More on project management from Feb. 2006 Hospitals & Providers

Leadership cements the foundation for increasing the efficient and effective delivery of treatment plans in project management and performance improvement programs at Sparrow Hospital in Lansing, Mich. Leadership is the cornerstone at every level, beginning with the executive sponsors, project managers, physicians, nurses, respiratory therapists, pharmacists, discharge planners, case managers and social workers. Stakeholders are critical to program success not only because they implement the protocols from admission to release but also because they play an important role in spreading the philosophy of this approach to healthcare. A physician champion within each group provides additional leadership by promoting the program and securing peer support.

The requirements for successful implementation of program management in healthcare are simple but not easy. The climate must be right and executive sponsors must be able to adapt their plan or adjust the climate. Physicians must buy into and sell their colleagues on the program. Everyone must be committed to following the protocols that make up the various programs and meet the standards of care. The organization must be committed to seeing the programs through from the moment of inception.

The key to performance improvement is receptivity, says Dennis Swan, CEO of Sparrow Health System. "You have to start with an environment of openness to new ideas and strategies, and you need strong physician leadership to make this work. You look for those who say, 'I will try this in my own practice.'"

Project Manager Mark Wehner, PMP, RRT, a respiratory therapist at Sparrow believes that it requires patience to allow enough time to fairly judge the program's success. "Performance improvement takes time, and it requires making adjustments," Wehner says.

There are two challenges in standardizing care. "One is to build expectations that a certain area of treatment will be approached in a certain way and to build consensus that that will happen," says Larry Rawsthorne, MD, vice president of medical affairs at Sparrow. "This requires letting go of one's clinical idiosyncrasies, which may or may not be evidence-based. To surrender the way you do things requires a change in approach to care.

"The second challenge is to develop the institutional ability to understand when an approach is not appropriate for a particular patient, for example, special variance may be required because of other medical issues," Dr. Rawsthorne says.