Delays and failures of IT projects are common in both private and public sector. With this in mind three staff members at University College London (UCLH) set out to study and review all the IT projects initiated within UCLH over three years.
Within this study they identified characteristics of projects which were risk at factors for failure, and to recommend processes which could improve project success rates. In fact 60 per cent of ICT projects at UCLH were a success, which compares favorably with private and public sector.
Typical projects included implementing EPR components, upgrading IT infrastructure or setting up departmental applications. Data collected included the type of project, the role of project sponsor, number of departments involved, the adherence to PRINCE2 methodology, the number of end users, and whether the project was a success or failure. The projects were retrospectively analysed to classify the reason the project failed in line with failure reasons identified by the National Audit Office NAO report.
NAO identified risk factors are as follows:
Out of the total of 377 projects 40 per cent failed to meet the original objectives. Factors which affect the project outcome are as follows:
Out of the 40 per cent of projects which failed it was found that:
The most likely reasons for project failure are design and definition failures, and decision-making failures. Projects with a large number of end users or a large amount of cross boundary working are around twice as likely to fail due to design and definition failures.
This may be due to the nature of such projects being technically more complex, and such projects should therefore have a robust technical assessment of feasibility. Projects with a small number of end users, or projects which do not cross boundaries are around five times more likely to fail due to decision making failures.
These are typically clinician led, and failure may be due to clinicians not having time or skills to manage projects, or not having line management responsibility for project managers.
The findings in this study demonstrate that project success rate could be significantly improved with the implementation of a robust programme management process which manages identified risks and enables appropriate staff to shape the IT priorities to meet the organisations objectives and save resources.
Clinical staff are key to the NHS business of healthcare, it is critical that clinicians, managers and IT work together. In order to be successful, projects need appropriate levels of sponsorship (to mitigate against decision making failures) management (to mitigate against risks such as project discipline failures) and technical input (to mitigate against design and definition failures).
A programme of projects with input from clinical, managerial and technical stakeholders, with clear governance and reporting lines is key to ensuring a higher success rate of IT projects in line with strategy.
The following five steps should be included in the programme management process to help mitigate against identified risks.
Toby Cave, senior ICT project manager. University College London Hospital,
Professor David Ingram, health informatics and director of the centre for health informatics, University College London,
Dr Rob Stein, medical oncologist, University College London Hospital.
BMA report on the NPfiCT August 2006
INTOSAI EDP Audit Committee - Best Practice - Why IT projects fail August 2005
Royal College of Physicians London, Making a difference together January 2005