The Expert:

Dr. Lynne Maher

Dr Lynne Maher is director of innovation at Ko Awatea. She is a recognised international leader in healthcare improvement and innovation, with an extensive career ranging from critical care nursing to operational and board posts at local and national level. Dr Maher has published guidance on innovation, patient experience, improvement and change management, and has worked with a wide range of healthcare organisations and charities to provide advice in these fields.

Their View:

Countless improvement projects have faltered because project teams did not get the support they needed from senior leaders.

This can sometimes happen because the project leaders and senior leader do not share a common understanding of their respective roles in the project or of how they will communicate with each other.

For example, I have worked with a number of co-design project teams which failed to seek assistance from their senior leader sponsor to deal with barriers they were experiencing because they assumed that the senior leader would take the initiative.

Compacts help project teams to avoid these problems.

What is a compact?

A compact agreed between the senior leader and the project leader at the beginning of an improvement project ensures that both parties have a clear understanding of the unique role each will play and of how they will work together.

A compact is a written document signed by both parties. It covers:

  • the aim statement of the project
  • a description of the key roles and responsibilities of the senior leader
  • a description of the key roles and responsibilities of the project leader
  • agreement on how the parties will communicate, including expectations for attendance at project meetings and events.

The benefits of compacts

One of the key benefits of the compact is that it brings the project leader and senior leader together into a conversation about how they will work together in practice. For example, if the senior leader is unable to attend project meetings regularly due to other commitments, alternative arrangements can be made that work for both parties. Similarly, the way senior leaders like to receive information from the team, the type of information they want and when they want to receive it can be agreed upon.

Ideas akin to a compact are sometimes built into other aspects of project management, such as stakeholder analysis. Such an analysis may define the project leader’s role and how they link with the senior leader. However, stakeholder analysis assumes that once roles are defined, stakeholders will get together and form a relationship that works to deliver the project. This does not always happen in practice. Compacts remove that assumption by bringing project leader and senior leader together at the outset.

Compacts applied in practice

Compacts have been used at Counties Manukau Health, two other New Zealand district health boards and a hospital system in Australia. At present, they are chiefly used in co-design projects, but they are applicable to any improvement project.

Teams using compacts report a better relationship between project leader and senior leader. When challenges occur, senior leaders are better able to help remove or navigate around barriers. In addition, senior leaders are more aware of project progress and, as a result, projects are communicated more widely across the organisation.

Compacts help project leaders and senior leaders to form a high-performing partnership and should be used in all improvement projects.

Readers are welcome to download and adapt the compact template developed by Dr Lynne Maher here.

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