Disruption and change are a constant part of reality in healthcare. To successfully navigate this terrain, organizations must continuously reassess their initiatives and project investments. This ensures alignment with resource capacity, strategic goals, and operational priorities. Therefore, it is critical for health systems to adopt strategies and practices that enable adaptive portfolio management.
Accepting and Understanding Disruption
As we navigate the post-pandemic landscape, healthcare organizations face a multitude of challenges, from defining organizational strategies to meeting financial and regulatory demands while embracing emerging technologies.
A prominent New England healthcare system found itself in such a predicament, grappling with over 400 active projects and a daunting backlog of requests, some of which had been lingering for years. Rather than reassessing and reprioritizing in reaction to disruption, the organization continued to pile on new initiatives, leading to stagnation where few projects reached successful completion. It was clear the organization needed to recalibrate its portfolios to prioritize effectively, enabling the completion of the right projects and creating the capacity to take on new requests.
Portfolio disruption can originate from various sources, including conflicts between projects, shifts in technology, changes in project scopes, unexpected resource requirements or constraints, external mandates, and alterations to strategic and operational direction. The complexity of healthcare delivery necessitates continual evaluation, synchronization, and adaptation to negotiate disruption effectively.
Failing to Adapt to Disruption
Organizations that fail to proactively monitor and adapt their portfolios in response to disruption face a multitude of challenges, including increased conflicts, delays, and inefficiencies. Inadequate data and information lead to diminished decision-making agility, growing backlogs, and ultimately, failure to meet stakeholder expectations.
As witnessed by the health system in New England, without the right tools and practices to aid proactive portfolio adjustment and manage disruption effectively an organization becomes overwhelmed with wants that were not being met.
These challenges compound, creating a cycle that becomes increasingly difficult to rectify. Inaccurate data and poor information result in bad decisions, resource bottlenecks, and overstretched and misaligned staff. These in turn drive wedges between departments, increasing organizational silos, conflicts of interest, and resource demands. The ultimate result is higher costs and customer/staff dissatisfaction.
Monitoring and Reacting to Disruption with Tools and Practices
Portfolio managers must constantly monitor the environment and advise the organization when disruption impacts existing roadmaps, necessitating adjustments in priorities, reallocation/rebalancing of resources, or even project cancellations.
Effective portfolio management requires vigilance and the utilization of appropriate tools and practices.
- Work Breakdown Tools: Utilizing a portfolio work breakdown tool facilitates the systematic collection of data across all projects. This enables a consistent and collaborative review process, providing essential insights for decision-making.
- Frequent Portfolio Reviews: Regular reviews, supported by reliable data in a shared platform, enhance analysis and decision-making agility. This ensures timely responses to environmental changes, allowing for proactive adjustments in priorities and resource allocation.
- Visual Aids for Strategic Insight: Visual aids, such as portfolio roadmaps facilitate the identification of conflicts and collisions as well as opportunities for resource and project synergies within the portfolio, aiding in rapid response strategies.
- Transparent Project Selection Criteria: Request scoring worksheets ensure transparent and consistent project selection aligned with strategic and operational objectives. This helps in prioritizing and sequencing projects that contribute most effectively to organizational goals.
- Efficient Resource Management: Resource management planning tools, including heatmaps and dashboards, enable efficient allocation and utilization of talent By providing visual indicators of resource utilization, these tools facilitate proactive adjustments, prevent over and underutilization, and improve forecast predictions.
- Change Request Mechanisms: Project change request forms facilitate informed decisions by assessing the impact of proposed changes on other projects within the portfolio. These forms ensure that decisions are made with a holistic understanding of potential consequences. Requiring a change request form be submitted for portfolio review when a project wants to change scope, budget, resources, or timeline prevents a single project from independently deciding something that has detrimental consequences for other projects. It also allows for planned adjustments across the portfolio to accommodate the change.
- Reassessment Processes: Recalibration worksheets provide a structured approach to reassessing projects against evolving expectations and disruptions. This ensures projects remain relevant and meaningful.
By leveraging these tools and practices, organizations can effectively utilize data to navigate disruption and make informed decisions in a timely manner. This enhances organizational resilience and fosters agility, enabling the organization to operate more dynamically.
Recalibrating a Portfolio
Projects within a portfolio should undergo reevaluation if the initial rationale for selection is no longer valid or appropriate, required resources are unavailable, newer priorities emerge, or anticipated value diminishes or is no longer expected to be realized.
At times, a full portfolio recalibration is necessary to ensure the organization is focused on the right projects. To recalibrate the portfolio effectively, organizations should establish tailored evaluation criteria. Because these projects have previously been approved, planned, and may be actively underway, the criteria should be slightly different than what was used to initially select the project. (Click here for an example Recalibration worksheet.)
Prior to empowering a governing body to conduct a project review utilizing the criteria, an escalation process for disagreements should be established, deadlines set, and transparent communication with stakeholders should occur about the recalibration process and its benefits.
Conclusion: Embracing Adaptive Portfolio Management
Disruption is inevitable in healthcare, making adaptive portfolio management indispensable. By adopting a proactive mindset, leveraging appropriate tools and practices, and fostering a collaborative culture, organizations can navigate disruption with confidence. Adaptive portfolio management ensures that project investments are aligned with strategic objectives, resources are optimized, and stakeholders' expectations are met.
How MAKE Solutions Can Help
MAKE’s operational excellence team and services help organizations develop the tools and competencies necessary to make critical recalibration decisions confidently. Our workshops teach organizations to capture and connect real-time data, conduct portfolio reviews, create visual roadmaps, and monitor resource capacity effectively.
Access the free Resources on our website to discover your opportunities and gain supporting tools for driving improvement. For further operational excellence insights, review other articles on our website under Assets-Insights.
Visit our website at makesolutionsinc.com to learn more about MAKE’s consulting services, or contact Tamara Pomerantz, VP Client Operations, Tamara.Pomerantz@makesolutionsinc.com.
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