“Being busy does not always mean real work. The object of all work is production or accomplishment and to either of these ends there must be forethought, system, planning, intelligence, and honest purpose, as well as perspiration. Seeming to do is not doing. “ - Thomas A. Edison
The purpose of this blog is to set out some ideas on the how of a 90-day improvement project within the context of healthcare. This project process is evolving so please add comments to this post so everyone can learn from your experience.
- Having more time doesn’t mean getting more done
- Manage the tasks not the time
- Deliver incremental value
- Deliver results within a defined timeframe
- Honour the concept of organisational learning and continuous improvement
- Discover a rhythm of change and implementation that balances risk with results
- Use these ideas as ingredients and make your own recipe
- Ensure a focused, targeted and committed action process
“Absorb what is useful, reject what is useless, add what is specifically your own.“ –Bruce Lee
There are a variety of approaches. The choice of your approach will depend on your strategic aim, the timing that best suits you as well as the nature of your improvement process.
STEP 1: Create your format based on your timescale
“Once you have mastered time, you will understand how true it is that most people overestimate what they can accomplish in a year - and underestimate what they can achieve in a decade!” - Tony Robbins
It is possible to deliver changes in 3 days (see Kaizen methods for further information).
Consider your desired results, the amount of people who need to be involved in the process, the team and organisational culture as well as the nature of the problem to be solved / the solution to be implemented. With this in mind, look at the options below and see which most closely matches your needs. Where possible make your task
smaller and the timing shorter.
All of the timescales contain a basic strategic rhythm of
a) diagnostic steps
b) implementation focus
c) review and next steps
It is possible to design a 90 project so the phases are sequential, or it can be built up from a series of smaller 30 day cycles. The choice depends on your strategy for change:
“Hell, there are no rules here - we’re trying to accomplish something.” - Thomas A. Edison
Why 90 days?
- Scope is more complex though is manageable within the timescale
- Sufficient interdependencies that will need to be followed through with conversation and negotiation
- Good if have high energy people working on the project who can also maintain their focus
Why 30 days?
- May be easier to commit to than 90 days or 18 months
- Deal with the now; plans remain relevant
- Long enough to see an improvement (or not, so can then change the strategy)
- Scope is such that one individual or a small team can make the changes with no further resource to committees or individuals for permissions
Why 1 week?
- Good for those who are too time / task pressured to commit to improvement
- Able to test an improvement-through-learning process
- If used as part of a longer project the 1 week cycle can provide a mechanism for involvement (different people different weeks)
- Good for working with those with a low energy
12 week (90 day)
8 week (60 day)
4 week (30 day)
1 week (5 day)
A diagnostic phase includes, to varying degrees, some of the following (remembering that diagnosis is part of the change process as individuals discuss and assess their own situation):
R What is the current situation, including baseline measures; this needs to be localised to the context of those making the changes. Process and value mapping, relationship mapping and other techniques are useful here.
R Creating ideas for change and improvement; being creative rather than just implementing known tasks (otherwise we end up with low energy projects)
R Understanding any interdependencies and carrying out appropriate negotiation
R Planning, designing, getting in the resources that may be need (like equipment) etc.
An implementation phase includes, to varying degrees, some of the following
R Action, with measureable results
R Learning, from personal and team reviews
“Words may show a man’s wit but actions his meaning.” - Benjamin Franklin
A review phase includes, to varying degrees, some of the following
R Working out what is going well, and why
R Figuring our and being honest about the problems, and then working through some ideas to resolve these
R Capturing personal learning as well as team and organisational learning, specifically noting those things you would like to do / feel more of
A project of any length can be constructed from a weekly pattern of activities.
“If we did all the things we are capable of, we would literally astound ourselves. “ - Thomas A. Edison