Tipton, Phyllis Hart PhD, RN; Pulliam, Miley O. MSN, RN
Never, never, never give up" is a famous quote attributed to Sir Winston Churchill, who was the prime minister of Great Britain during one of its most tumultuous times in history. Even when war or other challenging situations aren't pervasive, popular maxims emphasize winners never quit and tout the virtues of staying the course. Within an organization there are certain projects that can't be stopped, including those vital to the life of the organization, to the safety of patients and/or staff, and those mandated by regulatory or licensing agencies. At times, the most beneficial choice an organization and/or an individual can make is to cease working on certain endeavors, even if a considerable amount of time and resources have already been expended. This article describes some determinants of when it may be appropriate to stop working on a project and necessary actions to take when terminating a project.
A decisive factor for terminating an institutional project can be the result of changes in national, state, or regional regulatory or licensing requirements. For example, a hospital provided a teen pregnancy program in conjunction with the state public health department (SPHD). Initially, this program involved two nurses who completed 40 hours of SPHD training, providing a series of four prenatal classes to underprivileged teen mothers. After a review of the project, the SPHD mandated the following changes: 100 hours of training, eight prenatal classes, and adding a registered dietitian and social worker to the project team. Implementation of these changes could require a considerable amount of time, finances, or other resources, which could challenge effective project outcomes.1 Thus, because the original requirements have changed, terminating the project might be the most appropriate action even if it was properly started and well managed.2
Factors within the organization
Sometimes factors within the organization signal that a project needs to be ended. Projects should align with the organization's goals and objectives, and a change in an organization's focus may indicate the need to terminate a project.3 For example, a project to promote colorectal cancer screening among all hospital employees has had some promising results. However, top administration determines that a major focus for employee health should now be smoking cessation. Despite the previous amount of work on this project, it's important to consider future time, energy, and effort that doesn't need to be devoted to it if there's a lack of institutional support or enthusiasm.
Imperative to desired project outcomes is the support of organizational leadership.1–3 Leadership changes can result in retiring a project if an organizational leader who was serving as a champion for the project changes positions either within or outside of the organization. A new supervisor may also signal the end of a project. It's never appropriate to assume that a priority project of a former supervisor will hold the same importance to your next supervisor. Your new supervisor may not see the need for you to take time away from other responsibilities to continue working on the project.
Whether there are termination indicators from within or outside the organization, an initial action is to discuss the potential for project termination with your supervisor or other administrative representative(s) who have insight into the situation. The meeting's purpose is to determine the feasibility of continuing a project.
The following illustrates one way to conduct such a meeting. An opening statement might be: "As the leader of the Colorectal Cancer Employee Screening Program, I would like your feedback about the appropriateness of continuing the project." After obtaining feedback, identify factors believed to be indicators for discontinuing the project (such as new regulatory agency requirements, observed change of the organization's focus, or leadership changes). These observations aren't to be presented as accusations of lack of administrative support, but instead to verify whether the situation is being accurately interpreted. If the decision is to terminate the project, it's important to reflect on any positive outcomes related to it. The meeting should conclude with an expression of appreciation for the supervisor/administrator's time and also for the opportunity to be a part of the project. This scenario reflects the steps in the change process using the nursing process as a model.4
Another component of terminating a project is to meet with others who have worked on the project (such as the project committee). The project committee has invested a considerable amount of time and effort; therefore, they have a right to know the project is being terminated. Planning this meeting should occur during the meeting with the supervisor/administrator and should include clarification about what can be shared with the committee concerning project termination. Other agenda items should include acknowledging committee members' contributions to the project. This often-forgotten action helps build goodwill for the next project and strengthens working relationships.5 Also, project members shouldn't be blamed for the cessation of the project or threatened with disciplinary action.2 When considering that the process can prove to be more significant than the final product, it can be productive for the committee to reflect on what they've learned through working on the project and how they'll use this experience in future endeavors.6 The committee should also be allowed to verbalize their feelings about the termination of the project.
Factors related to the project
The reasons related to project cessation may be linked directly to the project itself. For instance, the project may have become over-budgeted in time, material, or financial resources.1,3 Even with the best made plans, it's still difficult to anticipate every foreseeable impediment. For example, a program for decreasing patient falls is to be implemented. It will involve extensive training for the staff and purchasing special no-slip stockings for all at-risk patients. However, shortly before program implementation, both staff trainers become unavailable because of increased additional work demands and a major family illness. Also, you learn that the manufacturer of the no-slip stockings is going out of business within 2 months. Although this may be an excellent project, trying to implement it at this time could result in overstressing and overstretching all involved.
Another problem may be that the project isn't having the desired outcomes. Barriers to desired outcomes may be the result of a wide variety of behaviors and unanticipated reactions.3 The colorectal cancer staff screening project scenario can illustrate this. Despite having a massive educational effort on the importance of getting screened early and providing multiple free screening opportunities for staff, less than 1% of the total workforce is participating in the project. Other threats to desired outcome may be that implementation could potentially interrupt normal patient-care delivery or staff productivity.1
Because an important component of change process is that all major players be involved in assessing, planning, and implementing the change, the decision to terminate because of problems with the project should be made with a supervisor and/or the project committee.3,4,7 Asking those involved to share how they feel about the project's progress may confirm your concerns, identify other concerns you haven't observed, or provide rationale for the project continuation. You may then want to share your concerns (such as specifying how the project is over-budget or the limited response to the project) and ask for feedback on your observations. Meeting attendees may identify resources you might not have thought of or know someone who has the time or skills needed to salvage the project. They may suggest ways to remove barriers to implementation and/or determine that the outcomes need to be revised instead of just scrapping the project. Even if it's decided to terminate the project, allowing key staff members to help make this decision can certainly be empowering, assist with morale, and cultivate support for future projects.
Factors related to the individual
Harborview Medical Center in Seattle, Wash., recognized that project success is enhanced if project managers can dedicate themselves fully to planning and implementing projects.1 Sometimes there are changes within your job or personal life that indicate the need to terminate a project. It may be because of additional work responsibilities or because of added stressors in your personal life (such as illness or family problems). Each day we begin with a finite amount of time and energy. We all have periods in our lives during which meeting the demands of work and personal needs expends all our time and energy. Project termination should be considered if you continue working on a project when you should be focusing on other pressing things at work or you're giving up time that should be spent sleeping, exercising, spending time with friends/family, or other activities needed for personal health. The project can become an albatross around your neck if you constantly waste time and energy feeling guilty or anxious about not working on it. When limited time and energy become barriers, it may be time to stop the project, place it on hold, or see whether someone else can take over.
Again, this is the time to meet with your supervisor and/or the project committee. They may have solutions you haven't considered (such as identifying someone to help with your other work responsibilities or take over the project, identifying a new timeline for implementing the project, or identifying additional resources to help you either professionally or personally). Although there's an assortment of ways this can be resolved, the only wrong action is to do nothing. Letting the project remain undone and doing nothing about it can result in frustration and demoralization for both yourself and all involved with the project.
Sometimes it's all right to say enough is enough and make the decision to terminate a project. The reasons for doing this can be due to changes from either outside or within the organization or problems with the project or responsible individual(s). After conducting an honest inventory of the project, sometimes the most helpful and healthy action for both the organization and the individual(s) is to recognize some projects are best left unfinished. In the event a project is terminated, instead of labeling it as a failure, it's much more productive to review what benefits were reaped and what was learned in the process. These lessons can be used to promote the success of future projects.
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5. Maurer R. Managing change—make the endings count. J Qual Participation
6. Tyler S, Downe S, Day-Stirk F. Sustaining innovation. RCM Midwives
7. Butt S. Managing change. Pulse
© 2010 by Lippincott Williams & Wilkins, Inc.