Solution Implementation is Not One Size Fits All

Have You Put the Cart Before the Horse With Your Implementation Efforts?

By Tom Overton

The expression “Don’t put the cart before the horse” has always brought a funny image to my mind. I have never seen a cart in front of a horse, nor do I think anyone would actually make this mistake, but the words are used frequently to express a desire not to allow things to get out of order. How does that apply to service delivery in a customer environment where results matter? In implementation efforts, what is the horse, and what is the cart?

So many software and services companies have a “one size fits all” approach to processes. The software functions in a certain way with specific configuration options. To use the software, the processes must be implemented the same way regardless of the customer culture, goals, or desired and expected outcomes. In my career, I have seen this “cookie-cutter” approach applied repeatedly with unpredictable results. The truth is the order of implementation between processes (horse) and software (cart) matters. In other words, don’t put the cart before the horse.

If every hospital had the same challenges, it would make performance excellence easy to achieve with a one-size-fits-all approach. Since hospitals are not all the same, there must be a methodology that takes those differences into account.

Imagine a world where shoe stores only have one type of shoe, in one size and color. Your only choice is a white tennis shoe in a size 7. For some people, this is the perfect shoe, they will be quite happy with the choice and will walk around in comfort and style. The rest of the population will struggle with walking due to the shoes either being too big or too small. Those with shoes too big will have a different set of issues and/or discomfort than those with shoes too small. And it is unclear what future problems the non-size 7 people will have due to years of walking in the wrong size shoe. Thankfully we don’t live in that world, so we should not expect something as important as patient progression in a hospital to be improved with a single set of processes that are designed only for the features and functions of a specific software solution.

A unique approach is to design processes that consider the hospital’s challenges and then go live with those processes before the software is deployed. Those processes would have metrics and measures that are readily available to ensure the processes support the hospital’s defined goals. Hospitals would see great results with the new processes designed for them. They get the opportunity to adapt to the new methods without the need to also learn a new software tool…yet. Then, and only then, you would go live with the technology solution that undergirds the processes. Individual users are so well versed in the processes, and so prepared and trained for the new technology, the technology go-live would be a yawn in an otherwise busy day. Then the hospital’s results are elevated to an even higher level.

Do not accept a world in which a white, size 7 tennis shoe is your only option. And don’t accept that there is only one way to implement a solution. Your results depend on a solution that is designed for your challenges and desired results. Get those results with the right horse, and the right cart, in the right order.