Are You Skillful at Project Management?

Most individuals who are responsible for departments that perform credentialing and privileging do not have the title of “Project Manager.” But the reality is, project management or support usually takes up a lot of time during their daily activities. Here are examples of projects that we see many of our clients involved in (and in many instances, multiple projects go on simultaneously):

1. Implementation of new credentialing/enrollment software or new software components.
2. Incorporating new facilities into a health system – or conversely, being absorbed into a new health system.
3. Updating privilege delineations (often including standardization if the organization is part of a health system).
4. Standardizing the credentialing process across facilities (again, if the organization is part of a health system).
5. Centralizing credentialing (setting up a health system CVO – or revising current CVO operations in order to be more streamlined/efficient).
6. Standardizing the case review process or development/revision of OPPE reports.
7. Applying for NCQA certification for credentialing/the CVO.
8. Overhaul of medical staff organization structure (including medical staff bylaws update).
9. Setting up collaborative credentialing and privileging decision-making within a health system (can involve setting up a health system credentials committee, rather than using the credentials committees of each facility and other innovations related to the decision-making process).

As you will note from the list above, many projects that are credentialing/privileging-related are extremely visible projects that typically involve multiple stakeholders, including medical staff organizations (and many physician leaders) of facilities that are part of health systems. This type of exposure puts a spotlight upon the success (or failure) of these projects.

Unfortunately, I do see projects fail. And all too often, it is difficult to get a second chance at doing a project once failure has occurred. There are a number of reasons that projects fail, but here is my list of the top five reasons for project failure.

Reasons for Failure

There is a lack of project leadership.

Many of the projects described above include multiple stakeholders – and they often have diverse opinions on the desired outcome of the project. Leaders during these projects must be involved and resolute.

There is no project plan that reflects the beginning of the project, the milestones and a target completion date.

This is basic project planning. However, I often see projects for standardizing privileges, that go on for years – one of the reasons being that there was no reasonable plan from the beginning related to how and when to get to the finish line.

A project structure that assures accountability of all participants was not put in place.

Projects that involve a lot of stakeholders need a project structure that identifies accountability for outcomes (and what the desired outcomes are) as well as a reasonably-sized oversight group (no more than 7-10 members) who keep the project on track, remove barriers when necessary, etc.

There are misaligned expectations.

Expectations about the outcome of a project need to be thoroughly communicated from the beginning. For example, in many of the examples of projects given above, individuals and groups in health systems must be willing to give up some power and control in order to get to the desired outcome. The desired outcome must be sufficiently compelling to keep all participants committed. It also helps to have a document that clearly articles the end-state of the project that the various organization components agree to at the start of the project.

The project wasn’t resourced appropriately.

Lack of project resources is deadly. I often see individuals who are running several different projects simultaneously – and try to do so without any additional resources, while still doing their “day job.” For example, implementation of new software often proliferates other projects such as standardizing privileges, standardizing credentialing and establishing a CVO. One person can’t manage all these projects while doing their regular job. Why is it that people take on these immense projects without getting some additional resources? We all believe in working smarter – but we must remember that there is only 24 hours in a day and a person does need some sleep. People who support projects must clearly state their needs before the project starts.

When projects fail, organizations typically find someone to blame. Don’t make yourself a target by agreeing to take on a leadership or major supportive role of a project that you know is doomed. Do yourself and your organization a favor by speaking up to make certain that at the end of a project there is a celebration rather than the sad alternative.