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Why does change fail? What helps a project succeed?

The factors that either helped or hindered the success of an operations improvement project were identified based on the experience of 6 hospitals that participated in the Robert Wood Johnson Foundation Urgent Matters program.  This program was intended to assist hospitals with information to improve patient flow and decrease crowding in the emergency department.

What facilitated implementation of change

  • Being part of the Urgent Matters learning network
  • Putting together an inclusive planning team with representatives from various areas of the hospital
  • Executive leadership support
  • Homegrown implementation strategies
  • Aligned reporting structure
  • Trying things that were not radically different

What got in the way of change

  • Staff resistance
  • Organizational culture
  • Inadequate staffing
  • Cynicism leftover from past failed efforts
  • Lack of information monitoring progress

What I like about this article: That there was an effort to methodically study why a performance improvement effort in a small group of hospitals succeeded or failed; and, that these results can be generalized and applied to other types of situations.

Source: Van Dyke, K.J., and others.  Facilitators and barriers to the implementation of patient flow improvement strategiesQuality Management in Health Care;20(3):223-233, July-Sept. 2011.  Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

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