[2024]Digital Global Overview Report 2024 Meltwater.pdf
An Agile Journey in Healthcare
1. AN AGILE JOURNEY IN HEALTHCARE
Alston Hodge, Enterprise Agile Coach
A presentation at the
2012 Cincinnati Day of Agile (University of Miami)
May 19,2012
4. HISTORY
• Nov 2007 – IT dept established Agile charter
• Feb 2008 – IT dept created Agile implementation plan, training
campaign, pilot projects
• Oct 2008 – IT dept created Agile Community of Practice
• Oct 2009 – consulting firm recommended coaches
• Apr 2010 – IT dept created Agile Maturity Model
• Oct 2010 – BP survey highlighted Agile issues
• Apr 2011 – hired first Agile coach, conducted organizational assessment
• Oct 2011 – BP survey highlighted Agile issues
6. ASSESSMENT FINDINGS
• 53% of projects use Scrum
• 55% of people trained (mostly IT)
• 70% global partner utilization
• Sampled 35% of Scrum teams (47/136):
• Only 13% (6 teams) practice “true” Scrum
• 87% (41 teams) struggle with 4 or more key Scrum principles and practices
7. ANTI-SCRUM PATTERNS
• Scrum-> Scrum-lite-> O-gile
• Mini-waterfall approach
• Multiple concurrent projects in Sprints – 83% have 3 or
more projects
• Teams with few or no retrospectives
• Risks not being identified and managed
8. Attribute
Team
Distribution
Product
Owner
Product
Complexity
True Sprint
Length
Projects per Team
Scrum
Experience
XP
Experience
Team
Structure
Lowest
Risk
Lower
Risk
Higher
Risk
Highest
Risk
Collocated
Collocated
Part-time
Distributed
Overlap
Distributed
No Overlap
1
Lead
PO
2
multiple POs
(no lead)
1 system
2 systems
3 systems
4+ systems
2 wks
4 wks
6 wks
8+ wks
1
2
3
4+
Proficient
Advance
Beginner
Novice
Proficient
Advance
Beginner
Novice
Expert
Expert
Truly crossfunctional
Specialized
roles
9. MORE ANTI-SCRUM PATTERNS
• SM assumes some responsibilities of PO
• Stakeholders not attending demos
• Inconsistent use of VersionOne
• New teams adopting anti-Scrum habits of early adopters
• IT PM, Business PM
• No lead Product Owner
12. AND SOME MORE….
• Individual performance measures
• Workload exceeds capacity
• Start most/all stories at same time
• No sprint goals
• No tracking velocity
• Teams larger than 12 members
• Separate testing from development
15. ROOT CAUSE 1:
ADAPTING VS. ADOPTING SCRUM
• “We need your help to adapt Scrum to fit our culture” – PMO Program
Manager
• “Perhaps we need to adopt the Values and Principles, and adapt the
techniques and practices instead.” – Alston
16. AGILE VALUES AND PRINCIPLES
• Already complement our corporate values and principles.
• Guide us in our daily decisions.
• Are foundational, the core of what we believe to be true about us.
• Generally accepted Scrum practices are based on Agile values and
principles
• Changing the values and principles de-stabilizes our Scrum framework.
17. EXAMPLE
• Choosing to not have retrospectives hampers:
• Continuous improvement
• Transparency
• Sustainable development
• Not tracking velocity hampers:
• Continuous improvement
• Transparency
• Sustainable development
18. ROOT CAUSE 2:
ADOPTION VIEWED AS AN IT CAMPAIGN, NOT A
COMPANY CAMPAIGN
• Initiated and supported as IT campaign
• Business partners not fully understanding the implications:
• PO develops the backlog
• PO prioritizes based on business value
• PO approves story completion
• PO decides when to release
With Agile, the Business is in the driver’s seat!
19. IT LEFT WITH UN-ANSWERED QUESTIONS
• Service Provider vs. Business Partner
• IT projects vs. Business projects
• What to do with PMs?
• Scrum-> Scrum-lite-> O-gile?
20. ROOT CAUSE 3:
ACCELERATED OFFSHORE UTILIZATION
• 2008 – 60% company, 40% contractor
• 2011 – 30% company, 70 % contractor
• Source of business innovation cut in half
21. LOOK AT THE NUMBERS
• US health care insurance experience
• 160+ years as an industry
• Over 80% of Americans with healthcare insurance today
• India’s health care insurance experience
• 12 years experience in industry
• Less than 6% with healthcare insurance (as of 2010)
22. ROOT CAUSE 4:
ADD – AGILE DEFICIT DISORDER
• Symptoms
• Difficulty in focusing
• Hard to develop self-discipline (team & organizational)
• Commitment issues
• Scrum Buts
• Resistance to Transparency
24. COLLABORATION CHALLENGES
• Agile Community of Practice stalled
• Increasing collaboration issues
• Increase turnover (company, vendors) in some areas
• Decline in Partnership survey scores
• Innovation
• Communications
• Ownership
• Increased use of PMs (IT and Business)
26. UPDATE THE TRAINING
• Use experienced SMs and POs
• Lots of new resources available now
• Address the common Anti-Scrums
• Introduce eXtreme Programming
• Continuous integration
• Paired programming
• Automated testing
• Focus more on the “Why” of key Scrum concepts
27. KEY CONCEPTS OF SCRUM
• Transparency
• Prioritize Business Value
• Commitment
• Incremental development
• Continuous Improvement • Minimal documentation
• Collaboration
• Sustainable pace
• Discipline
• Iterative development
• Stop.Inspect.Adapt
• Swarming
• Cross-functional teams
• Sprint planning
• Retrospectives
• Product Demos
28. RE-BUILD THE AGILE COMMUNITY
• Coach’s Corner
• BUZZ
• Tips and Tricks (12 guidelines)
• Agile tract in Learning Week
• Monthly Corporate Scrum Gatherings
• Agile Team of the Year Award
• Louisville Agile Forum
• Partner with regional Agile groups
30. PROMOTE VALUE OF COACHING
• organizationally agnostic - not subject to the same pecking
order, enabling them to tell the hard truths that may need to
be said
• Help teams develop self-discipline and good habits
• provide needed on-the-job learning and mentoring
opportunities soon after training
33. PROMOTE VALUE OF COACHING
• Challenge teams to address the difficulties they face rather than
sweep them under the rug.
• bring both tried and new practices and processes to the team
and organization reducing the degree of trial and error.
• bring an outside view of the organization, team and individuals
and remove intrinsic bias and interpersonal issues.
34. “GROW YOUR OWN” COACH
• Internal coach program
• 6 months to “coach the coach”
• Full time commitment
• Workload of 12-15 teams
• Already knows the business
• Limitations
• Agile experience limited to one company
• Not organizationally agnostic
• No previous coaching experience
35. EDUCATE BUSINESS LEADERSHIP
• Find the champions
• Educate top down and bottom up
• 30 minute intro to Scrum
• Provide Product Owner learning map
• Solicit their help to champion Scrum
• Sell the idea of external coaches
• Help Business “take back the reins”.
36. EDUCATE IT LEADERSHIP
• Find the champions
• Provide Agile PM learning map
• Address the unanswered questions:
• Are we a Service Provider or Partner?
• How to develop Agile PMs?
• Do we understand and accept the risk of offshoring?
• Are we serious about Scrum adoption?
37. TREAT THE ADD
• Guidance of prioritizing projects/features
• Help teams develop self-discipline
• Educate on myth of multi-tasking
38. ADDRESS COLLABORATION ISSUES
• Lack of trust - team building exercises
• Triangulation
• Painters Pyramid
• Matthew 18
• 360˚ Surveys
• Monthly joint meetings
45. CONTACT ME
•
alstonehodge@gmail.com
•
Alston’s Awesome Agile Blog www.alstonhodge.com (free coaching and advice!)
•
Twitter: @alstonhodge
•
Join me each month at the Louisville Agile Forum meetup
• Farm Credit Services office (1601 UPS Drive, Louisville, KY)
• 4th Wednesdays (6:30PM)
•
Call me at 309-531-0611
Hinweis der Redaktion
Here’s a sampling of some of the companies I’ve assisted in the past. They represent a spectrum of Agile maturity and successes. Some are just starting in Agile adoption, and some have over 10 years of Agile experience.