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This chapter presents the first step of the process: defining the needs and corresponding objectives for a project. This step positions the project for success by aligning its intended outcomes with organizational needs. This business alignment is essential if the investment in a project is to reap a return. The term business need is used to reflect important outcome measures (e.g., output, quality, cost, and time) that exist in any healthcare setting, including governments, nonprofits, and nongovernmental organizations (NGOs).


Bridgeport Hospital decided to implement an employer of choice program. By doing so, the hospital would be listed among the community's preferred employers. The hospital would also be included in several national lists as an employer of choice.

To analyze the payoff of this proposed project, executives thought that if the project was successful, they would be able to sustain a positive work environment by recruiting, developing, and retaining a diverse, high-quality, engaged workforce. To begin, they needed to recruit and retain the best talent.

Next, the specific business needs were detailed. To achieve the designation of employer of choice, several specific measures must be improved. The registered nurse (RN) turnover rate had to be less than 11 percent and the overall turnover rate, less than 10 percent. The attrition rate among nursing students was to be less than 19 percent, and positive employee relations would be maintained, as evidenced by the employee satisfaction and employee engagement scores.

To meet these business needs, the performance needs were defined. The first requirement was adequate professional and support staff to care for the patients and to ensure that the staffing levels remained sufficient. Also, employees must be more engaged for organizational performance to improve. This engagement would come through increased employee participation, feedback, communication, and collaboration from the management team. Also, management development was needed to enhance customer service and focus on employee retention.

Next, the learning needs were identified in each of these categories, detailing specifically what must be learned by stakeholders to meet the performance needs. The team concluded that significant learning was necessary for each participant group.

Finally, the entire workforce, particularly the management team, must see the value and need for this program. More specifically, preference needs included the management team who should see the program as valuable, necessary, and critical to sustaining a competitive healthcare organization. All employees should see the program as motivational, satisfying, and important to their own success.

Addressing these multiple levels of needs and developing objectives ensured that the project was absolutely necessary, positioned for success, and included the proper solutions.1


Based on approximately 3,000 case studies, the number one cause of project failure is lack of business alignment. Projects must begin with a clear ...

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