Transcript Project Definition & Benefits Realisation Framework

Our Focus On Benefits Realisation
>> Delivering Accelerated and Sustainable Business Benefits
An introduction to our Project Definition & Benefits Templates
Version As At_November 2009
Introduction
Provide an overview of our Project Definition and Benefits Templates which will help ensure we deliver
integrated quality and efficiency outcomes from our improvement projects. It is being used to:
 Agree what projects should be started and what delivery outcomes (quality and efficiency) should be
targeted
 Allow the key benefits to be achieved by the project to be defined in more detail, including agreement
on measures, any interim outcomes to be achieved and the changes that need to happen to make
benefits realisation possible (People, Process, Technology, Other)
The use of these templates will help ensure there
Shared understanding across the Project Teams
State the case for change
Benefits being targeted
Current delivery status
Benefits that have been achieved
and where support to maximise benefits is required.
Our Service Improvement Context
We need to focus on achieving quality and efficiency outcomes.
 Safe: Avoiding injuries to patients from the care
that is intended to help them
Safe
Patient
Centred
Effective
 Timely: Reducing waits and sometimes harmful
delays for both those who receive and those who
provide care
Our focus on
achieving
balanced
benefits
Equitable
 Efficient: Avoiding waste, releasing time to care,
and reducing unnecessary expenditure
Timely
Efficient
 Effective: Improving clinical decision making,
supporting multidisciplinary care and supporting
clinical audit
 Equitable: Providing care that does not vary in
quality because of personal characteristics or
circumstances
 Patient Centred: Providing care that is
respectful of, and responsive to individual patient
preferences, needs, and values
Our Service Improvement Context
We need to link Performance Improvement, Project Delivery and Benefits Realisation.
Performance
Improvement
 Track benefits
delivery
 Track our
performance
 Identify where
improvements are
required
 Intervene where
required
 Agree when and how
benefits will be
realised
 Agree minimum
outcomes to be
achieved
Our focus on
continuous
service
improvement
Benefits
Realisation
Project
Delivery
 Prioritise our projects
 Target the benefits
 Start the projects
 Manage the changes
Our Service Improvement Context
We need to build on the strategic improvement work that is already on-going.
C
= Constraint
Q
= Queue Before Activity
T
= Target Challenge
We have modelled
many areas of our
health system and
we are now doing
this across Mental
Health
= Trend in Volume
= Known Issue
NHS 24
= Suspected Issue
OOH
SAS
T
acute services
Specialist
acute care
A&E
Walk-In
MIU
OOH, urgent & emergency
services (community)
GP
referral
acute
acute
receiving
receiving
ward
ward
(Med/Surg)
(Med/Surg)
Q
GP
T
referral
in-patient
Patient focused mgt plan
approach to reducing
multiple admissions in
over 75's
Improve Capacity &
Flow in Medicine and
RVH
Quality Discharge
Communications
Elective
Community Care Services
Develop use of
Community Hospitals improve use/flow
Community Nursing patient contact
time/anticipatory care
AHP activity rebalance the activity
towards community
Community Diagnostics
- to support Community
Hospital model
Virtual Ward
Self Management
Enhance the Ambulatory
Care service offered in
Ward 15
routine
routine
discharge
discharge
Endoscopy
Radiology
Efficiencies in General
Surgery OP Clinics
Information provision
and coding (e.g. The
Gap)
Streaming Access A/E
complex
complex
discharge
discharge
day case
out-reach
T
Pre-assessment
screening
CKD - IT enabled
Pathway
Laboratory
GP
direct
access
Variation in GP referral
rates
tertiary services
GP
feedback
day patient
refer to GP
End to end Orthopaedic
pathway hip/knees
rehab
Q
out-patient
out-patient
Q
Urgent & Emergency
sub-contract
refer on-going
community care
Community
Pharmacists
Community
(day) Hospitals
Care in the
community
C
GP
Q
Prescribing
Outpatient
Day Patient
Medicines
at Admission
Local
Authorities
Prescribing Practice
Anti-microbials
Patients still on
medicines they no
longer need
Inpatient
Community Services – partnership model with LA
Partner & Vol
organisations
Projects overlapping more than one stream will require cross cutting team resource
We have started to
roll out a training
programme focused
on Lean-enabled
improvement
(Facilitator, Expert
and Leader)
Lean
Leader
es
family health services
Clinic
ppr
oac
h
Optom
mental health
district nursing
health visiting
specialist nursing
AHP (e.g. physio, OT)
elderly care
other
rtfo
lio
of A
Q
Po
Home Visit
GDP
Lean Expert
4 Day
Classroom Training
Lean Facilitator
4 Day
Classroom
Training
On Project
Skills Transfer
& Coaching
Lean Awareness
Lean
Pocket
Guide
e-Learning
Master
Classes
Good
News
Stories
We defined a 1st
phase Service
Improvement
Programme having
analysed and
prioritised our whole
system challenges
with key
stakeholders
Our Approach To Benefits Realisation
We need a stronger focus on benefits realisation across our organisation.
Building evidence of success
to share across our
organisation
Encouraging better
information capture
and use for decision
making
Achieving stronger and quicker
returns on investment
(quality & efficiency)
A stronger focus on
benefits management
will support us in...
Building a
performance
improvement culture
Linking business
performance to projects to
benefits
Stating the case
for change and
prioritising
projects
Linking project activity
more directly to strategic
objectives
Only around 25% of benefits from change
programmes are usually achieved….costing the
UK economy over £50B per annum.
Over 80% of CEOs are disappointed in the
Return on Investment following major change
initiatives.
A lack of focus on benefits realisation is at the
heart of this sorry tale.
A stronger focus on benefits planning and
realisation must be a priority for all public
sector organisations.
- London School of Economics
- Audit Commission
Our Approach To Benefits Realisation
We need to recognise there are different types of benefit.
Quantifiable Benefits
=
 We have agreed the measures we will use to
track benefits delivery
 We understand what we are trying to achieve
Measurable Benefits
=
 We have agreed the measures we will use to
track benefits delivery
 We understand what we are trying to achieve
Observable Benefits
=
 subjective assessments of whether benefits are
being realised
Move towards measurable and quantifiable benefits wherever possible
 We understand what we are trying to achieve
Our Approach To Benefits Realisation
We need to recognise there are different categories of benefit.
Quality Improvement
Direct Cost Saving
Resource Release
Cost Avoidance
=
We are targeting changes that will improve patient safety,
improve the patient’s experience, improve clinical
outcomes, minimise delays, and remove variation
=
We are targeting changes that will allow us to reduce
unnecessary expenditure and actually reduce budgets year
on year
=
We are targeting changes that will allow us to release
resources to focus on “value adding” activities: staff
(release time to care), clinics/theatres (increase utilisation)
=
We are targeting changes that will allow us to avoid having
to make future investments that would have been incurred
Our Approach To Benefits Realisation
We need to recognise what actually needs to change to realise the benefits.
=
We will need to change: Roles? Training? Stakeholders?
Communications? Organisational Structure? Behaviours?
Terms & Conditions?
Process Changes
=
We will need to change: Ways of working? Procedures?
Locations? Performance Measures? Governance?
Reporting? Contracts?
Technology Changes
=
We will need to change: IT systems? IT infrastructure? Data
availability? Data access? Data sharing?
=
Any other changes required to move from an opportunity for
benefits to be realised to actually realising the benefits?
People Changes
Other Changes
Our Approach To Benefits Realisation
We need to work as a team to make it happen.
 The Information Team should be engaged as early as possible to help understand the current
performance (the baseline) and to agree how benefits will be measured (how & when)
 The Finance Team should be engaged as early as possible to help understand the current cost
position (the baseline) and to determine what savings should be targeted
 The eHealth Team should be engaged as early as possible if any IT changes are required to help
realise benefits
 The Modernisation Team should be engaged as early as possible to help define the project and to
ensure that learning and evidence from other projects is shared
 Clinical staff
Our Benefits Realisation Templates
We are using the following templates (double click to launch the templates)
Project
Definition
Statement
Benefit
Statement/s
Project
Status
Report
Is used to:
Is used to:
Is used to:
State your Case For
Change (What & Why?)
Define each key benefit in
more detail
Report on delivery progress
Summarise the current
performance, including
evidence (Measure &
Baseline?)
Define the appropriate
measure/s
State what changes will be
targeted
Summarise the enabling
changes that are required
(people, process,
technology)
Summarise what benefits
will be targeted (Quality
and Efficiency)
Summarise the milestones
that will be tracked (What
& By When?)
Report on benefits
realisation against plan
Escalate any requests for
support, issues or decisions
to the Project Sponsor or
Executive Team
Our Benefits Realisation Templates
The Project Definition Statement:
Project Definition Statement - The Case For Change
Project Information
Benefits Information
Key Success Measures
1
Project Name What is the title of the project?
ID ABC?
2
3
Project Lead Who is leading the project?
Benefit Category
1. Quality Improvement
ABC1
ID
>> What benefit is being targeted
>> Measured by?
>> By when?
2. Direct Cost Saving
ABC2
>> What benefit is being targeted
>> Measured by?
>> By when?
ABC3
>> What benefit is being targeted
>> Measured by?
>> By when?
3. Resource Release
ABC4
>> What benefit is being targeted
>> Measured by?
>> By when?
4. Cost Avoidance
ABC5
>> What benefit is being targeted
>> Measured by?
>> By when?
What will be changed?
Measure?
Target Date?
Sponsor Who is the project Sponsor?
The Change Rationale
>> Why do anything?
>> What needs to change?
>> Who will benefit?
>> What are we trying to achieve?
Opportunity and Evidence Statement
The Benefits Case
You should talk with the Information Team and your Senior Accountant as early as possible to help complete this section:
This project will effect the following dimensions of quality:
Safe
>> What is the current level of performance and what measures are available?
Efficient
Effective
Timely
Patient Centered
Equitable
>> What improvements are we targeting in terms of Quality and Efficiency?
>> How will success be measured - achieve what and by when?
Category
>> What learning points from other projects can be used?
What improvements will be achieved?
How will we measure success?
>> What improvement is being targeted?
>> What measure/s will we track?
>> What improvement is being targeted?
>> What measure/s will we track?
>> What improvement is being targeted?
>> What measure/s will we track?
>> What improvement is being targeted?
>> What measure/s will we track?
>> What improvement is being targeted?
>> What measure/s will we track?
>> What improvement is being targeted?
>> What measure/s will we track?
Safety
In Scope Statement
Out of Scope Statement
Efficiency
>> What areas will be involved in/impacted by the proposed project? >> What potentially "in scope" areas need to be recorded as being
"out of scope", if any?
Effectiveness
Timeliness
Patient Centred
Risk Statement
>> What risks to successful project completion and benefits
realisation need to be recorded?
Dependency Statement
>> What dependencies need to be recorded, if any?
Equitable
Panel Review Status
1st Review Date
2nd Review Date
3rd Review Date
12/12/09
12/02/10
12/06/10
Review
Review
Approved
Approved
Review
Reject
Approved Date
12/06/10
Our Benefits Realisation Templates
Use the Project Definition Statement to: (nb: read the completion comments that are available)
 Summarise the change rationale – why do anything?
 Summarise the opportunity for improvement and the evidence that is available – how will success be
measured?
 Summarise the position in terms of realising benefits – Safety, Efficiency, Effectiveness, Timeliness,
Patient Centred, and Equitable
 Summarise how success will be measured against each benefit and by when?
The focus is on outlining the Case For Change to allow the Project Sponsor and Executive Team to approve
the project, to understand what benefits are being targeted (Quality & Efficiency), and to understand how
success will be measured (What & By When?)
Our Benefits Realisation Templates
The Benefit/s Statement:
Benefit Statement - The Outcomes To Be Realised
Benefit Headlines
ID
Target Outcome
Sponsor
Owner
Quality Benefits
Efficiency Benefits
Impact
Likelihood
Benefit Score
Benefit Measure/s
ABC1 (As Per Project Definition)
What benefit is being targeted? (As Per Project Definition)
Who is the Sponsor who will track whether the benefit is being realised?
Who is resposnsible for realising the benefit?
Timely: Reducing waits and sometimes harmful delays for both those who receive and those who provide care
Resource Release: Release time, increase productivity and increase utilisation
4 - High Impact
2 - Difficult To Achieve (High Effort, W orth It AND Some Confidence)
What is the Impact x Likelihood score?
What measure will be used to track benefits realisation? (As Per Project Definition)
What measure will be used to track benefits realisation? (As Per Project Definition)
Baseline Position
What is the current performance using this measure?
What is the current performance using this measure?
Target Date
When will the benefit be fully realised - target date? (As Per Project Definition)
Change Area
People
Changes
What key things need to change?
Benefit Realisation Actions
By When?
Owner?
Insert statement on what needs to change
Insert statement on what needs to change
Insert statement on what needs to change
Process
Changes
Insert statement on what needs to change
Insert statement on what needs to change
Insert statement on what needs to change
Technology Changes Insert statement on what needs to change
Insert statement on what needs to change
Insert statement on what needs to change
Other Changes
Insert statement on what needs to change
Insert statement on what needs to change
Insert statement on what needs to change
Benefit Tracking Milestones
Measure
Tracking Point 1
Tracking Point 2
Tracking Point 3
Final Outcome To Achieve
Description of 1st Measure
Outcome/Date
Outcome/Date
Outcome/Date
Outcome/Date
Description of 2nd Measure
Outcome/Date
Outcome/Date
Outcome/Date
Outcome/Date
Collection Frequency
Collection Mechanism (Who/How?)
Benefit Measures Definition
Measure
Description of 1st Measure
Calculation To Be Used
Numerator
Weekly
Denominator
Weekly
Calculation
Description of 2nd Measure
Numerator
Monthly
Denominator
Monthly
Calculation
Our Benefits Realisation Templates
Use the Benefit/s Statement to: (nb: read the completion comments that are available)
 Provide more detail on each benefit to be targeted (x “n”)
 Provide clarity on what measures will be used to track each (if >1) benefits
 Agree what people, process, technology, and other changes are required to actually realise the target
benefits
 Summarise how success will be measured against each benefit and by when?
The focus is on outlining what benefits are being targeted and what will be achieved against each of the Quality
and Efficiency categories
Our Benefits Realisation Templates
The Project Status Report
Project Status Report - <Insert Project Name>
Summary Delivery Status
Date
Summary Benefits Status
Review
Status
13/04/2009
10%
Green
Project
Week
green
0
20%
30%
Target X
X
X
Actual X
X
X
Phase
Insert Name
Team
Name
X
50%
60%
70%
80%
90%
100%
Total
Saving To
Date
X
enter 'x' to fill
0
Team and High Level Plan
Project Leader
40%
Benefits Realisation
1
2
Month
3
4
5
6
ID
Category
Target Outcome
ABC1
Direct Cost Saving
Target Date
Progress Statement
Green
Status
ABC2
Resource Release
Amber
ABC3
Timely
Red
Plan
Role
FT/PT
Do
Study
Act
Project Start Date
Target End Date
Key Achievements This Week
Key Actions For Next Week
The 6 Keys To Success
Stakeholders Are Committed
green
Benefits Will Be Realised
amber
Delivery Is On Track
amber
Team is High Performing
green
Scope is Realistic and Managed
red
Risks are Being Mitigated
amber
For Escalation (Requests, Issues or Decisions)
Insert statement on what requests, issues or decions need to be escalated for action (if any)
Our Benefits Realisation Templates
Use the Project Status Report to: (nb: read the completion comments that are available)
 Summarise achievements over the last period (week?)
 Summarise the focus of change activities to be completed over the next period (week?)
 Escalate any delivery issues that need to be addressed
 Highlight progress in terms of realising the target benefits
The focus is on providing comfort that the approved changes are being delivered and the targeted benefits are
being achieved – or at least the “conditions” for potential achievement are in place