As we indicated in an earlier ‘lessons learned’ about project benefits, “Driving Project Benefits, an Introduction”, our client experience has demonstrated that the primary challenge to an organization achieving project benefits is effective executive sponsorship. However, with sponsorship in place, the ability to identify, measure and quantify benefits becomes the next challenging hurdle to the organization. Based upon our work with a wide range of healthcare client organizations and business and information technology projects, we have compiled some key insights to guide an organization’s effort to truly achieve measurable project benefits.
Types of Benefits
Broadly speaking, benefits are either qualitative or quantitative in nature. Qualitative benefits are subjectively measured; they are represented by the perception or feelings of the key stakeholders with regards to whether the project change has made a positive contribution to their work or interactions. Organizational leadership, however, clearly prefers quantitative benefits; they represent an objective and measurable way in which to demonstrate the project has accomplished the desired change and achieved the planned benefit.
While subjective in nature, qualitative benefits are important and legitimate to measure, monitor and report. The perception of key stakeholders regarding the effect of the project change is an indication of whether the intended change is working as designed and whether the change will ‘stick’ long-term to achieve planned quantitative benefits.
For example, one of our regional hospital system clients utilized baseline and periodic surveys post go live of the change to gauge staff perception and acceptance of various organizational changes. When the second post go live survey continued to indicate that staff didn’t understand how the change was benefitting them, the project’s leadership conducted a quick, detailed analysis of the change. It was determined that the enabling application wasn’t configured properly and was ‘working against’ the project’s change. As a result, the project team made the appropriate intervention and subsequent staff surveys indicated that the change was working as planned.
Conducting multiple stakeholder surveys, prior to the change (or baseline) and at periodic points post go live, allows the organization to quantitatively measure perceptions on the viability of the change. With a number of commercially available web-based survey instruments available, it is fairly simple and easy to formalize a regular survey process. We recommend keeping the questionnaires short (six to ten questions) and utilizing questions that are worded in a manner that allows measurement from baseline to subsequent survey points. For example, when measuring if “The process works well and supports my clinical needs.”, use a scale from 1 to 10, where 1 represents ‘no agreement’ and 10 represents ‘complete agreement’. This allows one to numerically measure the perception of a changed process in this case between two, or more, points in time.
For many of our clients, measuring quantitative benefits tends to be an easier course of action, since they use a formal ‘business case’ vetting process that requires the project’s sponsor to demonstrate the type and magnitude of quantitative benefits expected to be realized by the investment. While many clients engage in this type of exercise and have a track record with it, many can benefit from the following insights.
A proven tool to measuring the quantitative benefits of projects is the adoption of the SMART approach to goal setting to the quantification of benefits. As you recall, we have been told from early in our careers that when setting goals either for ourselves, other individuals or organizations one should adopt the SMART approach. SMART is the acronym for Specific, Measurable, Attainable, Relevant, and Time-bound
Specific: Be as detailed oriented in identifying the benefit and avoid vague statements. For example, rather than using ‘improve financial results’ as the metric, make it ‘reduce operating expenses’.
Measurable: Make sure that the benefit can be easily calculated with easily accessible data. An integral part of this characteristic is to calculate the baseline value of the metric prior to implementing the project’s change. Using the above example, ‘reduce operating expenses’, establish the current or baseline value of the operating expense to be impacted by the project change and document the way in which changes to it will be calculated. Be cognizant of ensuring that you don’t have other variables that may affect the value of your measurement. This can be addressed by being even more ‘specific’. Rather than using ‘reduce operating expenses’ as the metric, if the change is intended to reduce the number of clinic registration clerks, then have the metric be ‘reduce clinic registration clerk worked hours’.
Attainable: Ensure that the benefit and magnitude can be achieved by the change. Once again, the more specific the metric, the more confident one can be with its attainability. Will the project change actually impact the selected metric?
Relevant: The objective isn’t to measure benefits for the sake of doing it, but rather to ensure that the project change is addressing a benefit that matters to the organization. We had one health plan that was focused on measuring staff use of the newly implemented claims processing system. While user acceptance is obviously important, it didn’t represent the ultimate goal of implementing the new system – increasing the level of auto-adjudication.
Time-bound: Does the target or goal for the quantitative measure represent a performance level that can be achieved within the expected timeframe? It is important to recognize that proficiency in the use of a new process, system, etc. takes time for staff to develop and that achievement of benefits will have a similar ramp up in terms of magnitude. We encourage our clients to identify both interim (can be multiple ones) and final goals or targets, allowing the organization to recognize progress and improvement on its way to the final benefit level.
The executives of one of our provider clients believe that benefits are the detailed answer to the question – why are we embarking upon this project? This client has made benefits measurement and realization an integral part of their enterprise wide vetting process for making project investment decisions.
Achieving and measuring project benefits doesn’t need to be complex or intimidating. It is the natural conclusion related to a resource investment that healthcare organizations make to improve their performance and competitive position. Healthcare organizations that embrace a thoughtful, planned and documented benefits measurement process improve their chances of achieving substantive results from their projects.
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