Interventions are usually accepted or rejected on the basis of a submitted project design. The design describes the goals of the intervention, lists planned actions and defines the timeframe, which is subdivided into milestones. While approval of an intervention is pending, more detailed planning for the implementation makes little sense at this point, especially for longer programs or projects. Detailed planning will be the task of the program/project managers during the implementation phase when they can also take into account any new developments in the settings for which the intervention has been planned. Milestones divide the intervention into several regular stages. They are the central structural elements for management of a project.
Milestones are breakpoints during the implementation phase. They are set at periodic intervals. They provide opportunities to view retrospectively the progress made and to plan the details of the next stage. It is advisable to have milestones at regular intervals of 3-9 months. This will divide the implementation phase into periods of similar length.
In “classic” project management, milestones are defined as points in time by which agreed services must be delivered. They are prerequisite for the next steps. Milestones are usually defined by content and are either “„achieved” or “not achieved”. However, in the field of health promotion and prevention, the interdependency of actions on all levels normally is not very strong. Therefore, the focus of milestones is primarily on regular discussion and reflection on the activities on all levels. This is why the quality system quint-essenz for milestones emphasizes regularity. Content arises naturally when the intermediary targets that are set for each action are checked and discussed at the relevant milestone meeting.
In health promotion and prevention, management is not primarily focused on the stakeholders’ deliverables, but on the effects that are generated in the targeted system.
Periodical milestones, with clearly defined intermediate objectives for each ongoing activity, serve as retrospective critical reflections on the preceding phase and as prospective planning opportunities for the next phase (see Fig. 1).
Implementation starts when the first concrete activities are undertaken. Important dates such as beginning and end and the person who is in charge must be clearly defined for each activity in this first phase, unless they already have been stated in the design. Then, an intermediate objective, which must be attained by the next milestone, is set for each undertaking.
Target values are set for each intermediate objective. Project progress is monitored in relation to these targets. Intermediate objectives are formulated according to the same criteria as project objectives – they must be verifiable and, if possible, effect-oriented. If it is not immediately apparent that an interim objective has been reached, some evaluation measures may be needed before embarking on the next phase.
The interim objectives that have been set for the activities in the first implementation phase will form the basis of the discussion at the first milestone meeting. Which objectives have been reached? Which actions were successful and which were not? Has anything happened that has consequences for the next stage and/or are any corrective measures needed?
In milestone meetings, the achievement of intermediate objectives is checked and the budget and project progress are reviewed. The meetings are ideal for discussing unforeseen events and developments, opportunities and risks and possible consequences of the next phase. There is an opportunity to not only address professional questions and technical matters, but also to discuss teamwork, communication within the team, possible conflicts and rivalries and other personal issues.
Finally, the team’s achievements should be acknowledged and shared success celebrated.
Setting interim objectives and monitoring progress - by checking the attainment of these objectives - are recurring tasks. Therefore, managing interventions becomes a cyclic process in which each phase consists of four tasks:
In this cycle, planning is where concrete actions are specified and intermediate objectives are set. The implementation of these actions is followed by evaluation. Sometimes, when it is obvious that intermediate objectives have been reached, there is no need for evaluation at this point. Reflection means discussing the efficacy and efficiency of the implemented actions. The results of the reflection process are considered in the detailed planning of the next phase and so a new cycle begins.
Structuring your program or project with milestones established at regular intervals will permit you to react promptly to unexpected changes and to make appropriate corrections. If you reflect on the progress of the program or project at these defined occasions, you can dedicate later all of the time between milestones to actual implementation work.
Carefully planning and implementing the first stage provides the greatest likelihood of success.
Milestone meetings enable you to keep your planning flexible and to direct your project in an active and ongoing way. This dynamic process encourages creativity and innovation. Regular discussions about teamwork help to discover potential sources of conflict in the project team at an early stage and to find constructive solutions.
Establish milestones at regular intervals and specify verifiable intermediate objectives for each action that is relevant for every milestone.
At milestone meetings, be sure to do the following: