How to Turn FQHC Challenges and Opportunities into Project Success
Project Management Roadmap for FQHCs
By Andy Eck, MBA, Senior Director, Facktor
In the years just prior to COVID, FQHCs were presented with exciting opportunities to participate in new HRSA grant programs, Service Area competitions, Rural Assistance Center Initiatives, new Access Point grants, Federal programs to acquire new equipment and other resources, and more. These opportunities meant that FQHCs could grow geographically, centralize service lines or departments, and/or try something new and innovative. These programs and opportunities haven’t gone away, but now, with COVID, FQHCs face unprecedented challenges and pressures that are also driving a powerful need for change.
Opportunities and challenges alike all have real impact on FQHC operations, finances, staff satisfaction, the community, and above all else—the patient experience. Yet some health centers, community healthcare organizations, and hospital systems are addressing both change and opportunity with greater ease, less stress, and more success than others.
To be “Good At Change”, FQHC execs should start with a solid Project Management Structure
Look closely at the health centers that are good at change and innovation and you will find a solid project management (PM) structure. The structure may be centralized or de-centralized, performed by one person, or many, but whatever the structure, the organization approaches change in a similar and consistent fashion. Although there’s a lot of flexibility in how your organization sets up a project management process, doing so has a lot of advantages. It decreases risks, cuts costs, improves project success rates, and makes the process less taxing on the individuals on the project team, and on the organization as a whole.
Follow these steps to decide the right project management infrastructure for your health center:
1. Decide on a Project Management Structure.
PM efforts can be centralized, de-centralized, or a combination of both. Experts recommend a hybrid centralized approach to start, so that’s a safe way to begin. Re-evaluate in one year, and shift resources appropriately.
2. Define What Constitutes a “Project.”
What kinds of initiatives or efforts should be elevated to the level of projects, vs. tasks that are part of everyday operations? What is the monetary or personnel resource minimum that turns a work effort into a project? Is there a timeline minimum, e.g., over three months? It is important that leaders at all levels understand what constitutes a project. Defining this will assist with making sure all projects are supported with adequate resources and will also help prevent “scope creep”—a term used to describe a project that infringes upon another or starts to require more and more unintended resources.
3. Define a Standardized Project Scope Document.
Projects vary widely, in levels of detail, whether they are larger or smaller, amount and type of resources required, and project schedules. For example, a pilot program to remotely monitor patients with chronic illness is very different from a project that explores where to open new community health centers. Yet all projects should be scoped in a standard way, and include the same basic elements.
Your standard Project Scope Document might include, for example: project duration, budget, strategic plan alignment and goals, departments and personnel affected, who is managing the work, who is performing the work, who will review the work, associated risks, mitigation plans for risks, and how success will be measured. This consistency helps leaders make appropriate decisions, helps team members stay on track, and sets uniform expectations, which saves time in both planning and execution.
4. Establish Vetting Criteria and a Vetting Committee.
Choose a committee to assess all proposed projects, and use the same criteria to evaluate them. This helps each project pass through an organizational lens versus a departmental review, ensuring strategic plan alignment. The process will also ensure that all projects can be adequately resourced and are aligned to the strategic plan objectives.
We suggest choosing items that are of importance to the organization in its current state, weigh those items, and determine a weighted score (for example, number of patients served, budget advantages, aids in meeting HRSA compliance needs). If an organization uses the same criteria for all projects, it becomes very clear which projects are more important. This can be used to vet both new and existing projects.
5. Decide Who Should See Project Progress Reports, and When.
Identifying the key stakeholders ensures proper reporting and information flow, and makes sure that everyone who needs to stay in the loop at key decision points does so. Think beyond the C-suite: if your project has a significant online component or changes the nursing schedule, for example, don’t wait until it’s nearly completed to get your webmaster or nursing supervisor involved.
6. Perform a “Start, Stop, or Continue” Review of Current Projects.
At the same time you’re establishing best practices for new projects, you almost certainly have older or ongoing projects in progress. Now is the time to evaluate current projects to make sure that each aligns fully with your organization’s strategic plan. Some refer to this as a “Start, Stop, or Continue” step, and it’s a smart way to make sure you’re using limited resources effectively. Projects that aren’t in alignment commonly include efforts like a pet project of an executive, or a legacy program that has not been evaluated in some time.
7. Map Projects to the Strategic Plan, and Compile a Project Portfolio.
If you’ve chosen a hybrid centralized approach to project management (Step 1), you’ll have a lead project manager in addition to managers of individual projects. Once the organizational project and work effort analysis is complete for each project, the lead central project manager can map these projects to the strategic plan and see how they align and where they fit best in the organization’s flow of work and resources. With that information, they can develop a portfolio of projects and an overall plan that allocates resources efficiently and sets project start- and end-dates in a way that keeps progress moving forward.
These plans are most effective when broken down into actual work streams with owners and deadlines. They also ensure that leaders have the resources needed to actually execute on the strategy. For example, a strategic plan may have eight distinct sections, one of which is dedicated to improving patient access. The project portfolio may have 20 projects, two or three of which directly support patient access.
8. Abandon or Conclude Other Projects.
Through this process, you will identify projects that can’t be brought to completion at the present time. They might not be fully aligned with your current strategic plan, or you cannot provide them with adequate resources. Developing a plan for concluding these projects is difficult but necessary, especially since projects often come with deep emotional ties. It’s easier for stakeholders to let go and turn their energies to new projects if the new plan development is comprehensive, risks are identified, and when there is an effort to mitigate problems when both cutting and adding projects.
9. Developing the Plan.
Starting with the Project Scope Document (Step 3), develop a detailed plan with dates, deliverables, sponsors, executors and necessary resources. Executives should feel free to discuss and outline the plan specifics. But once the document is drafted, you’ll have much more success if you engage those who will be executing it in creating the final draft. Doing so will ensure “buy-in” from staff who may be at different structural levels, or in different departments within your healthcare organization, but whose efforts are critical to the project’s success.
10. Communicate the Plan.
Once the plan is finalized, be sure to not only share with the affected department(s), but publish the plan for all to see. It is important that leaders in other departments have an opportunity to understand and support both the plan, and the work that their peers will be doing. Communicate through multiple mediums and in meaningful ways to engage staff. Work with the committee leads to determine what a meaningful report looks like to them and be sure to include that in the communication plan.
11. Execute.
With a plan in place, execution is next. As a leader in your healthcare organization, be sure to check in on key projects, offer support when possible, and hold project owners responsible for both reporting and achieving milestones. While project managers and directors will naturally be responsible for shepherding projects in their own departments, they should also be sure to support the organization’s projects in other departments.
12. Follow Up and Analyze.
How many times has a great idea/project been birthed, only to have it placed on the back burner as newer and more pressing projects come along? This happens quite often, and the root causes of this are poor planning, lack of analysis along the way, and lack of follow up. Just because a project launched successfully, it does not mean it will succeed. Market conditions change, personnel transition, and without planned follow up and reevaluation periods, projects often fail or are not brought to fruition.
13. Celebrate Success.
Of course you want to celebrate once your project is complete, but you should also celebrate success after achieving milestones along the way. As important as they are, projects are often just one of many tasks competing for employee time and attention. Building time into the project plan to celebrate success helps to build a positive culture around project management, makes staff want to achieve milestones even when final project completion feels difficult or a long way off, and fosters a desire to participate in future projects. This step, the simplest and most enjoyable, is often overlooked. Yet it’s a key ingredient to success with future projects.
At a time of great challenges, and great opportunities, for FQHCs and other healthcare organizations, a well-defined project management process can take a lot of stress and uncertainty out of achieving your goals. If you need help getting started, or if you have elements of the above PM practices but are looking to move your organization to the next level, talk with us. As a first, simple step, we can perform an organizational PM analysis or readiness assessment. We can help you to create a culture of accountability and transparency by adopting health center PM best practices. When we’re done, everyone in your organization can be good at change.
