ICRC Physiotherapy Standards Project Cycle

Welcome to The ICRC Physiotherapy Standards Content Development Project. This space was created by Physiopedia for the creation of content relating to the ICRC Physiotherapy Standards Workshop. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Original Editors - ICRC uploaded by Kim Jackson

Top Contributors - Kim Jackson and Admin      

Related Pages

1. Professional Standards in (ICRC) Physiotherapy
2. ICRC Physiotherapy Standards Project Cycle
3. ICRC Physiotherapy Standards Rehab Cycle

Introduction

Project Cycle Management (PCM) describes the process of planning and managing projects. Setting clear goals and objectives will help to plan for better results. The project cycle helps to guide the Results Based Management (RBM) by outlining the steps that lead to successful outcomes.

The ICRC describes planning for results as "A corporate function that assesses context, target groups, problems/needs, risks, constraints and opportunities and sets priorities to ensure an appropriate level of coordination and alignment of actions and resources towards the achievement of expected results"

The aim of PCM is to maximise the benefits of projects for the intended population and ensure that projects:

• are relevant and will meet the needs of the intended population
• that objectives can be realistically achieved and take into account the environment and available personnel and resources
• are sustainable

Types of Projects in Rehabilitation

Project in this case can refer to a Physical Therapy (PT) department, a PT team, a Continuing Professional Development cycle. Regardless of the type of project, any intervention that is identified will have similar characteristics:

• Their purpose is to solve “a problem”
• A deadline will be set and agreed upon, i.e. a timeframe and a completion date.
• It will take into account current services and opportunities based on available resources and local capacity
• It benefits a specific, identified group
• It is implemented by a team and has a team leader

The ICRC adopted the Results-Based Management (RBM) approach, in the mid 1990s, with a aim of strengthening performance and to justify and demonstrate the effect of its policies and interventions when working with people affected by armed conflict and other situations of violence.

Project Cycle Management Planning for ResultsThe Process

In order for any project to be successful it is important to set objectives that focus on the population and their current situation and the intended outcome of any intervention. The objectives need to be written with the desired outcome in mind so that that the results can be measured and assessed to ensure that there has been a positive impact on the targeted population. Once the objectives have been set and been agreed the following phases are necessary to ensure that the project is successful and meets the identified goals and desired outcome:

• Assess and Analyse -What is the current situation? Identify problems! What caused it? Who is involved? What are we going to achieve?

• Formulate and Plan - What is the desired outcome? Set objectives, strategies and activities that are needed!
• Implement and Monitor - This is the stage where activities are undertaken. It is important to monitor throughout the whole project so that any successes and/or changes are identified to meet the set goals
• Evaluate and Learn - This can be carried out at any stage highlighting any recommendations and adaptations.

Assess and Analyse

The aim of an assessment is to understand a situation in order to identify the problem(s), the source of the problem(s) and the consequences of the problem(s). The purpose of an assessment is not to identify an intervention but to find out whether or not an intervention is required, based on identified needs. The following tools can assist with this stage:

• Situation Analysis Word document
• Gap analysis. [Excel document]
• Physiotherapy competency checklist [Excel document]

Situation Analysis

A situation analysis gives insight into the environment, the needs of the population and current available resources. Once there is an understanding of what is needed it is easier to develop a plan that is realistic and prioritises actions. Here is and example example of a Situation Analysis Tool. The steps involved in at situation analysis will depend on the stage of the project, but could include Analysis of:

• Current situation, available services and resources, Service needs
• Workforce and multi-disciplinary team - Examples of key perfomance indicators for physiotherapists [PDF document]
• Service Users and their needs
• Health, Safety & Service Security
• Physiotherapy Department - ICRC PT Competency Table [PDF document]
• Stakeholders

Gap Analysis

A gap analysis is a useful tool that can assist in prioritising service and rehabilitation needs by determining the current performance of your project - against desired goals, as well as identifying any components that are missing from the project. Once a gap has been identified an action plan needs to be developed and incorporated into the the project, including the resources needed, who is responsible for addressing the gap, who will benefit and of course a timeline for implementation.

A gap analysis provides an overview on the current situation and what is needed to reach goals and best service delivery addressing the needs of the population and adding to workforce satisfaction. An example of the steps involved in a gap analysis of a rehabilitation service could include:

• The needs of the service user, taking into account - respect, confidentiality, individuality, race, gender, culture and emotional state
• Assessment process
• Analysis of assessment and treatment planning
• Implementing and monitoring treatment plan
• Discharge/transfer process
• Communication with Multidisciplinary team
• Data management
• Physical environment and health and safety of service user and staff
• Human resources
• Continuing education
• Professional conduct
• Quality improvement

Formulate and Plan

Setting goals and creating a plan are an important step in the project cycle and will help to prioritise tasks to achieve the end goal.

The best way to ensure success is to make sure your goals are sustainable and SMART

S   Specific

M  Measurable

A   Attainable or Assignable

R   Realistic

T   Time-related

Once the goals have been set and agreed it is time to develop an action plan.This plan will include:

• SMART goals/objectives identified
• Actions required
• Resources that are needed
• Indicators
• Who is responsible

Here are some examples of project action plans:

Action plan example PT association [Excel document]

Action plan example PT equipment [Excel document]

Implement and Monitor

Once you have assessed the situation, identified gaps in the service using the situation analysis and gap analysis tools, set objectives and created a timeline to achieve the goals set it is time to put your plan to action. An important part of the implementation stage of project is monitoring.

Monitoring your project is an integral step in the process as it enables you and your team to check on the progress and identify and deviations or obstacles in your plan and take action to put things back on track. This may be by adjusting timelines or setting new steps in the project plan. Regularly collecting and analysing information, that tracks the progress of the project, provides feedback, ensures accountability and also assists in making informed and timely decisions to reach the desired goals and outcome.

A useful tool to direct project progress monitoring is the Action plan. The same tool serves the steps "Formulate and Plan" and "Implement and Monitor". In summary the purpose of monitoring is to:

• Keep track of project/ patient progress
• Keep project staff/ patients motivated
• Empower patients: self-monitoring ‘manage your progress’
• Correct action/treatment plan if necessary

Evaluate and Learn

The steps in this stages can use the same tools that are used in the Assess and Analyse step, but what we do with this information may be a little different. This is because at this stage we are looking at the success of the project and the focus will be on what went well and does anything need to change and why!

A good model for managing complex change described by Knoster T, Villa R, Thousand J (2000) shows us the steps needed to promote change and how any missing components can lead to confusion, anxiety, resistance, frustration and false starts.

These changes require considerable effort, negotiations, convincing and resources such as money, time, skills, human resources. The key to this is called change management. The principles of change management must take into account:

• Human side – confront reality and respect culture
• Leaders must start the change and be role models

• Break barriers
• Mobilise people and stimulate ownership

How to do it

• Communicate the vision/opportunity

• Design and plan
• Implement:  prepare for the unexpected!
• Empower action
• Expect to encounter resistance and see why
• Support, reward, training, TOOLS

The Continual Cycle

Once all gaps have been addressed it is important to re-assess, which may identify a new objectives or problems and the beginning of new cycle. So although the project may be time-limited, it is important to ensure quality through re-assessment, therefore the cycle is continual and never ending.

Resources

• Video - RBM in a nutshell

For further reading

• Format for Journal Club [PowerPoint Presentation]
• Journal Club summary template [Word Document]
• PEDro scale [Word Document]
• Physiotherapy outcomes meetings info [Word document]
• PRISMA checklist [PDF doc]
• A Simple Guide to Change Management [PDF doc]
• Reflective Meeting Info Sheet Sample [Word Doc]