Draw up your own implementation plan

Good preparation is essential to making an implementation plan. We have five tips for you. Read them carefully so that the implementation will be successful!

Tip 1: Be aware of what you are embarking upon  

Before getting started, it is advisable to examine whether your care innovation is going to achieve what you are hoping for. What is the reason that you wish to make this innovation? Is the innovation the right solution? How big is the problem and who does it affect? Ascertain what solutions other organisations or departments have already implemented. What were their experiences? 

Tip 2: Implement with the help of others 

It is important to enlist help when implementing innovations. Consider setting up a preparatory group. Involve others in your plans at an early stage, as that will provide you with more knowledge and help you to gain the support you need. Involve people who will eventually work with the innovation: they will be the ambassadors for your innovation. What problems or opportunities do they envisage? What is and is not feasible? Also involve managers and boards at an early stage: their support and commitment is essential. And don’t forget any opponents: it’s important for them to feel heard and understood. Don’t sidestep them, but give them a role in the innovation process.

Tip 3: Set up a project group 

A good project group is vital in both the preparations and implementation, and it should contain a good mix of professional experts and project staff. Ambassadors in the organisation can also contribute to the success of your innovation.

Tip 4: Project managers are the key to success  

Research has shown that project managers play a crucial role in implementing innovations. Some project managers will be more successful than others, depending on their particular capabilities and characteristics. You should therefore determine to what extent you, or the project manager that you have in mind, have these skills.

Tip 5: Enlist the help of implementation expertise

Consider whether you yourself have everything it takes to lead the project. Bring in an implementation expert as the project manager or a member of the project group. More and more professionals are specialised in implementing innovations. Some of them work in a particular sector, such as youth healthcare or hospital care. Others work for knowledge institutions, universities or universities of applied sciences and also conduct research and teach. You can ask ZonMw’s implementation team for advice.

The input tools provided for each step will help you to answer these questions and based on these answers you can select the implementation strategies you intend to use. Within these strategies you can plan actions and get started. The implementation plan is, however, not a blueprint! You will need to revise it, preferably in collaboration with the people on the ground, depending on progress and any problems you encounter on the way. An adaptive and participatory strategy is nowadays regarded as the right way to achieve successful implementation.

This section of the step-by-step plan provides a description of the various elements of the implementation plan.

1. Identifying goals and target groups

Who or which organisation will be affected by the change? Set SMART goals and consider which target groups you want to reach.

Set SMART goals

Take a critical look at what you want to achieve with the innovation. Ambition is a good driver, but make sure the project is feasible. Find a good balance between challenge and acceptable risk. Be clear about what you want to accomplish. Goals such as ‘better care’ or ‘more customer satisfaction’ do not provide a solid footing for managing the process: it will not be possible to assess whether such goals have been achieved. Also consider the scale on which you want to innovate. Will it be a specific department, or an entire organisation? Set clear deadlines, but check that they are realistic. Allow sufficient time, but don’t make the time frame longer than necessary. In this way you will ensure that the innovation doesn’t just go out like the snuff of a candle.

Make a list of target groups

What target groups do you need to reach your goal? Make a list of these target groups. They could be direct target groups, e.g. nurses who need to follow instructions. Or they could be indirect target groups that you need to achieve your goal, for example, an insurer that is willing to fund a new type of care. Limit the number of target groups and put the most important ones at the top of the list as they have highest priority.

2. Analysing the target group

It is important to have a good understanding of the characteristics and positions of the various target groups. Selecting the right advocate for the innovation and being aware of pioneers and stragglers contributes to success.

Obtaining information

Bear in mind that not everyone will come on board with your ideas immediately. Some people will have had a bad experience with a previous innovation. Or they may regard your proposal as a saving measure through the back door. People’s willingness to change will have an impact on the implementation process. Use the ‘Analysing target groups’ matrix to visualise what your target groups’ concerns are, so that you can focus on them more effectively. For example, talk to the people who will eventually need to work with the innovation and involve them in discussions on the initial ideas. They can tell you better than anyone what they know and think about the ideas.

Pioneers and stragglers

In any implementation process there will be pioneers, stragglers and an in-between group. Pioneers will often be quick to see the benefits of an innovation, especially if you underpin it with scientific evidence. Stragglers, on the other hand, will not be interested in that information: they will often need more pressure and support. Determine who the pioneers and stragglers are in your situation and who belongs to the in-between group and consider how you can approach those groups. The order in which you approach them is also important: it may help to get the pioneers on board first as the others will then be more likely to follow. If you would like to gain a better understanding of this, you will find the ‘Gearing to pioneers and stragglers’ matrix useful.

Ascertaining the advocate’s influence

We often underestimate the influence that the person proposing an improvement can have. It can make an enormous difference whether the initiative comes from the finance director or from healthcare professionals: in the first case one is more likely to think of an efficiency measure and in the second more in terms of genuine commitment. The advocate’s power is also important: how much authority do they have? Even more important is their credibility. Given a person’s reputation or position, it may be better to have someone else introduce the improvement.

3. Examining the innovation

Consider beforehand what the strengths and weaknesses of the innovation are. That may differ for each target group. Take a critical look at the innovation: what do you intend to do with it and what are the best follow-up steps in your situation?

Knowing the strengths and weaknesses

Whether a project is going to succeed will depend partly on the actual innovation. People do not tend to take a positive view of something that takes a lot of time and is unlikely to produce much benefit. An innovation is more likely to succeed if it can be clearly explained, or if it shows results quickly. So identify the strengths and weaknesses of the innovation. Bear in mind that the outcomes may differ per target group: advantages for one person may be a disadvantage for someone else.

What should you do with the outcome?

Take the outcome into account in the next steps. Now that you know what the strengths and weaknesses of the innovation are, you can act on them. Bear this in mind in the way in which you communicate the innovation. Teach people to work with it. There is also another option: you could adapt the innovation itself. Perhaps the innovation is too complicated, but you can simplify it substantially with a few adjustments. Always take a critical look at the innovation itself!

Business case

A business case is a report listing the potential costs and benefits of an innovation. It systematically documents the pros and cons of an innovation. Drawing up a business case provides information on the investments, costs and returns for an organisation – not only in a financial sense, but also in terms of the efforts that people need to make and the effects on quality.

4. Examining the context

The environment will affect the change. Identify the opportunities and threats beforehand. Use them to your advantage, or be aware of how to anticipate them.

Identify what things in the environment could affect implementation. There may be circumstances that impede or accelerate implementation. Look at the social context and the relationships between the various staff members. Determine how the organisation in which you are going to implement the innovation works. How do the decision-making processes work? What leadership style prevails? Also look at the economic and financial factors. And what about training budgets and national laws and regulations?

5. Selecting a strategy

To implement a change successfully, it is important to select a change strategy. A combination of strategies will prove most successful.

Different strategies are possible

You will have gained a lot of knowledge from the previous steps. You know what the current situation is and what your goals are. To achieve those goals you need a strategy, which must be suited to the target groups as far as possible and to what the change will require of them. There are strategies that help to increase support on the ground, but there are also strategies that start by addressing obstacles to the innovation in the organisation. Research shows that a combination of strategies is more successful than a single strategy.

Selecting the right strategy

You will require the information from the previous steps to select the right strategy. What is required to achieve the goals? What stands in the way of achieving the goals? Are there factors that could help so that you can make smart use of them? The ‘Deciding on the approach’ table will show you the best strategy, linking the outcomes directly to a strategy that best suits your situation. This is also the time to select the tools that you are going to use.

Ensure that the innovation is embedded

Anyone working on healthcare innovation will be keen for the innovation to be embedded. All the efforts will have been wasted if the innovation is watered down. Embedding is an ongoing process that begins right at the start of a project. Many of the embedding elements will be integrated in the steps taken in the step-by-step plan. There will also be additional points that require special attention. Look at the embedding checklist and incorporate the ideas into your plans.

6. Planning actions and communicating strategy

How can you select and plan the right actions to make the implementation a success? And: What is the best way to communicate the message about your strategy? Read more here.

Select the right actions

You now know what you need to do for each target group. You also have the right words to summarise it all. It is important to link them to specific actions. Numerous tools and activities can be used for each strategy. Indicate what tools and activities you intend to use for each target group. Be as specific as possible. Enter them, along with the key messages, in the ‘Overview of actions’ table.

Knowing time, tasks and costs

Decide when each activity should be carried out. Also determine who is going to ensure that it actually happens. Will it be you? Will it be your colleagues? Or will you bring someone in? This is also a good time to take another look at the feasibility of your plans. Check, for instance, whether the costs are in line with the budget available. And whether the plans are feasible within the timeframe. Revise them if necessary.

Communicating the strategy

Summarise your findings in a few powerful sentences. We call this the ‘key message’. Do this for each target group. The message will convey what you want to accomplish, where and how. Putting the message in writing will force you to articulate your plans clearly. At the same time, bear in mind how you can best communicate that message. What words will help to convince the target group, for instance? What opposition do you need to take into consideration?

7. Evaluate

To bring about successful change, you must evaluate the project while it is in progress as well as after completion. In this way you will be able to see whether the implementation is successful or whether adjustments are needed.

Why evaluate?

Evaluation is important when implementing an innovation. It will tell you whether the implementation was successful or whether adjustments are needed. Evaluation is not only necessary at the end of the project, but especially while it is in progress. You will need data and periodic checks to monitor the process.

How to measure outcomes?

There are numerous ways, ranging from simple, transparent research methods to complex and highly complicated ones. Which one you select will depend on several factors. How large is the project, for instance? How much money do you have for evaluation? What are your options for collecting data?

Some tips on measuring outcomes

• Keep the evaluation as simple and small as possible
• Use existing registrations as much as possible as collecting additional data will take more time and can put pressure on the team
• Decide who will carry out the measurements. Are you going to do it yourself or will you hire an external consultant? Consider getting advice from experts on evaluation and monitoring
• Make sure the evaluation includes a comparison, for example, between the old way and the new way, or between the baseline measurement and the final measurement
• Decide who the target group for the evaluation is. Who needs to know about the project and what do they need to know? Is it an internal matter or is there external accountability? What do you as a professional or organisation want to learn about?

Make a plan

Make a clear plan before you start the evaluation. Who is going to take responsibility for it, for instance? When will measurements be carried out, and how? Calculate what you need in terms of time and money and include this in your action plan.

What will you do with the outcomes?

There is no point in evaluating if you do not draw conclusions from the outcomes. Evaluating often results in action, which could be a variety of things. It may be necessary to adjust the strategy, or to take another look to see whether you have overlooked important factors. You may also be satisfied with the outcomes. That could be a reason to speed up the process or embark on a new challenge.

Afbeelding

After making the plan, it is time to put the implementation plan into practice. Below are some tips to help you with this process.

Making adjustments if there are problems

Unexpected events can always occur while implementing an innovation. Sometimes, for example, the innovation will give rise to opposition, or people may fall back into old habits. In most cases, you yourself will have been working on the innovation for some time, whereas the project is new for the people involved in implementing it. They need to find out about it first and gain an understanding. They will ultimately need to accept the innovation, implement it and safeguard it. Take a careful look at the problems that could occur and how you can solve them.

Keep in touch

Innovation processes usually take a long time. Keep in touch regularly throughout the process, as that will keep people involved and motivated. Inform them regularly about how the innovation is going, for instance. Specify the milestones and celebrate them when they have been achieved. It is also important to pay frequent visits to places where your colleagues are working on the innovation, so you can hear from them how it’s going. This also provides a good opportunity to discuss things in more depth, such as any doubts or prejudices that they may have.

Celebrate

Successes need to be celebrated, and this should also be the case for the rounding off of the innovation project. Find a suitable ritual: for example, a cake for the department, flowers for every staff member, or a big party.

Publicise it

Innovations are an opportunity to put out the flags, to show competitors, for instance, or insurers, suppliers, the authorities and other important partners what you have achieved. Publicise your achievements. This is important not only to set you apart from other organisations, but also because of the glory that it projects on your staff.

After the innovation has been successfully implemented, you can scale it up. This is the process whereby a proven innovation is put into practice on a larger scale. The approach required to do this will often be different from that of implementing it. The scaling up guide, which can be downloaded using the link below, contains useful tips and tricks on how to successfully scale up your innovation.