Hospitals are going through a period of change and reform, facing the challenging task of delivering transformation while protecting quality, the effective use of resources and continuing productivity. This change is unrelated to the current situation regarding Covid-19.
The Hospital sector shared its need for a framework to manage and control the delivery of change across portfolio, programme and project management. The aim is to build its capabilities to manage the implementation of transformation objectives both effectively and efficiently.
Why Is Project Management Important in Healthcare?
A range of statistics* indicate the enormous size of the healthcare industry in Belgium.
- Total amount of hospitals: 103 (197 establishments)
- Total amount of beds; 52.565 (of which 34.962 acute, 13608 chronic and 3995 psychiatric)
- Number of hospital beds/1000 inhabitants (2019); 4.6
The amount of beds has been decreasing for years. However, the amount of healthcare professionals has seen a steady increase over the years. There are currently more beds taken by chronic diseased and less in ambulatory care.
These stats underline the amount of work that healthcare organisations require for project management to continually improve operations in such a huge industry. For this reason Project Management has taken an important role in the Hospital sector. However, Project Management in Hospitals brings risks that other sectors do not experience. Which is due to safety concerns: a healthcare project done ineffectively can lead to patients’ health problems.
Challenges Of Healthcare Project Management
Project management in healthcare is distinct because it takes complexity and risk to a whole new level. Here are some of the primary reasons it’s different than other industries:
Funding and Optimization
Project management aligns money with activity. It ensures you have the funding for your efforts at various stages of a project.
To derive the greatest benefit from the available finance the project must be optimised, which means allocating exactly the right amount of space to wards, operating theatres, diagnostic suites, public areas and other facilities to design the most cost-efficient arrangement.
Quality and Efficiency
The cost-reducing force of managed care has galvanized numerous mergers and acquisitions in the hospital and medical group sectors in an attempt to gain economies of scale and offer a more economically attractive service.
There are harsher and more serious ramifications if projects go over budget or off schedule because patients’ well-being may be at stake. Any mistake or lack of process can have a detrimental effect on patients.
Quality control is a major part of project management: in healthcare, all opportunities should be considered for efficiency from the project’s inception. This includes ensuring that the architectural and engineering designs are aligned to the budgetary and functional goals of the project.
The increased demand for healthcare combined with rising costs has put more pressure on the industry to deliver economical, high-quality services. Trying to find the balance between efficiency and quality places even more importance on the need for better project management.
High Discipline Diversity
High-technology care is provided by very specialized health care professionals.
Teams of multiple disciplines, especially if they have not worked together before, are likely to lack a common language. People from the same discipline share a common meaning for the words they use and understand each other. But, when a number of disciplines are involved—surgery, physical therapy, social work, nursing—people may use the same words and incorrectly assume they mean the same to everyone around the table.
In communication terms, what occurs is erroneous translation: a person from one discipline encodes a meaning for a term but someone from a different discipline decodes a different meaning. As a result, the message is not understood.
This is particularly difficult to address in the health care team because of the apparent simplicity of the terminology. Perhaps the safest assumption the project leader can make at the start of the effort is that people from different disciplines do not understand each other and that giving and receiving feedback is crucial. Asking apparently obvious questions can be very useful until a common language is achieved within the team.
The project manager must ensure that team members overcome their functional unfamiliarity and has to confront the skepticism and suspicion between functions before the team can work effectively.
Lack of Skilled Resources
As health care’s landscape changes, so do the type of resources required on successful projects. The current trend of adopting the Project Management Office (PMO) framework does not always equate to the ability to successfully lead multi-organisation projects, work side by side with clinicians to change care delivery or assess the impact of a significant regulation. A project team without the necessary skills and experiences, including health care industry expertise, will ultimately fail. Read more about the set up of a PMO in the hospital sector in this interview.
Deficient Change Methodology
The pressure to change rapidly is especially palpable in health care, as organizations that historically ‘grew into’ change now must employ change methodology to be successful. Often, projects do not include a work stream dedicated to preparing the organization for significant change. Change communication is particularly challenging due to the political dichotomy between physicians and administration. The result is lack of understanding, acceptance and ultimately adoption of the change, leading to failed project outcomes.
A range of other issues are affecting the evolving industry — issues for which project management is increasingly vital. These issues include the following:
Decreasing payments from government health programs and private insurance companies have compelled healthcare organizations to find ways to save money.
- New and complicated systems for electronic health records on patients need continual monitoring and improvement.
- New technologies also need tracking and improvement.
- New regulations continue to emerge.
- There is greater scrutiny from outside groups, including government, health insurance companies, and patients.
Benefits of Healthcare Project Management
Strong project management helps improve healthcare and the healthcare industry in a number of ways.
Project management can do the following:
Ensure
- that the technical composition of the project team is based on the project objective. If the objective is to reduce costs, ensure that all members are knowledgeable about cost measurement and accounting.
- that team members are at a high enough level in their respective organization that recommendations have a high probability of being implemented.
- that the politics of integration are not underestimated. Only when team members appreciate that all stand or fall together can the actual project work begin.
- that team members genuinely relate to each other as peers. Hierarchy must not interfere with the peer relationships of the team. The person(s) who directs the team in solving a particular problem should be that member with the relevant knowledge and experience, rather than the person at the top of the implicit hierarchy.
Improve
- the quality of care by improving processes used to provide that care.
- communication among healthcare staff caring for patients.
- organizational planning.
- budgeting, as strong project management directly aligns resources with important work.
- processes that are established to decrease the risk of lawsuits — in large part because improved processes increase the quality of care.
- relations with stakeholders, including insurance providers, government agencies, patients, and others.
- staff productivity
- the mitigation of the risk and prevent legal issues from arising.
*Figures – provided by the Belgian Statistics Office; https://www.health.belgium.be/sites/default/files/uploads/fields/fpshealth_theme_file/blikvanger_gezondheidszorg_az_v10.pdf