How to spot initiatives headed for disaster

The best-laid plans of mice and men (and re-engineering professionals) can go astray, warns Terry Williams, MBA, a senior consultant at LUMEN, a healthcare consulting company in Atlanta.

He offers Patient Focused Care 10 symptoms of a troubled redesign initiative:

1. Change is treated as a project.

2. Only a chosen few engage in measuring performance.

3. Such measurement is always retrospective.

4. Decisions are based on anecdotal stories, instead of data-and useful information-driven.

5. Unclear boundaries slow down decision making.

6. Energy is spent fighting old political battles; productivity wanes in spite of your best efforts.

7. Most hot issues are between departments, rather than within single ones.

8. Unsolved system issues create people issues.

9. Decisions require "rubber stamping" from many higher levels.

10. Data is difficult to internalize or understand.