Rebecca Lawn is a project manager in the Development & Delivery Team at Ko Awatea. She acted as team lead for a collaborative project team under 20,000 Days and is now a project manager in Manaaki Hauora – Supporting Wellness, Now We’re Talking and the Modified Diabetes Care Improvement Package programme.
Danni Farrell is a project manager in the Development & Delivery Team at Ko Awatea. She joined Ko Awatea in 2012 and has worked with collaborative teams in the 20,000 Days, Beyond 20,000 Days and Manaaki Hauora – Supporting Wellness campaigns.
Sneha Shetty is an improvement advisor in the Development & Delivery Team at Ko Awatea. She joined Ko Awatea in 2011 and has worked with collaborative teams in the Manaaki Hauora – Supporting Wellness campaigns. She is also working with Early Childhood Centres in the Now We’re Talking project, a Ministry of Education Collaborative.
Bob Diepeveen worked with Ko Awatea as an improvement advisor between 2015 and 2016. He worked with three teams in the Manaaki Hauora – Supporting Wellness campaign and also worked on the Faster Cancer Treatments project.
No one ever said improvement work was easy! This article presents the lessons Ko Awatea has learned from at-risk collaborative project teams – the risk factors for failure, the warning signs, and the things project managers can do to help at-risk teams get back on track.
Risk factors for failure
- Lack of engagement with the Model for Improvement. For many frontline staff who become involved in project teams, the Model for Improvement is a new way of thinking. The teams that perform poorly are often those that are reluctant to fully engage with it.
- Lack of leadership. The project leader is a key influencer of team performance. Without clear, effective and consistent leadership, teams lack drive and direction and make poor progress. The leader must be someone who is respected by everybody in the group, will embrace the methodology and will lead by example.
- High staff turnover. High turnover among staff involved with the project is disruptive. It negatively affects the team’s engagement with the work because new staff may lack buy-in. In addition, new team members lack understanding of the improvement methodology because they have missed learning sessions. High staff turnover can also result in unstable leadership, fluctuating numbers or over-reliance on a single champion. For this reason, services and units undergoing restructuring are at higher risk of project failure than stable ones.
- Overlarge team. Large teams can create a perception of time-wasting and lose engagement if meetings include too many people who have little direct involvement with the current stage of the work. Overlarge teams also make it more difficult to form strong intra-team relationships. While optimum team size depends on the nature of the project, large teams may need to form workstreams around a core project team.
- Lack of support from management. Teams that lack support from management find it difficult to secure the time and resources they need for training and for developing and testing change ideas.
- Undisciplined documentation. Documenting plan, do, study, act (PDSA) cycles is crucial to maintain progress and understand the learning from the change ideas teams develop and test. Having a comprehensive PDSA tree keeps testing on track, helps to tie up loose ends, highlights gaps and provides a valuable resource for project reviews.
- Irregular meetings. There is no opportunity to progress PDSAs if the team does not meet regularly and maintain good communication. Although some successful teams meet only once a fortnight or once a month and hold regular huddles in between to maintain communication, most teams make better progress by meeting weekly.
The warning signs
Warning signs that teams could be at risk include:
- Meetings lack focus and there is little clarity about what is happening in the project. Discussion frequently wanders off-task.
- Attendance at the team meeting dwindles.
- There are no new ideas and no PDSA testing.
- The project manager and/or improvement advisor feels ‘out of the loop’.
- There is still disagreement about the team’s aim statement, or questions about why the team is doing this work or what it is trying to achieve, weeks after the aim has been identified.
Getting teams back on track
Project managers or improvement advisors who observe warning signs that teams are at risk must act quickly to prevent teams from deteriorating into a negative spiral. First, find out what is going on by speaking to sponsors or team members. An open, up-front approach is best. Work with the team to devise a strategy to address the problem. Encourage team members to take ownership of the problem and responsibility for solving it with the team’s internal resources.
It may be necessary for the project manager or improvement advisor to take more control over team meetings temporarily if a lack of focus is hindering progress. Set an agenda with action points and monitor documentation of PDSAs to keep the team on task. Once the team is functioning better, pull back and return control to them.
If there are issues around buy-in, the aim, not understanding why the team is doing things or other disagreements, teams may need to start afresh to create engagement. Facilitate a group discussion or brainstorming session to get everyone back on the same page.
The project manager or improvement advisor can intercede with sponsors if there is engagement among team members but progress is compromised by lack of time for training or conducting PDSAs. It is important to make sure teams have time allocated to attend learning sessions so they can build capacity to use the improvement methodology themselves.
By understanding the factors that can put collaborative project teams at risk, keeping a lookout for the warning signs, and taking prompt action, project managers and improvement advisors can help teams at risk of failure get back on track to success.