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Improving Improvement

A toolkit for Engineering Better Care

 

Manage the Plan

The plan describes a detailed proposal for enabling change to a system and delivering a particular solution(s) to a problem within the system.

Contents

 

Introduction

The need to Manage the Plan is the sixth of the seven strands in the improvement model. It underlines the importance of managing the plan for improving the system, following understanding the system, defining the problem, developing the solution and collecting the evidence. As a result, it is expected that such a plan will be developed in the early stages of the improvement process and revised, as appropriate, as the process develops.

Purpose

Managing the plan has practical importance to systems improvement: identifying the right team to deliver change; planning and scheduling appropriate activities for delivering change; and assessing the risk associated with delivering the programme of change.

Activities

The process of managing the plan may include a wide range of activities including, but not limited to: Identify Enablers and Blockers, Manage Team, Ensure Shared Understanding, Review Project Performance, Review Project Progress and Plan Future Activities.

Tools

The practice of managing the plan may draw on a wide range of tools including, but not limited to: Failure Mode and Effects Analysis, Fault Tree Analysis, Hazard and Operability Analysis, Structured What-if Technique, Risk Matrix, PEST(LE) Analysis, SWOT Analysis, Stakeholder Analysis, The Five Ws and Two Hs, Driver Diagram, Gantt Chart, Activity Dependency Diagram and LoMo.

Getting Started

Managing the plan is key to the successful evaluation of an improvement project. It is particularly important to communicate the plan from the beginning of the improvement process and to update the description as necessary during the remainder of the process.

The Understand, Design, Deliver and Sustain stages of an improvement process were previously described within the Introduction section, where each stage will likely comprise a preliminary activity, followed by a number of stage activities.

For the Manage the Plan strand of the Understand phase, the preliminary activity is entitled Describe the Next Step. For the Design, Delivery and Sustain stages, the initial plan should be further developed into a full programme to design, deliver and sustain the benefits to be provided by the proposed solution(s).

Decide the Next Step

This preliminary activity encourages people to choose the activities most likely to improve the system and enable progress to the next stage gate and deliver the most effective plan to deliver the proposed solution(s) for improving the system.

Worksheets: Improvement Questions, Improvement Stakeholders, Improvement Strands Canvas, Improvement Plan

Top tips:

  • Assess the quality and confidence levels of existing outputs
  • Identify the outputs required to pass the next stage gate
  • Decide the activities required to reach the next stage gate

Following on from this preliminary activity, the remaining stage activities are: Identify Enablers And Blockers, Manage Team, Ensure Shared Understanding, Review Project Performance, Review Project Progress and Plan Future Activities. Each of these are now described in turn, together with the tools that may be used to support them.

Activities

Identify Enablers and Blockers

The identification of stakeholders who have the potential to enhance or disrupt the delivery of an improved system

Purpose: to identify stakeholders who are able to facilitate or block delivery of an improved system

Inputs: Define Requirements, Develop Concepts, Synthesise Evidence, Present Case for Change, Manage Team, Review Project Performance, Review Progress, Plan Future Activities, Agree Aim Statement

Tools: SWOT Analysis, Stakeholder Analysis, Gantt Chart, Activity Dependency Diagram

Cards: Service Stakeholders, Service Improvers

Outputs: a list of the enablers and blockers likely to influence the delivery of an improved system

Top tips:

  • Identify stakeholders who are most likely to influence a change
  • Build on the enthusiasm of actively supportive stakeholders
  • Develop strategies to disarm potentially disruptive stakeholders

Manage Team

The assembly and empowerment of a team who have the potential to develop and deliver the modified system

Purpose: to manage a team who are enabled and willing to embark on the programme of improvement

Inputs: Define Requirements, Develop Concepts, Synthesise Evidence, Present Case for Change, Identify Enablers and Blockers, Ensure Shared Understanding, Review Project Performance, Review Progress, Plan Future Activities, Agree Aim Statement

Tools: SWOT Analysis, Stakeholder Analysis, Gantt Chart, Activity Dependency Diagram, LoMo

Cards: Service Improvers

Outputs: a description of the team most likely to deliver the modified system

Top tips:

  • Build a team from stakeholders, influencers and facilitators
  • Ensure team members are clear of their roles within the programme
  • Agree a framework for team communication and meetings

Ensure Shared Understanding

The identification and agreement of key improvement terms to bring clarity to the delivery of an improved system

Purpose: to ensure the team share a common understanding of the key improvement terms

Inputs: Define Requirements, Develop Concepts, Synthesise Evidence, Present Case for Change, Manage Team, Review Project Performance, Review Progress, Plan Future Activities, Agree Aim Statement

Tools: tbd

Cards: Improvement Terms

Worksheets: Improvement Terms

Outputs: a collection of key improvement terms and their corresponding definitions

Top tips:

  • Identify the key terms to be used in the improvement programme
  • Ensure the team have a shared understanding of the key terms
  • Use the terms consistently in all communication and meetings

Review Project Performance

The systematic review of the risks evident in the delivery of an improved system and their likely impact on stakeholders

Purpose: to review risks present in the programme required to deliver an improved system

Inputs: Define Requirements, Develop Concepts, Synthesise Evidence, Present Case for Change, Identify Enablers and Blockers, Manage Team, Ensure Shared Understanding, Review Progress, Plan Future Activities, Agree Aim Statement

Tools: Failure Mode and Effects Analysis, Fault Tree Analysis, Hazards and Operability Analysis, Structured What-if Technique, Risk Matrix, SWOT Analysis, Stakeholder Analysis,, Gantt Chart, Activity Dependency Diagram, LoMo

Outputs: a list of the hazards present in the programme and the risk they pose to its delivery

Top tips:

  • Understand the risks present in the improvement programme
  • Estimate the likelihood of disruption posed by these risks
  • Identify the likely extent of disruption posed by these risks

Review Project Progress

The systematic review of progress made in the delivery of an improved system and the likely impact on stakeholders

Purpose: to review progress against the programme required to deliver an improved system

Inputs: Define Requirements, Develop Concepts, Synthesise Evidence, Present Case for Change, Identify Enablers and Blockers, Manage Team, Ensure Shared Understanding, Review Project Performance, Plan Future Activities, Agree Aim Statement

Tools: PEST(LE) Analysis, The Five Ws and Two Hs, Wardley Diagram, Driver Diagram, Gantt Chart, Activity Dependency Diagram, LoMo

Worksheets: Improvement Strands Canvas

Outputs: a review of the progress made against the planned programme delivery targets

Top tips:

  • Understand the progress made in the improvement programme
  • Review the progress made against the plan of future activities
  • Identify areas where progress is not in line with that planned

Plan Future Activities

The development of a resilient plan for the timely and cost effective delivery of an improved system

Purpose: to plan the next steps in a clear and robust programme to deliver an improved system

Inputs: Define Requirements, Develop Concepts, Synthesise Evidence, Present Case for Change, Identify Enablers and Blockers, Manage Team, Ensure Shared Understanding, Review Project Performance, Review Progress, Agree Aim Statement

Tools: PEST(LE) Analysis, The Five Ws and Two Hs, Wardley Diagram, Driver Diagram, Gantt Chart, Activity Dependency Diagram, LoMo

Worksheets: Improvement Strands Canvas, Improvement Activities, Improvement Plan

Outputs: a detailed plan of the next steps required to deliver an improved system

Top tips:

  • Establish a clear and effective planning and reporting process
  • Define clear targets for each stage of the improvement process
  • Deliver regular progress updates to the programme funders

Tools

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