaged in the work itself. Coaching becomes about helping each employee deliver the work. Reviews are about lessons learned and developed skills.

For managers it’s a win-win-win: trust comes easily, engagement happens naturally, and everyone is striving to move the company forward.

Engagement surveys continue to tell companies the same thing every year: employees aren’t. After years of failed engagement improvement initiatives, perhaps it’s time to point the finger at the organization’s structures and systems (i.e., how we do things around here…) as the culprit for low engagement. And perhaps it’s time to start experimenting with new structures and systems that create the workplaces we all desire. Maybe there are better ways.

Here’s to finding all of them.

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