Change can be exhilarating and exhausting.


Like all issues of hfm, this one describes how to change health care, from merging with another organization to implementing rolling forecasting. But no matter how many different changes the magazine covers, they share one characteristic: They’re all big.

At the outset, change of this dimension can have strong momentum as the parties contemplate achieving bold objectives. But that momentum can easily flag with the daily reality of each unfamiliar and challenging step toward what may increasingly seem a distant goal.

Maintaining momentum is critical, and the article “Achieving Clinical Integration” in this month’s hfm (pages 56-60) has two out-of-the-ordinary tips for how to do that. 

The first tip that caught my eye is “Embrace progress rather than perfection.” I suspect that most people reading this magazine strive for excellence. And if we’re fortunate, all those surrounding us feel the same.

However, the article’s author warns of the negative consequences when a quest for excellence becomes a quest for perfection. “[C]reating an expectation that the [clinically integrated network] will perfectly meet the comprehensive needs of each of its members is, at best, counterproductive, because the program will inevitably experience growing pains as it begins its full operations.” Rather, the author proposes “seeking consistent, positive progress,” which can help an organization “implement a [network] more quickly and sustainably while preparing itself and its members for bumps in the road….” 

Another tip for maintaining momentum is what the author calls “project management in reverse.” This concept is the opposite of traditional, linear project design (“project management in drive”), which involves identifying each project component and the time necessary to complete it, and using that information to determine the dates for major milestones and project completion. This approach, according to the author, can slow progress by encouraging elusive perfection in each phase. In contrast, project management in reverse “organizes the overall project timeline around high-priority goals and sets specific limits on the time allotted for completion of each step in the project plan.” As a result, progress is more brisk and achievements more evident, resulting in improved momentum.

Planning backward and promoting imperfection may seem counterintuitive. But when tackling something big and unfamiliar, a visceral sense of progress trumps a perfect outcome—especially when that perfect outcome may never be achieved.

Publication Date: Friday, November 01, 2013

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