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Business Report: Chaos in Project Sustainability

Business Report

Executive Summary

The purpose of this report is to suggest strategies for Mohawk Hospital to improve its performance improvement efforts going forward. The healthcare system is on a constant improvement cycle with the top priority being performance enhancement to foster improvements in care delivery and patient outcomes. However, changes within the healthcare delivery system in the United States has traditionally been criticized for being slow and ineffective in promoting the requisite performance improvement. Despite the development and implementation of various strategies to improve organizational performance, the hospital has not managed to attain the desired results as the change and improvement initiatives have not yet been perfectly integrated into the organization. To improve future performance improvement initiatives and ensure that the implementation is successful, the organization should create ownership of the initiative, promote effective accountability and leadership, ensure proper planning and realistic timelines, promote proper teamwork and communication, ensure adequate resources and support, and implement ongoing measurement and feedback.

Business Report: Chaos in Project Sustainability

The Scenario

In a bid to improve performance and enhance the quality of care for patients, Mohawk Hospital – a 212 bed community hospital in Malone New York, implemented several performance improvement programs. These included Lean Performance Improvement Service Excellence Program (Customer Service) Waste Not, Want Not (A program to reduce hospital cost by 10% in one year.) Fall Not (An effort to reduce patient falls to zero) Dress Up (An effort to improve the overall look of hospital staff). However, despite the extreme important of the programs in helping improve patient care, a survey conducted to evaluate employee commitment and knowledge indicated that employee awareness and active participation was wanting while leaders did not think they are accountable for driving hospital improvement performance. Staff were not aware of performance metrics and outcomes or training opportunities available to them while organizational leaders considered the projects short-lived efforts that will soon be forgotten. There is therefore and urgent need to implement proper strategies that will make process improvement sustainable.

Recommended Strategies

  1. Create Ownership of the Initiative

One of the key findings from the survey at Mohawk Hospital was that employees were not fully aware of the process improvement initiatives that had been implemented. To ensure the success of change and improvement efforts, it is critical to ensure that anyone within the organization has buy-in, ownership, and input. As pointed out by Studer (2014), buy-in entails connecting to the why by clearly explaining to the healthcare individuals the real need for the change and how the proposed improvement efforts will contribute to a better work environment.

Without proper buy-in and ownership of the improvement efforts, there is little likelihood that employees will be dedicated to take the required steps that are necessary to appropriately implement the change and attain desired results (Longenecker, & Longenecker, 2014). Therefore, leaders within the hospital should make strong cases and solid explanations why the upcoming change is necessary, and clearly communicate desired expectations and outcomes. By doing this, leaders will e able to ignite commitment by presenting compelling evidence that the new best practice will positively and considerably advance high-quality patient care. 

  • Promote Effective Leadership and Accountability

Without effective leadership at all levels of the organization, it is difficult or impossible to attain real change or improvement (Longenecker, & Longenecker, 2014). When people do not trust the leaders, or when the leaders possess inadequate leadership skills, then it is most likely that people will not provide maximum effort as the lack of credibility will prevent them from fully engaging with the improvement efforts. Therefore, leaders should be able to identify the necessary traits that are necessary to make process improvement stick (Studer, 2014). On the other hand, leaders should be held accountable by tying performance evaluations to organizational objectives.

As Studer (2014) noted, not holding leaders accountable for process improvement outcomes implies that conformity to organizational objectives is a matter of choice. Mohawk hospital should therefore provide adequate leadership training to organizational leaders to ensure that they are sufficiently capable to directing and managing change and process improvement as well as inspire trust and dedication among the employees. Also, the hospital should make leaders accountable to the process improvement efforts by ensuring that only those who demonstrate alignment with organizational goals receive strong performance reviews.


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  • Ensuring Proper Implementation Planning and Realistic Timelines

One of the primary reasons why change and improvement initiatives within healthcare organizations fail to attain the desired outcomes is because of poorly planned implementations coupled with overly ambitious deadlines (Longenecker, & Longenecker, 2014). Proper implementation plans and realistic deadlines directly influence program participation and success. Appropriate planning will ensure that roles and responsibilities are clearly communicated and effective implementation strategies utilized. On the other hand, overly ambitious schedules may short-circuit the process thereby leading to improperly done tasks and negative outcomes. Hence, going into the future, the hospital should ensure that adequate time is provided to properly plan all process improvement programs and that the programs have realistic deadlines.

  • Promote Proper Teamwork and Communication

Healthcare is fast becoming the ultimate team sport and so it is important for diverse groups within the hospital setting to come together and work towards shared goals and objectives to ensure that improvement objectives are successful (Longenecker, & Longenecker, 2014). Teamwork promoted a shared sense of purpose and encourages people to work together towards common organizational goals. On the other hand, extensive and intensive two-way communication is critical when implementing any change or improvement initiative (Longenecker, & Longenecker, 2014). Communication ensures that roles, goals, and expectations are clear, and that concerns can be quickly and easily addressed. Mohawk hospital should therefore ensure superior and ongoing communication among all parties involved in the improvement initiatives. In addition, proper teamwork and cooperation should be promoted to enhance the hospital’s ability to accelerate change improvement processes.

  • Adequate resources and Support, and Ongoing Measurement and Feedback

All change or improvement processes should be facilitated by adequate resources and sufficient support from top-level management (Rahimi, 2015). Mohawk hospitals should therefore ensure that all future improvement efforts have been accompanied with full managerial support and all the necessary resources need to actualize the change. The success of any change improvement effort is dependent on adequate measurement, feedback, and follow-up (Longenecker, & Longenecker, 2014). For the hospital to achieve the desired outcomes from its improvement programs, proper measurement and evaluation processes should be established and performance and progress feedback provided so that necessary improvements or adjustments can be made.


Healthcare organizations are responsible for attaining the triple objectives of excellent patient experiences, quality care delivery, and reduced healthcare costs. This requires that such organizations implement performance improvement programs and initiatives that promote higher quality care, lower costs, and better patient experiences. However, if not properly done, such improvement efforts will fail to realize the desired results and outcomes. Mohawk hospital is a perfect example of failed process improvement. Despite rolling out five projects to help improve the quality of care for the patients, the improvement efforts failed to achieve the expected results. To rectify this and foster successful performance and process improvement in future, the hospital should adopt and implement effective strategies. The recommended strategies for the hospital to improve its performance improvement efforts are;

  1. Properly plan for implementations and provide realistic timelines and expectations
  2. Create buy-in and ownership of improvement initiatives by clearly explaining how it will positively impact the organization
  3. Improve teamwork and cooperation, and ensure proper communication
  4. Promote effective leadership and hold individuals accountable
  5. Provide adequate resources and managerial support, and ensure proper monitoring and regular feedback


Longenecker, C. O., & Longenecker, P. D. (2014). Why hospital improvement efforts fail: A view from the front line. Journal of Healthcare Management, 59(2), 147-157.

Rahimi, A. R. (2015). Performance Improvement in Healthcare Is Personalized Site Feedback Enough? Circulation: Cardiovascular Quality and Outcomes, 8(4). 335-337. DOI: 10.1161/CIRCOUTCOMES.115.002039

Studer, Q. (2014). Making process improvement ‘stick’: There are five traits common to healthcare organizations that develop process improvement initiatives that successfully sustain gains. Healthcare Financial Management, (6), 90-96



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