- Project start up
- Identifying the right people
- Facilitating improvement team meetings
- Project Planning
Project start up
Project start-up or initiation is the first phase of project management. This is where a business case/project charter is developed to establish why the work is important, the problem the work will address, any funding required, the anticipated outcomes and how this links to your organisation’s objectives.
Project charter – the statement of scope, objectives and people who are participating in a project and supports the team to document what they want to achieve, why it is important and how they will measure success.
Identifying the right people
Before you begin, it is important to note that work of this nature, cannot be, achieved by one person. A team made up of different roles, skills and views will be essential to effective service improvement.
Key roles who should be part of the project team are:
- a lead to co-ordinate the project and facilitate the team
- service leads (clinical and non-clinical) who have the authority to change processes
- representatives impacted by the intervention, this could be IT (Trakcare), Health Records, GPs, patients, etc
- a quality improvement practitioner to provide advice and/or coaching
- a data analyst to provide support accessing and interpreting data
- a project sponsor who may be someone who can help you address any barriers
Agreeing key roles and responsibilities for everyone in the team is important at the beginning of a project. Having clarity at this stage reduces the possibility of confrontation and confusion further on, and can be used to re-establish them if the team begins to drift.
Stakeholder analysis – an interest/influence grid with four quadrants, enabling you to plot or map stakeholders based on their level of interest (high/low) and level of influence (high/low).
Use it to:
- Identify who your stakeholders are; this is anyone who has interest in the improvement project or will be impacted by any changes
- Use the opinions of your stakeholders to help define your improvement work at an early stage and gain their support
- Guide the development of a communication plan for stakeholders to help them understand what the improvement work is about, to maintain and build further support for it where possible
- Identify potential issues which could arise as the project develops, identifying ways to manage negative impacts
RACI Matrix – responsibility assignment chart that maps out task, milestone and key decisions involved in completing a project. It assigns which roles are Responsible for each action item, which personnel are Accountable, and, where appropriate, who needs to be Consulted or Informed on tasks.
- Basic RACI Template – for those in small teams wanting to quickly allocate responsibilities on limited tasks
- RACI Matrix Template – for Project Managers or those in larger teams with multiple stakeholders
Communication plan – will help to ensure that staff across your service are, kept informed and updated of any changes.
Facilitating improvement team meetings
An improvement meeting should be a multidisciplinary meeting where all staff involved in the improvement journey come together to assess, diagnose and iteratively test changes to improve patient experiences.
When engaging with and establishing an improvement meeting, it is important to ensure that expectations are set out.
Expectations in relation to:
- roles and responsibilities
- deliverables and objectives
- how much time per week/month will be required
- how progress will be monitored
Consider during your meeting:
- Clarify Aim/Purpose
- Assign Roles
- Review Agenda
- Work through Agenda
- Review meeting record
- Plan Next Steps and Next Agenda
7 Step meeting process – To help you have more focused and productive meetings, use this process.
Facilitators toolkit – provides suggestions and details of activities and exercises for you to use during your facilitated events.
Team huddle – a 15-minute huddle, led by a consistent person, taking place on the same day/time every week.
Team huddle checklist – a checklist to support your Team huddles.
Team huddle script – this script is to support the running of a Team Huddle, to help keep the huddle focused and undertaken in only 15 minutes.
Visual management boards – a communication tool to proactively, manage quality and safety within teams, providing real time information about current improvement work, displaying both quantitative and qualitative data, to help teams monitor ongoing improvement projects.
- BMJ Open Quality Visual Management Board example (see figure 2)
Project planning comes after project start-up and should be informed by your project charter, stakeholder analysis and, communication and engagement plan.
At this stage, it’s, essential to develop detailed key milestones of activity and tasks that need to be, completed, so that the project team are all aware of expectations.
Highlight reporting provides progress updates through agreed governance channels and helps to maintain momentum in the project.
Gantt Chart – visual timeline of tasks that will help a team to identify what should be done by when.
Action Plan – robust plan detailing all the actions required to achieve project goals.
Action tracker – Monthly reporting for governance purposes
Risk & Issue Log
Flash reports are another tool to help share progress aimed at providing information locally and where appropriate, nationally.
Flash report – short summary that can provide a snapshot of key outcomes.
Examples of flash reports: