Pitfalls of implementation

From HMCwiki

The following pitfalls of implementation is from scripted piece of a 5 part streaming video series that is viewed on the desktop of teams throughout hospital system. It’s part of MD Anderson's experiment with virtual consulting with fifty teams.

Introduction: Here are some of the common pitfalls of project implementation. People are pretty good at doing what we know to do. It’s the stuff they forget that causes problems. Dome of the greatest solutions never turned to value because of what was overlooked in implementation.

A great quote came from General Dwight Eisenhower (led the forces at Normandy during WWII) Planning is everything…plans are nothing. Implementation is more than just a plan; it is an evolving adjustment to integrate a change or solution into the existing environment Implementation can only be as good as the solution its rolling out. So before designing the implementation plan, make sure the foundation it is working from is solid.

• Pitfall #1: is going into implementation with an Incomplete Solution. Look at your Aim (purpose) Statement. If you haven’t done your homework refining your Aim Statement, making it clear so that everyone in the department can interpret it the same way, broad enough to allow creativity (that is not including a solution in the Aim) and specific enough to allow focus, the resulting work be less than it could be. The Causes define where the problem focus lies. Where possible, validate them with objective data. If it must be subjective, then get the workforce to validate and add to it. This not only gives a global view, it becomes part of the acceptance-finding needed for the solutions that are developed. Remember: an untested cause is just a best guess. The Solution had better be complete enough to make a dent in the Aim Statement, or it may not be the a good solution. As long as there is a good alignment from the Aim to the Cause(s) to the Solution(s), a good implementation will bring the desired results.
• Pitfall #2 Under-Resourcing the change effort. There should be at least a believable rationale of not business case for introducing the change. People don’t change for the fun of it and leadership wants to support what is good for the organization. The cost of introducing the solutions must have at least an inherent value that the leadership and workforce can understand. So what are the people, facilities, equipment, moneys, time needed to make this a success? A good implementation knows the costs and even includes the loss in production or service until the ‘new’ way is debugged and burned in. It considers the lead time needed to secure all the needed times before implementation. Anything less is courting failure. Being successful in change is not something performed with your spare time and spare people.
• Pitfall #3 Under-Sell the change. They forget people’s feelings are attached to their job. And implementation doesn’t spend the time necessary to sell the solution. People don’t mind change; they just mind surprises and changes forced upon on them when they had no input. Forgetting this raises their resistance and implementation becomes a fight instead of an expedition. Hopefully, staff’s input was obtained during the Aim Statement, Cause determination and the Solution development. If not, it may have to be done one-on-one before rolling out the implementation. It is time well-spent if it is needed, especially with those in the staff who are key influencers in the culture. Get them to see the benefits and costs to them personally. Surface concerns and try to If you can’t win them over, at least get them closer to a tipping point of acceptance. As Michael Hammer, author of the Reengineering Handbook said, ‘It is much easier to push people into the future than it is to pull them out of the past’ Sometimes, large projects are best implemented in stages, which brings about Pitfall #4.
• Pitfall #4 Change too MUCH too fast. Some solutions are too big to absorb by the culture all at once. If possible, break these into manageable portions and develop separate implementation plans for each. It respects the workforce’s ability to change. It readies them for their next change. It places the organization in a mode for continuous change. Tackling change in more manageable doses allows the implementation team to respond quicker and more thoroughly as the unexpected happens. Going through the change adds to the success of the next change. Finally, it can also allow for quick-wins which are much needed during large-scale change. The next pitfall prepares to expect chaos until the new way becomes second nature.
• Pitfall #5 Expect Smooth Sailing (for you and the workforce). The implementation plan attempts to predict what will be needed for successful change, but guess what; surprises happen. The implementation teams needs to be prepared for adjusting to the unknown. Hand-holding staff during the change, receiving and adjusting to their input is a must. Extra staff, a supportive manager…whatever is needed to tip success on your side. Learn to promise them chaos in the early stages; when it comes off better than that, everyone win.
• Pitfall #6 Forget To Train The Ranks. It’s a big mistake the expect workforce to understand new roles, new ways without a sufficient break-in period. People learn differently so consider visual, verbal, experiential ways of getting the instructions across. Proper documention and consideration for details honors their position during change. Give them ample opportunity to experiment and ask questions, before risking failure in front of their peers and the public. Give scenarios of how things might go wrong and give examples of how to respond to them. This is that ‘safety’ need around change we mentioned earlier.
• Pitfall #7 Expect Your Implementation To Last. Think the project is finished? Remember that today's problems were yesterday's solutions. The way to prevent this from happening is to keep the implementation adaptable to the environment around it. Expect it to change. Policies, procedures, etc. should there to support efficiency, not get in the way of reality. Implementation never really stops. Keep it evergreen with the changes going on around it and the solutions value will gain over time.

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