Depending on the scale and scope of the improvement(s) you are planning, it may be useful to follow a more structured, project management approach to implement changes.
A project is a temporary organised effort that creates a unique product, service, process or plan. It should have a clear start and finish point and has planned activities which are different to the normal way of working.
Project management is the application of processes, methods, skills, knowledge and experience to achieve specific project objectives according to the project acceptance criteria within agreed parameters. Project management has final deliverables that are constrained to a finite timescale and budget.
Project management is relevant to quality improvement because quality improvement is all about change. Without change there can be no improvement, although it is important to remember that not all change leads to improvement. Experience suggests quality improvement (QI) projects in the NHS often lack robust project management.
Using a project management approach provides a structure within which to deliver a change and a framework to help ensure that the change is successful. Project management complements the delivery of quality improvement but in itself cannot guarantee the success of the improvement project.
Projects usually go through a lifecycle of: Planning, Delivery, Evaluation and Closure. As you go through your project it is important to consider the following elements at all stages:
- Project scope
- Project team and governance
- Project plan (including timescales and dependencies)
- Stakeholder commitment and communication
- Understanding benefits which can include patient, clinical, organisational, staff, and financial
- Managing risks and issues
Key activities undertaken during the first part of the planning phase include:
- Agree project objectives, scope and deliverables. Create project initiation document (including deliverables, resources, risks, governance and so on). Download a Project Charter.
- Identify the project team and sponsor. NB: The sponsor is the person who is responsible for the project to be delivered successfully and therefore has a critical role in the planning and delivery of the project.
Planning is a critical phase and adequate time and resource should be spent to ensure this phase is completed. This phase involves creating ‘live’ plans to guide the project team through the phases of the project, manage time, resources, risk and issues.
A project plan sets out the activities that need to be undertaken, the expected timescales and the individual responsible for completing each activity. If the project is very large in scale, additional action plans breaking down smaller tasks might be helpful. The plan should be viewed as a live document and reviewed on a regular basis to ensure that delivery of the improvement is on track. A3 planning (also known as project on a page) is a tool used to summarise your plan. Download an A3 template with prompts.
Risk and issues will need to be identified and logged. Management of key stakeholder engagement through effective communication is often vital to support successful project delivery.
In this phase, the change defined in the Project Charter will be undertaken. Delivery involves coordinating people and resources, as well as integrating and performing the activities of the project in accordance with the project plan.
Any project planning documents developed during the initiation and planning phases, such as the project charter, project plan, A3 / Project on a Page , risks and issues register, and benefits realisation plan, driver diagram should be continually updated and monitored against throughout the delivery phase. Regular reporting through the planned governance channels is important to provide assurance that the project is on track.
Project evaluation is a process of collecting, recording and organising information about project results and lessons learned for future projects which are captured during the closure phase. Independent evaluation may also be conducted.
On project completion it is necessary to close the project. This is important on a practical level to ensure that all loose ends are tied up and that stakeholders are satisfied with the outcomes of the project.
For sustainability beyond the project, it is important to ensure stakeholders have accepted all outcomes, operational procedures, documentation and materials are in place and handed over to operational staff, and that actions and results are documented and disseminated to relevant people.
In addition to the practical considerations it is necessary to ensure that any learning from the project is captured so that it can be used to inform other projects in the future. Find out more about evaluation here.