The 8 Most Costly Project Management Mistakes in Healthcare—and How to Fix Them
By Dr. Nicole Dhanraj
Whether you’re managing a hospital, outpatient center, or ambulatory surgery center (ASC), every project you implement has one goal: to make operations more efficient and patient care more effective.
But even the best-intended projects can stall, run over budget, or fail to deliver results—not because they weren’t needed, but because execution is where most initiatives struggle.
Dr. Rogers’ eight rules of project management highlight common missteps that can slow progress, increase frustration, and lead to disengaged teams.
The good news?
These challenges aren’t inevitable.
With the right strategies, projects can run smoothly, staff can stay engaged, and organizations can see measurable improvements in efficiency and patient care.
If you’ve struggled with implementing change in your organization, you’re not alone.
Here’s how to avoid the most common pitfalls and set your projects up for success.
1. If You Can’t Measure It, You Can’t Manage It
Too many healthcare initiatives launch without clear success metrics.
A hospital may introduce a new imaging workflow or OR scheduling system, but six months later, no one can say whether it's actually improved efficiency or patient outcomes.
How to Fix It:
Focus on leading indicators, not just lagging metrics. Instead of tracking how many patients were seen, measure how many were scheduled without cancellations or how quickly imaging reports are completed and acted upon.
Involve frontline staff in defining metrics. If you want meaningful improvement, let the people closest to the work help define what “better” looks like.
Make data visible and usable. A dashboard no one checks is useless—embed real-time performance tracking into daily workflows so staff can adjust on the fly.
2. Failure to Plan is a Plan for Failure
Most organizations plan for the “go-live” date but not for long-term adoption.
A new EHR function may be turned on, but if physicians and nurses don’t integrate it into their workflows, the project hasn’t succeeded—just completed.
How to Fix It:
Reverse-engineer the implementation. Instead of asking, "When can we launch this?" ask, "How will staff use this daily six months from now?"
Test with the biggest skeptics, not just the early adopters. If a busy PACU nurse or a high-volume radiologist can’t use the new process seamlessly, neither will anyone else.
Think beyond training—focus on usability. If a system requires extensive training just to navigate basic functions, adoption will be low. Design for intuitive use first.
3. Focus on Product Over Process
Many healthcare leaders celebrate project completion instead of actual impact.
A hospital may successfully roll out a new enterprise imaging system, but if radiologists struggle to retrieve outside studies, is it truly a success?
How to Fix It:
Make changes to upstream workflows before launching new tools. If your imaging software reduces turnaround time but schedulers still book the same appointment lengths, efficiency gains are lost.
Eliminate the soft launch mentality. If an initiative is meant to improve efficiency, force process adjustments on day one, not months later.
Measure success in time savings and reduced frustration, not just compliance. If staff is using a new system but complaining about added clicks or slow processing, you haven't improved their work—you've burdened it.
4. Effective Work is Doing the Right Things. Efficient Work is Doing the Right Things Well.
Healthcare is full of busy work that doesn’t improve patient care or operational efficiency. More documentation, more sign-offs, and more checklists don’t automatically equal better outcomes.
How to Fix It:
Challenge every step in a process: If a step doesn’t reduce errors, speed up patient flow, or improve care, remove it.
Test process changes in high-volume areas first. If a change works in the ER, PACU, or imaging department, it will work elsewhere.
Reduce documentation overload. Before adding a new form or checklist, ask whether the information is actively used for decision-making. If it isn’t, it’s wasted effort.
5. Project Communication is an Active, Two-Way Process, Not a One-Way Street
Many initiatives fail because the frontline staff wasn’t involved in shaping them. A new OR block scheduling policy, for example, may seem great on paper, but if surgeons and schedulers weren’t consulted, gaps will surface immediately.
How to Fix It:
Hold 5-minute huddles instead of long meetings. People retain information better when it’s immediately relevant to their work, not buried in a memo or a 30-minute briefing.
Use “explain-back” rounds to confirm understanding. If a nurse manager can’t articulate why a process change is happening, the message didn’t land.
Let the end-users write the first draft of policy changes. If you want staff to follow a new workflow, have them shape it from the start.
6. If It Hasn’t Been Done Before, That’s Reason Enough to Consider Trying It
Healthcare tends to default to the status quo, even when better approaches exist.
Many hospitals, for example, resist teleradiology for overnight reads, even though it could reduce burnout and improve coverage.
How to Fix It:
Pilot new methods in the highest-friction areas first. If something works in a busy ASC or high-volume ER, it will work anywhere.
Remove “we’ve never done it that way” from your vocabulary. Look at benchmark hospitals and high-performing outpatient centers—if they’re doing it successfully, so can you.
Test small, scale fast. Instead of a full-system rollout, try a 30-day micro-pilot in one department to get real-world feedback.
7. When All Else Fails, Read the Directions
Many failed projects aren’t failures of strategy but failures of execution. Organizations often repeat the same mistakes because no one captures lessons learned.
How to Fix It:
Create a living “lessons learned” database that people use. Most post-project reviews end up in a file no one reads. Before starting any new initiative, require teams to review past similar projects.
Force vendors to test solutions in real-world workflows. If an IT system “should” integrate but wasn’t tested with actual patient encounters, it’s not ready.
Appoint a process historian. There are staff members who remember every failed initiative from the past 20 years. Use them to avoid repeating the same mistakes.
8. Have Fun!
Burnout is real, and every process change can feel like just another mandate if leadership doesn’t make engagement a priority.
How to Fix It:
Use reverse shadowing to build buy-in. Let leaders spend a day with techs, nurses, or schedulers—then have those frontline teams shadow decision-makers so they see how leadership works.
Create an ongoing "What Would You Change?" campaign. Let staff submit workflow improvement ideas anonymously—and commit to implementing at least one change per month.
Celebrate real wins, not just compliance. If a new imaging workflow reduces turnaround time by 5%, recognize the radiology team, even though they may not have hit the major goal. If a new OR protocol reduces case delays, highlight the schedulers and nurses who made it happen.
Let’s Talk About Execution
Every healthcare organization has great ideas.
The real challenge isn’t coming up with new projects—it’s executing them well.
If you’ve struggled with getting initiatives to stick, improving operational efficiency, or engaging your teams in process improvement, I’d love to help. Let’s talk about how your outpatient center, or ASC can turn ideas into results.
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