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When I reflect on the times in my career that perfect alignment of environmental factors resulted in high productivity and innovation, the following themes come to mind:
1. A sense of urgency to change - John Kotter's change model starts with creating urgency. A perfect 2011 example of this is Meaningful Use Stage 1. All stakeholders recognize that MU is a high priority requiring complete organizational focus with a well understood timeframe and clear outcomes.
2. A clearly defined scope - Often, business owners choose software solutions before they analyze their workflows and define requirements. Automating a broken process does not make it better. The rational way to approach projects is define an ideal workflow, develop requirements, create specifications for automation, and build/buy products. Currently, BIDMC is designing the medication workflow of the future. Our first step was to assemble all the stakeholders for a 3 day retreat to define the ideal functional characteristics without being biased by existing technology or practices. In the next two years, you can expect us to create an automated medication workflow that looks more like a Toyota production system and less like a traditional hospital ward.
3. A guiding coalition of leaders serving as champions for the project and providing ideal leadership characteristics - leaders need to be positive, visionary and supportive, not angry, autocratic and arbitrary.
4. A dedicated implementation team and appropriate funding - How many times have you been asked to do more with less? Eventually you'll do everything with nothing. Your lean and mean teams will become bony and angry. If an urgent project with a tightly defined scope and unified leadership is resourced with dedicated staff, you'll be unstoppable.
5. A timeframe that makes it possible to do the project with enough attention to detail that the result is high quality, well communicated, and innovative - every project needs to link time, scope and resources. 9 women cannot have a baby in 1 month. A fixed scope and fixed resources implies a fixed time. Attempts to artificially shorten the time will compromise scope or quality. A project that goes live at the right time, even if the timeframe seems long, will never be remembered. A project that goes live too early will never be forgotten.
May you all have the time, resources, scope, noble leaders, and urgency you need to succeed. May you be driven by innovation and the desire to make a difference instead of a pugilistic project manager creating fear of failure. May you all have your Man on the Moon moment.
These are the successes we'll tell our grandchildren about.
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