What happens when your quality improvement project is too long

Quality improvement projects have traditionally been 18 months long - at least that's my experience in the healthcare in the NHS in England. I expect they are that length of time because it is about the right length of time to second someone into the role of project leader. After 15 years of experience, I believe this is far too long for a QI project.




The problems with 18 month projects

• they take 18 months... 
• over-work the process; carry out redundant tasks to fill the time (every project leader wants to look good)
• too much emphasis on innovation and clever solutions, that are difficult for others to adopt
• difficult to maintain focus over so many months
• many clinical staff are unwilling to commit to the project
• the context changes  reforms, new organisations, new care methods - all come into play during the period of the project

Instead, I advocate the 90 day project. This is enough time for the average team to implement the average type of changes; and average matters. Most teams can imagine 90 days and are more likely to commit to making the effort to improve a targeted area. They will know within 90 days whether their efforts were worth it. 90 day projects need lots of planning by the project leader, though this can be done with minimal intervention with the clinical team, leaving them to spend more time with patients. They are best done with known best practices that are known to work in a similar context.

For more info on 90 day projects from this blog:

1. What are 90 day projects
2. How to implement 90 day projects

Or hang in there for my new book on 90 day projects which will be out in January 2013.

How do we tell our Emperors and Empresses that we know they are naked?

Image from: www.emperorerswithoutclothes.com

The fable about the Emperor who had no clothes is well known. He believed he was wearing sumptuous velvet adorned with jewels, but in truth he was naked. His minions played along with him, "dressing" him every day and complimenting him on his attire.  Then one day, someone decided to tell the truth...      

How to diagnose whether you are an emperor or empress

1. Do you have strong beliefs about something?  What people or processes do you have in place to ensure you are not believing your own beliefs? For example, a mentor or critical friend who has the strength to point out when you are dashing about naked.
2. Do you have "minions" around you who are constantly agreeing with you, forwarding your tweets, nodding their heads in meetings and running about in the shadow behind you.  Can you remember the last time someone really disagreed with your point of view? Does it happen often? Do you ever disagree and have a constructive debate with someone?
3. Do you talk about your "clothes", are you constantly changing them, adding jewels etc.  The endless focus on the clothes, and the changing thereof, can make it difficult for "minions" to comment.
4. Do you marginalise the person who disagrees with you. This may happen without any conscious thought. You could be picking up a signal and then ignoring them out of fear they may point out what you already know.

A number of CEO's have mentioned to me that one of their greatest fears on appointment to their role, is that staff no longer tell them the truth about what it happening and instead tell them what they think they want to know. They then set up ways to counter this problem.

If you are an improvement leader in healthcare  do you have a way to check the extent to which your clothes belong to an emperor or empress?

        

Book Review: The 29% Solution by Misner & Donovan

How can you improve your networking skills so you become one of the 29% of people who are separated from the rest of the world by six degrees? After explaining that we are not all connected to everyone by six degrees and that it takes some work to be in that position, this books provides a 52 week guide to achieving this.

Here are the week by week headings (it is worth reading the book to understand the detail underlying each one):
1. Set networking goals
2. Make time to network
3. Profile your preferred client
4. Recruit your word-of-mouth marketing team
5. Give to others first
6. Create a network relationship database
7. Master the top 10 traits of an effective networker (these include positive attitude, trustworthiness, good listening skills, helpfulness, timely response etc)
8. Diversify your contacts
9. Meet the right people
10. Reconnect with people from the past
11. Talk to your family
12. Break out of your "cave-like" routine
13. Participate in a web networking group
14. Become a centre of influence (develop magnetism)
15. Go the extra mile; be value-added
16. Become a catalyst who makes things happen
17. Find a networking partner to help accountability
18. Volunteer visibly
19. Send thank you cards
20. Follow up today
21. Be available 24/7
22. Create catalyst events beyond the workplace
23. Have purposeful meetings
24. Make first impressions count
25. Seek out a referral networking group
26. Join a Chamber of Commerce
27. Sponsor events
28. Host a purposeful event
29. Ask questions of others
30. Talk about benefits not features
31. Comunicate your business succinctly
32. Speak about your business
33. Leverage your business card
34. Give high-value presentations
35. Create an informative newsletter
36. Write press releases
37. Write your own identity
38. Ask for written testimonials
39. Share your success stories
40. Write your own personal introduction
41. Blow your own trumpet (or toot your own horn if you're in the USA!)
42. Ask for feedback
43. Adopt a host mentality at functions
44. Use the law of reciprocity
45. Write a letter of support
46. Ask for referrals
47. Read the paper with the intent to discover referrals
48. Conquer your public speaking fear
49. Become the hub of a power team
50. Become a networking mentor
51. Recruit an advisory board for your business
52. Commit to lifelong learning

(I've tweaked the wordings on the list a bit to suit my own understanding.)

Summer reading for Healthcare Change Leaders

Freedom is blogging in your underwear
How can this not be on your list!  It's about getting on with the job, the highlights of working form home - and basically, you've got no-one other than yourself to blame...


Ignore Everybody
Creativity is something you do, not what you steal from others. This is an edgy book with humour that works on the proposition that talent does not need props.



Poke in the Box
Seth Godin is one of my favourite authors. In this book he points out the necessity of standing out (not conforming) and the need to take the initiative. It will leave you feeling uncomfortable.

Velocity: The Seven New Laws for a World Gone Digital

Technology getting you down? Find out how others are embracing it, changing with the times and not waiting until new "things" have become mainstream. Are you ahead of your tribe, or just a digital follower?