Getting Ready to Start a Project? A Key First Step

After over a year of dealing with the impact of a pandemic, VerityStream is seeing many of our customers and others in the healthcare industry decide that the time is right for a project. There is a bit of urgency to many of these projects, since big projects were delayed in until now due to the priority of dealing with Covid-19.The types of projects that we are seeing initiated include:

• Migrating to new software
• Standardizing privileges within a health system
• Designing and implementing a Centralized Verification Office/Department (CVO) within a health system
• Combining departments/functions, such as a health system CVO and provider enrollment services
• Restructuring the credentialing and privileging decision-making process within a health system (for example, creating a system-wide credentials committee or some other type of collaborative decision-making process)

One of the things that all of the above projects have in common is that success will be transformative for the healthcare organizations in a very positive way. In all examples, the way in which processes are deployed and supported will be dramatically changed – which means big changes for the involved staff. And - in most of the examples there will also be a significant impact upon how providers interact with the organization. All of the above projects also have in common the risk of failure. Failure is not what anyone wants to contemplate at the beginning of a project – but it is a reality that should be considered.

There are many strategies that can be employed to avoid failure. One of these is to make sure that the project is appropriately structured and that all participants understand the scope of the project and the desired outcome. When projects involve a lot of collaboration to get to an expected outcome, it becomes critical to assure that all participants are in agreement related to the outcome as well as the journey to achieve the outcome.

A “concept document” (another name used is a “project charter”) authorizes a project. It is a document that helps to keep all participants on the same page about a project. You could think of it as an executive summary or overview of a proposed project. It should be concise (or the leaders won’t read it). A concept document includes the following key elements:

1. A short statement to identify the scope of the project

(i.e., to move from separate departments for credentialing and enrollment into a combined department).

2. Why the project is necessary.

This includes the business case for the project. In the scenario of standardizing privileges, the business case could include the information that currently there are 15 facilities within a health system, each with its own privileges (some of which are laundry lists, others are organized by categories, still other by core privileges), that many providers are privileged at multiple facilities within the health system – which requires that they apply separately for privileges, that disparate privileging criteria leads to a provider being eligible for the same privileges at some – but not all – facilities, etc.

3. The project outcome.

This provides what will be different when the project is concluded. Think of this as being the component of the document that – when the project hits some rough patches (which almost all projects do when big changes are being made) – participants can be reminded of the rewards/benefits that they seek to achieve via this project.

4. Project structure and approach.

This is where the project manager will be identified, the project sponsor(s), the description of the involvement of an oversight body/task force as well as the task force’s composition, roles and responsibilities, and relationship(s) within the organization. The bigger the footprint of the project, the more essential an oversight body becomes. For example – a privilege standardization project has a large footprint. All medical staff organizations are involved, in additional to the administrative and clinical staff who will support the project during and after the project is concluded. When this type of project is initiated, we believe it is critical to establish a privilege project task force. It is also critical to define the relationship of that task force within the current medical staff organizations – i.e., relationship to current credentials committees, medical staff executive committees, etc.

If there will be phases to a project, this is where those phases would be articulated. For example, if designing and implementing a health system CVO is the project, the CVO might launch with processing initial appointments first (phase 1) with reappointments being added as phase 1. Or – the first phase might include 5 of 15 facilities, with the second phase adding additional facilities to the CVO.

A timeline for the project would be included in this section (not a detailed project plan, but a target for completion of the project).

Additionally, project guidelines (or rules), as applicable, would be included here. Here is an example of a statement from a concept document that authorized development of a health system CVO:

• Credentialing operations will recognize providers as customers of the credentialing function, and be designed to be efficient and “user-friendly” while meeting regulatory requirements and incorporating recognized best practices.
• The CVO that will be responsible for operations of credentialing and privileging services will be designed to ensure patient safety and the integrity and confidentiality of provider information. Additionally, credentialing services will be entirely electronic (no paper) and designed to eliminate duplication and non-value added work.

5. Communication Strategy

An additional element of a concept document might include a communication strategy – or at least a statement related to how key stakeholders of a project will be kept informed of progress throughout the duration. The more complex the project – and the longer the project – dictates that a good communication strategy be instituted from the beginning. Lack of communication provides opportunity for miscommunication – and that is never beneficial to a successful project outcome. Finally – many organizations require signature of the concept document by key individuals (at the very least, the project sponsor). Signature(s) convey authority and ownership of the project and add weight to making the project official. I highly recommend obtaining signatures of the key individuals responsible for launching and resourcing a project.