The document discusses using findings from a clinical needs assessment throughout the project life cycle to improve success rates. It describes assessing needs, developing a project charter and plan using models like PDSA, collaborating with stakeholders, managing risks, and evaluating outcomes. Conducting a needs assessment, creating a compelling value proposition, and strong communication are key to developing a sustainable, executable project.

1. Chapter Ten
Using Findings from the
Clinical Needs Assessment
to Develop, Implement,
and Manage Sustainable
Projects

2. Introduction
• Success rate of projects: an estimated 37%
– Attributed to limited time and resources spent to
determine project’s overall value to the system
• Importance of using findings from a needs
assessment to inform developing, planning,
and implementing phases of a project

3. Project Life Cycle:
Role of the Clinical Needs Assessment
• Initiation Phase
– Defining of scope, purpose, objectives, resources,
deliverables, time scales, and structure of project
– Guided by results of a clinical needs assessment
– Root cause analysis (RCA) and failure mode effects
analysis (FMEA): tools and processes that give
team direction when considering the level of
information needed to improve overall process

4. Project Life Cycle:
Role of the Clinical Needs
Assessment—cont’d
• Planning Phase
– Detailed project plan created
– Monitored by project manager and referred to
throughout life of the project
– Examination of results such as cost and quality of
expected outcomes

5. Project Life Cycle:
Role of the Clinical Needs
Assessment—cont’d
• Execution Phase
– Staying on task when implementing action plan
– Monitoring time, cost, quality, change, risks, buy-
in, and communication by project manager and
team
– Sharing this information essential to success of
project and to future dissemination of its
learnings, extension of its scope, sustainability

6. Project Life Cycle:
Role of the Clinical Needs Assessment
—cont’d
• Evaluation Phase
– Reviewing overall project outcomes, performance
of project team, and stakeholder involvement
– How project performed relative to description in
business case, objectives (outcomes), quality
targets, timelines, budget, and resources

7. Planning for Implementation
• Implementation
– Creation of executable work plan
– Defining goals, objectives, and strategies
– Developing a timeline
– Establishing project milestones
– Matching project tasks with resources

8. Developing a Project Charter
• Project Charter
– Provides clarity regarding goals, objectives, and
timelines for project plan
– Establishes written plan for improvement
intervention
– Defines small test-of-change methods to be used
– Formation of interprofessional team as first step
– Definition of all aspects of project plan and
establish written charter by members

9. Model for Improvement
• Model for Improvement (MFI)
– Strong foundation and plan for any improvement
effort or intervention
– What am I trying to accomplish?
– How will I know a change is an improvement?
– Which changes can I implement that will result in
an improvement?

10. Model for Improvement—cont’d
• Plan–Do–Study–Act (PDSA) Cycle
– Plan an improvement effort
– Do or implement the plan
– Study the results of the implemented plan
– Act upon results by disseminating project or
changing plan and repeating in iterative fashion
• MFI and PDSA should be included in charter

11. Model for Improvement—cont’d
• Needs Assessment
– Descriptions of qualitative and quantitative data
that support the need for project
– Costs, resources, stakeholder buy-in, and work
requirements for successful and meaningful
project outcome prior to implementation
– Determination of whether needs are strategically
aligned with organization’s mission and goals

12. Model for Improvement—cont’d
• Compelling Value Proposition Four Steps
– Defining step: team provides information that
determines if the problem is worth solving
– Is the concern Unworkable?
– Is fixing the problem Unavoidable?
– Is the concern Urgent?
– Is the problem Underserved?

13. Model for Improvement—cont’d
• Compelling Value Proposition Four Steps
–Evaluating step: whether solution is unique
or compelling enough to continue the effort
in the planning
–Three D’s
• Discontinuous innovation
• Defensible technology
• Disruptive business model

14. Model for Improvement—cont’d
• Compelling Value Proposition Four Steps
—cont’d
– Measure step: gain/pain ratio of potential
adoption of a solution to a problem
– Build step: moving from defining, evaluating, and
measuring to actually creating value proposition

15. Model for Improvement—cont’d
• Project Charter and Action Plan
– Agreement between organization providing
service and stakeholder requesting service and
receiving deliverables
– Comprehensive description of project
– Anticipated project team members and roles
– Outlines scope and measures of success
– Signatures for project authorization and approval
– Action plan: delineates particular strategies

16. Micro, Meso, and Macro
Collaboration
• Collaboration
– Requires communication, commitment,
accountability, and continuity
– To ensure full potential, requires understanding of
strategic alignment by stakeholders
– Collaboration with stakeholders: priceless

17. Communicate, Communicate, and
Communicate
• Communications
– Communications management: share right
information, at right time, with right people, and
in right format
– Accompaniment of strong communication by
mutual trust
– Management of communication implemented
through three essential processes: identification,
reporting, and distribution

18. Change Management
• Change Management
– Led by someone external to organization
– Begins same time as implementation
– Collaborate with implementation project manager
and stakeholders to craft a change management
blueprint tailored for organization
– Staged approach
– Important role of training and education in
overcoming resistance

19. Post-Project Monitoring
and Evaluation
• Post-Implementation Reviews
– Conducted to identify value achievement progress
and steps needed to achieve maximum gain
– Ensure delivery of results
– Identify steps to ensure value
– Reinforce accountability for results
– Monitoring: continuous process that should be
put in place before project implementation starts

20. Project Implementation Challenges
and Risks
• Challenges and Risks
– Funding
– Management of stakeholders
– Lack of communication among stakeholders,
leadership, and implementation project manager
– Organizational resistance to change
– Scope creep
– Lack of project ownership and champion
– Shifts in organizational priorities

21. Summary
• Implementation is the final process of moving
the solution from development to production
status.
• Successful implementation begins with an
executable plan.
• SWOT analysis and needs assessment are
critical to successful project implementation.

22. Summary—cont’d
• Project charters identify outcomes that can be
tracked.
• Collaboration requires communication among
and between all stakeholders.
• A systems change project considers several
aspects that impact practice outcomes.