In the successful implementation and sustainability of any project, whether it be a patient's recovery from a chronic illness or a complex project with significant funding, roll-outs often fall short and create massive losses in either investments, financial and human resources, or human life for the following reasons:

• The foundation for success is not set at the outset;

• Accountabilities are not identified;

• Strategic communication is lacking throughout the implementation process;

• Transformation and change management support is often overlooked.

Our firm's knowledge and experience in transforming cultures and leading change within the healthcare industry has shown us that through a strong project management foundation, a strategic communication focus and change management initiatives, we bring together clinical and administrative components to increase organizational leadership capacity to drive the changes needed to assure long-term sustainability and better patient outcomes.

There are conflicting incentives in the healthcare industry that lead to difficulty in achieving the right outcomes. Within the care management process itself, the hospital is incentivized for shorter patient stays, while physicians' incentives increase as the patient stays under their care longer. A lack of team communication results in poor results, but in healthcare, clinical errors can be deadly. Strategic communication from the top is essential. But how can this be incentivized?

In healthcare, the directive for quality has led CEOs to mandate debriefing when something goes clinically wrong. Unfortunately, the reasons usually boil down to a breakdown in communication and teamwork. For example, a clinician could have picked up a sign from the patient or another staff member that something was not right and shared that information before it became a costly, or even deadly, error.