Project Management
Health
September 24, 2025
Project management in healthcare: the promise of efficiency and the challenges of practice
The success of new technologies depends on the ability to implement solutions in a planned manner, with governance mechanisms
The universe of health is one of society’s most complex and challenging environments, marked by constant tension between science and care, technological innovation and ethical limitations, economic interests and social responsibilities, as well as strict regulatory requirements. This intersection of forces, often contradictory, makes health a space in permanent dispute, where decisions must balance scientific advances, economic sustainability and the centrality of the patient.
Furthermore, every day new medications, clinical protocols, and digital tools emerge, while the pressure for more agile, safer, and more accessible services grows. In this context, management errors represent not only financial losses but also concrete risks to life.
Estimates from the World Health Organization indicate that adverse events that are preventable may be among the leading causes of death worldwide, responsible for millions of deaths each year. In high-income countries, about 1 in 10 patients suffers some adverse event. In low- and middle-income countries, this number is even higher: 1 in 4 patients, resulting in 134 million events annually and about 2.6 million deaths each year.
Most of these deaths (60%) in low- and middle-income countries are related to low-quality care. Although patient safety is often associated with hospitals, primary care contributes to 50% of harm (WHO, 2021).
The social cost of patient harm is estimated at US$1 trillion to US$2 trillion annually. The economic cost is high, with up to 15% of hospital expenses in high-income countries being wasted due to safety failures (WHO, 2021). These data show that thinking about management is not a luxury, but a vital necessity to ensure care quality and the survival of healthcare institutions.
It is in this scenario of high complexity that project management gains relevance. Far from being an abstract methodology imported from the corporate sector, it is a set of practices that help transform ideas into concrete results. Planning, executing, monitoring, and evaluating are not just technical steps: they are mechanisms that make it possible to translate innovations into tangible improvements for patients and professionals.
An example is the adoption of the electronic health record in Brazilian hospitals. Although it initially seems like just a technological change, in practice it involves reorganization of processes, training of teams and professionals, and cultural changes. Research shows that institutions that adopted this system managed to reduce waiting time and increase safety in medical prescriptions (Cunha et al., 2020), which demonstrates how project management can directly impact people’s lives.
The same occurs in public initiatives. The Telessaúde program of Rio Grande do Sul, linked to the Unified Health System, supports primary care through teleconsultations since 2007. With millions of consultations performed, it has managed to significantly reduce unnecessary referrals to specialists, avoiding up to 80% of these cases. The experience shows that structured planning, clear goals, and team integration can expand access without overburdening the system. This is not an isolated effort, but a project conceived and conducted with strategic vision (Sarti and Almeida2022).
There are examples that inspire both in Brazil and outside of it. The Albert Einstein Israeli Hospital, in São Paulo, adopted agile methodologies to accelerate digital innovation projects, especially during the Covid-19 pandemic. With this, it managed to quickly implement telemedicine solutions and expand care without compromising patient safety. In public university hospitals, Lean Healthcare practices (a set of concepts and tools from Lean applied to healthcare), helped to reorganize workflows and reduce elective surgery queues , showing that concrete results can be achieved even in environments with financial restrictions (Ministry of Health, 2018).
The Moinhos de Vento hospital in Porto Alegre and the Beneficência Portuguesa hospital in São Paulo have adopted the Lean methodology as a strategy to face overcrowding in emergency services and reduce hospital stay time. Between 2018 and 2020, the “Lean in Emergencies” program was implemented in 102 hospitals, distributed across 24 states in all regions of the country.
The results were significant: participating hospitals registered, on average, a reduction of 38% in the overcrowding rate, a decrease of 41% in the average length of stay for patients who required hospitalization after emergency care, and a drop of 21% in the interval between patient arrival at the service and the first contact with the medical team (PROADI-SUS).
Challenges
However, the benefits should not obscure the challenges. The application of management methodologies in healthcare settings encounters significant resistance . Part of this stems from a lack of engagement from clinicians: doctors and nurses often associate management tools with bureaucracy, far removed from the reality of care. Another point is the rigidity of some methodologies, such as PMBOK, which can be difficult to adapt in contexts where unforeseen events and emergencies are part of the routine. The scarcity of resources is also a significant hurdle, especially in the public sector, where basic care is often lacking. Furthermore, the organizational culture is still, in many cases, fragmented, with teams working in silos and resisting the integration required by projects.
Despite these challenges, it is impossible to deny that project management has proven essential for driving innovation in healthcare. The Covid-19 pandemic made this even clearer: in a few months, institutions needed to implement digital telehealth services, reorganize care flows, and rapidly expand hospital beds. Such changes were only possible because they were conducted as projects, with defined deadlines, clear objectives, and continuous monitoring. This experience reinforces the idea that, in the face of crises, structured management is what differentiates improvisation from effective response.
With increasing digitalization, new possibilities emerge. Technologies such as artificial intelligence applied to diagnosis, internet of things for remote monitoring, and analysis of large volumes of data to predict epidemiological outbreaks are already in use in different contexts. However, their success depends not only on technological development but on the ability to implement these solutions in well-planned projects, with evaluation indicators and governance mechanisms. Project management thus becomes the link between innovation and concrete results.
The great reflection that arises for managers and professionals is: to what extent can management be separated from care? Every time a new care flow is created, a clinical protocol is structured, or a digital technology is adopted, we are facing a project. Recognizing this is fundamental so that project management is not seen as something external, but as an integral part of the care practice. Perhaps its greatest contribution lies in fostering a collaborative culture, in which different actors work together, with shared responsibility and a focus on continuous improvement.
In this scenario, applying good project management practices is more than a technical decision: it is an ethical commitment to the sustainability of the system and to patient safety. However, the process cannot be romanticized. Projects fail, resources can be misapplied, and results can be frustrating. Recognizing these risks is essential so that methodologies are not treated as panaceas, but as instruments to be constantly adapted and improved.
Thus, project management in healthcare should be understood as a possible path to transform waste into value, risks into safety, and challenges into opportunities. When applied with criticality and flexibility, it can reduce errors, expand access, improve clinical outcomes, and drive innovation. But its true strength lies in remembering that, behind every chart, indicator, or schedule, there are people: patients awaiting care, families seeking support, and professionals dedicating their lives to healing. The future of healthcare will depend on our ability to plan and execute projects that are not only technically sound but also humanly relevant. After all, healthcare is not just management: it is, above all, care.
| To access the references of this text click here |
Who wrote this column
Beatriz Cristina de Freitas
