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Lessons from the ObamaCare Rollout Fiasco for Grant Writers

Regardless of one’s politics or policy preferences, it’s painful to watch the ongoing Affordable Care Act rollout fiasco.* Developing is obviously a complex undertaking. One thing lost in the cacophony over the botched rollout is that many large scale IT projects fail to launch successfully, with being the most widely publicized example this year.

We recently wrote some proposals for an electronic health record (EHR) development project on behalf of a California hospital. When scoping the project, our client told a story about a very large Los Angeles hospital that spent several years and $34 million rolling out an EHR system that its doctors refused to use. This well-known hospital failed to involve the docs—the users, in other words—in system development and the whole system had to be trashed.

Since President Obama and his team—or the L.A. hospital—presumably didn’t set out to create a debacle, there are lessons to be learned for anyone involved in complex project development, including grant writers. Perhaps the most of obvious is to make sure that one person is in charge. This echos Steve Jobs’s insistence on a Directly Responsible Individual (DRI) (to use the Apple-speak) for all projects. That ensures that one person has their head cut off in the event of failure, and beheading tends to focus the mind. If your agency is going to be serious and successful in grant seeking, either hire a competent staff grant writer or consultant and hold them responsible for getting job done.

For nonprofits, which often have fairly chaotic, or, to be less pejorative, “egalitarian” management structures, this simple strategy is frequently overlooked in proposal writing. Without a DRI, proposal planning meetings are likely to drift, with the management team espousing great, but vague, thoughts and the worker bees afraid to say they don’t understand what is wanted. Frequently their fears are well-founded, since nothing concrete has been specified by management.

The result is typically conflict and confusion, which results in a poorly written, incoherent and/or technically incorrect proposal, if the proposal gets finished at all. Most of our clients are astounded when we scope a project in an hour-long phone call and produce a more or less on-target first draft without any angst or finger pointing. Some details may be wrong, in which case they’re fixed in the next draft. It’s really not hard, because we assume the role of a DRI, get the job done, and don’t make excuses. We ask direct questions to elicit specific answers to the five Ws and the H that are central to proposal development or any information gathering effort. When in doubt we let the RFP dictate the proposal, instead of trying, probably futilely, to dictate the program to the funder.

* Otherwise known as “Obamacare.”