Multiproject interdependencies in health systems management: a longitudinal qualitative study.
BACKGROUND
A health care organization often engages in the simultaneous implementation of multiple organization change initiatives. However, the degree to which these initiatives are implemented and can be enhanced based on their interdependencies is an open question. How organizations and the change initiatives they pursue might benefit from more careful examination of potential interdependencies among projects was explored in this article.


OBJECTIVE
The aim of this study was to introduce a multiproject management conceptualization that stresses project interdependencies and suggests synergies can be found to enhance overall project and organizational performance. It examines this conceptualization in the context of a health system pursuing several major initiatives to capture insights into the nature of such interdependencies.


METHODS
Longitudinal qualitative analysis of interviews conducted with hospital leaders attempting to manage multiple initiatives being implemented by the system's leadership team was used in this study.


RESULTS
The implementation of an electronic medical record (EMR) is empirically identified as the most central among multiple projects based on other projects dependencies on the EMR. Furthermore, concerns for data are identified most frequently as success factors across all projects. This reinforces the depiction of the EMR as a central organizational focus.


CONCLUSIONS
A unique perspective on multiproject management in hospitals and on EMR projects is presented. In addition, the interdependency conceptualization and its application and results provide insights into multiproject management that can help ensure that benefits of individual projects are more fully optimized or exploited in leveraging the effectiveness of other project initiatives.
Aaron Spaulding, PhD, MHA, is Assistant Professor, Department of Public Health, Brooks College of Health, University of North Florida, Jacksonville. E-mail: aaron.spaulding@unf.edu. Larry Gamm, PhD, is Regents Professor, Director, Center for Health Organization Transformation, Texas A&M Health Science Center, College Station. E-mail: gamm@srph.tamhsc.edu. Jungyeon Kim, MBA, is Graduate Research Assistant, Department of Health Policy and Management, Texas A&M Health Science Center, College Station. E-mail: jkim@srph.tamhsc.edu. Terri Menser, MBA, is Graduate Research Assistant, Department of Health Policy and Management, Texas A&M Health Science Center, College Station. E-mail: menser@srph.tamhsc.edu.
Aaron
A
Spaulding
Larry
L
Gamm
Jungyeon
J
Kim
Terri
T
Menser
D003695:Delivery of Health Care / Q000458:organization & administration*; D017598:Efficiency, Organizational; D057286:Electronic Health Records / Q000458:organization & administration; D006270:Health Facility Administrators; D006801:Humans; D007407:Interviews as Topic; D007857:Leadership; D008137:Longitudinal Studies; D017146:Models, Organizational; D009936:Organizational Innovation; D036301:Qualitative Research