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All improvement is a change, and change is always met with varying degrees of resistance. You can also sort projects according to the amount of effort required to find a solution and the engagement or push‐back you can expect (see Figure 3‐3).

 Type A. These projects require a small investment of time to find the right solution. Once the solution has been appropriately trialed, the proposed changes will be well received and rapidly adopted by staff and providers. These types of projects require a small team and limited resources.

 Type B. These projects require significant efforts to find the best solution. However, the proposed changes will be generally well accepted and rapidly adopted by the front line. These projects require leaders and teams to focus on finding the best solution.

 Type C. These projects require a formal investigation of the causes, and a structured approach to finding the solution. Changes will be met with pushback and resistance from the front line. These projects are common in the clinical setting, where best‐practice and clinical pathways are being implemented.

 Type D. These are complex projects. They require significant resources to find the most likely cause of the problem and the best solution. Once the solution is rolled out full‐scale, the QI team is going to encounter significant pushback and resistance from key stakeholders. These projects are resource intensive for leaders, teams, and healthcare organizations, and require experience in both project and change management.

FIGURE 3‐3 Project types according to complexity and expected resistance.