The Failure Rate That Won’t Die
For three decades, the Standish Group’s Chaos Report has tracked IT implementations across industries. The headline hasn’t budged: barely one in three projects ends in full success. Their 2020 data show 29% delivered on time, on budget, and on scope, while 19% were outright write-offs.
Healthcare is no safer. A Stanford Health Care review reminded the HIMSS23 crowd that ≈70% of hospital tech pilots flame out or stall.
Why the Needle Hasn’t Moved
IT projects don’t usually fail for lack of effort or lack of analysis after the fact – if anything, organizations have spent countless hours dissecting project missteps. Managers routinely hold after-action reviews and write up “lessons learned” reports when projects go off course. However, these painstaking lessons-learned exercises often lead to no real change in outcomes. Harvard Business School professor Amy Edmondson observed that even in enterprises sincerely committed to improvement, “time after time I saw that these painstaking efforts led to no real change”. In other words, teams document what went wrong, vow “never again,” and then proceed to make the same mistakes in the next project. The wisdom of learning from failure is “incontrovertible,” Edmondson notes – yet organizations that do it well are rare. Why?
- Risk Averse Culture. In BCG’s global innovation survey, risk aversion ranked as a top barrier to ROI on new tech. In my experience, healthcare’s clinical grade caution turns that dial to 11.
- Lessons Filed, Not Applied. Harvard’s Amy Edmondson spent 20 years watching teams run post-mortems that produced zero behavioral change. Sound familiar? It does to me!
- Executive Distance. When projects sit three layers below the C suite, priorities shift, budgets shrink, and political cover evaporates.
- Methodology Without Mindset. Agile, Old-school Waterfall, Lean, PRINCE2—pick your flavor. Without a learning culture, these are just labels.
The Cost of Standing Still
PMI estimates that underperforming organizations waste 9.9¢ of every dollar invested in projects; champion organizations—those hitting ≥80 % of their targets—waste only 4.1¢.5 For a $50 M Epic upgrade, that gap equals $2.9 M in avoidable burn rate every year the project drags. And I think that really underestimates the cost.
A Process Playbook
1. Make Failure Discussable (and Fast)
This is huge. If we can't talk about it, we can't fix it. Every team member should feel comfortable discussing their and anyone's failures. Tough? Yes. Worth it.
Normalize “show me” retrospectives. Hold a 45-minute debrief within two weeks of every milestone, successful or not. Publish a public takeaway for your team. No blame, no spin.
Pilot tiny, kill early. Limit first wave deployments to one department or <5% of the user base. If KPIs slip >20 % from baseline at week 4, pause and retool.
2. Sponsor Like You Mean It
Name one accountable exec. Their bonus rides on delivery of the business outcome, not the go-live date. And OMG, how many times is it on the go-live date?!
Tie projects to strategy OKRs. If the initiative doesn’t map to a board-level objective, stop, re-scope, or shelve it.
3. Institutionalize the Lessons Learned Loop.
Track the changes to your delivery model.
M&M for Tech. Borrow the clinical Morbidity & Mortality model: a monthly, blame-free Zoom where teams dissect a miss, identify systemic factors, and log counter measures.
Checklist the Insights. Convert lessons into entry criteria, DoD (Definition of Done) items, and onboarding modules. The next team must physically check the box.
4. Skill Up the Squad
Cross-train PMs in clinical ops. A project manager who understands nursing workflows will spot friction before it torpedoes adoption.
Coach agile (or name your project execution style. it doesn't really matter which) fundamentals. Two-day workshops on backlog hygiene and demo etiquette pay for themselves in sprint 2.
5. Track Value, Not Vanity
Define two patient-centric KPIs (e.g., discharge to order time) and two cost/productivity KPIs before kickoff.
Publish a one-page KPI dashboard every 30 days. Tie them to the strategy OKR's mentioned above. If the impact is flat, pivot.
Quick Start Checklist for the Next 90 Days
Week 1: Appoint executive sponsors to all active IT projects; cancel any orphaned initiatives.
Week 2: Launch monthly Tech M&M sessions—first topic: the last project that missed its mark. Bet that wasn't too long ago :)
Week 4: Roll out a standard Lessons Learned template; make sure your delivery model has a process to update based on the template. I like Process Street for this. Mandate its review at every new project kickoff.
Week 6: Train PMs and clinical leads on rapid cycle pilot design and kill criteria.
Week 12: Publish the aggregate project KPI dashboard to the leadership steering committee.
Get these five moves right and you’ll shift from a 30 % success rate to champion territory, where nine out of ten projects deliver the goods. More importantly, you’ll build an organization that improves with every swing instead of repeating yesterday’s mistakes.
References
1. Ismail, Nick. “Why IT Projects Continue to Fail at an Alarming Rate.” Information Age, 16 Feb 2018. https://www.information-age.com/projects-continue-fail-alarming-rate-9611/
2. Adams, Katie. “Here’s What Stanford Learned From a Failed Tech Pilot.” MedCity News, 21 Apr 2023. https://medcitynews.com/2023/04/heres-what-stanford-learned-from-a-failed-tech-pilot/
3. Ringel, Michael; Taylor, Andrew; Zablit, Hadi. “The Rising Need for Innovation Speed.” Boston Consulting Group, Dec 2015. https://web-assets.bcg.com/img-src/BCG-The-Rising-Need-For-Innovation-Speed-Dec-2015_tcm9-61298.pdf
4. Edmondson, Amy C. “Strategies for Learning from Failure.” Harvard Business Review, Apr 2011. https://hbr.org/2011/04/strategies-for-learning-from-failure
5. Project Management Institute (PMI). Pulse of the Profession® 2018: Success in Disruptive Times — Expanding the Value Delivery Landscape to Address the High Cost of Low Performance. 2018. https://www.pmi.org/-/media/pmi/documents/public/pdf/learning/thought-leadership/pulse/pulse-of-the-profession-2018.pdf
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