This is the second of a series of posts about how we are transforming how we deliver improvement projects at Taunton & Somerset NHS Foundation Trust. In this post we will explore how and why we developed our proprietary “blended methodology”, and what exactly it is.
What was the problem?
IHI improvement methodology is a proven approach for improvement. However, our executive team, board and external stakeholders wanted greater visibility of our improvement work and a clear articulation of our plans, timescales and the benefits that our projects would deliver. Whilst our approach was predicated on the model for improvement, we were unable to easily or systematically provide the level of detail that they sought at an organisational level.
What did we do?
We needed an approach that could provide our stakeholders with the visibility and reassurance that they needed, in a language and format that they understood. What would we deliver when and how much would it save? To answer this we needed to supplement improvement methodology with robust project management and benefits realisation processes and tools. We couldn’t find anyone else who had done this and so we developed our own, proprietary methodology “blending” these three core elements of improvement, benefits and project management.
Our “blended methodology”
At the heart of our approach is IHI improvement methodology. All projects use the model for improvement. What is different about our approach is that in parallel there are also complementary project management and benefits realisation processes. These are aligned to the different stages of the model for improvement. So project management and benefits realisation are not standalone processes but are absolutely integral to how we run and deliver our improvement projects.
How did we do it?
The new processes and tools for project management and benefits realisation were developed by experts in those fields who we recruited to the team. Equipped with the latest evidence on global best practices a small team of improvement advisors, benefits and finance managers and project managers worked together to design our methodology. In true improvement style, this went through multiple PDSA cycles to test and refine it before being rolled out across the organisation.
How was it received?
Rolling it out was challenging, especially at the outset and it was a challenge to win ‘hearts and minds’. We had around 120 projects at different stages and we had to take them all ‘back to basics’ and revisit the problem that they were addressing, how they were doing it and qualify what the project could actually deliver. The benefits this exercise quickly became evident. It became clear that whilst some were very clear about what they were doing, the vast majority were not. As a result many projects were changed or disbanded. The process also helped break down organisational siloes. Instead of looking at each project in isolation, for the first time we had a complete and consistent picture all of our projects which enabled informed decision making based on organisational priorities, often resulting in decisions we simply wouldn’t have made before.
Where are we now?
The methodology is now being used for all improvement projects and it works. Our stakeholders have reported that they have much greater confidence in what we are doing as we are able to provide a complete, accurate and sophisticated picture of our improvement projects, the problem that we are solving and the outcome that we will deliver. We are clearly able to articulate the totality of the benefits of our projects, not just the cost savings.