- 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
AGENDA HistoryAssessment Findings Anti-Scrum Patterns Root
CausesImpacts to the Healthcare companyFixing the ProblemsLessons
Learned 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 2011
ORGANIZATIONAL ASSESSMENT 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 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 Attribute
Team Distribution Product Owner Product Complexity True Sprint
Length Projects per Team Scrum Experience XP Experience Team
StructureLowest RiskLower RiskHigher RiskHighest
RiskCollocatedCollocated Part-timeDistributed OverlapDistributed No
Overlap1Lead PO2multiple POs (no lead)1 system2 systems3 systems4+
systems2 wks4 wks6 wks8+ wks1234+ProficientAdvance
BeginnerNoviceProficientAdvance BeginnerNoviceExpertExpert Truly
crossfunctionalSpecialized roles 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
Product OwnerTeamScrum MasterSimple Scrum Product Owner 4Product
Owner 3 Business PM Product Owner 2Scrum TeamScrum MasterIT PM
SME/ArchProduct Owner 1 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 Sprint Models Model S
DEV-SIT-UATDEV-SIT-UATDEV-SIT-UATUAT.DEV + SITModel DS-U DEV +
SITUATUATDEV + SITModel D-D-D-S-U DEVDEVDEVSIT.SITUATUATModel D-S-U
DEVDefects DEVDefects UATSIT Defects DEVDefects SITUAT ROOT CAUSES
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 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. EXAMPLE Choosing to not have
retrospectives hampers: Continuous improvement Transparency
Sustainable development Not tracking velocity hampers: Continuous
improvement Transparency Sustainable development 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 releaseWith Agile, the Business is in the drivers
seat! 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? ROOT CAUSE 3: ACCELERATED
OFFSHORE UTILIZATION 2008 60% company, 40% contractor 2011 30%
company, 70 % contractor Source of business innovation cut in half
LOOK AT THE NUMBERS US health care insurance experience 160+ years
as an industry Over 80% of Americans with healthcare insurance
today Indias health care insurance experience 12 years experience
in industry Less than 6% with healthcare insurance (as of 2010)
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 IMPACTS TO HEALTHCARE COMPANY 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) FIXIN THE PROBLEMS 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 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 RE-BUILD THE AGILE COMMUNITY Coachs
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
CoachesCoachesCoaches Coaches CoachesCoachesCoaches 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 Training with Coaching Coaching 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. 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 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. 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?
TREAT THE ADD Guidance of prioritizing projects/features Help teams
develop self-discipline Educate on myth of multi-tasking ADDRESS
COLLABORATION ISSUES Lack of trust - team building exercises
Triangulation Painters Pyramid Matthew 18 360 Surveys Monthly joint
meetings ADOPTION LESSONS LEARNED Involve the Business from
beginning Utilize external coaches for first year Honor Scrum
values & principles Be transparent Be honest MOST IMPORTANTLY:
MAKE A DECISION Do you want to be a Guppy or an Olympic Swimmer?
Product Owner 4Product Owner 3 Business PM Product Owner 2Scrum
TeamScrum MasterIT PM SME/ArchProduct Owner 1 Product Owner
4Product Owner 3Product Owner 2Business PMLead Product Owner Scrum
TeamScrum MasterSME/Arch IT PM QUESTIONS? CONTACT ME
[email protected] Awesome Agile Blog
www.alstonhodge.com (free coaching and advice!)Twitter:
@alstonhodgeJoin 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
